https://publichealthmatters.blog.gov.uk/2014/06/26/at-the-heart-of-it-all-personalised-care-and-population-health/

At the heart of it all: personalised care and population health

43933This is the title of our second national conference focused on maximising the contribution of nurses, midwives, health visitors and allied health professionals (AHPs) to protecting and improving the public’s health.  Personalised care and population health is also the name given to both our national programme of work to enhance, extend, promote and celebrate the contribution of health care professionals (HCPs) and of our new Framework that will be launched at the conference on July 1st, with further development over the coming months and years. This development will be alongside the overarching PHE Health and Wellbeing Framework and identify and support the ways that HCPs can make the most difference.

We know that to meet the health and care challenges of western demographic change and lifestyles we need HCPs’ practice to encompass disease prevention, early intervention and promotion of health and wellbeing, as well as excellent personalised care when people are ill.  We have termed this ‘health promoting practice’  and our third ‘week of action’ for the national programme from 23rd to 27th June will focus on nursing, midwifery, health visitors and the AHP contributions to health improvement and on being ‘health promoting practitioners.’

Recently public health has been conceptualised as a series of waves, as set out by the Chief Medical Officer in the Lancet. The first, or structural, wave of public health concerned itself with the provision of clean water and sanitation.  The second, or biomedical, wave saw the emergence of science and of medicine.  The third wave saw the birth of the welfare state, including the emergence of the National Health Service, social security, social housing and universal education and the fourth brought healthcare public health and whole population approaches, including legislation such as smoke free public places and campaigns such as safe drinking.  These four waves have led to huge improvements in the health of the population and many HCPs within PHE have key roles in making sure that this is sustained.

However, inequalities in health persist within the UK and between the UK and other similar countries. Disadvantage because of education, income or social position is associated with a larger burden of disease.  To address this it is suggested we need to add a fifth wave of public health, in which we broaden the focus from treating illness towards shared responsibility for health and wellbeing. And in which we use our increasing understanding of the contribution of individual behaviours and lifestyle choices to health outcomes, to shape ‘support and care’ and to move to a culture where healthy lifestyles are the norm.  We need actions at national and local levels, from a range of agencies and from individuals to create a ‘culture for health’ in our society.

The ‘Personalised care and population health framework,’ which has been developed with advice from HCPs and leaders, introduces the new approaches to population health and provides evidence and guidance on roles and six key areas of activity for practice at individual family and community levels, which can have a demonstrable impact on the health outcomes of the population.

The six areas for ‘population health activities’ are:

  • wider determinants of health
  • health improvement and making every contact count (MECC)
  • health protection
  • healthcare public health
  • supporting independence and wellbeing
  • a life course approach.

The Framework aims to make the HCPs impact stronger and more measurable by providing easy reference to evidence and research, innovative practice examples and education. Our initial work, to be launched in July, will include models for meeting national priorities and challenges including:

  • health protection – TB
  • supporting independence – dementia and falls
  • life course – the early weeks of life.

Many HCPs already provide advice to reduce smoking, increase physical activity, improve diet and reduce alcohol intake. By understanding the latest knowledge and evidence for behaviour change, such as NICE guidance, and by using new techniques such as motivational interviewing in our practice we enhance the effectiveness of these activities for individuals and for population health outcomes.  The Framework will help to support this change and develop in HCP practice.

As HCPs within PHE we are leaders for population health. We can contribute to a social movement for a ‘culture for health’ through our daytime roles, through health promoting practice, role modelling and supporting other practitioners. In addition, as leaders we have the opportunity and responsibility to be strong visible players in the wider societal actions that are needed. For example, by working with communities for health through ABCD (asset based community development), by contributing to public education and as trusted professionals being informed contributors to the public debate for making healthy lifestyles the norm.

By using social media like blogs and twitter we can engage the wider HCPs workforce to be involved in population health.  For example, in our second week of action, #NMProtectHealth my blog page was visited 2701 times, there were 2,330 related tweets, RTs and replies and the health protection @WeNurses chat involved around 100 practitioners and 730 tweets.Our NHS pledge for ‘Protecting Health: Vital and Visible’ received over 600 pledges.

We are making a good start in PHE in working together to provide the professional leadership for population health but there is much more to do.  I urge you to look at the Framework, join in the week of action (#PHPWeek on Twitter) and take at least one action for encouraging ‘health promoting practice’ and contributing to a ‘culture for health.’

Featured image via PHE Image Library. Used under Crown Copyright

1 comment

  1. Bren

    Hello Viv,

    A great blog that crosses over to many others within PHE.

    I really like the inclusion of sustainability within the text of your blog, and also leadership. We often don't start with this as it is so often learning by doing; also leadership and being well led is something I cross over to the work of the CQC on.

    Good on you for all you and the whole team do and assets certainly do come in many forms.

    Best wishes,

    Bren.

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