Welcome to the latest issue of the UKPHA’s newsletter Report.

Before the UKPHA Forum in Telford becomes a distant memory, we are looking back at some of the highlights of the event. Having been closely involved in the planning of the event, I am amazed at the amount of work put into the Forum by the core staff of UKPHA. Bearing in mind there are only 3 full time staff based at the head office their efforts, and the work by our conference organisers Benchmark, has been tremendous. As outgoing chair of the Conference Steering Group, I’d just like to thank them all once again for all their hard work in pulling together what was a wonderful event.

The fact that so many people attended the Forum given the growing uncertainties in the NHS is a testament to the regard with which the Forum is held. A new financial year brings even more uncertainty for the NHS, with job losses, financial cutbacks and PCT mergers. The pressure on Public Health resources is ever increasing. When Dr Catherine Woodward from Telford PCT challenged Patricia Hewitt at the Telford Forum about the need to protect money set aside for Public Health schemes, the issue was sidestepped. Sadly, Dr Woodward’s fears seem to be becoming reality around many parts of the country as Public Health money is diverted to plug gaps in the acute sector.

It is perhaps timely then to hear Lucy de Groot, Executive Director of the Improvement and Development Agency, say in her speech recently that ‘We are entering a new era of local government’s involvement in public health.’ Perhaps the time has come to really take forward Public Health in a multidisciplinary and multi agency way. There are already many examples of public health initiatives working across the traditional boundaries, but perhaps it is time the funding reflected this. Are we moving toward a system where the NHS has two separately financed branches – a sickness service to look after those who are ill and a health service to promote health for all? Could organisations be given the flexibility to pool resources across different organisations to provide multidisciplinary Public Health services without the fear of the funding being pulled at the first sign of a crisis elsewhere in the system? There certainly seems to be hope.

The need for partnership working and collaboration has never been greater. The resources are scarce, but the enthusiasm and resourcefulness of those working in Public Health has never been stronger. The Forum showcased so many examples of this multidisciplinary working and will continue to do so.

The need to promote and encourage multidisciplinary working in Public Health is increasing. The UKPHA is the only multidisciplinary Public Health organisation in the UK, offering those involved in Public Health from any agency the opportunity to exchange ideas and to help shape future policies.

I hope this issue of Report will encourage and inspire you.

Andrew Lavelle
UKPHA Trustee, West Midlands

It was most interesting accompanying Patricia Hewitt on the platform at the Opening Plenary of the 14th Annual Public Health Forum. Her presentation and the wide range and diversity of questioning received from our delegates threw into stark relief the dilemma which confronts public health in the 21st Century.

What happens to the NHS does not, of course, determine the entire fate of public health policy but it still matters since, rightly or wrongly, the NHS retains the lead role for public health. Our aims as an Association go far beyond the travails of the NHS but at the same time many of our members work for or with the NHS and therefore what happens to it has a direct impact on them.

Public health has been in the ascendant over the past 18 months or so following the public health white paper and its accompanying delivery plan, and as a result of the white paper, Our health, Our care, Our say, which appeared earlier this year. It placed considerable stress on keeping people well and on creating services that genuinely focused on prevention and promoting health and wellbeing.

The paradox is that, despite its position at the centre of health policy, all the evidence suggests that public health is once again being marginalised as the ‘crisis’ befalling acute health care budgets and services preoccupies policy-makers. It may be that the purification underway to purge the NHS of inefficient practices and hospitals it no longer needs will result in a system that truly seeks to give a high priority to public health. But the stakes are high and the risk must be that the manner in which the changes are being applied will in fact merely buy time by making financial savings to balance the books without fundamentally changing the system. In short, the quick fix will prevail over the acknowledged need for long-term reconfiguration. History will repeat itself all over again and the loser will be public health.

What is happening was never envisaged by Derek Wanless, the government’s adviser whose two influential reports in 2002 and 2004 respectively have charted the direction for government policy. Indeed, he is on public record expressing concern that the welcome commitment to public health evident in recent policy now appears to count for little.

The marriage between the NHS and public health has been an uneasy one since 1974 when community health services were removed from local government and located in the NHS. One partner has clearly been dominant from the outset and has made few if any concessions to the other. Domestic violence is often threatened although those in public health are for the most part too decent and keen to avoid conflict.

Maybe it is time to change tactics. For decades, public health has waited patiently to be taken seriously. Just at the moment it is being listened to, it finds itself only months later having to defend its position and fight not only for the new resources that were promised in the public health white paper but to maintain the limited investment in services which currently exists. It is a bizarre situation even by this government’s standards.

Either public health matters or it does not. If it does, as the government appears to believe, then it is essential that the wherewithal to make it effective is available for this purpose. Otherwise, we are witnessing another example of symbolic policy-making where what matters is the gesture rather than the substance. It is time the public health community made its voice heard. Enough is enough and the present stop-go approach to policy is no guarantee that the upstream focus of policy will ever be achieved. We have a once in a generation opportunity to promote the public’s health. We should not allow the opportunity to be removed without making our concern felt.

David J Hunter
Chair
UKPHA

The Annual Public Health Forum is developing a unique character which not only encourages the showcasing and sharing of leading-edge practice, but also challenges delegates to question and explore the critical issues of the day.

Over two days 83 papers were presented within 28 parallel sessions, and 24 workshops were held, all focusing upon the progress being made across all sectors in improving the public's health.

                                        

Throughout the Forum Fiona Adshead and her staff from the Department of Health championed Sustainable Development, working with UKPHA staff, membership and key partners to thrust home the importance of addressing the social, economic and environmental determinants of good health.

The Natural and Built Environment sessions and workshops which ran through both days of the Forum attracted very large numbers of delegates from across a wide breadth of experience. This is a very significant development as it demonstrates a growing understanding of the major contribution that the environmental and societal infrastructures make to health. Obesity, CHD and mental ill health are now being seen as an outcome of degraded environments where outdoor activity and healthy eating are effectively ruled out for vast swathes of society.

The concurrent debates introduced for the first time in Gateshead 2005 were a major feature again this year. The Great Olympic Debate, chaired by Sue Atkinson (Regional Director of Public Health, London, and Health Advisor to the Mayor and Greater London Authority), attracted a very large group of participants arguing forcibly for using this unique opportunity for rolling out the benefits of London 2012 to reach the parts that other cities and countries have so signally failed to reach – the disempowered and marginalised who sometimes cannot even access the crumbs from the table.

The UKPHA SIGs triumphed with three concurrent debates offered by the Food, Environmental Pollution and Pharmacy SIGs. The debates were all highly popular and stimulated exciting discussions that will be taken forwards by the respective SIGs over the coming year. The sessions have been summarised in the Grassroots article later in this Report.

              

Running alongside and integrated with all of this high-powered activity, the Forum featured activities and presentations focusing delegates’ thoughts and attention on the role that the Arts have to play in creating good health. The physical and mental activity involved in the very natural enjoyment of dance and movement offer ways of socialising and engagement that are light years removed from the ethos of the gym or the prescription pad. We were very fortunate to receive funding from the Arts Council to support this work, which featured the now famous 'Recharge Zone', the Mood Cards and the amazing Blue Eyed Soul aerial dance.

As all who attended know, there were tandem bike rides to be enjoyed in the lunch breaks and health walks in the famous Telford Park. And as with Gateshead 2005, delegates were offered Offsite workshops through our Grass Roots Activity Stream and delegates were given the opportunity to explore a range of topics including sustainable community design, school meals/catering, community development through lifelong learning/health, green exercise and community smoking cessation services for hard to reach populations.

And I cannot conclude without referring to the Opening Plenary which featured the Secretary of State for Health, Patricia Hewitt. The SoS received a far more courteous and considered response from our 600 assembled delegates than she experienced at later events (!) and answered a wide range of very challenging questions. We were particularly encouraged to hear the Secretary of State’s undertaking that the Department of Health will be making strenuous efforts to ensure that the transitional boards of strategic health authorities recognise the need for the allocation and protection of appropriate levels of funding for public health. And bearing in the mind the Forum’s focus upon sustainable development we were also very glad to hear that all future plans for the NHS will involve contributing social, economic and environmental value to the communities which it serves.

They say that a week is a long time in politics and it certainly is in the complex area of public health policy which wavers and loops with each new prevailing wind blowing from Westminster and beyond. Who can imagine what might happen in a year? Well one thing you can be certain of is that the UKPHA 15th Annual Public Health Forum will be taking place in Edinburgh and will as ever be generating the winds of change that will guide the public health movement through the 21st Century! The Call for Papers will be with you very soon and we know we can rely upon you to feed in all that leading-edge thinking and action which is the mark of the public health community in the UK!

Angela Mawle
UKPHA Chief Executive

Not only did Rosy Glover coordinate and mange the whole of the Arts programme at the Forum, but she was also the artistic genius behind the colourful and enigmatic mood cards that delegates found mysteriously placed around the conference centre. Rosy has described the response to these cards elsewhere in Report and it is interesting to see the variety of reactions that they elicited. Here at the UKPHA offices we have developed quite a habit of selecting our ‘card of the day’ and reflecting on what it might be telling us! We are indebted to Rosy for her dedication and hard work before, during and after the conference. She is a true crusader for integrating the arts into public health practice and it was a great pleasure to work with her. Thank you Rosy!

Photo of Rosy

Article written by Angela Mawle
UKPHA Chief Executive

The Arts and Health elements at the Telford Conference inserted creativity into the delegate experience in order to give people a taste of what it is like to be on the receiving end of an Arts and Health project. Over the two days, twelve artists creatively stimulated discussion about Arts and Health, but more importantly, got delegates exploring the concept of movement in a variety of ways.

Delegates had the opportunity to be suspended from the ceiling by ropes and harnesses, sampling the freedom of movement in aerial dance with Blue Eyed Soul Dance Company. Some delegate comments were:

“Flying is FAB”

“Opportunity to do aerial flying = great!”

“I watched your performance this afternoon (Tuesday) with fascination. The conversion from choreographed movement to free expression was not seamless but deliberate and expressed as excitement, fear, hope! I enjoyed watching this process, and appreciated your clear enjoyment of the movement. Thank you for your skill and timing.”

Delegates also keenly acted out their favourite physical activities to ‘physical activity spotters’ while browsing the exhibition stands. Actors from Round Midnight showed delegates that creativity doesn’t have to be project based, it can be intervention based. An intervention can often encourage you to do something you wouldn’t normally have done. In this case it got people moving a bit more actively when they were meandering around the stands. Rosy Glover, Arts Manager at the conference said:

“there were horse riders galloping around the foyer, yoga postures in the exhibition hall and swimmers crawling over lunch.”

Almost everyone received a massage from either their fellow delegates or from artists in the creatively designed Recharge Area.

“Loved the relaxation and massage too.”

“Hand massage= a very much appreciated intervention.”

“Recharge area was truly inspired.”

“I learned more from the hand masseur about the conference than from anything or anyone else.”

A widely talked about arts intervention was ‘I feel...’. There were 25 different postcard designs speckled around the International Centre for people to pick up –again an interventionist approach. Originally designed to provide creative solutions to the way that delegates were feeling and as an evaluation tool at the conference, they were actually used by delegates in a variety of ways. Some delegates picked up a postcard in the hope that it would make them feel the sensation written on the front, others picked them up if they identified with the feeling on the card, or if they were drawn in by curiosity. For some it formed the basis of many a conversation. Others saw ways in which they could adapt the idea for use in their own work practice. Many people really wanted to collect the whole set of cards…which meant walking all over the Centre to look for them –probably the most physically demanding activity at the conference! Here are some comments made:

“I’m going to use this postcard idea in my work with young mothers”

“I’ve collected 8 postcards so far, is there a fast track way of finding all 25?”

“Postcards; great. They provoked a discussion about choice/the nanny state”

“Post-cards an absolute inspiration.”

“they make people think and engage”

“Postcards were a little light in what sometimes felt like a dark tunnel. Thanks!”

Out of 8200 postcards produced, the most picked up card at the conference was the one that said inspired. The card that was picked up least was happy. A more detailed breakdown is below.

          

This intervention was successful in that it encouraged discussion, encouraged people to self-diagnose, gave ideas and got people moving. It also provided organisers with an insight into the experience of the delegates.

The Voice of the Public Health Movement:
Building the UKPHA from the Grassroots Upwards

The UKPHA is founded on meaningful membership involvement both at the Annual Public Health Forums and beyond. As a membership organisation and focal point for bringing together individuals and organisations from all sectors who share a common commitment to promoting the public’s health, this is an integral part of the organisation’s work. With this philosophy, the Grassroots Project has continued to focus strongly on promoting meaningful communication with, and support of, UKPHA members.

The Special Interest Groups (SIGs) have continued to develop and we are now working with five groups looking at: devolution; environmental pollution; food; health visiting; and pharmacy. The groups are continuing to meet or teleconference regularly and each is developing a work plan with activities ranging from networking/educational meetings and debates to the production of policy or research documents for publication and dissemination.

The SIGs have recently undergone a review with substantial input from members, and this will guide how the UKPHA manages the groups’ activities over the coming year as well as feeding into the strategic development of the UKPHA as a whole. Initial results of the review have demonstrated the wide-ranging successes of the groups in terms of policy development initiatives, networking meetings and events as well as highlighting the unique character and emphasis that each one has developed. We would like to thank everyone who has contributed their views to the review process; results will be fed back to the SIGs in the near future.

Grassroots Activities at the 14th Annual Public Health Forum

Devolution SIG Workshop

The Devolution SIG organised a workshop to present the first draft of a paper comparing public health in the countries of the United Kingdom and Republic of Ireland. The workshop was facilitated to engage those present in discussions to highlight common themes across the countries and to identify priority questions and topics for the SIG over the coming twelve months. Three specific priorities were selected: language and vocabulary; work with other SIGs; and building a directory of expertise between the UKPHA and IPHA.

Environmental Pollutants SIG

The EP SIG hosted an interactive concurrent debate that considered social justice and environmental pollution. The debate was kick-started by introductory speeches by Professor Virginia Murray (HPA), Anthony Parsons (EA) and Colin Pritchard (Bournemouth University) and highlighted a number of key areas for the SIG’s work over the coming twelve months including Strategic Environmental Assessments (SEAs), the need for local and strategic partnerships, and Climate Change.

Food SIG

The SIG hosted a debate titled ‘Food Choice: Whose Choice is it?’ and brought together representatives from the farming community, consumers and conference delegates to debate ‘who chooses and who loses’.

Pharmacy SIG

This group hosted a debate about the changing role of the pharmacist and whether or not the profession was over-reaching itself. The debate was chaired by Mala Rao (DH) and featured contributions by Jill Jesson (Aston University/MEL Research) and Andrew Scott-Clarke (Swale PCT).

Off-site visits

The 14th Annual Public Health Forum saw six off-site visits to a range of locations near the Telford International Centre.

Delegates were given the opportunity to visit projects looking at: training and single-site community services (Donnington Wood Lifelong Learning Centre); health promotion and wider services (Community Health and Enterprise Centre, Madeley); Smoking Cessation (Community Help2Quit); green exercise (BTCV Green Gym); cashless school food systems (Deansfield High School/Wolverhampton 5-a-day) and sustainable community design (Lightmoor Village Development).

            

Future Grassroots Activities

The results of the SIG review will be used to strengthen and enhance the Grassroots project over the coming twelve months and we can expect to see the SIGs develop concrete workplans and contribute strongly to the evolution of public health practice and policy both within the UKPHA and beyond.

We will be supporting grassroots input to the 15th Annual Public Health Forum in Edinburgh both before and at the event and would welcome any comments or suggestions that UKPHA members have. We are always keen to hear from members. If you have any suggestions or queries about the Grassroots please do not hesitate to contact me on 020 7269 7962 or email kate@ukpha.org.uk. I look forward to working with you all in the future and hope to see many of you in Edinburgh if not before.

Kate Harvey
UKPHA Grassroots Project Co-ordinator

Sustainable development is one of the three priorities of UKPHA. The Natural and Built Environment Strategic Interest Group (StIG), established in the summer of 2005, is therefore of fundamental importance in carrying forward UKPHA’s mission.

Its membership represents the breadth and depth of the Sustainable Development community, including a number of national environmental organisations who have been outstanding in their commitment.

The main focus of the StIG’s work over the last few months has been supporting the natural and built environment theme at this year’s UKPHA Annual Forum in Telford, which was very popular and successful. Led by Marcus Grant from the University of the West of England, we introduced an expanded model of the Dahlgren and Whitehead diagram of determinants of health, to include explicitly the built and natural environments and the global ecosystem, which we hope will be a useful tool.

                                   

The Forum provided much food for thought. For me, the strongest practical message was the importance of health organisations and local authority planning departments getting together. Effective spatial planning for new developments can ensure the design of healthy, sustainable communities. Public health people need to become really involved with planning processes.

The StIG is now drawing up its forward work programme. We are considering, for example, meetings with Ministers and with Department of Health colleagues, drafting guidance on health and spatial planning, how we can support the mainstreaming of environmental sustainability within public health, how we can support regional initiatives, partnership with others in the planning of a day conference specifically on sustainability and health, and looking forward to the next UKPHA Annual Forum in Edinburgh in March 2007. As mentioned elsewhere in Report, UKPHA Scotland has been very active on this agenda.

We look forward to sustaining the momentum with you all.

Jenny Griffiths
UKPHA Trustee, South Eastern Region

UKPHA – Yorkshire and the Humber Region

At the inaugural meeting of the Yorkshire and Humber region, held in April, a Steering Group was identified. This group then met on 22nd May and elected Pam Ashton as Chair and Megan Patterson as Treasurer. It has planned to organise three meetings a year and members will be asked whether they would prefer an afternoon meeting or one which started late afternoon extending into early evening. It is hoped to have the first meeting in October on the theme of the health of local communities.

John Beal
UKPHA Trustee, Yorkshire & Humber Region

UKPHA - Scotland

It has been a busy few months for the UKPHA in Scotland.

Nathalie Holmerin, our development worker, has been continuing to work hard to develop links with other organisations in public health. She is planning an event for the autumn, focusing on smoking cessation and mental health and wellbeing.

Our AGM was held in the Lighthouse in Glasgow on the 30th of May. The formal business of the AGM was preceded by an open meeting with a number of speakers on the theme of Sustainable Development. As in previous years there was much lively discussion.

It is very exciting that the 2007 Forum is to be held in Edinburgh (27th to 29th March). The planning process is well under way through a national steering group. There is also a local group, one of whose roles will be to help to ensure that the conference reflects its Scottish location. For example, we will be looking for a range of projects that can be involved in the popular off site visits. This group is now meeting regularly, and if anyone is interested in the work that it is undertaking, or has feedback to offer on this year’s conference, please get in touch with Nathalie or Margaret.

Margaret Black
UKPHA Trustee for Scotland

South West

As your South West Council member, I have remained active in the work of the Council, contributing to policy documents, reviewing abstracts for the Annual Health Forum, recruiting and welcoming members at the UKPHA conference stall, responding to emails from grassroots members, etc. I am very aware that we do not have an active regional group in the South West, and that the geographical size of the region makes meeting up difficult. I would therefore like to develop more e-networking across the region. I’m also very keen to hear members’ ideas of how we can better support you, network, ideas for events, etc. Please contact me with any ideas, questions or comments at David9.Evans@uwe.ac.uk. I look forward to hearing from you.

David Evans
UKPHA Trustee, South West Region

North West

The AGM of the NW council was held on March 21st 2006. A decision to dissolve the formal status of the NW council was taken at this meeting as the funds held by the council are now audited by the UKPHA nationally and it was thought that a more flexible approach to meetings may encourage more participation from members. It was decided therefore to replace the council and constitution by a steering group with agreed terms of reference.

A meeting of the new steering group met following the AGM and Neil Turner was elected chair for the year 2006/7. Guy Harkin agreed to be the treasurer with Jane Spratley remaining as the NW representative on the national council.

Maureen Shorter continues to represent the NWUKPHA on the Economic and Social Partners Group of the Regional Assembly. We hope that this will put us in a strong influencing position, particularly with regard to strategic planning for transport, housing and sustainable development.

On April the 24th at the NW Public Health conference, the inaugural NW Public Health Awards ceremony was held. The awards have been set up to promote excellence and innovation in public health development across the NW.

We are pleased to say that the Regional Director of Public Health, Professor John Ashton CBE, presented one of his special awards to Jane Spratley who has chaired the NW council for a number of years. She was delighted to receive the award and in a brief thank you speech recognised the strong encouragement and support that Professor Ashton has given the UKPHA and in particular the NW council over the years.

West Midlands

The main focus over the last few months in the West Midlands has been around the Forum, both in its planning and post-forum evaluation. Work on the Forum helped put members of the UKPHA in the region in touch with each other and the challenge now is to consolidate these links.

Could I ask all UKPHA members in the West Midlands to give Fiona, the database administrator at the London office, their email address. If we have a current email address for you then you can benefit from regular email updates of UKPHA activities. In addition, we can take forward discussions within our Region on key topics.

There is an enormous amount of Public Health expertise within the West Midlands and with the ever-increasing importance of multi-disciplinary working, a strong network will be vital. Developments such as the Local Area Agreements offer an opportunity for putting multi-disciplinary Public Health at the heart of future policy developments and the UKPHA West Midlands should be looking to take this forward and to share experiences.

Andrew Lavelle
UKPHA Trustee, West Midlands

It is with the greatest sadness that we have to report the death of Dr Michael Varnam, a Trustee of UKPHA and a champion of public health. Michael died on the evening of Saturday 29 April, having been unwell since January. Michael dedicated his life to redressing all of the imbalances that exist in the world, particularly in his day-to-day work with patients and communities in Nottingham who struggled against the severest of disadvantage and inequalities.

When he joined the UKPHA as a Trustee, he did so with a great passion and commitment to bring public health to the forefront of the Government’s agenda. He was particularly determined that the UKPHA should argue forcibly for action to reduce health inequalities, and felt that as a membership organisation we should use our strength and pooled expertise to influence both national and international policy.

Yet with all of his deep compassion and fervour for social justice Michael was never one of those hair-shirters who constantly lament the wicked ways of the world. He loved this world and humanity as a whole and exalted in every aspect of his involvement with it.

At the funeral service in Nottingham on the 13th of May the church was literally packed. Every pew, aisle doorway, nook and cranny was filled to bursting and often the church rang with laughter as his family and friends recounted tales of Michael’s escapades, irrepressible sense of humour and his unique take on life.

His kindness, sincerity and enduring commitment will certainly remain with me as an example of how to ‘fight the good fight’ without becoming cynical or disenchanted. He leaves an enduring legacy to all who knew and worked with him and to the local and national institutions that he served. It is indeed such a loss at so many levels and our thoughts are with his wife Helen, and their family who have so big a gap to fill.

Angela Mawle

Contact Details

The UKPHA prides itself on its large membership base – after all, as ‘the voice of the public health movement’, members are the very reason for our existence. It is therefore vital that we hold up-to-date details for all our members so that we can contact you easily. If you change postal or email address, telephone numbers, or if the named contact for your organisational membership changes, please do let us know. You can do this via the ‘change of details’ form on our website, www.ukpha.org.uk , or by calling Fiona on 020 7269 7964 or emailing admin@ukpha.org.uk. Do feel free to get in touch just to check that we’re holding the correct details on our database.

Payment Systems

We’d also like to ask for your help in streamlining our payment systems. More than 250 members currently pay us by standing order, and many of these standing orders are for the wrong amounts! Since a standing order is an instruction which you set up with your bank, we’re unable to do anything about it. So we are trying to phase out standing order payments and replace them by direct debits, which are a much more efficient means of paying. They are all centrally controlled by our bank and you have the advantage of being covered by the direct debit guarantee which ensures that if any problems ever arise, you will be refunded automatically.

We would ask those of you who currently pay by standing order to please help us switch to this simpler system by:

    1. contacting your bank to cancel your standing order
    2. checking which payment category you now fall into (see below)
    3. filling in a direct debit mandate form, signing it, and sending it to us.

We will then create a direct debit to pay us in the same month that your old standing order used to be paid, so you will have full continuity of membership.

We will be writing to all of our members who currently pay by standing order within the next few weeks to ask for your co-operation in making this change. We’ll send you the direct debit form with this letter, but if you want to make the change sooner you can download a form from our website. If you’re an existing member changing from a standing order to a direct debit please make a note of this on your form and if possible, tell us your membership number to help us locate your records.

If you’ve already switched by the time you receive your letter, thank you for your co-operation and please accept our apologies.

N.B. Many people are confused about the difference between standing orders and direct debits. If you are at all unsure, please ask your bank for an explanation or call Fiona who can explain the difference to you. Please don’t get the two mixed up and cancel direct debits by mistake!

New membership fees

Our membership fee categories and amounts have altered slightly in recent months. As always we have tried to keep them realistic and fair –you will see that while fees in some categories have gone up, others have remained the same or even gone down. Current amounts are as follows:

Individual membership fees (per year)