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Learning on all fronts for Population Health Fellows

In 2016 we recruited three fantastic GPs to undertake new CCG-funded roles, encompassing jobbing GP responsibilities, a commissioning project and support to complete a Master's degree in Public Health at King's College London (KCL). 

Katherine Taylor, Tehseen Khan and Alice Wu (pictured left to right) are our Population Health Fellows. All have been GPs for at least four years and currently do three sessions per week in Lambeth. At KCL they are taking a range of modules including statistics, epidemiology, global health, and public policy. Their fellowships end in October and our hope is that they will want to continue to work locally.

Work combinations

Katherine Taylor is at Mawbey Group Practice. She is working with the CCG cancer team looking at the inequalities in bowel cancer screen and how to achieve and improvement in uptake. As a result, her dissertation is likely to be focused on primary care involvement in NHS cancer screening programmes.

Alice Wu is at Lambeth Walk Group Practice. She is part of the team developing Lambeth DataNet(link to shortlist article) to provide useful demographic information to help in the design and delivery of services. Alice is looking at the best way to extend the information collected about a patient when they register so that we have data as set out in the Equality Act 2010. This has involved engaging with a range of Lambeth residents through a number of focus groups.

Tehseen Khan is at Clapham Park Group Practice. His CCG work is on raising the uptake of NHS Health Checks. Though, as this is now a public health responsibility, he spends more time working with colleagues at Lambeth Council. This function will shortly move to the GP federations. Tehseen has helped with finding out what works in Tower Hamlets, the best borough for delivering health checks, and will put forward some of recommendations to make local improvements. Tehseen has also found it interesting to see public health stakeholders' different priorities and how the budget cuts are affecting local authorities and what they will deliver.

Gaining perspective

The fellows all agree that their roles have given them perspectives on healthcare that they would not have had from any single element.

"The knowledge from each element is very complementary," says Katherine. "Our monthly peer supervision sessions, as well as linking with the three Southwark fellows, is a useful opportunity to think about triangulating the links. We talk about different ways of working and learning from each other."

Alice says: "The Master's gives us a different perspective. It is quite focused on the social determinants of health, and there is a lot on the political perspective of the NHS which has influenced my whole view. I thought it was going to be a lot more objective. It has unexpectedly complemented the other work very well. I thought it was going to be much more academic but it is actually useful on a day to day basis.  It does affect your interpretation of what's going on in your work as a GP."

There are of course pressures from having three full and different roles, but Tehseen says: "It can be difficult managing the different roles but maybe that's what makes it enjoyable… Practice life is busy but it's a different pressure than academic or CCG work. It's good to have that clinical work to see the impact on patients of implementing commissioning decisions, and critiquing and analysing those decisions based on our academic knowledge."

The fellows have improved many of their skills along the way with the need for research, analysis, report writing alongside team working. However it is the breadth of understanding that the combined work brings which has made the most impact.

"As a clinician in a surgery we don't normally have an insight into the CCG but working at the CCG you realise where strategy comes from," says Tehseen.  "There's a collaborative process that ensures that the decisions that are actually made are about decreasing inequities and improving the health of the local population. Knowing how that decision process occurs is really useful. The programmes aren't just plucked out the air - it's good to know those decisions are based on needs assessment."