Introduction to Public Health

Module details

Title

Introduction to Public Health

Type

Rotation

Module code

SBI200

Credits

10

Requirement

Compulsory

Aim of this module

The aim of this rotation is to introduce trainees to the principles and practice of public health and the public health system in the UK. All trainees must successfully complete the national Information Governance training modules with a score of more than 80%. The role of public health organisations is to promote and protect health and wellbeing, prevent ill health and reduce health inequalities. This module will provide the trainee with an introduction to the principles and practice of public health and the public health system in the UK. Trainees will be expected to apply their knowledge and develop their skills in applied epidemiology using routine data within a public health organisation.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1	Competency Apply information governance principles and best practice in the workplace.	Action View
# 2	Learning outcome 1	Competency Pass a recognised Information Governance training module.	Action View
# 3	Learning outcome 2	Competency Identify data needed to answer a public health question.	Action View
# 4	Learning outcome 2	Competency Identify relevant population health data sources.	Action View
# 5	Learning outcome 2	Competency Assess the quality of data within the data source.	Action View
# 6	Learning outcome 3	Competency Identify appropriate indicators of disease and estimate the burden of disease.	Action View
# 7	Learning outcome 3	Competency Describe the data and identify an appropriate comparator.	Action View
# 8	Learning outcome 3	Competency Assess the significance of the data.	Action View
# 9	Learning outcome 3	Competency Identify the intended audience for the output of the analysis and interpretation of the data.	Action View
# 10	Learning outcome 3	Competency Prepare a report detailing the findings; defend your conclusions and recommendations.	Action View

Assessments

You must complete:

• 1 case-based discussion(s)
• 1 of the following DOPS/ OCEs:

Learning outcomes

1. Successfully complete a recognised Information Governance training module.
2. Access health data from at least one of: a routine data source (e.g. Hospital Episode Statistics), a surveillance system; or a registration database to answer a public health question.
3. Use routine numerator and denominator data to calculate a public health measure of disease burden/frequency, interpret the significance of these data to patient and public health, and present a report on the findings for a specific audience.

Learning outcomes

1. Define the key concepts of public health.
2. Define the role of the UK public health function to protect and improve the patient’s and public health.
3. Describe the historical and legal context of public health.
4. Describe the key components of public health systems.
5. Describe and evaluate the key sources of routine health data.
6. Discuss the application and evaluate the limitations of the different clinical coding systems in use and how they influence patient safety and patient care.
7. Describe the importance of high-quality coded clinical data in communication and using it to improve patient and population care and outcomes/
8. Describe basic population indicators and cite the methods used to estimate the burden of disease to inform planning of public service ensuring patient safety and care.
9. Define wider determinants of health and health inequalities and their impact on patient care, patient safety and health outcomes.

Indicative content

• Define the key concepts of public health
  • Individual versus population health
  • Domains of public health
  • Determinants of health
  • Health promotion
  • Communicable versus non-communicable diseases, underlying causes and public health responses
  • Principles of screening
  • Criteria for screening programmes (e.g. Wilson Junger criteria)
  • Measures for evaluating screening tests
  • Sensitivity
  • Specificity
  • Positive predictive value (PPV)
  • Negative predictive value (NPV)
  • Public health ethics; rationing, value for money
  • Assessment of risk and risk management
• Define the role of the UK public health function to protect and improve the nation’s health
  • National public health organisations (e.g. Public Health England, Public Health Wales)
  • Surveillance and investigation of health problems and hazards in the community
  • Prepare for and respond to public health emergencies
  • Develop and apply policies that improve health and ensure safety
  • Lead efforts to mobilise communities around important health issues
  • Advocate for effective health services
  • Achieve excellence in public health practice through a trained workforce, evaluation, and evidence-based programmes
  • Public health ethics
  • Structure and function of health and social care services in the UK
• Define the historical and legal context of public health
  • Prominent events in history
  • Historical developments in public health legislation
  • Current legal framework for delivering public health
  • Current legislation applicable to the work of applied epidemiologists
• Describe the key components of public health systems
  • Contributions of different institutions, sectors and professions
  • Interface between clinical, community and public health
  • Organisation and delivery of public health in England and the wider UK
• Describe and evaluate the key sources of routine healthcare data
  • National census (resident populations)
  • GP practice populations (registered populations)
  • Catchment populations
  • Indices of Multiple Deprivation and other measures of deprivation
  • Numerators and denominators
  • Vital statistics and the birth and deaths registration process
  • Birth and mortality files
  • The role of the Office for National Statistics (ONS) and the Health and Social Care Information Centre (HSCIC)
  • Hospital Episode Statistics (HES)
  • Sources of primary care data (e.g. Quality and Outcomes Framework [QOF], research databases)
  • Key developments such as care data
  • Disease surveillance (e.g. Notifications of infectious diseases [NOIDs], British Paediatric Surveillance Unit [BPSU], cancer registries)
  • Determinant surveillance (e.g. Chemical incident surveillance, COVER [vaccine coverage], National Child Measurement Programme)
• Discuss the application and evaluate the limitations of the different clinical coding systems in use
  • Terminologies vs classifications
  • Coding systems – nature, clinical applications, limitations
  • International Classification of Diseases (ICD)
  • NHS Dictionary of Medicines and Devices, Office of Population Census and Surveys (OPCS) Classification of Interventions and Procedures, Read Coded Clinical Terms, Systematised Nomenclature of Medical Terms (SNOMED CT)
• Describe the importance of high-quality coded clinical data in communication and using it to improve patient and population outcomes
  • Coding quality issues and risks
  • Coding and patient accessible information
  • Coding for management – importance of coded data for supporting business workflows, payment and administration (e.g. Quality and Outcomes)
• Describe basic population indicators and cite the methods used to estimate the burden of disease to inform planning of public services
  • Birth and mortality rates
  • Infant mortality
  • Fertility rate
  • Life expectancy
  • Disability-adjusted life year (DALY)
• Define wider determinants of health and health inequalities and their impact on patient safety, patient care and health outcomes
  • Dahlgren and Whitehead’s model of the social determinants of health
  • National Institute for Health and Care Excellence (NICE) guidance on health inequality
  • Equity vs equality
  • Role of local authorities in addressing inequalities
  • Types of inequalities (e.g. geographical, population group)
  • Measures of inequality
  • Measuring health outcomes

Activities

• Visit a unit that provides routine healthcare data: discuss the sources of data and the challenges of producing high-quality data with staff working in the organisation, critically reflecting on your experience. For example, acute hospital trusts, British Paediatric Surveillance Unit (BPSU), cancer registries, National Child Measurement Programme, National Drug Treatment and Monitoring Service (NDTMS).