Key aspects of public health in the uk
TASK 1 - KEY ASPECTS OF PUBLIC HEALTH IN THE UK
The official definition of public health “the science and art of preventing disease, prolonging life and promoting health through the organised efforts of society”
This definition was coined in 1988 in the Public Health in England report by Sir Donald Acheson.
Public health works across communities and populations rather than being targeted at an individual level. Public health is a collective responsibility linked to the concern for the underlying socio-economic and under determinants of health as well as disease. Professionals working in Public Health monitor the health status of the community, identify health needs, develop programmes to reduce risk and screen for early disease, control communicable disease, foster policies which promote health, plan and evaluate the provision of health care and manage and implement change.
In Northern Ireland the Chief Medical Officer advices government departments on public health matters including monitoring of the health of the public, communicable disease control, environmental hazards and the management of major incidents. Directors of Public Health within the 4 health and social services boards lead the public health function within their geographical areas.
Specific responsibilities of the directors of public health include:
- Assessment of health needs
- Advice on commissioning
- Development and implementation of local health strategies.
- Development and implementation of local health promotion strategies
- Leading the work on clinical effectiveness
- The surveillance, monitoring and control of communicable disease and non communicable environmental incidents.
The Public Health strategy “Investing for Health” launched in March 2002 contains a broad framework for the action to improve health and wellbeing and reduce health inequalities. This strategy is based on a partnership approach and builds on existing networks such as “Health Cities Projects”, “Health Action zones”, “Healthy living Centres” and Local Strategy Partnerships. This partnership approach takes into consideration known determinants of health and health inequalities, any historical trends and other health improvement programmes and strategies.
This is a preview of the whole essay
The strategy is being implemented locally for 4 investing for health partnerships comprising of statutory community and voluntary organisations in each area. Theses partnerships are responsible for developing health improvement plans to address identified needs of people in their area in line with priorities set out in the strategy. Existing or forthcoming HPSS strategies which support the Investing for Health agenda include:
- Drug and alcohol strategy
- Nutrition strategy
- Physical activity strategy
- Teenage pregnancy and Parenthood strategy
- Sexual health promotion strategy
- Home accident prevention strategy
- Tobacco action plan
- Mental health promotion strategy
Other relevant strategies include:
- Regional transportation strategy
- Reshape, rebuild, achieve-victims strategy
- Road safety strategy
- Essential skills for living strategy and action plan for adult literacy in Northern Ireland
- Report of the taskforce in employability and long-term unemployment
- Regional Development strategy
- Working together for a stronger economy
- Working for Health – workplace Health strategy for Northern Ireland
- Homelessness strategy for Northern Ireland
- Community safety strategy for N.I. (European observation on Health systems and policies)
Alongside public health specialists, many others have a role play to play public health within their roles for example school teachers, health visitors, housing officers, police, probation workers and community workers. There are also certain organisations which help to support the provision of public health in NI, these are as follows;
NORTHERN IRELAND STATISTICS AND RESEARCH AGENCY (NISRA)
This agency provides statistics and social research services to the N.I government department and agencies to assist in policy making, monitoring and evaluation. The agency also includes the General Register Office for N.I. which undertakes the registration of births, marriages, adoption and deaths and provides statistics on these as well as animal population estimates.
NISRA is the main source of official information on Northern Ireland’s population and socio-economic conditions. They collect information from individuals, households, businesses, schools, hospitals and courts to monitor the performance of public services and track changes in Northern Ireland society and economy. Government is the main customer because government requires official statistics to inform debates on a range of social and economic issues, for example listed are some types of information provided by the agency:
- Published an update report from the Health and Social Care Inequalities system in December 2004
- Commissioned a study to develop a predictive hospital catchment population model to assist with evaluating future hospital configurations such as envisaged under “Developing Better Services”
- Provided monitoring information in relation to priorities for action targets
- Provided data and advice for a number of key DHSSPS initiatives and strategies such as Performance Assessment and reporting framework (Regional Indications) and the new 20 year Regional Strategy for HPSS
() – as a result of a review of Public Health Function was carried out and published in December 2004 and promoted the following bodies:
HEALTH PROTECTION AGENCY
This agency was set up to provide an integrated approach to protecting UK Public Health through the provision of support and advice to the NHS, local authorities, emergency services, other arms length bodies, and was established as a special health authority in 2003. This was changed in April 2005 when the agency became a non-departmental body and incorporated radiation protection into its remit. A major part of public health is the analysis of data on health and the population this provides information on current and future health trends. It enables the public health system to plan for change, for example, the ageing population, or variations in the pattern of disease or lifestyle risk factors.
The local body for this in NI is “Communicable Disease Surveillance Centre”, (CSDCNI) the key elements of the service provided by the CDSC (NI) area.
SURVEILLANCE OF COMMUNICABLE DISEASE
This includes monitoring changes in the incidence, prevalence and patterns of communicable diseases and ensuring that this information is passed on quickly to relevant people such as consultants in Communicable Disease Control and microbiologists. Information is published monthly to a wide range of bodies in Northern Ireland, Great Britain, and Ireland and to the World Health Organisation in Geneva. With the CDSC (NI) being part of the Heath Protection Agency it is much easier to be part of national surveillance programmes.
Other functions are;
- Contributions to policy development and guidance in relation to Communicable Disease
- Assists in the assessment of local arrangements by being represented on the regional advisory committee on Communicable Disease Control and relevant sub-committees
- Provides advice and support to other professionals, this includes 24 hour advice to the Chief Medical Officer and Directors of Public Health
- Provides training and promotion of professional standards
- Undertakes research to support effective control of communicable Disease
HEALTH PROMOTION AGENCY (HPA)
The HPA is a special agency of the DHSSPS operating under the direction of a management board. Its statutory functions are;
- Advising the DHSSPS on issues relating to health promotion
- Undertaking health promotion activity
- Commissioning and carrying out research and evaluation
- Providing information to the public and professionals
- Working with and supporting other organisations
Their priority areas of work include drug and alcohol, smoking, nutrition, physical activity, mental health and sexual health and they work to achieve objectives set with the DHSSPS in these areas. The HPA provides strategic direction and support to all those involved in promoting health within the framework of Investing for Health they work to ensure that these bodies consider what impact their decisions will have on health.
Health Education is also important it aims to improve health and prevent ill health. Health education us about giving people knowledge, attempting to change behaviours and attitudes. Campaigns include National No Smoking Day and TV adverts to encourage and inform people about the risks of smoking. Healthy eating campaigns such as “five a day” and Jamie Oliver’s programmes about school meals are all about improving.
Health improvement in N.I. is characterised by activity which focuses on addressing the determinants of health and root causes of ill health such as poverty, education and housing as well as promoting positive health and well-being
Immunisation is a way of protecting people against serious disease. Children are immunised against diseases such as diphtheria, tetanus, whooping cough, polio and haemophilus influenza type B and meningococcal group C. when children were in Primary 7 they used to get their BSG but now this has been revised and a risk assessment approach targets those at highest risk. The immunisation MMR (measles, mumps and rubella) has caused much debate regarding its side effects. We also get immunised against disease if we travel to certain countries, for example, malaria, typhoid and Hepatitis C. Older people and those at risk get yearly flu and pneumococcal injections. Public health professionals are continually promoting and advising on immunisation is a very important part of their work.
Screening programmes for disease are another way public health can benefit people. Screening programmes are now available in the following areas, cancer, genetics for heart disease, diabetes and congenital genetic diseases such as Down Syndrome, Muscular Dystrophy and sickle cell anaemia helps to detect disease such as cancer at an early stage for example breast, bowel and cervical.
Public health professionals contribute to the development of local and regional health and social services through a range of activities which include – quality, clinical effectiveness, efficiency, service planning audit and evaluation and clinical governance.
The management of public health knowledge is felt to be an essential component in supporting the overall objectives of improving the populations health and decreasing inequalities. An all Ireland population health observatory has been set up in the institute of Public Health in Ireland. The observatory produces and sends out health information and works closely with others involved in the production of health information to ensure that this is brought into evidence based policy and practice.
All of these improvements in health is lead by a ministerial group on Public Health. Their role and function is to ensure integrated strategic planning, monitoring and implementation of policies and strategies including investing for Health which will hopefully improve the health of the population and reduce inequalities.