National Support Teams
Encyclopedia
The public health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...

 National Support Teams or NSTs constituted a consultancy-style organisational development and change management
Change management
Change management is a structured approach to shifting/transitioning individuals, teams, and organizations from a current state to a desired future state. It is an organizational process aimed at helping employees to accept and embrace changes in their current business environment....

 service provided by the UK Government Department of Health
Department of Health (United Kingdom)
The Department of Health is a department of the United Kingdom government with responsibility for government policy for health and social care matters and for the National Health Service in England along with a few elements of the same matters which are not otherwise devolved to the Scottish,...

.

History and role

Established in 2006, they provided consultancy-style support and assistance to local health economies across England (the UK's devolved administrations
Devolution in the United Kingdom
In the United Kingdom, devolution refers to the statutory granting of powers from the Parliament of the United Kingdom to the Scottish Parliament, the National Assembly for Wales and the Northern Ireland Assembly and to their associated executive bodies the Scottish Government, the Welsh Government...

 - Scotland, Wales and Northern Ireland generally having their own arrangements). Each team had access to national-level expertise on specific public health specialisms, including:
  • Sexual health
  • Tobacco control
    Tobacco Control
    Tobacco control is a field of public health science, policy and practice dedicated to controlling the growth of tobacco use and thereby reducing the morbidity and mortality it causes...

  • Health inequalities
  • Teenage pregnancy
    Teenage pregnancy
    Teenage pregnancy is a pregnancy of a female under the age of 20 when the pregnancy ends. It generally refers to a female who is unmarried and usually refers to an unplanned pregnancy...

  • Childhood obesity
    Childhood obesity
    Childhood obesity is a condition where excess body fat negatively affects a child's health or wellbeing. As methods to determine body fat directly are difficult, the diagnosis of obesity is often based on BMI. Due to the rising prevalence of obesity in children and its many adverse health effects...

  • Alcohol Harm Reduction
  • Infant mortality
    Infant mortality
    Infant mortality is defined as the number of infant deaths per 1000 live births. Traditionally, the most common cause worldwide was dehydration from diarrhea. However, the spreading information about Oral Re-hydration Solution to mothers around the world has decreased the rate of children dying...

  • Response to Sexual violence
    Sexual violence
    Sexual violence occurs throughout the world, although in most countries there has been little research conducted on the problem. Due to the private nature of sexual violence, estimating the extent of the problem is difficult...

  • Vaccination
    Vaccination
    Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

     and Immunisation
  • Children and Young Peoples' Emotional well-being
    Emotional well-being
    Emotional well-being is a term that has seen increasing use in recent decades. The implications of decreased emotional well-being are related to mental health concerns such as stress, depression, and anxiety. These in turn can contribute to physical ill-health such as digestive disorders, sleep...

     and Mental health
    Mental health
    Mental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...



Consultancy and support services were provided free of charge to public-sector clients including local authorities and National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...

 Trusts. The feedback reports generated as a result of these activities were not published by the Department of Health, although some clients choose to post reports (usually in PowerPoint or PDF format) on their own websites.

Each National Support Team also shared observations with central Government policy
Public policy
Public policy as government action is generally the principled guide to action taken by the administrative or executive branches of the state with regard to a class of issues in a manner consistent with law and institutional customs. In general, the foundation is the pertinent national and...

 advisors on the real-world public health challenges it identified through this work.

Activity

The primary activity of each Team was to carry out visiting inputs to local areas across England
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...

, more than 450 of which were undertaken during the existence of the NSTs. These visits lasted between two days and one week, using a mix of in-house NST experts and externally sourced advisors where appropriate. Subsequent change management
Change management
Change management is a structured approach to shifting/transitioning individuals, teams, and organizations from a current state to a desired future state. It is an organizational process aimed at helping employees to accept and embrace changes in their current business environment....

 support was offered as appropriate to the changes recommended, often around strengthening strategic coherence, enhancing commissioning
Project commissioning
Project commissioning is the process of assuring that all systems and components of a building or industrial plant are designed, installed, tested, operated, and maintained according to the operational requirements of the owner or final client...

 capabilities to respond to public health challenges, or improving operational effectiveness of treatment and/or behaviour change services.

Approach

The overall style of the National Support Teams was planned to be in line with Peter Block
Peter Block
Peter Block is an author, consultant, and speaker in the areas of organization development, community building, and civic engagement for the past 40 years. He was born in 1940 to Jewish parents, Ira and Dorothy Block...

's 'Flawless Consulting' approach . The diagnostic model employed was broadly influenced by Appreciative Inquiry
Appreciative inquiry
Appreciative Inquiry is primarily an organisational development method which seeks to engage all levels of an organisation to renew, change and improved performance. Its exponents view it as being applicable to organisations facing rapid change or growth...

, due to its tested relevance to healthcare environments and the emphasis upon positive potential to enhance organisational function (rather than a performance management
Performance management
Performance management includes activities that ensure that goals are consistently being met in an effective and efficient manner. Performance management can focus on the performance of an organization, a department, employee, or even the processes to build a product or service, as well as many...

 approach, which initial client feedback suggested would be perceive as judgemental). Recommendations for change were presented at closing plenary sessions to both senior leadership and operational managers with sufficient detail to trigger follow-up action and a delivery style reported by audiences as more memorable than was initially expected of an organisational development input.

Publications

NSTs created and published a range of practical guides to achieve public health improvements (several titled as 'high impact changes' guides) as well as summaries of applied learning from their reviews and support work in localities across England. Several of these remain available on the Department of Health website , and a wider range is available from the digital legacy site hosted by the National Archives. The feedback from NSTs to central Government policy teams also informed (and in some cases instigated) the publication of other policy documents including 'white papers' outlining proposed strategic improvements to overall action on public health.

Reception

As outlined in the NSTs' own end-of-project report (available at the Department for Health website ) the NSTs achieved significant results in strengthening the performance of a diverse range of NHS and local government public health interventions, resulting in high approval levels on the part of Chief Executives and Directors of Public Health who considered this to have been one of the most useful services which the Department of Health had made available.

Closure

All Teams closed in March 2011 as a result of the funding cuts affecting several areas of the public sector in the UK, following a perceived need to reduce public expenditure in the context of the international financial crisis of 2007-2010 and related recession. Internal communications to NST staff explained the closure as the result of a decision to abolish all posts not covered by a traditional civil service employment contract; as this included almost all NST employees, the service was to close as a consequence - it was stressed that closure was not intended to imply a comment on the success or usefulness of the NST approach.

Subsequent reputation

Specialist medical magazine 'GP' reported the regret voiced by public health leaders following the closure of the NSTs in August 2011. Their stories subsequently picked-up by the The Daily Telegraph
The Daily Telegraph
The Daily Telegraph is a daily morning broadsheet newspaper distributed throughout the United Kingdom and internationally. The newspaper was founded by Arthur B...

 newspaper and BBC news
BBC News
BBC News is the department of the British Broadcasting Corporation responsible for the gathering and broadcasting of news and current affairs. The department is the world's largest broadcast news organisation and generates about 120 hours of radio and television output each day, as well as online...

explained how the services of NSTs had been received and questioned the rationale for disbanding them. In response, an unidentified Department of Health spokesperson suggested that the teams were no longer required as they had worked to targets discarded by the incoming new national administration in May 2010, although the teams had continued to provide services used by localities and intelligence brought back into central Government for the rest of that financial year; the spokesperson did not suggest a new means by which continuing aspirations to address public health challenges could now be supported.

External links

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