Public Health England – failed organisation or scapegoat? CHSS Director comments

Following Health Secretary Matt Hancock’s announcement  (18 August 2020) that Public Health England (PHE) will be replaced with a new National Institute for Health Protection, Professor Stephen Peckham of the Centre for Health Services Studies (CHSS) says:

‘Since the beginning of July there has been speculation that Public Health would be abolished due to its failure to manage the COVID-19 pandemic. Stories of abandoning Track and Trace in March, a lack of testing, overstating daily deaths and poor leadership have been laid at Public Health England’s (PHE) door by newspapers and politicians. Now Matt Hancock has announced its abolition and the establishment of a new National Institute for Health Protection bringing together the current NHS Test and Trace Programme – which was outsourced to private providers – and PHE’s pandemic response work.

‘The new organisation – apparently modelled on the independent Robert Koch Institute – is to be in place in September 2020. There will be further organisational changes but these will not be finalised until 2021. While there has been much criticism of PHE it is not clear that a major reorganisation in the midst of a public health emergency is either sensible or desirable. While there have clearly been failings in dealing with the pandemic, making PHE take the blame may be missing the point.

‘There has long been criticism of the highly centralised structure of PHE and its lack of collaboration with and support for local authorities. However, PHE fulfils a huge range of roles. While national media attention has been focused on areas such as obesity, PHE’s work in many other areas is significantly important for protecting health. For example, on air quality PHE has provided critical guidance and planning for other central government departments and local authorities.

‘Given PHE was the key national agency for combatting the pandemic, it is plausible that blame for failings can be laid at their door. However, PHE was not, and is not, solely responsible for the pandemic response. Planning and developing responses to the pandemic has been coordinated through SAGE which has advised ministers on potential public health actions. Responses have also been guided by political considerations about when to lockdown, when to impose quarantine, and when to open up sectors of the economy. In his speech today at the think tank Policy Exchange, the Secretary of State acknowledged that while we have some of the best public health services and staff in the world, ‘we did not go into this crisis with the capacity for a response to a once-in-a-century scale event.’ Perhaps the actual problem though is that for many years the Government has been reducing budgets for PHE and local authority public health services and limiting their capacity.

‘So while PHE has been blamed for stopping testing and tracing in March – one of the key reasons for this was that there were insufficient resources to continue, given the rapidly increasing number of COVID-19 cases. The lack of resources and a desire to lead and control everything centrally has severely hindered the ability of our public health system to respond to the pandemic. The new NHS Test and Trace service is a national service provided by a range of private companies including SERCO, SODEXO and Deloitte, and appears to have largely failed to engage with local public health departments. It was contracted to private providers and has proved to be inefficient and failing to provide the level of tracing needed. One of the key problems is that the Government has tried to do everything centrally when what was needed was a close collaboration with local public health services leaving many local authorities trying to plug gaps in the system.

‘Failings in the public health response can just as easily be laid at politicians’ doors for not adequately funding or preparing for a pandemic which has been predicted for many years and those advising nationally. Whether disbanding PHE mid pandemic and replacing it with yet another centrally run organisation that is embedded in the private sector is questionable, and yet again appears to ignore the potential of more locally based services. We are also left not knowing what will happen to the remainder of PHE services – if other areas of public health now suffer because the Government wants to show it is taking action to solve the ‘shortcomings’ of PHE.’

HEEKSS/NIHR Integrated Clinical Academic Programme – Bridging Scheme 2020-21

Health Education England Kent, Surrey and Sussex (HEEKSS)/NIHR Integrated Clinical Academic Programme – Bridging Scheme 2020-21

CHSS will continue as a provider for the Health Education England Kent Surrey Sussex (HEEKSS)/National Institute for Health Research (NIHR) Integrated Clinical Academic Programme (ICAP) Bridging Scheme 2020-2021.

Funding has been awarded to the Centre to enable up to two successful pre or post-doctoral awardees to receive a bespoke learning and research development programme. HEEKSS will award funding to support backfill cost, academic supervision, and reasonable expenses.

Available to Nurses, Midwives, and Non-Medical Applied Health Professionals, the ICAP Bridging schemes are a way of providing support to clinical academics to build on their previous academic training and develop proposals for a pre or post-doctoral award, and take the next step on their clinical academic pathway.

Aims of the Bridging Scheme are to:

  • Enable awardees to develop skills in higher-level reflection in relation to research based upon their discipline.
  • Provide academic supervision and facilitate clinical mentorship to awardees to undertake research that builds upon a culture of critical evaluation and enquiry in relation to their services setting.
  • Develop opportunity for self-directed research and reflection.
  • Immerse pre-doctoral awardees into a research environment and enable them to develop an independent piece of research in preparation for a PhD application
  • Consolidate post-doctoral awardees academic training and development whilst supporting them in balancing their clinical service, and assisting them with developing an application for the Clinical Lectureship or Senior Clinical Lectureship

More information:
To discuss the programme email Dr. Julie MacInnes: j.d.macinnes@kent.ac.uk

Closing date for applications: 

Email Application forms and supporting documents to Programme Lead Dr. Julie MacInnes by 5pm, Friday 18 September 2020

UoK FAQ PRE-DOCTORAL 2020
UoK_Application form ICAP Pre-Doc Bridging Programme 2020
UoK FAQ POST-DOCTORAL 2020
UoK_Application form ICAP Post-Doc Bridging Programme 2020

More info on ICAP programme pathway on  Health Education England website
More info on ICAP Bridging Programme on Health Education England website

CHSS welcomes applications for (HEEKSS)/NIHR Integrated Clinical Academic Programme 2020/21

Health Education England Kent, Surrey and Sussex (HEEKSS)/NIHR Integrated Clinical Academic Programme Internships 2020-2021

CHSS will continue as a provider for the Health Education England Kent Surrey Sussex (HEEKSS)/National Institute for Health Research (NIHR) Integrated Clinical Academic Programme (ICAP) 2020-21

Funding has been awarded to the Centre to enable up to eleven successful interns to receive a bespoke learning and development programme. HEEKSS will award funding to support backfill cost, tuition fees and reasonable expenses. 

Available to Nurses, Midwives, and Non-Medical Applied Health Professionals, the ICAP is intended to develop practitioners confidence to apply their newly learned skills within their employing Trusts, become research champions and prepare applicants to apply for a NIHR Pre-doctoral Clinical Academic Fellowship, and in the long-term apply for Clinical Doctoral Research Fellowship, Clinical Lectureship or Senior Clinical Lectureship.

The internship scheme will:

  • Develop research and research capabilities throughout all levels of the NHS and Social Care in order to enhance and diffuse evidence based practice
  • Provide the opportunity to develop a network of clinical academics so that learning, best practice and innovation can be shared and disseminated
  • Support the development of clinical skills as well as research skills
  • Encourage research into areas related to HEE’s Mandate or to education and training as a whole
  • Offer an insight into a career in clinical academia and provide experience which would support applications for further formal research training.

More information:
To discuss the programme and request the University of Kent Application Form 2020-21
email Dr Julie MacInnes: j.d.macinnes@kent.ac.uk

Closing date for applications:
apply online and upload all supporting documentation to University of Kent by:
5pm, Friday 18 September 2020

Guidance for applicants: UoK FAQ ICAP 2020-21

UoK Application form ICAP 2020021

 

More information on the ICA programme on Health Education England website: https://hee.nhs.uk/our-work/clinical-academic-careers/integrated-clinical-academic-ica-programme

More information on internships on Health Education England website: https://hee.nhs.uk/our-work/clinical-academic-careers/research-internships

COVID-19 and Social Care – CHSS expert comments

CHSS Research Associate Dr Rasa Mikelyte has recently featured on KMTV commenting on Coronavirus and UK Social Care.

COVID-19: Why have UK care home residents been so badly affected?  29/6/20

Rasa talks about the ‘devastating but not surprising’ statistics around Coronavirus in UK care homes. She gives her views on why they compare so badly to other European countries, and what might have been done differently to avoid such a high death toll.

Watch the KMTV video 

Inadequate Government support ‘from the start’ for UK Care Homes:  7/7/20

Rasa asserts that inadequate support from Government and espeically a policy of Care Homes having to take in COVID positive patients from hospital, led to the dire situation witnessed in social care.

Watch the KMTV video

 

 

CHSS Newsletter Summer 2020

The Summer 2020 CHSS Newsletter is out now. This issue, written over the lockdown period, features latest CHSS research and news, including a look at the many varied media stories that the Centre team have been involved in shaping. Senior Clinical Research Fellow Lindsay Forbes who has been a frequent expert commentator on Coronavirus; is spotlighted in our regular ‘CHSS People‘ slot on page 6.

New project topics include community volunteering and evaluating virtual consultations for patients accessing NHS mental health interventions. Both are exploring what works best to deliver optimum outcomes.

Our cover is given over to COVID-19, and how CHSS has been adapting to our ‘new normal’.

You can subscribe to future issues by email. Our online archive is also available.

We always welcome feedback, suggestions or comments. Contact h.mcgregor@kent.ac.uk

 

Dr Lindsay Forbes on Kent’s COVID distribution

CHSS Senior Clinical Research Fellow (Public Health) Specialist Dr Lindsay Forbes offers expert comment on why there is a concentration of COVID-19 cases around Ashford, named as one of the country’s virus ‘hotspots’.

in a recent feature in Kent Online, Lindsay offers insight on underlying factors behind the data which may help to explain differences in rates across particular areas of Kent. As of 12 June, there were 858 recorded cases of COVID-19 in the area, with an infection rate of 663.7 per 100,000 people.

Lindsay is researching this very relevant and interesting picture. She said: ‘we’re working with Kent County Council to try to understand this better. The key thing is I don’t think there’s any evidence to support the idea that it’s about hospitals having different testing behaviours. What is more likely to explain it, we think, is something different about the populations of these places, the work they do, how they travel, where they live.

‘Ashford, for example, has more people in key worker occupations, who have had to carry on going out to work, than Tunbridge Wells. It is much easier to keep your distance from others if you are working at home or are furloughed. Or it may be that a higher proportion of the population commutes to London. The good news for Ashford is that it does not have strikingly high death rates. In Kent, Dartford has been hit worst in terms of deaths, which may be to do with population density. Also more people in Dartford belong to Black and Asian ethnic groups, who are at higher risk of dying of COVID-19 than White people.’

Read the full article 

Welcome Dr Natalia Gusak

CHSS welcomes Dr Natalia Gusak to the Centre until August from the National University of Kyiv-Mohyla Academy, Ukraine, funded by the Global Challenges Doctoral Centre. Natalia is Head of the School of Social Work Department. Her postdoctoral appointment will see her work with Professor Sally Kendall and Dr Olena Nizalova on the collaborative study exploring factors affecting mental health and wellbeing of mothers and infants in Ukraine, and evaluating the potential of Primary Health Care to play a role in its improvement.

The project will produce evidence on mental health among pregnant women and mothers in the 1001 days from conception to two years – a critical time in child brain development and physical, social and emotional well-being. Evidence shows that adverse childhood experiences like deprivation, neglect, substance misuse, maternal mental health problems and abuse – can negatively affect this period.

The project focuses on three main areas; antenatal care, pre- and post-partum maternal mental health, and breastfeeding. Some data exists on antenatal care and breastfeeding in Ukraine, but the maternal mental health picture is less clear. However, indirect evidence suggests a dire situation with a combination of existing factors which are likely to lead to high burden of maternal mental health problems.

The scoping study will explore existing mental health service provision for mothers: awareness, experience, use and satisfaction with quality, and test online research instruments around maternal mental health in the Ukraine setting.

The team will use the data to develop a Global Challenges Research Fund (GCRF) research agenda on maternal and infant health in post-Soviet countries, and to prepare for a wider future study.

 

CHSS Health and Social Care PhD Opportunities

These five 3-year full-time (5 years part-time) PhD scholarships are supported by the NIHR Applied Research Collaboration Kent, Surrey and Sussex. ARC KSS aims to develop applied health and social care research across the region for the benefit of patients and the public.

We are keen to invite applications from potential PhD applicants to undertake health and social care research, with interests in any of the ARC KSS research themes, commencing in October 2020:

  • Social care: person-centred, community based social care
  • Starting Well: Early detection and Intervention of Mental Health Problems in Children and Young People
  • Primary and Community Health Services: Sustainable and integrated care focusing on people with chronic conditions and marginalised groups
  • Dementia: Living Well with Dementia
  • Co-production: Involving and working with patients and the public to produce relevant research
  • Public Health: Improving health and reducing need among older patients with multiple conditions and younger people at time of transition
  • Digital Innovation: Harnessing digital technology to help create a sustainable health and social care system
  • Health and Social Care Economics: using best practice to efficiently fund health and social care services of benefit to patients.

Funding Notes

The studentship will cover tuition fees at the standard postgraduate home/EU rate (£4,407 per year) plus an annual maintenance stipend per annum £15,285 (2020-2021 rate). In addition, there is an annual Research Training Support allowance of £750 to cover conference attendance, training courses, equipment and books.

Closing date: 5 June 2020

Further information on the SSPSSR website and FindaPhD.

COVID-19: CHSS in the media

As UK Coronavirus cases have increased over the past week, CHSS Senior Clinical Research Fellow (Public Health) Specialist Dr Lindsay Forbes has given numerous tv and radio interviews.

On 12 March she talked to Fred Dinenage on ITV Meridian news on likely impacts for those of us who rely on the NHS.

She also appeared on BBC south east news and

BBC Radio Kent ‘wake up call’ [01h:14 – 1h:18]

Read Lindsay’s expert comments on the Coronavirus here

Find out more about her CHSS research on our staff webpages: