Academic journal article Perspectives in Public Health

An Evaluation of a Public Health Practitioner Registration Programme: Lessons Learned for Workforce Development

Academic journal article Perspectives in Public Health

An Evaluation of a Public Health Practitioner Registration Programme: Lessons Learned for Workforce Development

Article excerpt

IntroductIon

Public health reflects many of the tensions in debates about professionalisation.1-3 On the one hand, professionalisation can be seen as acting as a framework for good practice establishing rules and standards for training, practice and registration as well as the implementation of processes to tackle complaints and deal with disciplinary procedures and fitness to practise.4,5 it allows for an agreed title to be protected for individuals who are registered on a statutory register and enables regulators both to set standards for entry to practice and to remove those who failed to meet those standards. On the other hand, professionalisation came to be seen in the 1970s as a project of self-interest in which market power is achieved through restricting supply of a workforce and enabling those allowed entry to command high salaries.6,7 Gabriel Scally in his review of the public health workforce denies that there is any economic consideration and states that 'A move to statutory regulation is not intended to improve the standing or financial rewards for members of the profession'.8

in many countries, public health professionals are often physicians and therefore are already regulated.9,10 in these countries, public health workforce development has focused on defining the workforce and establishing the levels of competence to practise.11,12 Finland, ireland, the United States and the United Kingdom were among the first countries with multi- professional public health, and in these countries, the sheer breadth of those working in public health has stimulated debates about professional jurisdiction and regulation.13,14

in the United Kingdom, the requirement to be registered as working in public health has considerable variation. The UK Public Health register (UKPHr) is an independent regulator that provides professional registration15 for specialists/consultants in public health from backgrounds other than medicine successfully completing training and those able to demonstrate competence retrospectively - to take account of those already in practice. employers are then able to appoint to roles and posts with titles such as 'public health consultant' or 'public health specialist' those who have a protected title linking back to this registration.16,17 Statutory regulation with the Health and Care Professions Council (HCPC) for all public health specialists was recommended in a review in 2010,8 including public health alongside a wide range of other professional groups. At the same time, the current government is keen to reduce regulation, and the Hampton principles of regulation as expressed in 'enabling excellence'18 are that regulation should be proportionate, accountable, consistent, transparent and targeted.

Public health practitioners (PHPs) are those people in the public health workforce who spend much or all of their time in public health practice working at a minimum of level 5 of the Public Health Skills and Career Framework15 (PHSCF; Figure 1). They may work across the full breadth of public health from health improvement and health protection, to health information, community development and nutrition, in a wide range of settings from local government and the National Health Service (NHS) to the voluntary and private sectors.19,20 The term 'PHPs' is used in the United Kingdom to describe a level of practice - not a specific job role or type of job. Although they carry out key public health roles, many PHPs remain unregulated,21 and there is no obligation for those working as PHPs to register as a public health professional. Nurses (public health nurses, including health visitors and school nurses) must be registered with the Nursing and Midwifery Council and may choose to register via the Specialist Community Public Health Nursing (SCPHN) part of the register.22 Other PHPs are self-regulated by a voluntary scheme23 of the UKPHr that opened in 2011. Assessment of competence is done against standards developed by the UKPHr24 using the PHSCF15 (Figure 1) using a retrospective portfolio of evidence showing achievement against these standards. …

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