Public Health Intelligence — The Future is Here

Our Function

The function of Public Health Intelligence is to help Public Health Dorset, our two councils and Our Dorset (Integrated Care System) solve problems.

That’s it really. Solve problems.

Our intelligence function is staffed by analysts (traditionally viewed as geeks or digit heads with propeller hats…), but who are also creative and strategic systems thinking problem solvers.

We aren’t providing services to the public.

We don’t determine strategic direction.

We aren’t executive decision-makers.

We don’t commission services.

We aren’t allocating resources or balancing budgets.

Those are your roles.

And people like you are asking, “how can we improve what we are doing; how can we effect the change we think is needed in our area?”

More efficiency.

More effectiveness.

More value for money.

Better outcomes.

We are here to help everyone solve those challenges. We can’t do it for you, but we can provide support that might just help you effect the change that you came to work to make.

How do you effect change?

The process is deceptively simple

  1. Determine where you are (Thinking)
  2. Imagine where you want to be (Talking)
  3. Map a way forward (Deciding & Planning)

Easy as 1, 2, 3.

If only, eh?

Homelessness, smoking, poverty and inequality, drug and alcohol abuse, diabetes and coronary heart disease, food security, unhealthy homes, rising demand combined with declining resources, physical inactivity, social isolation, loneliness, family breakdown, crime, road crashes, domestic abuse, health service waiting times, depression, social immobility, climate change, environmental degradation, air pollution, stress, ecosystem collapse, lower back pain, housing affordability, financial crises…

and I’m not even warmed up!

Problems? We’ve got plenty that need solving.

If any of these and a 1000 more like them were easy to solve, they’d be solved already.

Whether you are working at the political level, managing local government programmes and processes, or dealing with the public on one of our many ‘coal faces’ — your job is probably getting harder. It’s certainly getting more complex.

Working Together as a System

Whether your ‘system of concern’ is confined to the workings of a small team, or an entire council, or even a multi-organisation Integrated Care System, such as Our Dorset — developing a shared-understanding of systems that are complex is crucial, but very difficult. If we don’t have a shared-understanding of a problem, it’s going to be very difficult to work together to solve it.

Our real-world challenges include people, places, and relationships. None of us have a complete picture of this system we call a ‘community’, much less the complex organisations we’ve created to try and manage the day-to-day functioning of our communities.

The reality we all face is that most ‘systems’ tend to be complex.

The ‘easy problems’ have been solved.

We are out of silver bullets.

Making progress in the future requires us to work with complexity, not ignore it.

This is why Public Health Intelligence is measuring its performance against three outcomes:

  1. Developing better shared-understanding across our system
  2. Creating compelling narrative that is easy to communicate
  3. Ensuring that everything we do is based on reliable data and robust evidence.

How can we help you effect change?

Determining where you are

Do: Articulate where you think you are at present and what is causing the current problems that you want to change — write it down, share it around — get feedback from as many people as possible (in proportion to the size of the challenge!). If any element(s) of the project seems too big, too complex or it’s hard to find a place to even start — then give us a call, we can help you paint a picture.

Maybe you want to illustrate your challenge? For example: What creates a healthy population; the role of public health in population health management; a social care perspective on public health outcomes; food security; children’s speech and language needs; the change our population health management programme will make; or the complexity of community development?

Name your challenge and we’ll help you build your own system map to share your understanding of a system challenge. Most of these system maps aren’t complete in any sense — they are sketches of what someone or some group understands to be how their system works. If any of these resonate with you that’s great — that’s an indication of some shared-understanding out there! If you find some of these maps a bit jarring — that’s OK. It means that at least we know where we don’t see things the same way — and better yet we have a way to fix that!

Don’t: Make data requests your first port of call. Data are really the last thing you need. If you haven’t spent a bit of time articulately what you think the problem is all about, what change you are trying to effect and how — then no amount of support from the geek team is going to get your closer to effecting the change you want to see. Data is often counter productive at this stage (I bet you’d never expected to hear that from a ‘Head of Programmes (Research & Intelligence)’ — well you just did). Data, the right data, are important in building an evidence-base that supports action — only when we all understand what it is we are trying to change and what the key questions are that need answering.

Imagining where you want to be

Do: Articulate where you want the desired change to take you. What does it look like? Write it down, share it around — get feedback from as many people as possible (in proportion to the size of the challenge). Sound familiar? We don’t have a crystal ball, but we can certainly help you and your colleagues map out and understand trends that might be important to consider. The easiest what to predict the future is to create it.

Maybe you want to develop a shared-understanding of your desired future? For example: What’s the likely impact of climate change on our elderly, and why do we still have to worry about cold weather in a warmer world; how do we create healthy places; what is universal basic income all about and why is it an emerging driver; why is health and well-being the most pressing Sustainable Development Goal; how do we generate transformational solutions to challenges arising from probable futures, desirable futures, strange futures, crazy ideas, and their policy implications?

Don’t: Ignore the system context in which you wish to effect change, or rely solely on an analytical forward projection of historical trends (history doesn’t always repeat itself, your history teacher may have fibbed about that…).

Map a way forward

Do: Consider where you currently are and where you want to be in the context of the underlying causes of your challenge. Identify and articulate questions that you need answers to in order to move forward. Now is the time to gather evidence — to answer key questions.

We might need to understand key health risks for our system, and monitor key health outcomes, or we may need to delve into locality level activity. Are there environmental issues we need to explore; we lead the development of air quality monitoring for our system, we are also developing measures of food insecurity will be available soon, as will a comprehensive database of green space accessibility for everyone of our 800,000 residents and why it matters what type of green space people access.

Don’t: Pin all your efforts on a single big impact remedy (aka silver bullet) or ignore cultural and organisational values, because “culture eats strategy for breakfast” (Peter Drucker). Many efforts to effect change founder on these hard to see elements of our system.

Future of Intelligence

We are small team of creative minds who have implemented our own transformational change over the past three years to develop Strategic, Systems and People Insights capability. We know that effecting change isn’t easy. I’ve talked many times about what I see as the future of intelligence and what we are delivering in previous blogs and I’ve also had a say on the future of public health interventions, prevention at scale — the mantra of the Sustainability and Transformation Partnership, the Joint Strategic Needs Assessment, and Population Health Management. They are all interconnected. Intelligence can no longer be solely the domain of geeks — everyone has a part to play. This is about ‘organisational intelligence’ — and I’ve tried to articulate some of the challenges we are going to have along the way.

However, we recognize that being able to effect change within complex working environments is essential if we are going to work effectively now and into the future — without creating “paralysis through analysis”.

Don’t we still do traditional public health data management and analysis? You bet!

Although we’ve moved away from the more traditional analyst focus of ‘spreadsheet analysis’. We’ve now fully implemented a modern business intelligence infrastructure and this traditional function now only takes a fraction of the time to process and use health data for our population of 800,000 people.

We work with BCP and Dorset council analyst groups, and through the Intelligent Working Programme based at the Dorset Clinical Commissioning Group (NHS), we all participate in the development and sharing of research and intelligence across our health and care system.

Our Team is responsible for Public Health research and intelligence work across our system — and to move forward we’ve freed up analyst time to work with you to develop Strategic, System and People Insights that will contribute to an enhance ‘collective intelligence’ that will help you in your problem solving efforts.

We look forward to working with you this year.

This futures blog

This blog series is about how we create ‘healthy places’ and what our possible ‘futures’ could be given current trends and momentum within society, the economic and political systems, and the environment. I use the plural ‘futures’ intentionally, because our future is not predetermined (I hope), we can and should work towards the future we want. This blog aims to generate discussion (maybe even some debate) around ‘Healthy places futures’ in the hope that if we all put our minds to it, a collective vision may emerge to inform any strategy we might put in place to get us to our preferred future. We’ll be leaning heavily on futuring tools found on our Shaping Tomorrow hosted website: phd.shapingtomorrow.com.

The future is already here — it’s just not very evenly distributed (William Gibson 1993).re

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