national occupational standards for the practice of - health in wales

Better SkillsBetter JobsBetter Health

National occupational standards for thepractice of public health guide

March 2004

Skills for Health, Guide to the National Occupational Standards for the Practice of Public Health, March 200402

These national occupational standards describegood practice in the practice of public health. Thestandards have been developed as a means ofimproving the capacity and capability of the publichealth workforce. The standards make the linksbetween what needs to happen to improve people’shealth and what individuals need to do to contributeto this effort effectively. These standards have beendesigned to be used across service, organisationaland individual levels across all sectors - to developservices, plan workforces, guide practice and themanagement of people, and form the basis ofeducation, training and qualifications.

Many practitioners and agencies willingly gave theirexpertise and time in the development of thesenational occupational standards. Without theircontribution it would not have been possible toproduce these standards nor have taken forwardthis work on a multi-agency and multi-disciplinarybasis.

The standards were approved as UK-wide nationaloccupational standards by the education regulatoryauthorities – the Qualifications and Curriculum

Authority (QCA) and the Scottish QualificationsAuthority – in February 2004. This approval atteststo the quality of these standards and theirappropriateness for all who contribute to improvingthe health of the public, wherever they work andwhatever their work role.

The project to produce these national occupationalstandards was led by Skills for Health, the UK-wideSector Skills Council for Health. The project wascommissioned and overseen by the four UK HealthDepartments. In addition a Core StakeholdersGroup, including representatives of regulatorybodies and professional bodies as well as the fourgovernment health departments, advised on theprocesses and outcomes of the work. The team ofindependent consultants who produced theoutcomes were: Lindsay Mitchell of Prime R&D,Thelma Harvey and Barbara Battel-Kirk.

The contribution of the many individuals andagencies involved in the development of thesestandards is gratefully acknowledged.

March 2004

Acknowledgements

Introduction

01 What are the national occupational standards for the practice of public health? 05Why were the standards developed? 05

Who do the national occupational standards apply to? 05

What are the benefits of the standards? 05

How can the standards be used? 05

What are the national occupational standards like? 05

How do the standards relate to the standards for public health specialists? 05

Who oversaw the development of the standards? 05

When were the standards developed? 05

02 What is covered by the standards for the practice of public health? 06What is public health? 06

What do the national occupational standards cover? 07

Who is involved in improving the health of the public? 09

03 What do the standards for the practice of public health look like? 10How are the national occupational standards structured? 10

What is included in the national occupational standards for public health? 10

04 How can the national occupational standards be applied? 21

05 How can the national occupational standards for the practice of public health be used? 22Who will use the national occupational standards? 22

What are the benefits of these national occupational standards? 22

How do these national occupational standards relate to other competences/frameworks? 22

What are the different uses of the standards? 23

Have you any examples of how the standards have been used? 26

06 How can I provide feedback on the national occupational standards? 42

07 What is on the CD-Rom? 43

Appendix A Example of the structure of a national occupational standard 44

Contents

Skills for Health, Guide to the National Occupational Standards for the Practice of Public Health, March 2004 03


Health is more than the absence of disease andbeing healthy is a positive state of wellbeing, onewhich is promoted through broad engagement ofmany groups and interests within society. To behealthy requires individuals to engage in their healthas much as it requires healthy and sustainableenvironments and well trained professionals. DerekWanless recognised this when he said in his report:

‘ Adequate workforce capacity will need to becreated with appropriately broad skill mixes.Because more of the activity will be concernedwith monitoring, interpreting data, identifying risk,educating people and motivating them to changebehaviour, the required mix of skills will change.’

Derek Wanless, Securing Good Health for theWhole Population: Final Report, February 2004

The publication of national occupational standardsfor public health is a timely response to the growinginterest in health and wellbeing and the challenge ofdeveloping the workforce to promote health andaddress the challenges of health inequalities. Thepublic health workforce needs to include a diversemix of people from different professional andpractice backgrounds working across all sectors of

the economy – education, transport, housing,agriculture, and the environment. Some will workdirectly in the health sector; the work of others willindirectly impact on health. Whatever thebackground, the occupational standards for thepractice of public health have been designed toassist with developing services, planningworkforces, guiding practice and managing people.They form the basis of education, training andqualifications, making links between practice andimpact on health. The standards arecomplementary to the standards for specialistpractice.

As with any developing area, these nationaloccupational standards for the practice of publichealth are not set in stone but provide a startingpoint. Feedback of your views will help us refinethem in the light of experience and practice, and wehope that they will be a useful tool to support broadengagement in improving health for all populations,particularly the vulnerable and excluded.

Sian Griffiths

President of the Faculty of Public Health

Introduction


Why were the standards developed?The national occupational standards for thepractice of public health were developed as one keypart of developing the capacity and capability of thepublic health workforce. The standards are seen asan essential component of improving the health ofthe public – identified as of vital importance by eachof the four UK countries.

Who do the national occupational standardsapply to?Anyone who works to improve the health of thepublic including those who work in: the NHS, localauthorities, the voluntary sector and independentsector across the UK.

What are the benefits of the standards?The standards provide a coherent overview ofpublic health. They have been developed from amulti-disciplinary and multi-sectoral approach andhave had a wide range of different practitionersfrom different agencies involved in theirdevelopment. The standards provide a sharedlanguage for partnership working that is capable ofbeing applied to different contexts and differentpractitioners.

How can the standards be used?The standards can be used in a variety of ways: bya number of agencies working in partnership to planservices and workforce development, byorganisations to develop, for example, jobdescriptions, and by individuals to identify learningneeds and interests.

What are the national occupational standardslike?The standards focus on good practice in specificareas of work. They are fairly broad and general innature. For example they look at primary preventionfunctions but do not look at each of these functionsin detail nor how they are undertaken by differentprofessional/occupational groups (e.g. childprotection, immunisation, infection control).

How do these standards relate to the standardsfor public health specialists?These national occupational standards for thepractice of public health use the same ten areas asthe standards for specialist practice. However theyare in greater detail than the specialist standards asthey describe good practice in the detailed workthat needs to take place in each of those areas ofpractice, whereas the standards for public healthspecialists show how they draw from, andcoordinate across, all of these different areas ofpractice.

Who oversaw the development of thestandards?The development was funded by the four UKGovernment Health Departments and the EducationRegulatory Authorities – the Qualifications andCurriculum Authority (QCA) and the ScottishQualifications Authority (SQA). The project todevelop the standards was led by Skills for Health,the Sector Skills Council for the health sector.Regulatory bodies, professionalbodies/associations and employing organisationsguided the work.

When were the standards developed?The development of these national occupationalstandards followed on from the development of thestandards for public health specialists. Thedevelopment work took place during 2002-2003and there was a UK-wide consultation in mid-2003.The standards were formally approved by keystakeholders in the sector in the autumn of 2003and quality approved as national occupationalstandards by QCA and SQA in February 2004.

05

What are the national occupationalstandards for the practice of publichealth?

01


What is public health?These standards/competences describe the qualityof work that is expected of people who work toimprove the health of the public in the UK i.e. whoare engaged in the practice of public health.

The purpose of public health is to:

improve the health and wellbeing of thepopulation

prevent disease and minimise its consequences

prolong valued life

reduce inequalities in health1.

Public health:

takes a population perspective

mobilises the organised efforts of society andacts as an advocate for the public’s health

enables people and communities to increasecontrol over their own health and wellbeing

acts on the social, economic, environmental andbiological determinants of health and wellbeing

protects from and minimises the impact ofhealth risks to the population

ensures that preventive, treatment and careservices are of high quality, based on evidenceand are of best value.

Ten broad areas of work have been identified whichenable the purpose of public health to be met.These are:

01 Surveillance and assessment of the population’shealth and wellbeing

02 Promoting and protecting the population’s healthand wellbeing

03 Developing quality and risk management withinan evaluative culture

04 Collaborative working for health and wellbeing

05 Developing health programmes and servicesand reducing inequalities

06 Policy and strategy development andimplementation to improve health and wellbeing

07 Working with and for communities to improvehealth and wellbeing

08 Strategic leadership for health and wellbeing

09 Research and development to improve healthand wellbeing

10 Ethically managing self, people and resources toimprove health and wellbeing.

The table that follows provides an overview of thedifferent national occupational standards in each ofthese ten broad areas. There are currently 65different national occupational standards, formedinto units, which make up this overall framework forpublic health.

06

What is covered by the standards for thepractice of public health?

02

1 This definition of public health was developed by the Tripartite Steering Group which produced standards for Specialist Practice in

Public Health. The Tripartite Steering Group comprised: the Faculty of Public Health, the Multi-Disciplinary Public Health Forum, and theRoyal Institute of Public Health.

02What do the national occupational standards cover?


Area Overview of the national occupational standards

01 Surveillanceandassessment ofthepopulation’shealth andwellbeing

This area focuses on good practice in collecting, forming, obtaining, linking, analysing,interpreting, communicating and disseminating data and information about health andwellbeing. There is also a standard on facilitating others to use data and information. This areahas standards for:

- people who collect, form, obtain, link, analyse, interpret, communicate and disseminate dataand information about the health and wellbeing of different populations using a wide varietyof qualitative and quantitative methods and techniques (units 01.01 - 01.05)

- individuals who do this data collection and analysis for a defined population (unit 01.06).

Unit 01.00 is included which is the original standard that was produced for Specialist Practice.

The areas of ‘developing, managing and quality assuring data and information systems abouthealth and wellbeing’ and of ‘knowledge management’ have been identified as relevant to publichealth. These standards are available in the Health Informatics standards. Surveillance andmonitoring of animal health will need to feed into the data and information about health andwellbeing and is included in unit 01.02 when data and information from various sources is linkedtogether.

02 Promoting andprotecting thepopulation’shealth andwellbeing

This area focuses on the spectrum of activity linked to the promotion and protection of healthand wellbeing - ranging across a spectrum from enabling to enforcement approaches. Thestandards are general in nature and designed to be applicable to the wide range of workers whohave a role in this area. The first standard relates to communicating with people aboutpromoting health and wellbeing. Unit 02.02 is about encouraging people to change theirbehaviour to improve health. Unit 02.03 relates to working with others to promote health andwellbeing in settings. Then there are two standards related to prevention - unit 02.04 relates toprimary prevention for the whole population whereas unit 02.05 is about prevention related tosituations when there are specific risks to health. Unit 02.06 is about health protection in relationto specific risks - due to the nature of this work aspects of enforcement are included. Otheraspects of the promotion of health (such as health education) are also to be found in otherareas of the framework.

Enabling societies to promote health and wellbeing and reduce risks through policies andstrategies is covered in area 6.

03 Developingquality and riskmanagementwithin anevaluativeculture

This area focuses on improving quality and making changes in organisations and services toimprove health and wellbeing. One important aspect of quality improvement is keeping up-to-date with developments in knowledge and practice, including evidence, (unit 03.01), helpingothers to develop their knowledge and practice (03.02), and supporting and challenging otherson specific areas of practice (such as through supervision approaches - unit 03.03. The area ofperformance management is included in unit 03.04, and contributing to improvements at workin unit 03.05.

04 Collaborativeworking forhealth andwellbeing

This area focuses on collaborative working and the effective communication and presentationskills that support collaborative working. The first two units relate to building relationships (unit04.01) and developing, sustaining and evaluating collaborative work (unit 04.02). The next isabout representing one’s agency at other agencies’ meetings (04.03). It is vital that individualswork in partnership with communities to improve their health and wellbeing (04.04). There issometimes a need to advocate on behalf of communities (04.05) or work with the media (04.06).

02


Area Overview of the national occupational standards

05 Developinghealthprogrammesand servicesand reducinginequalities

This area is about developing the different forms of programmes and services that may improvehealth and wellbeing. This includes working with others to plan, implement and review specificprogrammes and projects (unit 05.01) and managing changes in organisations (05.02). It mightalso be necessary to support the development of people’s skills and roles in communitygroups/networks (05.03). It is also vital that there are skills in assessing, negotiating andsecuring sources of funding (05.04).

06 Policy andstrategydevelopmentandimplementationto improvehealth andwellbeing

This area focuses on the planning, implementation and review of strategies (unit 06.01) and thevarious aspects of policy development. Health impact assessment on all forms of policies isincluded in unit 06.02, working jointly with others to develop policies is within unit 06.03 whileunit 06.04 describes standards for those who contribute through appraising policies andrecommending changes to improve health and wellbeing.

07 Working withand forcommunitiesto improvehealth andwellbeing

This area is about developing community capability (units 07.01 and 07.02), supportingcommunities to plan and take collective action (07.03) and facilitating the development ofcommunity groups/networks (07.04). There are then specific standards related to enablingpeople to address issues related to health and wellbeing (07.05) and enabling people to improveothers’ health (07.06). As health improvement also takes place at the individual level, there isalso a unit related to working with individuals and others to minimise the effects of specifichealth conditions drawing on the concept of the ‘expert patient’ (07.07).

08 Strategicleadership forhealth andwellbeing

This area focuses on the various forms of leadership that are necessary to improve health andwellbeing. Workers might take a strategic leadership role in improving health and wellbeing intheir own organisation and beyond (unit 08.00), apply leadership skills to health improvement(08.01) or promote the value of health and wellbeing more generally (08.02). The specific role ofleading teams and individuals, for whom one might not have management responsibility, isincluded in unit 08.03. Improving people’s capability and capacity is an important aspect ofleadership and these skills are included in relation to designing learning programmes (08.04),enabling learning through presentations (08.05) and evaluating and developing learningprogrammes (08.06).

09 Research anddevelopmentto improvehealth andwellbeing

This area focuses on research and development across a range of different aspects. First of allthere is a standard for undertaking research and development in improving health and wellbeing(09.01). Then there is: maintaining an overview of developments in knowledge and practice(09.02), developing and implementing strategies to advance knowledge and practice (09.03)commissioning and evaluating projects (09.04), and contributing to the evaluation of andimplementation of research and development outcomes in practice (09.05).

10 Ethicallymanaging self,people andresources toimprove healthand wellbeing

This area is about specific aspects of ethical practice and management. Unit 10.01 is aboutpromoting equality, diversity and rights while unit 10.02 is about the management of self andown activities. Unit 10.03 is about managing the use of financial resources. There are then threeunits focused on enabling individuals to learn and develop - monitoring and reviewing progresswith learners (10.04), mentoring (10.05) and coaching (10.06).


Who is involved in improving the health of thepublic?The practice of public health involves people from awide variety of backgrounds and work areas. Thepractice of public health can be thought of as aflower (see diagram below).

These national occupational standards for thepractice of public health cover the lighter shadedarea in the flower - that is, common standardsacross the whole area of improving the health of thepublic. The small darker circle in the middlerepresents the National Standards for Public HealthSpecialists - a specific work role equivalent to thework of Public Health Medical Consultants

2. The

standards for the practice of public health cover thesame ten areas as those for the specialists but areoften in greater depth signifying the expertise thatpractitioners have in specific areas of work. Publichealth specialists draw on the expertise andcommitment of practitioners in public health andintegrate their work across the whole spectrum ofpublic health to take forward the healthimprovement of the population.

The petals of the flower indicate that someindividuals have jobs that combine aspects ofimproving the health of the public with other areasof work. For example, a health visitor might have alarge proportion of their work covered by thesestandards plus a smaller proportion linked to directhealthcare activities. A physiotherapist might havemost of their work focused on direct healthcareactivities with a smaller proportion related to publichealth. A public health information specialist mightpractise for all of their working day in public health(covered by the shaded area). What is important isthat if each of these individuals is undertaking thesame functions they are working to the samequality benchmarks – this is what these standardsare intended to supply.

09

02

2Specialist practice in public health is used to describe the work of those

individuals who are independently accountable and work at a level currentlycomparable to consultants in public health medicine and dental public health.


How are the national occupational standardsstructured?All of the standards in each of the ten areas arestructured in the same way. The componentparts of the standards describe different things.There are currently 65 different nationaloccupational standards, formed into units, whichmake up the overall framework for public health

3.

Each of the units that make up the nationaloccupational standards is formed from betweentwo and five elements. Each element has anumber of performance criteria and a statementof scope/coverage attached to it. It is thesedetailed aspects that form the nationaloccupational standards themselves.

In addition each unit has descriptions of theknowledge, understanding and skills thatindividuals need to apply to meet the standards.On the CD-Rom that accompanies this

publication these descriptions are shown intables for each of the ten areas of public health.They show the knowledge, understanding andskills that are applicable to all of the standards inthat one area and that which is applicable to onlyone or a few of the standards. This is to helpeducation and training providers design learningprogrammes and packages for those who work,or wish to work, in public health.

An example of the structure of a nationaloccupational standard together with itsdescription of knowledge and understanding isgiven in Appendix A.

What is included in the national occupationalstandards for public health?The table that follows provides an overview ofthe different standards you will find in each of theten areas.

What do the standards for the practice ofpublic health look like?

03

3Please note: the original titles of the Standards for Specialist Practice in Public Health (coded .00 in each of the areas) have been

modified slightly to better reflect the content of the standard and to clearly distinguish them from the 10 areas of public health.

03


Area 01 Surveillance and assessment of the population’s health and wellbeing

Unit numbers and titles Element numbers and titles

01.01 Collect and form data andinformation about health andwellbeing and/or stressors tohealth and wellbeing

01.01.1 Collect data and information about health and wellbeing and/orstressors to health and wellbeing

01.01.2 Form data and information about health and wellbeing and/orstressors to health and wellbeing for later analysis

01.02 Obtain and link data andinformation about health andwellbeing and/or stressors tohealth and wellbeing

01.02.1 Obtain data and information about health and wellbeing and/orstressors to health and wellbeing

01.02.2 Link data and information about health and wellbeing and/orstressors to health and wellbeing

01.03 Analyse and interpret data andinformation about health andwellbeing and/or stressors tohealth and wellbeing

01.03.1 Analyse data and information about health and wellbeing and/orstressors to health and wellbeing

01.03.2 Interpret data and information about health and wellbeing and/orstressors to health and wellbeing

01.04 Communicate anddisseminate data andinformation about health andwellbeing and/or stressors tohealth and wellbeing

01.04.1 Draft and structure communications about health and wellbeingand/or stressors to health and wellbeing

01.04.2 Finalise and disseminate communications about health andwellbeing and/or stressors to health and wellbeing

01.05 Facilitate others’ collection,analysis, interpretation,communication and use ofdata and information abouthealth and wellbeing and/orstressors to health andwellbeing

01.05.1 Advise others on data and information related to health andwellbeing and/or stressors to health and wellbeing and its uses

01.05.2 Enable others to develop and apply their knowledge and skills inrelation to data and information about health and wellbeingand/or stressors to health and wellbeing

01.06 Collect, structure and analysedata on the health andwellbeing and related needsfor a defined population

01.06.1 Collect and link data and information about the health andwellbeing and related needs of a defined population

01.06.2 Analyse and interpret data and information about the health andwellbeing and related needs of a defined population

01.06.03 Communicate data and information about the health andwellbeing and related needs of a defined population

01.00 Undertake surveillance andassessment of thepopulation’s health andwellbeing

01.00.1 Manage, analyse, interpret and communicate information,knowledge and statistics about health and wellbeing

01.00.2 Manage, analyse, interpret and communicate information,knowledge and statistics about needs and outcomes of healthand wellbeing

Area 02 Promoting and protecting the population’s health and wellbeing

03



02.01 Communicate with individuals,groups and communitiesabout promoting their healthand wellbeing

02.01.1 Provide information to individuals, groups and communities aboutpromoting health and wellbeing

02.01.2 Enable individuals, groups and communities to develop theirknowledge and skills about promoting health and wellbeing

02.02 Encourage behavioural changein people and agencies topromote health and wellbeing

02.02.1 Encourage people and agencies to see the need to change theirbehaviour to improve health and wellbeing

02.02.2 Enable people and agencies to sustain their behaviour change

02.02.3 Work with people and agencies to evaluate the effectiveness oftheir behaviour change

02.03 Work in partnership withothers to promote health andwellbeing and reduce riskswithin settings

02.03.1 Work in partnership with others to assess risks to health andwellbeing in settings

02.03.2 Work in partnership with others to improve settings so that theypromote health and wellbeing

02.03.3 Work in partnership with others to evaluate settings followingimprovements

02.04 Work in partnership withothers to prevent the onset ofadverse effects on health andwellbeing in populations

02.04.1 Identify and contact people in the population who are in need ofprimary preventive interventions

02.04.2 Support people in the population during the process of primarypreventive interventions

02.05 Work in partnership withothers to contact, assess andsupport individuals inpopulations who are at riskfrom identified hazards tohealth and wellbeing

02.05.1 Trace and establish contact with individuals who are at risk, orplace others at risk, from hazards to health and wellbeing

02.05.2 Assist individuals to participate in secondary preventiveinterventions

02.06 Work in partnership withothers to protect the public’shealth and wellbeing fromspecific risks

02.06.1 Work in partnership with others to plan investigations to protectthe public’s health and wellbeing from specific risks

02.06.2 Work in partnership with others to identify how to apply plans toprotect the public’s health and wellbeing from specific risks

02.06.3 Undertake own role in a partnership to protect the public’s healthand wellbeing from specific risks

02.00 Promote and protect thepopulation’s health andwellbeing

02.00.1 Plan, implement, monitor and evaluate strategies for promotingthe health and wellbeing of the population

02.00.2 Plan, implement, monitor and evaluate disease prevention andscreening programmes to improve the population’s health andwellbeing

02.00.3 Plan, implement, monitor and evaluate strategies for protectingthe health and wellbeing of the population

Area 03 Developing quality and risk management within an evaluative culture

03



03.01 Develop one’s own knowledgeand practice

03.01.1 Reflect on and evaluate one’s own values, priorities, interests andeffectiveness

03.01.2 Synthesise new knowledge into the development of one’s ownpractice

03.02 Contribute to the developmentof the knowledge and practiceof others

03.02.1 Enable others to solve problems and tackle issues arising inpractice

03.02.2 Enable others to learn and benefit from one’s experience

03.03 Support and challengeworkers on specific aspects oftheir practice

03.03.1 Enable other workers to reflect on their own values, priorities,interests and effectiveness

03.03.2 Provide professional supervision to individual workers

03.04 Manage the performance ofteams and individuals

03.04.1 Allocate work to teams and individuals

03.04.2 Agree objectives and work plans with teams and individuals

03.04.3 Assess the performance of teams and individuals

03.04.4 Provide feedback to teams and individuals on their performance

03.05 Contribute to improvements atwork

03.05.1 Improve work activities

03.05.2 Recommend improvements to plans

03.00 Develop quality and riskmanagement within anevaluative culture

03.00.1 Assess risks to the population’s health and wellbeing and applythis to practice

03.00.2 Assess the evidence and impact of health and healthcareinterventions, programmes and services and apply theassessments to practice

03.00.3 Improve the quality of health and healthcare interventions andservices through audit and evaluation

Area 04 Collaborative working for health and wellbeing

03



04.01 Build relationshipswithin and withcommunities andorganisations

04.01.1 Develop contacts within and with communities

04.01.2 Negotiate the purpose and basis for community developmentopportunities

04.01.3 Initiate joint working relationships within and with communities

04.02 Develop, sustain andevaluate collaborativework with others

04.02.1 Explore and assess the potential for collaborative working

04.02.2 Initiate and develop collaborative working relationships

04.02.3 Sustain collaborative working relationships and arrangements

04.02.4 Review and evaluate collaborative working

04.03 Represent one’s ownagency at otheragencies’ meetings

04.03.1 Obtain information from other agencies’ meetings

04.03.2 Make contributions to other agencies’ meetings

04.04 Work in partnershipwith communities toimprove their healthand wellbeing

04.04.1 Work in partnership with communities to assess health and wellbeingand related needs

04.04.2 Work in partnership with communities to plan how to improve health andwellbeing

04.04.3 Work in partnership with communities to implement policies, strategies,services, programmes and interventions to improve health and wellbeing

04.04.4 Work in partnership with communities to evaluate policies, strategies,services, programmes and interventions to improve health and wellbeing

04.05 Enable the views ofgroups andcommunities to beheard throughadvocating on theirbehalf

04.05.1 Establish with groups and communities their interests, concerns andpriorities

04.05.2 Act on behalf of groups and communities when they are not able torepresent their interests, concerns and priorities

04.05.3 Enable groups and communities to monitor and evaluate the advocacy

04.05.4 Enable groups and communities to find alternative solutions toadvocacy

04.06 Provide information andadvice to the mediaabout health andwellbeing and relatedissues

04.06.1 Advise the media about specific issues relating to health and wellbeing

04.06.2 Respond to requests for information from the media

04.00 Improve health andwellbeing throughworking collaboratively

04.00.1 Develop and sustain cross-sectoral collaborative working for health andwellbeing

04.00.2 Advise others on health and wellbeing, related issues and their impact

04.00.3 Communicate effectively with the public and others about improving thehealth and wellbeing of the population

Area 05 Developing health programmes and services and reducing inequalities

03



05.01 Work in partnership withothers to plan,implement and reviewprogrammes andprojects to improvehealth and wellbeing

05.01.1 Work in partnership with others to plan programmes and projects toimprove health and wellbeing

05.01.2 Work in partnership with others to implement programmes and projectsto improve health and wellbeing

05.01.3 Work in partnership with others to evaluate programmes and projectsto improve health and wellbeing

05.02 Manage change inorganisational activities

05.02.1 Identify opportunities for improvements in activities

05.02.2 Evaluate proposed changes for benefits and disadvantages

05.02.3 Plan the implementation of change in activities

05.02.4 Agree the introduction of change

05.02.5 Implement changes in activities

05.03 Develop people’s skillsand roles withincommunitygroups/networks

05.03.1 Assist community groups/networks to define their needs for people andskills

05.03.2 Enable community groups/networks to support volunteers and staff

05.03.4 Work with community groups/networks to review their purpose

05.04 Assess, negotiate andsecure sources offunding

05.04.1 Determine and assess potential sources of funding

05.04.2 Negotiate and secure sources of funding

05.00 Develop healthprogrammes andservices and reduceinequalities

05.00.1 Enable inequalities in health and wellbeing to be reduced throughplanning and targeting services and programmes

05.00.2 Plan, implement, monitor and evaluate programmes, services andinterventions to address health and wellbeing needs

Area 06 Policy and strategy development and implementation to improve health and wellbeing

03



06.01 Work in partnership withothers to plan, implement,monitor and review strategiesto improve health andwellbeing

06.01.1 Work in partnership with others to develop and agree prioritiesand targets for improving health and wellbeing

06.01.2 Work in partnership with others to plan how to put strategies forimproving health and wellbeing into effect

06.01.3 Work in partnership with others to implement strategies forimproving health and wellbeing

06.01.4 Work in partnership with others to monitor and review strategiesfor improving health and wellbeing

06.02 Work in partnership withothers to assess the impact ofpolicies and strategies onhealth and wellbeing

06.02.1 Work in partnership with others to make a preliminaryassessment of the impact of policies and strategies on healthand wellbeing

06.02.2 Work in partnership with others to undertake a full assessment ofthe impact of policies and strategies on health and wellbeing

06.03 Work in partnership withothers to develop policies toimprove health and wellbeing

06.03.1 Advise how health improvement can be promoted in policydevelopment

06.03.2 Contribute to the formulation of policy specifically focused onimproving health and wellbeing

06.03.3 Evaluate and review the effects of policies on health improvement

06.04 Appraise policies andrecommend changes toimprove health and wellbeing

06.04.1 Monitor trends and developments in policies for their impact onhealth and wellbeing

06.04.2 Present information and arguments to others on how policiesaffect health and wellbeing

06.04.3 Evaluate and recommend changes to policies to improve healthand wellbeing

06.00 Improve health and wellbeingthrough policy and strategydevelopment andimplementation

06.00.1 Shape and influence the development of policies to improvehealth and wellbeing and reduce inequalities

06.00.2 Implement strategies for putting policies to improve health andwellbeing into effect

06.00.3 Assess the impact of policies on health and wellbeing

Area 07 Working with and for communities to improve health and wellbeing

03



07.01 Facilitate thedevelopment of peopleand learning incommunities

07.01.1 Work with communities to define human resource needs

07.01.2 Work with communities to meet personnel requirements

07.01.3 Work between organisations in communities to identify and developopportunities for learning in partnership

07.02 Create opportunities forlearning from practiceand experience

07.02.1 Promote opportunities for learning from practice and experience

07.02.2 Facilitate opportunities for learning from practice and experience

07.03 Support communities toplan and take collectiveaction

07.03.1 Support communities to identify aims and objectives for collectiveaction

07.03.2 Support communities to develop a plan of collective action

07.03.3 Support communities to put an agreed plan into action

07.04 Facilitate thedevelopment ofcommunitygroups/networks

07.04.1 Support community groups/networks to identify and review strengthsand weaknesses

07.04.2 Support community groups/networks to develop their own practice

07.04.3 Promote inclusive and empowering ways of working within communities

07.05 Enable people toaddress issues relatedto health and wellbeing

07.05.1 Enable people to determine their own issues and concerns

07.05.2 Enable people to plan how to address their issues and concerns

07.05.3 Act as a resource as people take actions to address their issues andconcerns

07.05.4 Support people in evaluating their actions and learning from theirexperience

07.06 Enable people toimprove others’ healthand wellbeing

07.06.1 Negotiate and agree with people how they may enable other individualsto improve their health and wellbeing

07.06.2 Enable people to improve the health and wellbeing of others

07.06.3 Enable people to review the effectiveness of their work with others

07.07 Work with individualsand others to minimisethe effects of specifichealth conditions

07.07.1 Provide initial support to individuals who have been identified with aspecific condition

07.07.2 Provide further support to individuals with a specific condition to enablethem to minimise its effects and complications

07.00 Improve health andwellbeing throughworking with and forcommunities

07.00.1 Involve communities as active partners in all aspects of improving healthand wellbeing

07.00.2 Empower communities to improve their own health and wellbeing

07.00.3 Enable communities to develop their capacity to advocate for health andwellbeing

Area 08 Strategic leadership for health and wellbeing

03



08.01 Use leadership skills toimprove health and wellbeing

08.01.1 Sustain and share a vision of improving health and wellbeing

08.01.2 Lead others in improving health and wellbeing

08.02 Promote the value of, andneed for, health and wellbeing

08.02.1 Create and capitalise upon opportunities to advocate the needfor improving health and wellbeing

08.02.2 Advocate the improvement of health and wellbeing

08.03 Lead the work of teams andindividuals to achieveobjectives

08.03.1 Plan the work of teams and individuals08.03.2 Assess the work of teams and individuals

08.03.3 Provide feedback to teams and individuals on their work

08.04 Design learning programmes 08.04.1 Choose options for meeting learning needs

08.04.2 Design learning programmes for learners

08.05 Enable learning throughpresentations

08.05.1 Give presentations to groups

08.05.2 Produce follow-up exercises

08.06 Evaluate and improve learningand development programmes

08.06.1 Choose how to evaluate programmes

08.06.2 Analyse information to improve learning and developmentprogrammes

08.06.3 Make improvements to learning and development programmes

08.00 Strategically lead theimprovement of health andwellbeing and the reduction ofinequalities

08.00.1 Develop, sustain and implement a vision and objectives forimproving health and wellbeing

08.00.2 Lead teams and individuals to improve health and wellbeing

08.00.3 Develop capacity and capability to improve health and wellbeing

Area 09 Research and development to improve health and wellbeing

03



09.01 Plan, undertake, evaluate anddisseminate research anddevelopment about improvinghealth and wellbeing

09.01.1 Plan research and development about improving health andwellbeing

09.01.2 Research and develop the improvement of health and wellbeing

09.01.3 Evaluate and disseminate research and development aboutimproving health and wellbeing

09.02 Develop and maintain astrategic overview ofdevelopments in knowledgeand practice

09.02.1 Collate and appraise developments in knowledge and practice

09.02.2 Identify areas of knowledge and practice that need furtherdevelopment

09.02.3 Coordinate the dissemination of information about developmentsin knowledge and practice

09.03 Develop, implement andevaluate strategies to advanceknowledge and practice

09.03.1 Prioritise areas for research and development activity to advanceknowledge and practice

09.03.2 Plan how needs for research and development activity should beaddressed

09.04 Commission, monitor andevaluate projects to advanceknowledge and practice

09.04.1 Commission projects to advance knowledge and practice

09.04.2 Monitor and evaluate the process and progress of projectsagainst targets

09.04.3 Support project staff to enable them to achieve objectives

09.05 Contribute to the evaluationand implementation ofresearch and developmentoutcomes

09.05.1 Contribute to decision making about the potential value ofresearch and development outcomes

09.05.2 Contribute to planning the implementation of research anddevelopment outcomes

09.05.3 Facilitate the implementation of research and developmentoutcomes

09.05.4 Contribute to the evaluation and review of implementing researchand development outcomes

09.00 Improve health and wellbeingthrough research anddevelopment

09.00.1 Appraise, plan and manage research related to improving healthand wellbeing

09.00.2 Interpret research findings and implement them in practice

Area 10 Ethically managing self, people and resources to improve health and wellbeing

03



10.01 Promote people’s equality,diversity and rights

10.01.1 Promote people’s rights and responsibilities

10.01.2 Promote equality and diversity of people

10.01.3 Promote people’s right to the confidentiality of information

10.02 Prioritise and manage ownwork and the focus ofactivities

10.02.1 Evaluate demands for services

10.02.2 Negotiate and agree priorities and plans

10.02.3 Monitor and review services in response to emerging needs andissues

10.03 Manage the use of financialresources

10.03.1 Make recommendations for expenditure

10.03.2 Control expenditure against budgets

10.04 Monitor and review progresswith learners

10.04.1 Review progress with learners

10.05 Facilitate individual learningand development throughmentoring

10.05.1 the learning and development needs of individuals

10.05.2 Plan with individuals how learning and development needs will beaddressed through mentoring

10.05.3 Mentor individuals to achieve identified outcomes

10.05.4 Review the effectiveness of mentoring with individuals

10.06 Enable individual learningthrough coaching

10.06.1 Coach individual learners

10.06.2 Help individual learners to apply their learning

10.00 Ethically manage self, peopleand resources to improvehealth and wellbeing

10.00.1 Manage the development and direction of work

10.00.2 Manage services that are aimed at improving health andwellbeing


The national occupational standards have beendeveloped generically across all the different waysin which the health of the population might beimproved. This means that they do not containspecific standards for different aspects of healthimprovement, such as smoking cessation, dieting,physical activity etc. Neither do the standardsdistinguish the role or jobs of specific groups ofpractitioners. Rather the national occupationalstandards can be applied to different forms ofpractice. For example, they can be used as follows.

1. To identify the specialist contributions thatdifferent agencies or practitioners make to theimproving the health of the public. The differentareas are likely to be helpful in this regard.

For example

• Public health information specialists will havemuch of their work captured in area 1 –surveillance and assessment of the population’shealth and wellbeing.

• The work of the Health Protection Agency inEngland and the practitioners within it are likelyto be focused on area 2 relating to promotionand protection.

• Health Improvement Officers in Scottish localauthorities have as a major focus collaborativeworking which is in area 4.

2. To identify the competences needed when atopic approach is taken such as smokingcessation, breastfeeding, drugs and alcohol –here a thin slice right across the framework isneeded concentrating on that one particulartopic.

For example

A breastfeeding scheme in Scotland used theframework of the standards to identify the differentroles they had within their team and identify anygaps in their skills.

3. To identify the starting point / particularapproach taken in areas of improving the healthof the public.

For example

Some SureStart schemes have the specific focus ofcommunity development (area 7) and promotionand protecting health and wellbeing (area 2), andthen later become more actively engaged in policydevelopment (area 6)

4.

4. To identify the different contributions thatagencies and practitioners make to improve thehealth of the public and the interaction anddependencies between them. Thesecontributions might be multi-agency (e.g. NHSand local authorities); or different types ofagency within the same sector.

For example

One LHCC in Scotland identified that they wereresponsible for collecting some routine health dataand might choose to collect more through specificprojects (e.g. lifestyle). The LHCC was verydependent on receiving good quality data from theHealth Board on other areas as they were oninformation from the local authority. All of thisinformation was used in strategic decision-makingabout health improvement, the delivery of servicesetc. However the discussion highlighted concernsabout the quality of data collected in the LHCCitself and also used from elsewhere, and the impactof this on decision-making within the LHCC. Thisled onto identifying a workforce need for thatparticular organisation.

21

How can the national occupationalstandards be applied?

04

4SureStart are multi-agency, community-based projects that work with families in areas of deprivation to give children a good start in

life. SureStart projects exist across the UK.


Who will use the national occupationalstandards?These national occupational standards aredesigned as a resource for organisations andindividuals to use to improve their capacity andcapability. As the standards have been developedacross the UK, they provide a common referencepoint or language of good practice.

The standards are a source of information to helppeople:

link health improvement to partnership,organisational and team delivery

design and plan the development, deploymentand appraisal of the workforce

identify good practice in specific areas of work

recognise their current good practice andidentify areas for improvement.

These national occupational standards can help toestablish the link between broadorganisational/partnership aims and objectives andwhat individuals need to be able to achieve. Theycan be used for organisational and individualmanagement and development and for the designof education and training and related qualifications.

What are the benefits of these nationaloccupational standards?Respondents to the consultation on the draftversion of these national occupational standardsidentified a number of benefits – see below.

How do these national occupational standardsrelate to other competences/frameworks?These national occupational standards have thesupport of the four Government HealthDepartments and a number of professional andregulatory bodies. However these are also one of anumber of competences in existence and it can beconfusing as to how all of the differentdevelopments fit together.

The NHS Knowledge and Skills Framework

Under the Agenda for Change NHS PayModernisation initiative, an NHS Knowledge andSkills Framework (NHS KSF) has been developed toform the basis of career and pay progression in theservice across the UK. The NHS KSF will beimplemented through a development reviewprocess where there is a commitment frommanagement and staff sides that all staff will havean annual review of their development against theKSF, a personal development plan, support to learnand develop, and an evaluation of that learning anddevelopment. The NHS KSF is a broad genericframework which applies to all staff across theNHS. While the national occupational standards forthe practice of public health are themselves fairlybroad, they are much more detailed than the NHSKSF. The NHS KSF will show how more detailedUK/national quality assured standards andcompetences, such as the national occupationalstandards for the practice of public health, relate tothe broad generic NHS KSF. This will mean that

22

How can the national occupationalstandards for the practice of public healthbe used?

05

The benefits of the national occupational standards:

provide and promote a coherent, explicit overview of how to improve the health of the public

provide an insight into the breadth and complexity of the public health function and the various rolesnecessary to deliver that function

provide a tool for implementing policies to improve the health of the public

enable public health to be integrated into the broader planning agenda

facilitate a wide ranging discussion and dialogue on how to improve the health of the public

provide a shared language to support partnership working.


users can move readily between the broad NHSKSF and the more detailed standards andcompetences produced for different areas, such asthe practice of public health. Skills for Health isworking in partnership with the Agenda for Changedevelopment group who are responsible for theNHS KSF to ensure alignment between the genericKSF and the more detailed statements ofcompetence within national occupationalstandards.

Other national occupational standards and caregroup competences

As the UK Sector Skills Council for the healthsector, Skills for Health are actively engaged intaking forward the development of nationaloccupational standards and other nationalcompetences (e.g. competences to support thedelivery of the National Service Framework forCoronary Heart Disease). Individuals andorganisations that wish to use national occupationalstandards can either focus their work on one set ofstandards (such as the practice of public healthstandards) or draw from a range of differentstandards and competences. As the nationaloccupational standards are developed throughdifferent projects, the various project teams makesure that there is as little duplication as possibleand that all of the different standards andcompetences fit well together. This means, forexample, that a Drug and Alcohol service with ahealth improvement remit could draw from thestandards that have been developed specifically fordrug and alcohol work as well as the standards forthe practice of public health to identify an overallframework of standards for its work. Skills forHealth is working at a strategic level to produce anoverall map of standards across the whole of thehealth sector showing how all the differentstandards and competences that it produces fittogether.

The UK Voluntary Register for Specialist Practice inPublic Health

A UK Voluntary Register has been established by aJoint Register Board comprising the Faculty ofPublic Health, the Royal Institute of Public Healthand the Multidisciplinary Public Health Forum. Thevoluntary register is based on the specialiststandards for public health and the Faculty ofPublic Health’s Record of In-Training andAssessment (RITA) and informed by the Faculty’sPart I and Part II examinations. The specialiststandards were developed by the Tripartite Group(the three organisations detailed above) andHealthwork UK (the predecessor organisation toSkills for Health). The voluntary register appliesnationally recognised standards to accredit andregulate qualified public health specialists. Thevoluntary register is applicable to individuals whohave worked at senior level for three or more yearsand have had several years in a leadership rolewithin public health. The register was developed toprovide confidence to the public as posts (which atone time were held by public health medicalconsultants) were opened up to individuals from avariety of backgrounds. There are two means ofadmission to the register; one is by examinationand accredited training; the other is by portfolio. Asdescribed earlier, there is a close relationshipbetween the specialist standards for public healthand the national occupational standards for thepractice of public health as they both use the sameten areas of practice. However the voluntaryregister is intended for those working, or seeking towork, at a senior and strategic level in public health– this means it is only applicable to the specificgroup of staff who work at that level.

What are the different uses of the standards?The standards can be used in a number of waysand these are outlined below. The uses to whichpeople wish to put the national occupationalstandards will affect the level of detail that theyneed to work with.

23

05


At the service and organisational level

At service and organisational level, the nationaloccupational standards are most likely to be of useat a high level of description i.e. using the ten areasand the titles of the units. It might be necessary toalso look at the element titles (the subsets of theunits as these provide further information). There isa range of uses at service and organisational levelincluding:

for service planning – identifying thecompetences that are needed across a serviceto improve the health of the public

workforce development/planning – to work outwho in the workforce has these competencescurrently, where there are skill gaps and then toconsider how these might best be addressedgiven the current workforce

informing organisational change – from theservice planning and workforce planningidentified above, the standards can help toinform how organisations need to change anddevelop to meet skill gaps and/or improveservices

helping organisations improve the health of theirown workforces - linking to such policies asImproving Working Lives, and the ScottishHealth at Work (SHAW) initiative.

For human resource management and developmentpurposes

For human resource management and developmentpurposes it is generally possible to use thestandards at a high level of description i.e. using theten areas and the titles of the units. However whenan individual’s or team’s performance is beingconsidered it will be necessary to look at thegreater detail within the standards themselves.There is a range of uses for human resourcemanagement and development purposes including:

informing job descriptions – through identifyingthe national occupational standards that wouldmake up a particular post and using the titles ofthe units or the elements as the basis of job/roledescriptions

to set performance indicators and appraiseperformance – through using the nationaloccupational standards to clarify the level ofperformance that different posts are designed tomeet

governance – as the national occupationalstandards identify competent performance inparticular areas of work, they can be used as atool for governance ensuring individuals aremeeting the standards set in these differentareas

24

05

Respondents to the consultation said:‘ I welcome this piece of work which has the potential to develop a coherent approach to the formulation and

delivery of strategies for improving the health and wellbeing of the community. It will be a particularly usefultool when working with partners to refresh our Community Plan. … The standards will be put to good use asa resource document that can be dipped into as and when appropriate, both at the corporate and servicedelivery level.’

Local Authority Chief Executive, England

‘ The standards are a good framework to work from. They will give credence to future service developments,especially in line with emerging Community Health Partnerships (CHPs). They will fit into the clinicalgovernance structures being developed within the CHPs and be integral in developing sound public healthpolicy.’

Public Health Practitioner, North West Scotland

‘ The standards will be useful in supporting the Primary Care Trust developing action plans for health priorities.Thus integrating public health skills and action within all the PCT’s action. The process will include identifyingexisting roles and responsibilities with aligned expected standards along with gaps. It would be important fororganisations to develop processes ensuring individuals working to standards share their experience and aresupported to develop to meet the identified priorities.’

Senior Nurse, A Primary Care Trust in Yorkshire


facilitating team review – through using thestandards as the basis of identifying thecompetences that teams currently have andthose areas in which the team would benefitfrom skill development

training needs analysis – organisations can usethe standards as the basis of undertaking atraining needs analysis of their staff and identifyfrom this where there are areas for development

personal development planning – individuals canassess themselves against the nationaloccupational standards that are relevant to theirpost, identify their strengths and areas forimprovement

career development – as the nationaloccupational standards cover the whole area ofpublic health, individuals can look across thestandards to identify areas for development andthe next stage of their careers.

A Public Health Lead and a Public Health Nursefrom Yorkshire identified that they planned to usethe standards in the following ways:

reviewing job design, using the standards todesign job descriptions

to assist individual practitioners with personaldevelopment planning

to undertake audit and team review activity

to plan learning and development needsassessment across the workforce and withinparticular teams

to clarify the learning needs of individuals andlevels of achievement

to promote a coherent overview of what isincluded within public health practice

to use alongside Agenda for Change and JobEvaluation and job grading

to map and focus at an organisational levelareas requiring cultural change andorganisational development to achieve improvedservice delivery.

For education and training purposes

For education and training purposes it is necessaryto work with the greater detail within the standardsand also use the descriptions of knowledge andunderstanding. Education and trainingcommissioners and providers might need to use allof the standards that have been identified if theyplan to develop programmes across the wholespectrum of public health or they might find thatselecting those standards relevant to specific areasof practice is more appropriate to their interests andneeds. There are a number of different ways inwhich the standards can be used for education andpurposes including:

commissioning education and training – throughidentifying the competences that need to bedeveloped in the workforce and using this toinform the basis of the commissioning process

designing and structuring education and training– through identifying the knowledge and skillsthat individuals need to develop to meet certainnational occupational standards and therelationship of this to the different areas of publichealth practice

informing the delivery of training – as thenational occupational standards clearly describethe outcomes of effective performance, thisprovides a link to learning methods andapproaches – to help individuals apply theirknowledge and skills in practice

accreditation – national occupational standardsare used as the basis of National and ScottishVocational Qualifications and other vocationalqualifications within the National QualificationsFramework, and also as the basis of highereducation programmes. Education and trainingproviders might also seek to use the nationaloccupational standards as the basis of otherforms of accreditation given that they are UKbenchmarks of good practice in public health

mapping relevant training and qualifications toareas of practice – education and trainingproviders, professional bodies and associations,and employers can find out how well theircurrent education and training provision relatesto standards of good practice and identify areasfor development. Education and trainingcommissioners are likely to be interested ineducation and training provision that shows agood fit

25

05


regulation – as the national occupationalstandards specify good practice in the practiceof public health, regulatory bodies can drawfrom these standards to set the level ofperformance that is required for statutory orvoluntary registration. This is the approach thatwas taken with the specialist standards in publichealth and the establishment of the voluntaryregister.

‘ We are sure that these guidelines will be avaluable asset for the various professionalsinvolved in public health practice, and indeveloping the public health speciality.’

Professional Officer from a council for the healthprofessions

Have you any examples of how the standardshave been used?As outlined above, there are a number of ways inwhich the national occupational standards can beused. Below are some examples of how thestandards have been used by different teams andindividuals.

Identifying team roles in a health improvementproject

A team of primary care staff in Scotland identifiedthe need to improve breastfeeding rates in theirlocal area as only 37.1% of mothers were stillbreastfeeding at 7 days. In the local culturebreastfeeding was seen as ‘not very nice’ and thisview of breastfeeding permeated many people inthe healthcare team as well. The nationaloccupational standards for the practice of publichealth were used as a framework to explore theskills of this health improvement team. Thoseinvolved in using the overall framework of thestandards were the three people who initiated anddrove the breastfeeding project – a GP researchlead, a nurse manager/lead and a health promotionspecialist – and a sample from the fourteen healthvisitors (HVs) and midwives (MWs) involved in thebreastfeeding groups.

The different team members identified the rolesthey undertook in the breastfeeding project againstthe standards – these are shown in the table thatfollows. The table only shows the standards that thegroup identified in their work rather than all of thenational occupational standards in the wholeframework. It also does not show all of the otherroles that these individuals might undertake in otheraspects of their work.

A table for use by teams and organisations toidentify their different roles and the interactionbetween them is provided on the CD-Rom.

26

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out

the

bre

astf

eed

ing

grou

ps

02.0

2E

ncou

rage

beh

avio

ural

cha

nge

inp

eop

le a

nd a

genc

ies

to p

rom

ote

heal

th a

nd w

ellb

eing

✔

Enc

oura

ging

hea

lthvi

sito

rs a

nd m

idw

ives

to p

rom

ote

bre

astf

eed

ing

and

chan

ge t

he a

ttitu

des

of m

othe

rs

✔

Sup

por

ting

pra

ctiti

oner

s to

eval

uate

the

ir su

cces

s

✔

Enc

oura

ged

mot

hers

and

the

ir co

lleag

ues

to d

evel

op t

heir

know

led

ge &

ski

lls in

rela

tion

tob

reas

tfee

din

g an

db

reas

tfee

din

g gr

oup

sen

cour

aged

mot

hers

to c

ontin

ueb

reas

tfee

din

g w

hen

pre

viou

sly

they

ten

ded

to g

ive

up v

ery

easi

ly.

HV

s w

ere

able

to

illus

trat

e th

e b

enef

itsof

bre

astf

eed

ing

and

to h

elp

mot

hers

car

ryou

t th

eir

own

eval

uatio

ns.

The

HV

sal

so r

an a

'Fa

ir'at

tend

ed b

y 90

bre

astf

eed

ing

mot

hers

to c

eleb

rate

the

succ

ess

of t

heb

reas

tfee

din

g gr

oup

s

✔

Enc

oura

ged

mot

hers

and

the

ir co

lleag

ues

to d

evel

op t

heir

know

led

ge &

ski

lls in

rela

tion

tob

reas

tfee

din

g an

db

reas

tfee

din

g gr

oup

sen

cour

aged

mot

hers

to c

ontin

ueb

reas

tfee

din

g w

hen

pre

viou

sly

they

ten

ded

to g

ive

up v

ery

easi

ly.

MW

s w

ere

able

to

illus

trat

e th

e b

enef

itsof

bre

astf

eed

ing

and

to h

elp

mot

hers

car

ryou

t th

eir

own

eval

uatio

ns.

The

MW

sal

so r

an a

'Fa

ir'at

tend

ed b

y 90

bre

astf

eed

ing

mot

hers

to c

eleb

rate

the

succ

ess

of t

heb

reas

tfee

din

g gr

oup

s


05Te

am r

ole

s in

the

bre

ast

feed

ing

hea

lth

imp

rove

men

t p

roje

ct

Co

ntri

but

ions

as

des

crib

ed in

the

nat

iona

lo

ccup

atio

nal s

tand

ard

sR

esea

rch

Lead

(GP

)N

urse

Man

ager

/Le

adH

ealt

h P

rom

oti

on

Sp

ecia

list

Hea

lth

Vis

ito

rsM

idw

ives

02.0

3W

ork

in p

artn

ersh

ip w

ith o

ther

s to

pro

mot

e he

alth

and

wel

lbei

ng a

ndre

duc

e ris

ks w

ithin

set

tings

✔

Pro

mot

ed t

hed

evel

opm

ent

ofb

reas

tfee

din

g fr

iend

lylo

catio

ns a

nden

cour

aged

the

shop

s, r

esta

uran

tsan

d p

ubs

that

wer

eal

read

y ha

pp

y to

acce

pt

bre

astf

eed

ing

mot

hers

✔

Pro

mot

ed t

hed

evel

opm

ent

ofb

reas

tfee

din

g fr

iend

lylo

catio

ns a

nden

cour

aged

the

shop

s, r

esta

uran

tsan

d p

ubs

that

wer

eal

read

y ha

pp

y to

acce

pt

bre

astf

eed

ing

mot

hers

03D

evel

op

ing

qua

lity

and

ris

k m

anag

emen

t w

ithi

n an

eva

luat

ive

cult

ure

03.0

1D

evel

op o

ne’s

ow

n kn

owle

dge

and

pra

ctic

e✔

Kee

pin

g up

to

dat

e on

bre

astf

eed

ing

thro

ugh

atte

ndin

g co

urse

or

by

criti

cal r

ead

ing.

One

HV

had

fou

ndev

iden

ce t

hat

sore

nip

ple

s ne

eded

moi

stw

ound

hea

ling

tech

niq

ues

and

had

sour

ced

a p

ure

lano

linlo

tion

for

mot

hers

to

use

✔

Kee

pin

g up

to

dat

e on

bre

astf

eed

ing

thro

ugh

atte

ndin

g co

urse

or

by

criti

cal r

ead

ing

03.0

2C

ontr

ibut

e to

the

dev

elop

men

t of

the

know

led

ge a

nd p

ract

ice

of o

ther

s✔

Faci

litat

ing

the

Bre

astf

eed

ing

Ste

erin

g G

roup

to

find

it ow

n so

lutio

ns t

op

rob

lem

s

✔

Pro

vid

ing

the

time

and

spac

e fo

r th

e H

Vs

and

MW

s to

set

up

and

run

the

grou

ps

✔

Sup

por

ting

and

offe

ring

advi

ce t

o th

eH

Vs

and

MW

s

✔

Gav

e ad

vice

to

the

mot

hers

in t

heb

reas

tfee

din

g gr

oup

san

d e

nab

led

the

mot

hers

to

lear

n fr

omon

e an

othe

r

✔

Gav

e ad

vice

to

the

mot

hers

in t

heb

reas

tfee

din

g gr

oup

san

d e

nab

led

the

mot

hers

to

lear

n fr

omon

e an

othe

r


05

Team

ro

les

in t

he b

reas

t fe

edin

g h

ealt

h im

pro

vem

ent

pro

ject

Co

ntri

but

ions

as

des

crib

ed in

the

nat

iona

lo

ccup

atio

nal s

tand

ard

sR

esea

rch

Lead

(GP

)N

urse

Man

ager

/Le

adH

ealt

h P

rom

oti

on

Sp

ecia

list

Hea

lth

Vis

ito

rsM

idw

ives

03.0

3S

upp

ort

and

cha

lleng

e w

orke

rs o

nsp

ecifi

c as

pec

ts o

f the

ir p

ract

ice

✔

Pro

fess

iona

l sup

port

to

thei

r as

sist

ants

. Som

eH

Vs

chal

leng

edco

lleag

ues

on t

heir

prac

tice,

e.g

. allo

win

gfo

rmul

a fe

ed r

eps

tota

lk t

o an

te-n

atal

grou

ps; e

ncou

ragi

ngth

e us

e of

'top

-up'

bott

le fe

edin

g

✔

Pro

fess

iona

l sup

port

to

thei

r as

sist

ants

. Som

eH

Vs

and

MW

sch

alle

nged

col

leag

ues

on t

heir

prac

tice,

e.g

.al

low

ing

form

ula

feed

reps

to

talk

to

ante

-na

tal g

roup

s;en

cour

agin

g th

e us

e of

'top-

up' b

ottle

feed

ing

03.0

4M

anag

e th

e p

erfo

rman

ce o

f tea

ms

and

ind

ivid

uals

✔

04C

olla

bo

rati

ve w

ork

ing

fo

r he

alth

and

wel

lbei

ng

04.0

1B

uild

rel

atio

nshi

ps

with

in a

nd w

ithco

mm

uniti

es a

nd o

rgan

isat

ions

✔

Sha

re t

he r

esul

ts o

fth

e p

roje

ct w

ithS

ureS

tart

tea

ms

and

will

als

o fe

ed t

here

sults

into

Loc

alA

utho

rity

pla

nnin

g re

heal

th o

utco

mes

04.0

2D

evel

op, s

usta

in a

nd e

valu

ate

colla

bor

ativ

e w

ork

with

oth

ers

✔

Sha

re t

he r

esul

ts o

fth

e p

roje

ct w

ithS

ureS

tart

tea

ms

and

will

als

o fe

ed t

here

sults

into

Loc

alA

utho

rity

pla

nnin

g re

heal

th o

utco

mes

✔Fe

d ba

ck in

form

atio

nfro

m th

e B

reas

tfeed

ing

Stee

ring

Gro

up to

thei

row

n lo

calit

ies.

Diff

icul

ties

aris

ing

from

the

lack

of

cons

iste

ncy

in th

ein

form

atio

n be

ing

give

n to

mot

hers

by

HVs

and

MW

s bo

th lo

cally

and

regi

onal

ly w

ere

note

d as

ade

velo

pmen

t nee

d

✔Fe

d ba

ck in

form

atio

nfro

m th

e B

reas

tfeed

ing

Stee

ring

Gro

up to

thei

row

n lo

calit

ies.

Diff

icul

ties

aris

ing

from

the

lack

of

cons

iste

ncy

in th

ein

form

atio

n be

ing

give

n to

mot

hers

by

HVs

and

MW

s bo

th lo

cally

and

regi

onal

ly w

ere

note

d as

ade

velo

pmen

t nee

d


05

Team

ro

les

in t

he b

reas

t fe

edin

g h

ealt

h im

pro

vem

ent

pro

ject

Co

ntri

but

ions

as

des

crib

ed in

the

nat

iona

lo

ccup

atio

nal s

tand

ard

sR

esea

rch

Lead

(GP

)N

urse

Man

ager

/Le

adH

ealt

h P

rom

oti

on

Sp

ecia

list

Hea

lth

Vis

ito

rsM

idw

ives

04.0

3R

epre

sent

one

’s o

wn

agen

cy a

t ot

her

agen

cies

’ mee

tings

✔

Att

end

ing

loca

l,re

gion

al a

nd n

atio

nal

mee

tings

ab

out

bre

astf

eed

ing

✔

Att

end

ing

loca

l,re

gion

al a

nd n

atio

nal

mee

tings

ab

out

bre

astf

eed

ing

✔

Att

end

ing

loca

l,re

gion

al a

nd n

atio

nal

mee

tings

ab

out

bre

astf

eed

ing

✔

Att

end

ing

loca

l,ne

twor

ks a

bou

tb

reas

tfee

din

g

✔

Att

end

ing

loca

l,ne

twor

ks a

bou

tb

reas

tfee

din

g

04.0

6P

rovi

de

info

rmat

ion

and

ad

vice

to

the

med

ia a

bou

t he

alth

and

wel

lbei

ng a

ndre

late

d is

sues

✔

Use

d t

he lo

cal m

edia

whe

reve

r p

ossi

ble

to

pro

mot

e th

e p

roje

ct

✔

Use

d t

he lo

cal m

edia

whe

reve

r p

ossi

ble

to

pro

mot

e th

e p

roje

ct

05D

evel

op

ing

hea

lth

pro

gra

mm

es a

nd s

ervi

ces

and

red

ucin

g in

equa

litie

s

05.0

1W

ork

in p

artn

ersh

ip w

ith o

ther

s to

pla

n, im

ple

men

t an

d r

evie

wp

rogr

amm

es a

nd p

roje

cts

to im

pro

vehe

alth

and

wel

lbei

ng

✔

Pla

nned

the

res

earc

hm

etho

dol

ogy

of t

hep

roje

ct

✔

Initi

ator

of

the

pro

ject

,an

d e

nab

led

HV

s an

dM

Ws

to im

ple

men

t th

egr

oup

s

✔

Targ

eted

bre

astf

eed

ing

as a

nin

equa

lity

05.0

4A

sses

s, n

egot

iate

and

sec

ure

sour

ces

of fu

ndin

g✔

Sou

ght

sour

ces

offu

ndin

g fo

r th

e p

roje

ct

✔

Sou

ght

sour

ces

offu

ndin

g fo

r th

e p

roje

ct

✔

Sou

ght

sour

ces

offu

ndin

g fo

r th

e p

roje

ct

06P

olic

y an

d s

trat

egy

dev

elo

pm

ent

and

imp

lem

enta

tio

n to

imp

rove

hea

lth

and

wel

lbei

ng

06.0

4A

pp

rais

e p

olic

ies

and

rec

omm

end

chan

ges

to im

pro

ve h

ealth

and

wel

lbei

ng

✔

Ste

erin

g G

roup

plu

sd

evel

opm

ent

ofp

roje

ct in

to lo

cal

look

ing

pol

icie

s an

dst

rate

gies

✔

Ste

erin

g G

roup

plu

sd

evel

opm

ent

ofp

roje

ct in

to lo

cal

look

ing

pol

icie

s an

dst

rate

gies

✔

Ste

erin

g G

roup

plu

sd

evel

opm

ent

ofp

roje

ct in

to lo

cal

look

ing

pol

icie

s an

dst

rate

gies

✔

Som

e of

the

HV

s w

ere

par

t of

the

Ste

erin

gG

roup

look

ing

aton

goin

g p

olic

ies

✔

Som

e of

the

MW

sw

ere

par

t of

the

Ste

erin

g G

roup

look

ing

at o

ngoi

ngp

olic

ies


05

Team

ro

les

in t

he b

reas

t fe

edin

g h

ealt

h im

pro

vem

ent

pro

ject

Co

ntri

but

ions

as

des

crib

ed in

the

nat

iona

lo

ccup

atio

nal s

tand

ard

sR

esea

rch

Lead

(GP

)N

urse

Man

ager

/Le

adH

ealt

h P

rom

oti

on

Sp

ecia

list

Hea

lth

Vis

ito

rsM

idw

ives

07W

ork

ing

wit

h an

d f

or

com

mun

itie

s to

imp

rove

hea

lth

and

wel

lbei

ng

07.0

2C

reat

e op

por

tuni

ties

for

lear

ning

from

pra

ctic

e an

d e

xper

ienc

e✔

Pro

vid

ed le

arni

ngop

por

tuni

ties

for

mot

hers

by

invi

ting

pre

gnan

t w

omen

to

atte

nd t

heb

reas

tfee

din

g gr

oup

and

by

invi

ting

bre

astf

eed

ing

mot

hers

to a

tten

d a

nte-

nata

lcl

asse

s

✔

Pro

vid

ed le

arni

ngop

por

tuni

ties

for

mot

hers

by

invi

ting

pre

gnan

t w

omen

to

atte

nd t

heb

reas

tfee

din

g gr

oup

and

by

invi

ting

bre

astf

eed

ing

mot

hers

to a

tten

d a

nte-

nata

lcl

asse

s

07.0

0In

volv

e an

d e

mp

ower

com

mun

ities

to

imp

rove

the

ir he

alth

and

wel

lbei

ng✔

As

par

t of

the

act

ion

rese

arch

08S

trat

egic

lead

ersh

ip f

or

heal

th a

nd w

ellb

eing

08.0

1U

se le

ader

ship

ski

lls t

o im

pro

ve h

ealth

and

wel

lbei

ng✔

As

cham

pio

ns o

fb

reas

tfee

din

g

✔

As

cham

pio

ns o

fb

reas

tfee

din

g

✔

As

cham

pio

ns o

fb

reas

tfee

din

g

08.0

2P

rom

ote

the

valu

e of

, and

nee

d fo

r,he

alth

and

wel

lbei

ng✔

As

cham

pio

ns o

fb

reas

tfee

din

g

✔

As

cham

pio

ns o

fb

reas

tfee

din

g

✔

As

cham

pio

ns o

fb

reas

tfee

din

g

✔

Som

e p

assi

onat

eab

out

the

ben

efits

of

bre

astf

eed

ing

and

wer

e ac

ting

asb

reas

tfee

din

gp

rom

oter

s in

the

ir ow

np

rofe

ssio

ns

✔

Som

e p

assi

onat

eab

out

the

ben

efits

of

bre

astf

eed

ing

and

wer

e ac

ting

asb

reas

tfee

din

gp

rom

oter

s in

the

ir ow

np

rofe

ssio

ns


05Te

am r

ole

s in

the

bre

ast

feed

ing

hea

lth

imp

rove

men

t p

roje

ct

Co

ntri

but

ions

as

des

crib

ed in

the

nat

iona

lo

ccup

atio

nal s

tand

ard

sR

esea

rch

Lead

(GP

)N

urse

Man

ager

/Le

adH

ealt

h P

rom

oti

on

Sp

ecia

list

Hea

lth

Vis

ito

rsM

idw

ives

08.0

3Le

ad t

he w

ork

of t

eam

s an

din

div

idua

ls t

o ac

hiev

e ob

ject

ives

✔

Man

agin

g a

larg

e te

am

08.0

5E

nab

le le

arni

ng t

hrou

gh p

rese

ntat

ions

✔

Man

y of

the

HVs

gav

epr

esen

tatio

ns o

n th

ebe

nefit

s of

bre

astfe

edin

gto

the

brea

stfe

edin

ggr

oups

and

regu

larly

rein

forc

ed th

eir m

essa

ge

✔

Man

y of

the

MW

s ga

vepr

esen

tatio

ns o

n th

ebe

nefit

s of

bre

astfe

edin

gto

the

brea

stfe

edin

ggr

oups

and

regu

larly

rein

forc

ed th

eir m

essa

ge

09R

esea

rch

and

dev

elo

pm

ent

to im

pro

ve h

ealt

h an

d w

ellb

eing

09.0

1P

lan,

und

erta

ke, e

valu

ate

and

diss

emin

ate

rese

arch

and

dev

elop

men

tab

out i

mpr

ovin

g he

alth

and

wel

lbei

ng

✔✔

09.0

2D

evel

op a

nd m

aint

ain

a st

rate

gic

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Identifying plans for multi-agency working

At a multi-agency workshop in Kent, members of aSureStart team and staff from the local HM PrisonService were in a group identifying their relativeroles using the standards for the practice of publichealth. The group identified that their commoninterest was the health and wellbeing of prisonersand their families. When a parent goes into prisonthey miss out on seeing their children develop. Theyalso are isolated from their family and are less likelyto develop parenting skills which gives rise toproblems on their return home. From the family’spoint of view, they are isolated from the parent inprison, often experience difficulties in visiting, andprisons are not child-friendly places causingdifficulties in maintaining contact and relationships.

Using the standards as the basis for stimulatingdiscussion, the SureStart health visitors andmidwives identified that they had no experience ofvisiting prisons or of the conditions and so wereunable to support the families of prisoners in thisregard. The group identified that a good first step intheir area would be for the SureStart staff to gothrough the same process as families do whenvisiting prisoners. This would enable the staff tounderstand the process and share their newknowledge and understanding with prisoner’sfamilies. The prison staff identified that the

parenting classes which SureStart were offering inthe community could be made available toprisoners and invited the SureStart health visitorsand midwives to run these classes. The commonwork also identified issues between the twohealthcare teams that could be addressed by betterpartnership working. For example, a midwife hadtold a pregnant woman prisoner the date of herelective Caesarian section and had not understoodwhy the prison service felt this to be inappropriate.During the workshop it was possible to explore whythe prison service are reluctant to agree dates inadvance due to the security risks that need to bemanaged (e.g. potential planned escape, drughandover). In turn this led on to the proposal that astrategy document should be produced to explainpractice for teams working with the prison service.

A developing role for a professional group

Community pharmacists have been identified asone professional group with an increasing role inimproving the health of the public across the UK.The overall framework of the national occupationalstandards was used to stimulate discussion withgroups of community pharmacists as to how theycontribute to health improvement. A summary ofthe comments made at three UK workshops isshown below against the ten areas of public healthpractice.

35

05Area of public health practice Examples of the contributions of community pharmacists

01 Surveillance and assessment of the population’shealth and wellbeing

Analysing pharmacy data to identify health needs of thepopulation / groups with poor health (e.g. BMI, diabetes,blood pressure, methadone, smoking cessation)

Monitoring service activities in relation to performanceand health indicators (e.g. inequalities in prescribing andsubstance misuse)

Contributing to the development of a pharmaceuticalpublic health data set

02 Promoting and protecting the population’s healthand wellbeing

Understanding models of behaviour change and their usein health promotion

Contributing to harm reduction strategies, communicabledisease control strategies and screening programmes

Ensuring medicines are used effectively

05


Area of public health practice Examples of the contributions of community pharmacists

03 Developing quality and riskmanagement within an evaluativeculture

Use of different ways of assessing outcomes including patientsatisfaction, qualitative measures, patient acceptability and qualityof life

Contributing to the development of multi-disciplinary guidance foridentifying and reporting potential hazards (e.g. safe administrationand disposal of medicine)

Developing and maintaining high standards of pharmacy practice

Applying evidence in pharmacy practice

04 Collaborative working for health andwellbeing

Working with other stakeholders to develop pharmacies as a localand accessible advice point complementary to existing services

Working with others in partnership to find solutions to specificproblems (e.g. childhood immunisations)

05 Developing health programmes andservices and reducing inequalities

Working with others on the development of programmes andprojects to promote and protect health, reduce inequalities andachieve long-term equity in health (e.g. smoking cessation,methadone use, minor ailments)

06 Policy and strategy development andimplementation to improve health andwellbeing

Working in partnership with others to develop and deliver local andnational policy initiatives (e.g. smoking cessation, methadone use)

07 Working with and for communities toimprove health and wellbeing

Working in partnership with communities and others to improvehealth (e.g. SureStart, Health Action Zones, Healthy Living Centres,Primary Care Centres, local asylum and refugee groups, ExpertPatient Programme)

Responding to the public about the application of NICE guidancelocally

Being able to listen to and help communities articulate their ownhealth concerns

Acting as an advocate for the public health articulating the needs ofthose with poor health in society including those who aredispossessed, vulnerable and discriminated against

8 Strategic leadership for health Ensuing that staff and self are trained to the level of competencerequired

9 Research and development to improvehealth and wellbeing

Using local information networks to update and exchangeinformation

10 Ethically managing self, people andresources to improve health andwellbeing

Understanding and appreciating ethical and legal issues relating toconfidentiality, data protection and information

Supporting and regularly reviewing staff


Identifying individuals’ roles in public health

Individuals can use the framework of occupationalstandards to identify and clarify their role in publichealth. Three different examples of how the nationaloccupational standards have been applied todifferent posts follow. These were developed usingthe overall framework of the standards produced ina chart form. A chart to use the framework as anindividual is available on the CD-Rom. Individuals

need to be selective in identifying the standardsthat relate to their post – thinking of the key resultareas of the post is a useful guide. On average itwould be unusual for more than about 15 unitswithin the national occupational standards to berelevant to a post, considering the amount of detailand performance requirements sitting behind theunit title.

37

05

A health promotion manager from Kent

Unit no: National occupational standard Examples of how applied

01.05 Facilitate others’ collection, analysis,interpretation, communication and use of dataand information about health and wellbeingand/or stressors to health and wellbeing

Encourage the team to promote Health ImpactAssessment, health needs assessment etc

03.04 Manage the performance of teams andindividuals

Design and agree jobs for and with team. Regularmeetings, appraisals, objective setting

04.03 Represent one’s own agency at other agencies’meetings

Strategic meetings to keep health on others’ agendaplus look at ethics of involvement with differentgroups etc. Also bottom-up approach

04.05 Enable the views of groups and communities tobe heard through advocating on their behalf

Use the information from own team to advocate theneeds and interest of communities with which theyare working in other settings e.g. strategic meetings

05.01 Work in partnership with others to plan,implement and review programmes and projectsto improve health and wellbeing

Within team, PCT team and when collaborating aboutstrategy

05.04 Assess, negotiate and secure sources of funding Identify and bid for education funding usingpartnership approach

06.01 Work in partnership with others to plan,implement, monitor and review strategies toimprove health and wellbeing

Management team review and comment ongovernment strategies and also plan theirimplementation locally

06.04 Appraise policies and recommend changes toimprove health and wellbeing

For collaborative partnership work

07.02 Create opportunities for learning from practiceand experience

A past responsibility which now achieve throughteams for communities to link education and health

08.00 Develop capacity and capability and lead otherswith a vision of improving health and wellbeing

Develop organic methodology and new ways ofworking. Enable team to learn and developthemselves and bring forward new ideas


05

A health promotion manager from Kent

Unit no: National occupational standard Examples of how applied

08.03 Lead the work of teams and individuals toachieve objectives

Be up-to-date with policies and strategic direction.Ensure the working of the team reflects this. Plusensure regular appraisals, training opportunities etc

10.02 Prioritise and manage own work and the focus ofactivities

Delegate work, provide opportunities for others

10.03 Manage the use of financial resources Team budget management

A locality health development lead officer, primary care trust in the north-east of England

Unit no: National occupational standard Context for post

01.06 Collect, structure and analyse data on the healthand wellbeing and related needs for a definedpopulation

Will be undertaking a needs assessment of the areain which I work through the collation of qualitativedata and linking it to epidemiological data to developa health profile. I will then feed this into other groups’and partners’ data and information

02.01 Communicate with individuals, groups andcommunities about promoting their health andwellbeing

Through different agencies and networks to raiseissues of promotion and prevention and the healthinequalities agenda, highlighting areas that needaddressing e.g. wards with high rates of CHD

03.01 Develop one’s own knowledge and practice Continuously involved with further learning / personaldevelopment e.g. MSc, CertEd. Also keep up-to-datethrough journals and as a member of a professionalassociation

03.02 Contribute to the development of the knowledgeand practice of others

Support team members. Deliver training to supportthe practice of other workers / people in thecommunity

03.04 Manage the performance of teams and individuals Manage and support a locality team

03.05 Contribute to improvements at work Specifically at the moment focusing on ImprovingWorking Lives

04.01 Build relationships within and with communitiesand organisations

Work across localities through networks and multi-agency groups to address inequalities

04.02 Develop, sustain and evaluate collaborative workwith others

Develop collaborative working thorough existing andnew networks e.g. Healthy Cities


05

A locality health development lead officer, primary care trust in the north-east of England



Attend locality and citywide meetings e.g. HealthyCities, Single Regeneration Budget etc


Respond to needs identified from needs assessment


Developing programmes and responding to healthinequalities to address local needs

05.04 Assess, negotiate and secure sources of funding Have applied for funding e.g. 5-a-day, SRB and willcontinue to identify funding for other work that isneeded

06.03 Work in partnership with others to developpolicies to improve health and wellbeing

Contribute to the development of policy and strategyto address particular issues e.g. a recent needidentified in a ward in relation to drugs

08.01 Use leadership skills to improve health andwellbeing

Essential with multi-agency working that I amengaged in


Responsibility for leading a team

08.05 Enable learning through presentations Presentations to disseminate information at meetingsetc and for training purposes

10.01 Promote people’s equality, diversity and rights Essential to do this in my role as a team lead


Need to balance my own workload and resources andthose of the team

10.03 Manage the use of financial resources Manage the budget for locality work


05

A health visitor from the east of England


01.06 Collect, structure and analyse data on the healthand wellbeing and related needs for a definedpopulation

Assess the health of the local population and developa community profile to inform key decision makersand local primary care teams so they can planservices appropriately. Within this triangulateinformation to increase validity especially forqualitative data

02.01 Communicate with individuals, groups andcommunities about promoting their health andwellbeing

Such as through group working in relation to smokingcessation, elderly health promotion

02.02 Encourage behavioural change in people andagencies to promote health and wellbeing

On an individual basis when visiting people in theirhomes and during some group work

02.03 Work in partnership with others to promote healthand wellbeing and reduce risks within settings

General safety advice when in contact with nurseries,play groups etc

02.04 Work in partnership with others to prevent theonset of adverse effects on health and wellbeingin populations

Child health surveillance, and ill health preventionsuch as child accident prevention in post-natalgroups or home visits

02.06 Work in partnership with others to protect thepublic’s health and wellbeing from specific risks

Child protection role and where there are specificcontacts such as nurseries concerned about headlice, foot and mouth in infants and chicken poxoutbreak

03.01 Develop one’s own knowledge and practice Keep up-to-date with R&D

03.02 Contribute to the development of the knowledgeand practice of others

Teach and assess junior nurses and HVs

04.02 Develop, sustain and evaluate collaborative workwith others

Ongoing involvement with multi-agencies and jointworking ventures e.g. mother and baby supportgroup with local church


Regularly


In general sense during meetings with primary careteam and other agencies highlight concerns of localcommunity e.g. in relation to crime


We develop programmes and projects (e.g. elderlygroup, mothers and babies club) to meet the healthneeds of the local community within the overall policyand strategy set by the PCT. Have also developed aspecific project for a health visitor resource to localtravelling communities


05

A health visitor from the east of England


06.04 Appraise policies and recommend changes toimprove health and wellbeing

Involved in implementing local policies at grass rootslevel and appraise policies and feed back on theimpact they will have on our local community e.g. forSureStart, local child health group

07.05 Enable people to address issues related to healthand wellbeing

On a one-to-one basis as well as group working e.g.safe and stimulating play opportunities, shelteredaccommodation for young people, enabling familiesto help other family members

08.02 Promote the value of, and need for, health andwellbeing

Individual practitioners need to be passionate abouthealth and wellbeing themselves to be effective


Lead 63 staff for their professional development andkeep them up-to-date with research development etc

10.01 Promote people’s equality, diversity and rights On a one-to-one basis


On a daily basis as professional lead of health visitingactivities

10.05 Facilitate individual learning and developmentthrough mentoring

Act as a mentor to other staff and I also run a supportgroup for staff nurses and an induction and welcomepackage


The national occupational standards for thepractice of public health are designed to be usedand refined through their use. The standards willalso need to be refined and updated over time inline with changes in the health of the public,changes in technology and evidence-basedpractice.

Skills for Health welcomes feedback on thestandards at any time and in any form. Please sendyour feedback on the standards to:

Public Health Project ManagerSkills for Health1st FloorGoldsmiths House5-9 Broad PlainBRISTOLBS2 0JP

0117 922 1155

[email protected]

www.skillsforhealth.org.uk

42

How can I provide feedback on thenational occupational standards?

06


The CD-Rom contains: Appendix A

43

What is on the CD-Rom? 07

Folder Contents

Guide to the standards Guide to the national occupational standards for the practice of public health

Standards National occupational standards for the practice of public health

Tables for each area showing the related knowledge, understanding and skills

Glossary Terms used in the standards

Presentation The development and use of the standards

Templates For the use of organisations/teams and individuals

Unit title and code number 02.04 Work in partnership with others to prevent the onset of adverse effects on health and

wellbeing in populationsThis describes the purpose and focus of the particular standard.

SummaryThis unit is about preventing the onset of adverse effects on health and wellbeing in populations, oftenknown as primary prevention. Primary prevention may relate to any aspect of health and wellbeing. Thepurpose of such interventions would include: improving people’s resistance to adverse effects to their healthand wellbeing; limiting people’s exposure to adverse effects to their health and wellbeing; reducing thestressors that effect people’s health and wellbeing.

When this unit is applied to specific forms of intervention, a range of legislation and good practice guidelineswill apply. For example, this unit could be applied to different forms of prevention such as child protection,immunisation, food safety, environmental pollution. Users of this standard will need to be conscious of thisbroader context and the impact that it will have on the roles and responsibilities of practitioners.

There are two elements

02.04.1 Identify and contact the people in the population who are in need of primary preventiveinterventions

02.02.2 Support people in the population during the process of primary preventive interventionsThis section provides an overview of the standard and the number of different sections within it - known aselements.

Key words and conceptsStressors are features of the environment that may induce harm or damaging responses in a living system ororganism. They may be: biological, chemical, physical, social, psychosocial.

This section explains key words and concepts that are used in the standard. There is also a glossary for all ofthe national occupational standards.

Scope of the standardsInterventions might take the form of: advice and information; specific interventions to prevent the onset ofhealth effects in individuals (e.g. assessment of risk, immunisation); specific interventions to prevent orreduce stressors in the environment (e.g. related to food safety, controlling infection, environmental pollution).

This section provides the coverage of the standard i.e. the range of different types of public health practice towhich the standards apply and the range of different areas that need to be considered to meet the standard.

Origins of this unitThis unit has been developed specifically for the practice of public health.

This section explains whether the standard was developed specifically for the practice of public health or hasbeen ‘imported’ from other relevant standards (e.g. management, community development work).

Links to the NHS Knowledge and Skills Framework (Working Draft Version 6, March 2003)

This unit links to NHS KSF Dimension 10 Protection of health and wellbeing – level 3.

This section shows the links to the NHS KSF - a key strand of Agenda for Change Pay Modernisation in theNHS that will be mandatory for all staff once Agenda for Change is implemented.

Appendix AA


Example of the structure of a standard

First page

Element02.04.1 Identify and contact people in the population who are in need of primary preventive

interventions

Performance criteria

You need to1. Keep up-to-date with the range, application, effectiveness and public perception of primary preventive

interventions

2. Identify who the target populations are for preventive interventions and the reasons for this

3. Work with others to identify:

- the best methods for contacting the target population in the local situation

- who is best placed to do this

- the best times for making contact

- a plan for taking the work forward

4. Effectively participate as a member of the prevention team

5. Communicate with people in the target population in a manner that

- is appropriate to them

- encourages an open and frank exchange of views

- minimises any constraints

- is free from discrimination and oppression

6. Explain clearly to people in the target population

- the purpose and benefits of the intervention

- its risks

7. Review the effectiveness of the identification and contact and identify how practice can be improved in thefuture.

This section specifies the detailed standards i.e. good practice in the specific area of work. The element titlestates the specific area of work and the performance criteria describe the expected level of practice.

A


Following pages

Knowledge, understanding and skillsIn the publication this section appears as a table for the one area at a time.

A Health and wellbeing - concepts, models and stressors

A1 the social construction of health and illness and how this affects people’s perceptions

A2 the kinds of misinformation which people receive about health and wellbeing and how this can becounteracted

A3 stressors to health and wellbeing: biological; chemical; physical; social; psychosocial

(A4 Does not apply to this standard)

A5 inequality and discrimination and their impact on health and wellbeing: how to recognise and addressinequality and discrimination in the context of Human Rights legislation

A6 risks to health and wellbeing: consideration of avoidable, relative and absolute risk; the importance ofthe context of the risk and the factors that may modify its impact; appropriate risk managementobjectives; the concept of acceptable risk and whose values define this (i.e. political, social, scientific,the community); assessment of different types of risk and appraisal of the different strategies formanaging such risks; the importance of taking action that is proportionate to the scale and seriousnessof the risk so that fear is not disproportionate to the actual risk

C Preventing risks and effects to health and wellbeing

C1 the different forms of prevention: improving people’s resistance to health effects; limiting exposure tohealth effects; reducing the stressors that affect people’s health and wellbeing

C2 the different forms of intervention that are used in prevention: advice and information; specificinterventions to prevent the onset of health effects; specific interventions to reduce health effects;specific interventions to prevent or reduce stressors

C3 the increased risks to some individuals in populations relating to: age, sex, family history or ethnicbackground; exposure (e.g. social, environmental); the interventions that can be put in place to targetindividuals at increased risk; the different methods of tracing and establishing contact with individuals

etc

This section sets out the knowledge, understanding and skills that individuals are likely to need todevelop to meet the national occupational standards.

A


For each area

Skills for Health

Goldsmith’s House

5-9 Broad Plain

BRISTOL BS2 0JP

Telephone: 0117 922 1155

www.skillsforhealth.org.uk

This guide is available atwww.skillsforhealth.org.uk

national occupational standards for the practice of - health in wales

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