Better Skills Better Jobs Better Health. National occupational standards for the practice of public health guide

Better Skills Better Jobs Better Health National occupational standards for the practice of public health guide March 2004

Acknowledgements These national occupational standards describe good practice in the practice of public health. The standards have been developed as a means of improving the capacity and capability of the public health workforce. The standards make the links between what needs to happen to improve people s health and what individuals need to do to contribute to this effort effectively. These standards have been designed to be used across service, organisational and individual levels across all sectors - to develop services, plan workforces, guide practice and the management of people, and form the basis of education, training and qualifications. Many practitioners and agencies willingly gave their expertise and time in the development of these national occupational standards. Without their contribution it would not have been possible to produce these standards nor have taken forward this work on a multi-agency and multi-disciplinary basis. The standards were approved as UK-wide national occupational standards by the education regulatory authorities the Qualifications and Curriculum Authority (QCA) and the Scottish Qualifications Authority in February 2004. This approval attests to the quality of these standards and their appropriateness for all who contribute to improving the health of the public, wherever they work and whatever their work role. The project to produce these national occupational standards was led by Skills for Health, the UK-wide Sector Skills Council for Health. The project was commissioned and overseen by the four UK Health Departments. In addition a Core Stakeholders Group, including representatives of regulatory bodies and professional bodies as well as the four government health departments, advised on the processes and outcomes of the work. The team of independent consultants who produced the outcomes were: Lindsay Mitchell of Prime R&D, Thelma Harvey and Barbara Battel-Kirk. The contribution of the many individuals and agencies involved in the development of these standards is gratefully acknowledged. March 2004 02

Contents Introduction 01 What are the national occupational standards for the practice of public health? 05 Why 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? 06 What 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? 10 How 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? 22 Who 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 03

Introduction Health is more than the absence of disease and being healthy is a positive state of, one which is promoted through broad engagement of many groups and interests within society. To be healthy requires individuals to engage in their health as much as it requires healthy and sustainable environments and well trained professionals. Derek Wanless recognised this when he said in his report: Adequate workforce capacity will need to be created with appropriately broad skill mixes. Because more of the activity will be concerned with monitoring, interpreting data, identifying risk, educating people and motivating them to change behaviour, the required mix of skills will change. Derek Wanless, Securing Good Health for the Whole Population: Final Report, February 2004 The publication of national occupational standards for public health is a timely response to the growing interest in health and and the challenge of developing the workforce to promote health and address the challenges of health inequalities. The public health workforce needs to include a diverse mix of people from different professional and practice backgrounds working across all sectors of the economy education, transport, housing, agriculture, and the environment. Some will work directly in the health sector; the work of others will indirectly impact on health. Whatever the background, the occupational standards for the practice of public health have been designed to assist with developing services, planning workforces, guiding practice and managing people. They form the basis of education, training and qualifications, making links between practice and impact on health. The standards are complementary to the standards for specialist practice. As with any developing area, these national occupational standards for the practice of public health are not set in stone but provide a starting point. Feedback of your views will help us refine them in the light of experience and practice, and we hope that they will be a useful tool to support broad engagement in improving health for all populations, particularly the vulnerable and excluded. Sian Griffiths President of the Faculty of Public Health 04

What are the national occupational standards for the practice of public health? 01 Why were the standards developed? The national occupational standards for the practice of public health were developed as one key part of developing the capacity and capability of the public health workforce. The standards are seen as an essential component of improving the health of the public identified as of vital importance by each of the four UK countries. Who do the national occupational standards apply to? Anyone who works to improve the health of the public including those who work in: the NHS, local authorities, the voluntary sector and independent sector across the UK. What are the benefits of the standards? The standards provide a coherent overview of public health. They have been developed from a multi-disciplinary and multi-sectoral approach and have had a wide range of different practitioners from different agencies involved in their development. The standards provide a shared language for partnership working that is capable of being applied to different contexts and different practitioners. How can the standards be used? The standards can be used in a variety of ways: by a number of agencies working in partnership to plan services and workforce development, by organisations to develop, for example, job descriptions, and by individuals to identify learning needs and interests. What are the national occupational standards like? The standards focus on good practice in specific areas of work. They are fairly broad and general in nature. For example they look at primary prevention functions but do not look at each of these functions in detail nor how they are undertaken by different professional/occupational groups (e.g. child protection, immunisation, infection control). How do these standards relate to the standards for public health specialists? These national occupational standards for the practice of public health use the same ten areas as the standards for specialist practice. However they are in greater detail than the specialist standards as they describe good practice in the detailed work that needs to take place in each of those areas of practice, whereas the standards for public health specialists show how they draw from, and coordinate across, all of these different areas of practice. Who oversaw the development of the standards? The development was funded by the four UK Government Health Departments and the Education Regulatory Authorities the Qualifications and Curriculum Authority (QCA) and the Scottish Qualifications Authority (SQA). The project to develop the standards was led by Skills for Health, the Sector Skills Council for the health sector. Regulatory bodies, professional bodies/associations and employing organisations guided the work. When were the standards developed? The development of these national occupational standards followed on from the development of the standards for public health specialists. The development work took place during 2002-2003 and there was a UK-wide consultation in mid-2003. The standards were formally approved by key stakeholders in the sector in the autumn of 2003 and quality approved as national occupational standards by QCA and SQA in February 2004. 05

02 What is covered by the standards for the practice of public health? What is public health? These standards/competences describe the quality of work that is expected of people who work to improve the health of the public in the UK i.e. who are engaged in the practice of public health. The purpose of public health is to: improve the health and of the population prevent disease and minimise its consequences prolong valued life reduce inequalities in health 1. Public health: takes a population perspective mobilises the organised efforts of society and acts as an advocate for the public s health enables people and communities to increase control over their own health and acts on the social, economic, environmental and biological determinants of health and protects from and minimises the impact of health risks to the population ensures that preventive, treatment and care services are of high quality, based on evidence and are of best value. Ten broad areas of work have been identified which enable the purpose of public health to be met. These are: 01 Surveillance and assessment of the population s health and 02 Promoting and protecting the population s health and 03 Developing quality and risk management within an evaluative culture 04 Collaborative working for health and 05 Developing health programmes and services and reducing inequalities 06 Policy and strategy development and implementation to improve health and 07 Working with and for communities to improve health and 08 Strategic leadership for health and 09 Research and development to improve health and 10 Ethically managing self, people and resources to improve health and. The table that follows provides an overview of the different national occupational standards in each of these ten broad areas. There are currently 65 different national occupational standards, formed into units, which make up this overall framework for public health. 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 the Royal Institute of Public Health. 06

What do the national occupational standards cover? 02 Area Overview of the national occupational standards 01 Surveillance and assessment of the population s health and This area focuses on good practice in collecting, forming, obtaining, linking, analysing, interpreting, communicating and disseminating data and information about health and. There is also a standard on facilitating others to use data and information. This area has standards for: - people who collect, form, obtain, link, analyse, interpret, communicate and disseminate data and information about the health and of different populations using a wide variety of 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 about health and and of knowledge management have been identified as relevant to public health. These standards are available in the Health Informatics standards. Surveillance and monitoring of animal health will need to feed into the data and information about health and and is included in unit 01.02 when data and information from various sources is linked together. 02 Promoting and protecting the population s health and This area focuses on the spectrum of activity linked to the promotion and protection of health and - ranging across a spectrum from enabling to enforcement approaches. The standards are general in nature and designed to be applicable to the wide range of workers who have a role in this area. The first standard relates to communicating with people about promoting health and. Unit 02.02 is about encouraging people to change their behaviour to improve health. Unit 02.03 relates to working with others to promote health and in settings. Then there are two standards related to prevention - unit 02.04 relates to primary prevention for the whole population whereas unit 02.05 is about prevention related to situations when there are specific risks to health. Unit 02.06 is about health protection in relation to specific risks - due to the nature of this work aspects of enforcement are included. Other aspects of the promotion of health (such as health education) are also to be found in other areas of the framework. Enabling societies to promote health and and reduce risks through policies and strategies is covered in area 6. 03 Developing quality and risk management within an evaluative culture This area focuses on improving quality and making changes in organisations and services to improve health and. One important aspect of quality improvement is keeping up-todate with developments in knowledge and practice, including evidence, (unit 03.01), helping others to develop their knowledge and practice (03.02), and supporting and challenging others on specific areas of practice (such as through supervision approaches - unit 03.03. The area of performance management is included in unit 03.04, and contributing to improvements at work in unit 03.05. 04 Collaborative working for health and This area focuses on collaborative working and the effective communication and presentation skills that support collaborative working. The first two units relate to building relationships (unit 04.01) and developing, sustaining and evaluating collaborative work (unit 04.02). The next is about representing one s agency at other agencies meetings (04.03). It is vital that individuals work in partnership with communities to improve their health and (04.04). There is sometimes a need to advocate on behalf of communities (04.05) or work with the media (04.06). 07

02 Area 05 Developing health programmes and services and reducing inequalities 06 Policy and strategy development and implementation to improve health and 07 Working with and for communities to improve health and 08 Strategic leadership for health and 09 Research and development to improve health and 10 Ethically managing self, people and resources to improve health and Overview of the national occupational standards This area is about developing the different forms of programmes and services that may improve health and. This includes working with others to plan, implement and review specific programmes and projects (unit 05.01) and managing changes in organisations (05.02). It might also be necessary to support the development of people s skills and roles in community groups/networks (05.03). It is also vital that there are skills in assessing, negotiating and securing sources of funding (05.04). This area focuses on the planning, implementation and review of strategies (unit 06.01) and the various aspects of policy development. Health impact assessment on all forms of policies is included in unit 06.02, working jointly with others to develop policies is within unit 06.03 while unit 06.04 describes standards for those who contribute through appraising policies and recommending changes to improve health and. This area is about developing community capability (units 07.01 and 07.02), supporting communities to plan and take collective action (07.03) and facilitating the development of community groups/networks (07.04). There are then specific standards related to enabling people to address issues related to health and (07.05) and enabling people to improve others health (07.06). As health improvement also takes place at the individual level, there is also a unit related to working with individuals and others to minimise the effects of specific health conditions drawing on the concept of the expert patient (07.07). This area focuses on the various forms of leadership that are necessary to improve health and. Workers might take a strategic leadership role in improving health and in their own organisation and beyond (unit 08.00), apply leadership skills to health improvement (08.01) or promote the value of health and more generally (08.02). The specific role of leading teams and individuals, for whom one might not have management responsibility, is included in unit 08.03. Improving people s capability and capacity is an important aspect of leadership and these skills are included in relation to designing learning programmes (08.04), enabling learning through presentations (08.05) and evaluating and developing learning programmes (08.06). This area focuses on research and development across a range of different aspects. First of all there is a standard for undertaking research and development in improving health and (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 and implementation of research and development outcomes in practice (09.05). This area is about specific aspects of ethical practice and management. Unit 10.01 is about promoting equality, diversity and rights while unit 10.02 is about the management of self and own activities. Unit 10.03 is about managing the use of financial resources. There are then three units focused on enabling individuals to learn and develop - monitoring and reviewing progress with learners (10.04), mentoring (10.05) and coaching (10.06). 08

02 Who is involved in improving the health of the public? The practice of public health involves people from a wide variety of backgrounds and work areas. The practice of public health can be thought of as a flower (see diagram below). These national occupational standards for the practice of public health cover the lighter shaded area in the flower - that is, common standards across the whole area of improving the health of the public. The small darker circle in the middle represents the National Standards for Public Health Specialists - a specific work role equivalent to the work of Public Health Medical Consultants 2. The standards for the practice of public health cover the same ten areas as those for the specialists but are often in greater depth signifying the expertise that practitioners have in specific areas of work. Public health specialists draw on the expertise and commitment of practitioners in public health and integrate their work across the whole spectrum of public health to take forward the health improvement of the population. The petals of the flower indicate that some individuals have jobs that combine aspects of improving the health of the public with other areas of work. For example, a health visitor might have a large proportion of their work covered by these standards plus a smaller proportion linked to direct healthcare activities. A physiotherapist might have most of their work focused on direct healthcare activities with a smaller proportion related to public health. A public health information specialist might practise for all of their working day in public health (covered by the shaded area). What is important is that if each of these individuals is undertaking the same functions they are working to the same quality benchmarks this is what these standards are intended to supply. 2 Specialist practice in public health is used to describe the work of those individuals who are independently accountable and work at a level currently comparable to consultants in public health medicine and dental public health. 09

03 What do the standards for the practice of public health look like? How are the national occupational standards structured? All of the standards in each of the ten areas are structured in the same way. The component parts of the standards describe different things. There are currently 65 different national occupational standards, formed into units, which make up the overall framework for public health 3. Each of the units that make up the national occupational standards is formed from between two and five elements. Each element has a number of performance criteria and a statement of scope/coverage attached to it. It is these detailed aspects that form the national occupational standards themselves. In addition each unit has descriptions of the knowledge, understanding and skills that individuals need to apply to meet the standards. On the CD-Rom that accompanies this publication these descriptions are shown in tables for each of the ten areas of public health. They show the knowledge, understanding and skills that are applicable to all of the standards in that one area and that which is applicable to only one or a few of the standards. This is to help education and training providers design learning programmes and packages for those who work, or wish to work, in public health. An example of the structure of a national occupational standard together with its description of knowledge and understanding is given in Appendix A. What is included in the national occupational standards for public health? The table that follows provides an overview of the different standards you will find in each of the ten areas. 3 Please 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. 10

03 Area 01 Surveillance and assessment of the population s health and Unit numbers and titles 01.01 Collect and form data and information about health and and/or stressors to health and Element numbers and titles 01.01.1 Collect data and information about health and and/or stressors to health and 01.01.2 Form data and information about health and and/or stressors to health and for later analysis 01.02 Obtain and link data and information about health and and/or stressors to health and 01.03 Analyse and interpret data and information about health and and/or stressors to health and 01.04 Communicate and disseminate data and information about health and and/or stressors to health and 01.02.1 Obtain data and information about health and and/or stressors to health and 01.02.2 Link data and information about health and and/or stressors to health and 01.03.1 Analyse data and information about health and and/or stressors to health and 01.03.2 Interpret data and information about health and and/or stressors to health and 01.04.1 Draft and structure communications about health and and/or stressors to health and 01.04.2 Finalise and disseminate communications about health and and/or stressors to health and 01.05 Facilitate others collection, analysis, interpretation, communication and use of data and information about health and and/or stressors to health and 01.05.1 Advise others on data and information related to health and and/or stressors to health and and its uses 01.05.2 Enable others to develop and apply their knowledge and skills in relation to data and information about health and and/or stressors to health and 01.06 Collect, structure and analyse data on the health and and related needs for a defined population 01.06.1 Collect and link data and information about the health and and related needs of a defined population 01.06.2 Analyse and interpret data and information about the health and and related needs of a defined population 01.06.03 Communicate data and information about the health and and related needs of a defined population 01.00 Undertake surveillance and assessment of the population s health and 01.00.1 Manage, analyse, interpret and communicate information, knowledge and statistics about health and 01.00.2 Manage, analyse, interpret and communicate information, knowledge and statistics about needs and outcomes of health and 11

03 Area 02 Promoting and protecting the population s health and Unit numbers and titles 02.01 Communicate with individuals, groups and communities about promoting their health and 02.02 Encourage behavioural change in people and agencies to promote health and Element numbers and titles 02.01.1 Provide information to individuals, groups and communities about promoting health and 02.01.2 Enable individuals, groups and communities to develop their knowledge and skills about promoting health and 02.02.1 Encourage people and agencies to see the need to change their behaviour to improve health and 02.02.2 Enable people and agencies to sustain their behaviour change 02.02.3 Work with people and agencies to evaluate the effectiveness of their behaviour change 02.03 Work in partnership with others to promote health and and reduce risks within settings 02.03.1 Work in partnership with others to assess risks to health and in settings 02.03.2 Work in partnership with others to improve settings so that they promote health and 02.03.3 Work in partnership with others to evaluate settings following improvements 02.04 Work in partnership with others to prevent the onset of adverse effects on health and in populations 02.05 Work in partnership with others to contact, assess and support individuals in populations who are at risk from identified hazards to health and 02.06 Work in partnership with others to protect the public s health and from specific risks 02.04.1 Identify and contact people in the population who are in need of primary preventive interventions 02.04.2 Support people in the population during the process of primary preventive interventions 02.05.1 Trace and establish contact with individuals who are at risk, or place others at risk, from hazards to health and 02.05.2 Assist individuals to participate in secondary preventive interventions 02.06.1 Work in partnership with others to plan investigations to protect the public s health and from specific risks 02.06.2 Work in partnership with others to identify how to apply plans to protect the public s health and from specific risks 02.06.3 Undertake own role in a partnership to protect the public s health and from specific risks 02.00 Promote and protect the population s health and 02.00.1 Plan, implement, monitor and evaluate strategies for promoting the health and of the population 02.00.2 Plan, implement, monitor and evaluate disease prevention and screening programmes to improve the population s health and 02.00.3 Plan, implement, monitor and evaluate strategies for protecting the health and of the population 12

03 Area 03 Developing quality and risk management within an evaluative culture Unit numbers and titles 03.01 Develop one s own knowledge and practice Element numbers and titles 03.01.1 Reflect on and evaluate one s own values, priorities, interests and effectiveness 03.01.2 Synthesise new knowledge into the development of one s own practice 03.02 Contribute to the development of the knowledge and practice of others 03.02.1 Enable others to solve problems and tackle issues arising in practice 03.02.2 Enable others to learn and benefit from one s experience 03.03 Support and challenge workers on specific aspects of their 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 of teams 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 at work 03.05.1 Improve work activities 03.05.2 Recommend improvements to plans 03.00 Develop quality and risk management within an evaluative culture 03.00.1 Assess risks to the population s health and and apply this to practice 03.00.2 Assess the evidence and impact of health and healthcare interventions, programmes and services and apply the assessments to practice 03.00.3 Improve the quality of health and healthcare interventions and services through audit and evaluation 13

03 Area 04 Collaborative working for health and Unit numbers and titles 04.01 Build relationships within and with communities and organisations 04.02 Develop, sustain and evaluate collaborative work with others Element numbers and titles 04.01.1 Develop contacts within and with communities 04.01.2 Negotiate the purpose and basis for community development opportunities 04.01.3 Initiate joint working relationships within and with communities 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 own agency at other agencies meetings 04.04 Work in partnership with communities to improve their health and 04.03.1 Obtain information from other agencies meetings 04.03.2 Make contributions to other agencies meetings 04.04.1 Work in partnership with communities to assess health and and related needs 04.04.2 Work in partnership with communities to plan how to improve health and 04.04.3 Work in partnership with communities to implement policies, strategies, services, programmes and interventions to improve health and 04.04.4 Work in partnership with communities to evaluate policies, strategies, services, programmes and interventions to improve health and 04.05 Enable the views of groups and communities to be heard through advocating on their behalf 04.05.1 Establish with groups and communities their interests, concerns and priorities 04.05.2 Act on behalf of groups and communities when they are not able to represent 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 to advocacy 04.06 Provide information and advice to the media about health and and related issues 04.00 Improve health and through working collaboratively 04.06.1 Advise the media about specific issues relating to health and 04.06.2 Respond to requests for information from the media 04.00.1 Develop and sustain cross-sectoral collaborative working for health and 04.00.2 Advise others on health and, related issues and their impact 04.00.3 Communicate effectively with the public and others about improving the health and of the population 14

03 Area 05 Developing health programmes and services and reducing inequalities Unit numbers and titles 05.01 Work in partnership with others to plan, implement and review programmes and projects to improve health and Element numbers and titles 05.01.1 Work in partnership with others to plan programmes and projects to improve health and 05.01.2 Work in partnership with others to implement programmes and projects to improve health and 05.01.3 Work in partnership with others to evaluate programmes and projects to improve health and 05.02 Manage change in organisational 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 skills and roles within community groups/networks 05.03.1 Assist community groups/networks to define their needs for people and skills 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 and secure sources of funding 05.04.1 Determine and assess potential sources of funding 05.04.2 Negotiate and secure sources of funding 05.00 Develop health programmes and services and reduce inequalities 05.00.1 Enable inequalities in health and to be reduced through planning and targeting services and programmes 05.00.2 Plan, implement, monitor and evaluate programmes, services and interventions to address health and needs 15

03 Area 06 Policy and strategy development and implementation to improve health and Unit numbers and titles 06.01 Work in partnership with others to plan, implement, monitor and review strategies to improve health and Element numbers and titles 06.01.1 Work in partnership with others to develop and agree priorities and targets for improving health and 06.01.2 Work in partnership with others to plan how to put strategies for improving health and into effect 06.01.3 Work in partnership with others to implement strategies for improving health and 06.01.4 Work in partnership with others to monitor and review strategies for improving health and 06.02 Work in partnership with others to assess the impact of policies and strategies on health and 06.02.1 Work in partnership with others to make a preliminary assessment of the impact of policies and strategies on health and 06.02.2 Work in partnership with others to undertake a full assessment of the impact of policies and strategies on health and 06.03 Work in partnership with others to develop policies to improve health and 06.03.1 Advise how health improvement can be promoted in policy development 06.03.2 Contribute to the formulation of policy specifically focused on improving health and 06.03.3 Evaluate and review the effects of policies on health improvement 06.04 Appraise policies and recommend changes to improve health and 06.04.1 Monitor trends and developments in policies for their impact on health and 06.04.2 Present information and arguments to others on how policies affect health and 06.04.3 Evaluate and recommend changes to policies to improve health and 06.00 Improve health and through policy and strategy development and implementation 06.00.1 Shape and influence the development of policies to improve health and and reduce inequalities 06.00.2 Implement strategies for putting policies to improve health and into effect 06.00.3 Assess the impact of policies on health and 16

03 Area 07 Working with and for communities to improve health and Unit numbers and titles 07.01 Facilitate the development of people and learning in communities 07.02 Create opportunities for learning from practice and experience 07.03 Support communities to plan and take collective action Element numbers and titles 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 develop opportunities for learning in partnership 07.02.1 Promote opportunities for learning from practice and experience 07.02.2 Facilitate opportunities for learning from practice and experience 07.03.1 Support communities to identify aims and objectives for collective action 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 the development of community groups/networks 07.05 Enable people to address issues related to health and 07.04.1 Support community groups/networks to identify and review strengths and 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 07.05.1 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 and concerns 07.05.4 Support people in evaluating their actions and learning from their experience 07.06 Enable people to improve others health and 07.06.1 Negotiate and agree with people how they may enable other individuals to improve their health and 07.06.2 Enable people to improve the health and of others 07.06.3 Enable people to review the effectiveness of their work with others 07.07 Work with individuals and others to minimise the effects of specific health conditions 07.00 Improve health and through working with and for communities 07.07.1 Provide initial support to individuals who have been identified with a specific condition 07.07.2 Provide further support to individuals with a specific condition to enable them to minimise its effects and complications 07.00.1 Involve communities as active partners in all aspects of improving health and 07.00.2 Empower communities to improve their own health and 07.00.3 Enable communities to develop their capacity to advocate for health and 17

03 Area 08 Strategic leadership for health and Unit numbers and titles 08.01 Use leadership skills to improve health and Element numbers and titles 08.01.1 Sustain and share a vision of improving health and 08.01.2 Lead others in improving health and 08.02 Promote the value of, and need for, health and 08.02.1 Create and capitalise upon opportunities to advocate the need for improving health and 08.02.2 Advocate the improvement of health and 08.03 Lead the work of teams and individuals to achieve objectives 08.03.1 Plan the work of teams and individuals 08.03.2 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 through presentations 08.05.1 Give presentations to groups 08.05.2 Produce follow-up exercises 08.06 Evaluate and improve learning and development programmes 08.06.1 Choose how to evaluate programmes 08.06.2 Analyse information to improve learning and development programmes 08.06.3 Make improvements to learning and development programmes 08.00 Strategically lead the improvement of health and and the reduction of inequalities 08.00.1 Develop, sustain and implement a vision and objectives for improving health and 08.00.2 Lead teams and individuals to improve health and 08.00.3 Develop capacity and capability to improve health and 18

03 Area 09 Research and development to improve health and Unit numbers and titles 09.01 Plan, undertake, evaluate and disseminate research and development about improving health and Element numbers and titles 09.01.1 Plan research and development about improving health and 09.01.2 Research and develop the improvement of health and 09.01.3 Evaluate and disseminate research and development about improving health and 09.02 Develop and maintain a strategic overview of developments in knowledge and practice 09.02.1 Collate and appraise developments in knowledge and practice 09.02.2 Identify areas of knowledge and practice that need further development 09.02.3 Coordinate the dissemination of information about developments in knowledge and practice 09.03 Develop, implement and evaluate strategies to advance knowledge and practice 09.03.1 Prioritise areas for research and development activity to advance knowledge and practice 09.03.2 Plan how needs for research and development activity should be addressed 09.04 Commission, monitor and evaluate projects to advance knowledge and practice 09.04.1 Commission projects to advance knowledge and practice 09.04.2 Monitor and evaluate the process and progress of projects against targets 09.04.3 Support project staff to enable them to achieve objectives 09.05 Contribute to the evaluation and implementation of research and development outcomes 09.05.1 Contribute to decision making about the potential value of research and development outcomes 09.05.2 Contribute to planning the implementation of research and development outcomes 09.05.3 Facilitate the implementation of research and development outcomes 09.05.4 Contribute to the evaluation and review of implementing research and development outcomes 09.00 Improve health and through research and development 09.00.1 Appraise, plan and manage research related to improving health and 09.00.2 Interpret research findings and implement them in practice 19

03 Area 10 Ethically managing self, people and resources to improve health and Unit numbers and titles 10.01 Promote people s equality, diversity and rights Element numbers and titles 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 own work and the focus of activities 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 and issues 10.03 Manage the use of financial resources 10.03.1 Make recommendations for expenditure 10.03.2 Control expenditure against budgets 10.04 Monitor and review progress with learners 10.04.1 Review progress with learners 10.05 Facilitate individual learning and development through mentoring 10.05.1 the learning and development needs of individuals 10.05.2 Plan with individuals how learning and development needs will be addressed 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 learning through coaching 10.06.1 Coach individual learners 10.06.2 Help individual learners to apply their learning 10.00 Ethically manage self, people and resources to improve health and 10.00.1 Manage the development and direction of work 10.00.2 Manage services that are aimed at improving health and 20

How can the national occupational standards be applied? 04 The national occupational standards have been developed generically across all the different ways in which the health of the population might be improved. This means that they do not contain specific standards for different aspects of health improvement, such as smoking cessation, dieting, physical activity etc. Neither do the standards distinguish the role or jobs of specific groups of practitioners. Rather the national occupational standards can be applied to different forms of practice. For example, they can be used as follows. 1. To identify the specialist contributions that different agencies or practitioners make to the improving the health of the public. The different areas are likely to be helpful in this regard. For example Public health information specialists will have much of their work captured in area 1 surveillance and assessment of the population s health and. The work of the Health Protection Agency in England and the practitioners within it are likely to be focused on area 2 relating to promotion and protection. Health Improvement Officers in Scottish local authorities have as a major focus collaborative working which is in area 4. 2. To identify the competences needed when a topic approach is taken such as smoking cessation, breastfeeding, drugs and alcohol here a thin slice right across the framework is needed concentrating on that one particular topic. 3. To identify the starting point / particular approach taken in areas of improving the health of the public. For example Some SureStart schemes have the specific focus of community development (area 7) and promotion and protecting health and (area 2), and then later become more actively engaged in policy development (area 6) 4. 4. To identify the different contributions that agencies and practitioners make to improve the health of the public and the interaction and dependencies between them. These contributions might be multi-agency (e.g. NHS and local authorities); or different types of agency within the same sector. For example One LHCC in Scotland identified that they were responsible for collecting some routine health data and might choose to collect more through specific projects (e.g. lifestyle). The LHCC was very dependent on receiving good quality data from the Health Board on other areas as they were on information from the local authority. All of this information was used in strategic decision-making about health improvement, the delivery of services etc. However the discussion highlighted concerns about the quality of data collected in the LHCC itself and also used from elsewhere, and the impact of this on decision-making within the LHCC. This led onto identifying a workforce need for that particular organisation. For example A breastfeeding scheme in Scotland used the framework of the standards to identify the different roles they had within their team and identify any gaps in their skills. 4 SureStart 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. 21

05 How can the national occupational standards for the practice of public health be used? Who will use the national occupational standards? These national occupational standards are designed as a resource for organisations and individuals to use to improve their capacity and capability. As the standards have been developed across the UK, they provide a common reference point or language of good practice. The standards are a source of information to help people: link health improvement to partnership, organisational and team delivery design and plan the development, deployment and appraisal of the workforce identify good practice in specific areas of work recognise their current good practice and identify areas for improvement. These national occupational standards can help to establish the link between broad organisational/partnership aims and objectives and what individuals need to be able to achieve. They can be used for organisational and individual management and development and for the design of education and training and related qualifications. What are the benefits of these national occupational standards? Respondents to the consultation on the draft version of these national occupational standards identified a number of benefits see below. How do these national occupational standards relate to other competences/frameworks? These national occupational standards have the support of the four Government Health Departments and a number of professional and regulatory bodies. However these are also one of a number of competences in existence and it can be confusing as to how all of the different developments fit together. The NHS Knowledge and Skills Framework Under the Agenda for Change NHS Pay Modernisation initiative, an NHS Knowledge and Skills Framework (NHS KSF) has been developed to form the basis of career and pay progression in the service across the UK. The NHS KSF will be implemented through a development review process where there is a commitment from management and staff sides that all staff will have an annual review of their development against the KSF, a personal development plan, support to learn and develop, and an evaluation of that learning and development. The NHS KSF is a broad generic framework which applies to all staff across the NHS. While the national occupational standards for the practice of public health are themselves fairly broad, they are much more detailed than the NHS KSF. The NHS KSF will show how more detailed UK/national quality assured standards and competences, such as the national occupational standards for the practice of public health, relate to the broad generic NHS KSF. This will mean that 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 roles necessary 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. 22

05 users can move readily between the broad NHS KSF and the more detailed standards and competences produced for different areas, such as the practice of public health. Skills for Health is working in partnership with the Agenda for Change development group who are responsible for the NHS KSF to ensure alignment between the generic KSF and the more detailed statements of competence within national occupational standards. Other national occupational standards and care group competences As the UK Sector Skills Council for the health sector, Skills for Health are actively engaged in taking forward the development of national occupational standards and other national competences (e.g. competences to support the delivery of the National Service Framework for Coronary Heart Disease). Individuals and organisations that wish to use national occupational standards can either focus their work on one set of standards (such as the practice of public health standards) or draw from a range of different standards and competences. As the national occupational standards are developed through different projects, the various project teams make sure that there is as little duplication as possible and that all of the different standards and competences fit well together. This means, for example, that a Drug and Alcohol service with a health improvement remit could draw from the standards that have been developed specifically for drug and alcohol work as well as the standards for the practice of public health to identify an overall framework of standards for its work. Skills for Health is working at a strategic level to produce an overall map of standards across the whole of the health sector showing how all the different standards and competences that it produces fit together. The UK Voluntary Register for Specialist Practice in Public Health A UK Voluntary Register has been established by a Joint Register Board comprising the Faculty of Public Health, the Royal Institute of Public Health and the Multidisciplinary Public Health Forum. The voluntary register is based on the specialist standards for public health and the Faculty of Public Health s Record of In-Training and Assessment (RITA) and informed by the Faculty s Part I and Part II examinations. The specialist standards were developed by the Tripartite Group (the three organisations detailed above) and Healthwork UK (the predecessor organisation to Skills for Health). The voluntary register applies nationally recognised standards to accredit and regulate qualified public health specialists. The voluntary register is applicable to individuals who have worked at senior level for three or more years and have had several years in a leadership role within public health. The register was developed to provide confidence to the public as posts (which at one time were held by public health medical consultants) were opened up to individuals from a variety of backgrounds. There are two means of admission to the register; one is by examination and accredited training; the other is by portfolio. As described earlier, there is a close relationship between the specialist standards for public health and the national occupational standards for the practice of public health as they both use the same ten areas of practice. However the voluntary register is intended for those working, or seeking to work, at a senior and strategic level in public health this means it is only applicable to the specific group of staff who work at that level. What are the different uses of the standards? The standards can be used in a number of ways and these are outlined below. The uses to which people wish to put the national occupational standards will affect the level of detail that they need to work with. 23