Swimming Upstream: Inter-Professional Learning provides the key in tackling the spatial determinants of health
Colin Thunhurst PhDPatricia Bond PhD
Rachel Richards PhD
Outline• West Midlands Health & Wellbeing Strategy• Mapping the relationship with the Regional
Spatial Strategy• Inter-sectoral Action requires Inter-
Professional Learning• Opportunities for Inter-Professional Learning• Beyond Learning to Action – organisational
implications
Acknowledgements
• In this presentation we will be drawing upon work that we have undertaken for the DoH West Midlands on behalf of the West Midlands Teaching Public Health Network
• Thanks to Rowena Clayton (DoHWM), Ginder Narle (WMTPHN), Cathleen Manancourt (WMTPHN) and other colleagues in WMTPHN
West Midlands Teaching Public Health Network
West Midlands Teaching Public Health Network
Our Vision
To increase the standard, range and availability of public health training in the West Midlands, in order to improve the health of the
region’s population
The National Lead on:
Inter-professional learning (IPL) in public healthEngaging partners
Ethnic minority health
West Midlands Health and Wellbeing Strategyadopts an upstream model
• Planning Transport and Health• Housing and Health• Environment and Health• Economy Skills and Health• Culture Leisure and Health• Safer and Stronger Communities
Health analysed through underlying determinants rather than ‘priority issues’
Mapping and Aligning Policies at the Respective Levels
WM
H&
WS
Planning Transport &
Health
Housing & Health
Environment & Health
Economy Skills & Health
Culture Leisure &
Health
Safer and Stronger
Communities
Health Inequalities
Social Inclusion
Demographic Change
Mental Health
WM
RS
S
Urban Renaissance Rural RenaissanceDiversifying and Modernising the
Economy
Modernising the Transport
Infrastructure
Communities for the Future
Prosperity for All
Quality of the Environment
Accessibility
Objectives of the West Midlands Regional Spatial Strategy(WMRSS) and the West Midlands Health & Well-being Strategy (WMH&WS)
WM
H&
WS
Planning Transport &
Health
Housing & Health
Environment & Health
Economy Skills & Health
Culture Leisure &
Health
Safer and Stronger
Communities
Health Inequalities
Social Inclusion
Demographic Change
Mental Health
WM
RS
S
Urban Renaissance Rural RenaissanceDiversifying and Modernising the
Economy
Modernising the Transport
Infrastructure
Communities for the Future
Prosperity for All
Quality of the Environment
Accessibility
Children Young People and FamiliesChildren Young People and Families
Later LifeLater Life
++/-
Key: + indicates WMRSS supports objectives of WMH&WS - indicates WMRSS conflicts with objectives of WMH&WS +/- indicates WMRSS may either support or conflict with objectives of WMH&WS
Mapping the Objectives of the West Midlands Regional Spatial Strategy(WMRSS) and the West Midlands Health & Well-being Strategy (WMH&WS) at the macro level
Cross-cutting Themes
Cross-cutting Themes
+ +/-+/-+/-
Children Young People and FamiliesChildren Young People and Families
Later LifeLater Life
Key: + indicates WMRSS supports objectives of WMH&WS - indicates WMRSS conflicts with objectives of WMH&WS +/- indicates WMRSS may either support or conflict with objectives of WMH&WS
Mapping the Objectives of the West Midlands Regional Spatial Strategy(WMRSS) and the West Midlands Health & Well-being Strategy (WMH&WS) at the micro level
Cross-cutting Themes
Cross-cutting Themes
Planning Transport & Health
Modernising the Transport Infrastructure
WM
H&
WS
Improved Accessibility
Increased Social
Inclusion
More Active Transport
Less Road Accidents
Less Air Pollution/
Noise
Improved Built and Natural
Environment
Enhanced Community Participation
and Partnership
Working
Health Inequalities
Social Inclusion
Demographic Change
Mental Health
WM
RS
S
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Communities for the Future
Prosperity for All
Quality of the Environment
Accessibility
All
From Mapping to Shaping Inter-Professional Learning
• A full understanding of the inter-relationship requires a developed systems mapping exercise (in the manner of the Foresight Report)• However, more important than achieving an ‘accurate’ representation is establishing a medium, through which public health practitioners and spatial planners institute and maintain regular dialogue•Inter-professional Learning
The health dividend relies on seeing the big picture and the detail at the same time
“Devil in the detail”: The challenge
• Develop a fully shared purpose – Build mutual understanding – Appreciate the scope of each others areas of work
• Build mutual goals into core business plans
• A “regional” understanding
Vision: to strive beyond “the accepted” to “what
might be possible”
• The potential for new conceptual models of healthy urban planning
• New patterns of connection, collaboration and alignment
• New ways of sharing knowledge • Communities of practice
What could help? Additional principles and pre-requisites need
embedding in the system:
1.A commitment to seeing these regional strategies as a continuous process
2.A commitment to build relationships3.A commitment to collective action
• as a holistic process • that recognizes the many disciplinary and professional
interests of the collective.
Inter-sectoral strategy development requires Inter-Professional Learning
• Interprofessional education has been defined as "occasions when two or more professions learn from and about each other to improve collaboration and the quality of care" (CAIPE 1997).
• Based on the principles of organizational and educational psychology it provides a pedagogic model to underpin service realignment and integration
• IPE is not about "dumbing down" disciplinary intervention; neither is it about multiskilling. Rather it is a process that offers continuity and facilitates ongoing trust among professionals
Opportunities: IPL • A Common set of professional values relating to public sector
governance • A history of interdisciplinary working • The shared goal of creating “sustainable communities”. • No national overview of healthy urban planning skills• A Shortage of competencies to support the sustainable
community agenda (Egan Review , Association for Sustainable Communities)
• Absence of generic skills training • Collaborative working, Project management, Public
engagement.
Advancing Inter-professional Learning
• Tools exist to assess the health implications of planning applications
• Professional bodies are on board • The professions have comparative CPD requirements • The sustainable skills agenda could provide common
IPL content• Opportunities for IPL at prequalifying levels are scant
Inter-sectoral strategy development requires Inter-Professional Learning
• Translating IPL into practice is a complicated exercise, requiring:– models of service planning that allow for
measurement of change, as a function of the collaborative (teamwork) experience.
– Structures that facilitate IPE for collaborative practice
– Stability and sustained action
Organisational Implications
• Moving out of our silos– Organisational Alignment– Institutional commitment– From supportive partnerships to active joint
working
• Breaking down the barriers between statutory agencies and third sector organisations