National Support Teams - Engage Recommend Facilitate

The

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". Analyzing the det ...

National Support Teams or NSTs constituted a consultancy-style

organisational development Organization development (OD) is the study and implementation of practices, systems, and techniques that affect organizational change, the goal of which is to modify an organization's performance and/or culture. The organizational changes are ...

and

change management Change management (sometimes abbreviated as CM) is a collective term for all approaches to prepare, support, and help individuals, teams, and organizations in making organizational change. It includes methods that redirect or redefine the use of ...

service provided by the UK Government

Department of Health A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entities, such as states, counties and cities, often also operate a health department of their ow ...

History and role

Established in 2006, they provided consultancy-style support and assistance to local health economies across England (the UK's devolved administrations – Scotland, Wales and Northern Ireland generally having their own arrangements). Each team had access to national-level

expertise An expert is somebody who has a broad and deep understanding and competence in terms of knowledge, skill and experience through practice and education in a particular field. Informally, an expert is someone widely recognized as a reliable s ...

on specific public health specialisms, including: *

Sexual health Sexual and reproductive health (SRH) is a field of research, healthcare, and social activism that explores the health of an individual's reproductive system and sexual wellbeing during all stages of their life. The term can also be further de ...

Tobacco control Tobacco control is a field of international public health science, policy and practice dedicated to addressing tobacco use and thereby reducing the morbidity and mortality it causes. Since most cigarettes and cigars and hookahs contain/use to ...

Health inequalities Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequiti ...

Teenage pregnancy Teenage pregnancy, also known as adolescent pregnancy, is pregnancy in a female adolescent or young adult under the age of 20. This includes those who are legally considered adults in their country. The WHO defines adolescence as the period bet ...

Childhood obesity Childhood obesity is a condition where excess body fat negatively affects a child's health or well-being. As methods to determine body fat directly are difficult, the diagnosis of obesity is often based on BMI. Due to the rising prevalence of ...

* Alcohol harm reduction *

Infant mortality Infant mortality is the death of young children under the age of 1. This death toll is measured by the infant mortality rate (IMR), which is the probability of deaths of children under one year of age per 1000 live births. The under-five morta ...

* Response to

sexual violence Sexual violence is any sexual act or attempt to obtain a sexual act by violence or coercion, act to traffic a person, or act directed against a person's sexuality, regardless of the relationship to the victim.World Health Organization., World re ...

Vaccination Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating ...

and

immunisation Immunization, or immunisation, is the process by which an individual's immune system becomes fortified against an infectious agent (known as the immunogen). When this system is exposed to molecules that are foreign to the body, called ''non-sel ...

* Children and young peoples'

emotional well-being Emotions are mental states brought on by neurophysiological changes, variously associated with thoughts, feelings, behavioral responses, and a degree of pleasure or displeasure. There is currently no scientific consensus on a definition. ...

and

mental health Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health ...

Consultancy A consultant (from la, consultare "to deliberate") is a professional (also known as ''expert'', ''specialist'', see variations of meaning below) who provides advice and other purposeful activities in an area of specialization. Consulting servic ...

and support services were provided free of charge to

public-sector The public sector, also called the state sector, is the part of the economy composed of both public services and public enterprises. Public sectors include the public goods and governmental services such as the military, law enforcement, infr ...

clients including local authorities and

NHS Trust An NHS trust is an organisational unit within the National Health Services of England and Wales, generally serving either a geographical area or a specialised function (such as an ambulance service). In any particular location there may be several ...

s. 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 on their own websites. Each national support team also shared observations with central Government

policy Policy is a deliberate system of guidelines to guide decisions and achieve rational outcomes. A policy is a statement of intent and is implemented as a procedure or protocol. Policies are generally adopted by a governance body within an organ ...

advisers 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 is a country that is part of the United Kingdom. It shares land borders with Wales to its west and Scotland to its north. The Irish Sea lies northwest and the Celtic Sea to the southwest. It is separated from continental Europe b ...

, 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 advisers where appropriate. Subsequent

support was offered as appropriate to the changes recommended, often around strengthening strategic coherence, enhancing commissioning 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 (born 1939) is an American author, consultant, and speaker in the areas of organization development, community building, and civic engagement. He was born to Jewish parents, Ira and Dorothy Block. He currently resides with his wife, ...

's 'Flawless Consulting' approach. The diagnostic model employed was broadly influenced by

appreciative inquiry Appreciative inquiry (AI) is a model that seeks to engage stakeholders in self-determined change. According to Gervase Bushe, professor of leadership and organization development at the Beedie School of Business and a researcher on the topic, "AI ...

, 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 (PM) is the process of ensuring that a set of activities and outputs meets an organization's goals in an effective and efficient manner. Performance management can focus on the performance of a whole organization, a d ...

approach, which initial client feedback suggested would be perceived 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 Finance is the study and discipline of money, currency and capital assets. It is related to, but not synonymous with economics, the study of production, distribution, and consumption of money, assets, goods and services (the discipline of finan ...

and related

recession In economics, a recession is a business cycle contraction when there is a general decline in economic activity. Recessions generally occur when there is a widespread drop in spending (an adverse demand shock). This may be triggered by various ...

. 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 Daily Telegraph ''The Daily Telegraph'', known online and elsewhere as ''The Telegraph'', is a national British daily broadsheet newspaper published in London by Telegraph Media Group and distributed across the United Kingdom and internationally. It was fo ...

'' newspaper and

BBC News BBC News is an operational business division of the British Broadcasting Corporation (BBC) responsible for the gathering and broadcasting of news and current affairs in the UK and around the world. The department is the world's largest broadca ...

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.

References

{{Reflist

External links

* http://www.dh.gov.uk/en/Publichealth/Healthimprovement/NationalSupportTeams/index.htm Department of Health and Social Care Government agencies disestablished in 2011 Management consulting firms of the United Kingdom