1. What is Public Health Intelligence? Public Health Intelligence training course day 1 Liz Rolfe Knowledge & Intelligence Team (South West)

2. What is Public Health Intelligence? What is public health intelligence? Data, information, intelligence hierarchy Who does public health intelligence work? Knowledge and skills for public health intelligence work Public health intelligence as a career The effective public health analyst 2What is Public Health Intelligence?

3. Assessing, measuring and describing health and wellbeing, as well as health risks, health needs and health outcomes of different populations. Analysts are responsible for the collation, management, analysis, synthesis, interpretation and dissemination of data and information from a wide range of primary and secondary health, social, economic and demographic data sources. This supports the planning and development of more accessible, sensitive and responsive health services and public health initiatives to meet the needs of the local population, including making contributions to health needs assessment, health equity audit, health impact assessment, research and evaluation projects and the annual public health report. Public health intelligence may also include the production of performance indicator data related to public health. Taken from the Public Health online resource for careers, skills and training: http://www.phorcast.org.uk/page.php?page_id=36 3What is Public Health Intelligence?

4. is about... population health... and also about services covers the 3 domains of public health: health protection, health improvement, health and social care quality is usually based on analysis of existing data but can also involve new data collection data sources are usually quantitative but can also be qualitative often draws on multiple sources including research literature 4What is Public Health Intelligence?

5. 5 detective? Illumination? Assembly?

6. Data, information, intelligence hierarchy “Public health without information is like pathology without a laboratory” Michael Goldacre 6What is Public Health Intelligence?

7. Data, information, intelligence hierarchy 7What is Public Health Intelligence? Data... is raw. It simply exists and has no meaning in itself. Information... is data that has been processed in some way to make it (potentially) useful to somebody. Intelligence... is the appropriate, tailored collection and interpretation of information so as to be useful to a customer

8. Data, information, intelligence hierarchy 8What is Public Health Intelligence? Dr. John Snow’s map of cholera in London (1854)

9. Exercise 9What is Public Health Intelligence? Is it Public Health Data/Information?

10. Exercise 10What is Public Health Intelligence? A Social Model of Health (Dahlgren & Whitehead, 1991)

11. The ideal world of data linkage? 11What is Public Health Intelligence? Link all records of health, education, social services housing etc throughout life How do you feel about this? What are our responsibilities as epidemiologists?

12. The ideal world of data linkage? 12What is Public Health Intelligence?

13. Local health survey comments 13What is Public Health Intelligence? “Every problem I have can be traced directly back to work” Man, aged 34 “The area is very poor. It is not very safe to leave your home unattended. There isn’t much social life in this area for families” Man, aged 35, disadvantaged area “I feel a lot more pressure is on people these days. Although myself and partner earn a reasonable wage we still find money tight. If we have an argument it is always about money.” Woman, aged 26 “It is unsafe around here for young children due to crime and vandalism. There is usually glass on play areas and on the streets. I’ve found dirty needles on play parks.” Woman, aged 28, disadvantaged area “I don’t have time to exercise much. My weight has risen. I smoke more. I worry about my heart.” Woman, aged 31, disadvantaged area “This area is a good place for small children - plenty of open space and parks. But nothing for children from the age of 11-16 who only roam the streets” Man, aged 31

14. Why do we need public health information? 14What is Public Health Intelligence? Surveillance Forecasting/predicting Setting and monitoring health improvement targets Benchmarking - seeing how we compare with elsewhere “Needs assessments” o what are the health problems in our area? o where are these health problems worst? o what services are available and how good are they (quality)? o where is there unmet need or overcapacity? Planning interventions o where shall we concentrate our resources? o what capacity will be required? Evaluating interventions o did we make a difference?

15. Why do we need public health information? 15What is Public Health Intelligence? To colour local discussion and debate For advocacy Planning and resource allocation Indicators of change Performance monitoring and management Creation of targets

16. Questions PHI can help answer 16What is Public Health Intelligence? How many teenagers smoke in my local area and how can we, as a school, have an impact on this? What are the main health problems for materially deprived communities in my town? What is happening to rates of sexually transmitted diseases in my area, compared with the national average and what should we as a LA be doing about it? How big a problem is alcohol-related domestic violence in this area and which localities need most help? How effectively have new vaccines been introduced in this region and which communities need additional attention to improve coverage? Is specialist health care being provided equitably in this region? What are the health care needs of ethnic minorities in inner city areas? Where in this town should a new mental health clinic be sited to maximise its impact?

17. Who does public health intelligence work? 17What is Public Health Intelligence? PH specialists – whose broad training in public health includes working with PH information PH analysts - specialising in analysing, interpreting, presenting PH data Local Authority Public Health England/NHS England International organisations private companies and consultancies Other analysts/knowledge managers/researchers other analytical/intelligence staff in the LA librarians local authorities CCG/CSU ONS/HSCIC

18. LA example 18What is Public Health Intelligence? The Health Intelligence and Research Team consists of a health intelligence specialist and two researchers with quantitative and qualitative research skills. The Team supports the health inequalities agenda across the City and provides all those working in this field with advice and support in relation to the provision, analysis, interpretation and use of health-related information. Key Tasks 1.To support the work of the City Council, including the production and development of a Health and Well-being Strategy and Implementation Plan as part of the Manchester Community Strategy. 2.To develop targets and indicators for monitoring local activities and strategies around health improvement and health inequalities reduction. 3.To provide information, support and advice to key agencies around the extraction, use and interpretation of public health data sources. 4.To provide advice and guidance on research design and methods, including project planning, data collection, analysis, evaluation and report writing. 5.To support Health Inequalities Impact Assessment (HIIA) activities across the City. 6.To improve the capacity and understanding of individuals and agencies around the use of public health information and the planning and implementation of research projects. 7.To ensure a local input into regional and national developments in public health information, intelligence and research. 8.Where possible, to provide a reliable and timely response to ad-hoc requests.

19. 19What is Public Health Intelligence? Local Health Economy Community development Regeneration Food Immunisation Communicable disease Health promotion Access to health services Child health surveillance Welfare advice Emergency planning Crime & Disorder Screening NHS Local Government Community Sector Empowerment Build social networks Support services Build social capital Environmental improvement Employment National and international economic policy Welfare policy Pollution and environmental change Regulatory & legislative frameworks Housing Urban planning Transport Leisure Education Environmental health Trade policy Agricultural policy Support services With thanks to: Neil Bendel, Health Intelligence Manager, Manchester Joint Health Unit

20. PHE South West KIT roles 20What is Public Health Intelligence? National products, such as Public Health Outcomes Framework, Local Authority Health Profiles, Local Health National lead areas products and tools. SW lead areas: sexual health, injuries, liver disease, skin cancer, urological cancer End of Life Care Intelligence Network sits within the SW KIT. Provide a local K&I service alongside the PHE Centres to meet local public health needs Produce local K&I outputs in response to local public health needs Responsive ad hoc enquiry service Support to local users of national PHE K&I products and services Feed up local issues to steer improvements in national products Provide training and professional development support to local public health intelligence staff

21. Knowledge and skills for public health intelligence work 21What is Public Health Intelligence? The Public Health Skills and Careers Framework Identifies skill sets needed by those working in public health including a skill set specific to public health intelligence A “skills escalator” for those working up through levels of competence to achieve practitioner, advanced practitioner and defined specialist registration with the UK Public Health Register hthttp://www.sph.nhs.uk/sph-files/PHSkills- CareerFramework_Launchdoc_April08.pdf

22. Knowledge and skills for public health intelligence work 22What is Public Health Intelligence?

23. PHI Skills and Knowledge at Level 5 of Public Health Skills and Careers Framework 23What is Public Health Intelligence? Skills 1. Collect and collate data from a wide range of different sources. 2. Ensure data are complete and valid for the purpose for which it is to be used. 3. Analyse and interpret routine data using appropriate analytical techniques. 4. Present the outcomes of data analysis. 5. Monitor and quality assure routine data collection, collation and analysis Knowledge a) Knowledge of statistical methods appropriate to health and health needs b) Awareness of the qualitative methodologies used in health intelligence and their contribution to the understanding of health and wellbeing. c) Awareness of health needs assessment methods and their use d) Knowledge of different sources of data and information relevant to health and health needs and how to access them. e) Awareness of the principles of Geographical Information Systems and the importance of demography on assessing population health and wellbeing needs f) Knowledge of use of geographically linked packages. g) Knowledge of the Data Protection Act and its implications for data disclosure. h) Knowledge of software and database packages and their use in manipulating data. i) Understand the importance of quality assurance

24. Some qualities of an effective public health analyst 24What is Public Health Intelligence? When you are asked to provide intelligence on a public health topic what skills will you need?

25. Some qualities of an effective public health analyst 25What is Public Health Intelligence? Asks questions – inquisitive What data are available to answer this question? What is its quality? – can it be used for this purpose? What is the best method of analysis? What does the literature say? Resourceful and innovative If we can’t answer the question directly do we have a proxy measure? Can I get information from another source to check my results? Do we have to collect undertake some new data collection? Effective Communicator What does it mean? How can I best present it? How do I explain the limits of these findings, and give health warnings against inappropriate use?

26. Steps to increasing your effectiveness 26What is Public Health Intelligence? technical knowledge and skills (incl IT and statistics) + knowledge of wide range of data sources + good contacts and networks for accessing specialist advice + knowledge of data quality problems with particular kinds of data + in touch with best practice + firm grasp of policy context and needs of customers + core (generic) skills – management, communication + consultancy skills

27. Public Health Intelligence as a career 27What is Public Health Intelligence? still a relatively small community (?400 nationally) trainee PH analyst (NHS Band 5) analyst/practitioner senior analyst/advanced practitioner defined specialist/consultant the route map - public health skills and careers framework

28. Public Health Intelligence as a career 28What is Public Health Intelligence?

29. Public Health Intelligence as a career 29What is Public Health Intelligence?

30. Career pathways 30What is Public Health Intelligence? Within PH intelligence scope for progression scope for movement – local to PHE and vice versa scope for specialising (or not) To general PH e.g. specialist training scheme To other local authority intelligence functions Within NHS informatics Other private sector university posts

31. What you have learned 31What is Public Health Intelligence? What is public health intelligence? Data, information, intelligence Who does public health intelligence work? Knowledge and skills for public health intelligence work The effective public health analyst PHI as a career