leadership for health innovation: p ublic health education and entrepreneurship professor richard...
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Leadership for Health Innovation:Public Health Education and
Entrepreneurship
Professor Richard Parish
Chief Executive
Royal Society for Public Health
Today’s PresentationToday’s Presentation
• Focus on us – the public health community• Consider why public health is so often at the
margins of political commitment• Why have we not made more progress?• The role of public health leaders and how we
make the best use of the knowledge resource• Challenging and provocative – stimulate a
debate
The Royal Society for Public Healthwww.rsph.org.uk
The Royal Society for Public Health is an independent, multi-disciplinary organisation,
dedicated to the promotion and protection of collective human health and well-being.
Through advocacy, mediation, empowerment, knowledge and practice,
we advise on policy development; provide education and training services;
encourage scientific research; disseminate information; and certify products, training centres and processes
The Royal Society for Public HealthThe Royal Society for Public Health
Royal Society for Public HealthRoyal Society for Public Health• Newest and the oldest PH
body• National Awarding Body• 100,000 students• 1,450 education centres• ISO Certification• NGO Forum• National health promotion
support• IUPHE, APHA, WFPHA• John Snow Society
Future Health ChallengesFuture Health Challenges
• Modern day NCDs and so called ‘lifestyle’ issues
• Re-emerging communicable diseases
• Multi-resistant hospital acquired infections
• Emergency and disaster responses
• Impact of climate change• Emerging communicable
diseases
Health in the FutureHealth in the Future
1. Economic growth and sustainable development
2. Health care provision versus action on the fundamental determinants of health
3. Potential adverse effects of the media and IT and the obvious advantages of better communication
4. Energy demand versus environmental impact
5. Improvements for the affluent at the expense of the worst-off
Unresolved Dilemmas and ChallengesUnresolved Dilemmas and Challenges
• Growing inequalities• Social injustice• Governance and public
accountability• Ethics• Multisectorality – partners and
‘unethical enemies’
“If we don’t succeed this, we
run the risk of failure”
Ottawa and Beyond: 22 years of success?Ottawa and Beyond: 22 years of success?
• Five action areas – progress?
• Three functional responsibilities – competent?
• Pilots projects and demonstration areas
Successes and FailuresSuccesses and Failures
Successes – Yes!
But too often a failure in
• Political commitment• Programme implementation• Replication
Implementation and replication?
• Limited capacity/Not enough staff?
• Inadequate resources?
• Lack of skills?
• Unsupportive policy climate?
• Wrong policy instruments?
REASONS FOR FAILUREInternational Standards Organisation
• inappropriate standard
• low level of resources
• inadequately trained personnel
• organisational constraints
• unclear objectives
• poor communication
• inaccurate audit methodology
Real progress depends upon:
• Using the full range of policy instruments (fiscal, legislation, regulation, organisational development, funding, accountability, human resource deployment, pooled resources)
• Capacity, capability and infrastructure
• Communication and co-ordination
• New research and evaluation paradigms
Why are the policy-makers not begging public health to help?Why are the policy-makers not begging public health to help?
Better health benefits:
• Education• Economic prosperity and
wealth• Social welfare• Environment
ASPHEREuropean Public Health Core Competencies Programme
• Flexible competencies• Populations change• Different countries; different needs• Infrastructure• Labour market• Social norms• Economic and environmental
circumstances
ASPHEREuropean Public Health Core Competencies
ProgrammeMethods in Public Health
Epidemiology Data collection
Data analysis Evaluation
Surveillance Biostatistcs
Qualitative research
ASPHEREuropean Public Health Core Competencies
Programme
Social Environment and Health Physical, Chemical and Biological Environment
Social research methods Health risk assessment
Health risk management
Health risk communication
ASPHEREuropean Public Health Core Competencies Programme
Health Policy, Organisation, Management & Economics
Health Promotion and Disease Prevention
Application of theories and models
Health determinants and risk factors
Monitoring and evaluation Theory and principles
Management (resources, budgets, grants
Strategy and programme development, management and evaluation
Public Health Training?Public Health Training?
Problem definition and evaluation
V
Change agents and implementation management
Key QuestionsKey Questions
• Should we better differentiate between public health ‘scientists’ and ‘implementation managers’?
• Is the current curriculum too crowded?
Implementing the Ottawa Charter
• Enable
• Mediate
• Advocate
Asset mapping Disease profiling
Market research and intelligence
Epidemiological research methods
Media management Curriculum development
Economic and environmental assessment
Health services provision
Organisational change management
Community development
Policy development + policy impact assessment
Negotiating skills
Advocacy techniques
Social marketing
Management monitoring Outcome evaluation
Workforce planning
Quality Management for Quality Public Health
What can we learn from other sectors and
services?
What should we measure?What should we measure?
INPUTS PROCESSES OUTPUTS OUTCOMES
We tend to value the things we measure
rather than
Measure the things we value
Is something missing
in the DNA of Public
Health Practitioners?
The art as well as the scienceof public health
The art as well as the scienceof public health
ProblemDefinition
Priorities
Intervention Strategy
ProgrammePlanning
Implementation
Impact andEvaluation
Replication andMainstreaming
We learn from what we document
But
Do we document everything we know?
The Art not just the Science!The Art not just the Science!
• Public health in Wales
• Tesco
• Wanless Review
• Child and Adolescent Health and Development Strategy
The Assessment Tool• Identify current policies and strategies that contribute to
child and adolescent health• Clarify the goals and objectives for which these policies
and strategies have been formulated.• Map the existing policy provision• Assess the extent to which these are based on evidence.• Identify any gaps in policy provision.• Enable policy-makers to determine whether they have
utilised the full range of policy possibilities
Professor Richard Parish, Chief Executive, Royal Society of Health, United Kingdom
The Assessment Tool• Identify whether the necessary information systems are
in place to assist in policy formulation, implementation management, and outcome evaluation.
• Identify the sectors and key players involved in planning, implementation, evaluation and accountability.
• Assess the extent to which national policies and strategies have been implemented in practice.
• Determine the adequacy of the existing infrastructure required for the successful implementation of national policies and strategies, and identify any additional measures that might be required
Professor Richard Parish, Chief Executive, Royal Society of Health, United Kingdom
Policy Options
Professor Richard Parish, Chief Executive, Royal Society of Health, United Kingdom
LEGISLATION(e.g. smoking in public places, wearing seat belts, environmental
improvement, maternity leave, child rights)
REGULATIONS(e.g. consumer protection, food labelling,
industrial and vehicle emissions, speed limits)
ORGANISATIONAL CHANGE(e.g. new services, improved access)
PUBLIC EDUCATION(e.g. mass media campaigns)
PROFESSIONAL DEVELOPMENT(e.g. training of health professionals, professional regulation)
BUDGET ALLOCATION(e.g. increased health or education budget)
FISCAL MEASURES(e.g. taxation, corporate subsidies, financial penalties, investment
funds, tax exemption)
WELFARE POLICY(e.g. food coupons, welfare benefits, housing support)
RESEARCH(commissioned research, information dissemination)
PERFORMANCE RELATED PUBLIC SERVICE FUNDING(e.g. funds follow targets)
CURRICULUM DEVELOPMENT(e.g. primary and secondary school knowledge and skills development)
ENVIRONMENTAL CHANGE(e.g. transport planning, water and sewage supply, playground design)
OTHER(please specify)
OTHER(please specify)
Go to 1.13
The Assessment Exercise
• What?
• Why?
• Where?
• How?
• When?
• Which?
Professor Richard Parish, Chief Executive, Royal Society of Health, United Kingdom
Human Resources
• Skills• Location and
deployment• Recruitment and
training• Is there a Plan?
Planning and evaluation Implementation
Health indicators Management indicators
Outcomes Process
Epidemiology Asset mapping
Science Art
What can be documented What must be experienced
Map the Community’s Assets
• facilities
• networks
• community organisations
• communication structures
• local identity
• media
Half empty
Half full
“I have a vision for the future as well
as the past!”
Supporting PractitionersSupporting Practitioners
Professional development, skills and competencies
Organisation and system support - accreditation
National/International learning networks
Evidence-based tools
You must learn from the mistakes of others –
you will never live long enough to make
them all yourself
Most of the pieces, butwe don’t yet havethe jigsaw!
• Competencies
• Science
• Differentiation and specialisation?
• Art of public health?
The Missing LinksThe Missing Links
• Leadership development• Mentorship• Better use of existing leaders and
those who have recently retired• Draw on other disciplines• Learn the language and culture of
others – recruitment, secondment, etc
• International Journal of Public Health Failures
If you always do what you have always done, you will always get what you have always had
One ship sails east and another sails west
With the self same wind that blows
T’is the set of the sails and not the gales
That determines the way we go
Like the winds of the sea are the winds of fate
As we journey along through life
T’is the set of the soul that determines the goal
And not the calm or the strifeElla Wheller Wilcox