[applause]
>> Ms Sonya Scott Thanks very much. Thanks, Michele. And thanks
to the organisers for the invitation. Can everybody hear me okay? If I just maybe push
that over.
I'm absolutely delighted to be here today. I don't often get the chance to participate
in this sort of thing, and I'm really interested in professions other than medicine. I was
told today I should say, coming from a medical background, I'm not necessarily familiar with
all of that terminology. But from my perspective, multidisciplinary working is obviously absolutely
key. And I sometimes consider myself more of a non-medic than a medic.
So I was asked to present today because I had been involved in co-ordinating a series
of exploratory workshops which came out of the Public Health Review report. Public health
intelligence was clearly a strong theme in the Public Health Review. And on the back
of a number of issues that were identified, Health Scotland was asked to explore those
further and how we might respond to them. And a short life working group was set up
to co-ordinate some participatory events, to consider our current strengths, areas for development,
and how we might take those forward.
So in this presentation, I'm going to say a wee bit about that process and focus in
on the workforce-related findings and recommendations. And then say a little bit about how I think
the framework might be useful in taking forward those recommendations.
So an age-old public health intelligence, I'll start with the definition. This is the
Faculty of Public Health's definition of public health intelligence, and it was the one that
was used in the Public Health Review, and that that we stuck to in undertaking the series
of workshops.
Those who know me, and you'll see from my bio, I have a particular interest in public
health intelligence, not as an end in itself. I remember starting as a public health registrar
and thinking, a bit despondently, is a core function just describing what's happening
and not actually saying, so what, and taking it forward. And sometimes I think we can get
stuck into that loop of description. Having said that, description's obviously really
important, and persistence around description can have great impact, as evidenced by our
war on tobacco control. But I'm interested in taking knowledge into action. And I think
particularly at a local level, that's our key role.
I would want to stress here that I have a very broad conception of data. It's not just
about frequencies or counting things, it's about qualitative data as well, obviously,
but it's about a structured approach to evidence, taking that evidence to the table, understanding
need, and then monitoring the impact of anything we might do to meet it, particularly as it
relates to reducing inequalities.
So the participatory process in terms of public health intelligence in Scotland. There were
three facilitated face to face workshops across the central belt, and two additional videoconferences
with colleagues in remote and rural parts of Scotland. We managed to reach a really
broad audience through this. So it was a pretty robust consultation process, I feel. There
were 143 stakeholders in all that took part. And all of the territorial boards were represented,
all of the national boards, and we had some health and social care partnerships, the third
sector, and others. So it was wide and beyond the core workforce as well.
Each workshop focused on a series of questions; current strengths; areas for development;
how we might take those forward. And following the events, a very quick and dirty thematic
analysis of outputs of the events was undertaken, and a final report was written up. There was
a series of recommendations across public health intelligence, knowledge into action,
and so forth, but I'm going to focus in specifically on the workforce-related recommendations.
Some of this is about the review report itself and some of it relates to the subsequent participatory
process. But in summary, the key findings are that there are a small proportion of our
core public health workforce in dedicated technical roles. The vast majority of these
sit in our national organisations. Formally, accredited specialists comprise a very small
proportion of the overall workforce. And coming out of the events, it seemed to be there was
real variability in the technical knowledge and skills amongst core staff, particularly
at local levels. And we wanted to unpick this further and think how we might respond to
it.
So in terms of recommendations, we thought, first of all, we needed to be clear about
articulating the levels of knowledge and skills required for delivering effective public health
intelligence. And then, perhaps naively, we thought it might be helpful to audit then
what is happening in the various relevant organisations. We don't underestimate how
challenging that might be, particularly just now when there's a lot of change, people may
be reluctant to disclose their hand, to use a colleague's turn of phrase. But if we think
creatively about how we do that and it's done in a supportive way, I think it's quite important,
not least perhaps to show gaps and to highlight where capacity does need to be increased.
And that might allow us, once we have undertaken that audit, to identify training needs, and
then take action to meet them.
So how can the framework help with this? Well, it's absolutely ideal. It provides the functional
areas. And area one, as Claire has shown us, is technical. Statements within those functions
identify clearly the sort of tasks that were needing to be carried out. It's a reference
for standards of practice and it's an automatic benchmark against which we can audit. We need
to do a bit more thinking about how that's achieved, whether we take specific roles,
as Claire has already done in some areas, and say which technical sub-functions we would
be expecting of those roles, and then audit availability of those roles in our various
relevant organisations. Or whether we take the sub-functions themselves and take a sample
of individuals, and see who's able to meet or who's currently undertaking that work.
So I've pulled out just some of the functional areas or functions, rather, and sub-functions
that I think were particularly low in the ground in certain areas. This is really around
the surveillance and analysis. The second sub-function that I've included here is about
that knowledge into action, I think. And then there's something about predicting future
intelligence needs.
A4 for me is really about knowledge into action. As I say, I think at a local level, this is
a particular role. But in order to be able to undertake that knowledge into action process,
sit with key decision makers, make sense of what the intelligence means for them in their
local area, we have to be able to interpret it really well, perhaps even undertake some
of the analysis ourselves. So A1 definitely underpins our ability to undertake A4.
And finally, we've got that evaluation of services. Once we've been able to understand
need, are we able to monitor the impact that Andrew had referred to earlier. It's really
important that we're evidencing our impact, particularly just now in terms of scarcity.
So to summarise. The framework has already undertaken for us action one that we were
hoping to achieve. It's articulated the levels of knowledge and skills required by both creators
and translators of public health intelligence. And right now, I'm interested in its use for
the core workforce, not necessarily going to the wider workforce as yet. It will allow
us hopefully to undertake an audit and see where we might have gaps around this technical
set of sub-functions, and then to identify and hopefully meet workforce needs.
The public health intelligence work has morphed into the shared services portfolio of work,
and it's now a work stream. Health intelligence has been identified as something that perhaps
could be undertaken across organisational boundaries or better co-ordinated at least
across organisational boundaries. And the next meeting or the first meeting of that
work stream will happen next week.
We do hope that we will be able to undertake this audit, and from that audit then profile
where we are in terms of some of these technical sub-functions in Scotland. And from that,
we can make recommendations to increase capacity, if that is required.
Thanks very much. I hope that's been helpful. [applause]
>> Ms Michele McCoy Sonya, thank you very much.