The Ten Core Elements Of Public Health Practice

1. Surveillance and assessment of the population’s health and well being.

Health needs assessment is an important component of public health. It involves gathering data to define the number and identity of those suffering from a particular condition within a geographical community.
It can help with:

• Identification of unmet needs.
• Ongoing assessment of the health of a specific population. A population can be defined geographically or by patient group (e.g. those with a specific disease or an ethnic sub-group).
• Informing the future organisation and delivery of services.

2. Promoting and protecting the population’s health and well-being

It is well known that lifestyle changes, such as stopping smoking, better nutrition and more physical activity, can improve health and reduce the burden of disease from obesity, coronary heart disease and cancer. Health protection of both individuals and the wider population is also important, for example, to reduce the spread of infectious disease and protect against chemical, radiation or other hazards.

These activities can be divided into three main areas:

• Promoting health and well-being.
• Preventing and screening for disease.
• Protecting health and well-being.

3. Developing quality and risk management within an evaluative culture

The effective assessment and management of risk is key to preventing accidents and ill-health at an individual and population level. Clinical governance is about examining clinical effectiveness, quality assurance, risk management, audit and development of health care services. This may involve looking critically at individual and corporate performance, assessing the evidence of effectiveness of health and healthcare interventions and services, identifying areas of sub-optimal patient care and addressing deficits of both structure and process.

4. Collaboratively working for health

Multi-disciplinary working can make significant improvements in health through better co-ordination and delivery of services, such as smoking cessation. This area of practice focuses on building alliances and working in partnership with other practitioners and agencies to improve health and well-being. However, partnership-working is not limited to health professionals and there are many opportunities for joint working with local authorities, for example with social services in discharge planning, and other agencies, such as the police and education services, around substance misuse.

5. Developing health programmes and services and reducing inequalities

Reducing health inequalities is a priority and all health professionals have a role to play in the targeting of individuals whose health status is below average, or who may not access current health services for a variety of reasons. Health care commissioners can influence the design and delivery of services to better target those with the most ill-health.

6. Policy and strategy development and implementation

Public health practice is about collaborative, organised effort and this has to be supported and co-ordinated at a strategic level. Health professionals must be prepared to work within an integrated framework of health improvement strategies so that their individual and corporate contribution can be maximised. This area of practice focuses on the cyclical basis of influencing the development of policies, implementing strategies to put the policies into effect and assessing the impact of policies on health.

7. Working with and for communities

Acting as an advocate for the public and engaging with them is vital for the improvement of public health. Involving the public in service design can provide insight into what it is like to be a service user or to suffer from a condition such as asthma or diabetes, and thus adapt services to better meet their needs. This area of practice focuses on working with communities as active partners in all aspects of improving health; the empowerment of communities to promote their own health and well being; and enabling communities to develop their capacity to advocate for health and well being.

8. Strategic leadership for health and wellbeing

Health professionals should contribute to public health at both a strategic and operational level and use their influence with members of the public and other colleagues to promote better health outcomes. This is essential when a particular issues is receiving a lot of media attention, for example:

• Uptake of immunizations.
• Reduction in inappropriate antibiotic use.
• Promote understanding of mental health services within the local community.

This area includes leading teams and individuals and developing capacity and capability.

9. Research and development to improve health and wellbeing

New services, products or techniques should always be evaluated where possible locally as well as using research, and other, evidence gathered from elsewhere. Local data which has been systematically collected (e.g. population surveys) is another influential way of keeping health professionals up-to-date and changing practice.
This area of practice focuses on research and development for improving health.

10. Ethically managing self, people and resources to improve health and wellbeing

Commitment to continuing professional development and lifelong learning is a requirement for most healthcare professionals. A population perspective adds the dimension of equitable use and distribution of health resources, for example the availability of particular drugs or treatments across a population. This area of practice focuses on the management of self, people and resources. It includes developing direction for the work to be undertaken and delivering effective services.

More detail on each of these 10 core elements and examples of public health practice for pharmacy practitioners and specialists can be found here