South West Public Health Specialty Training Programme Policy

Section A - The Public Health Specialty Training Programme

 Section B - The Organisation of the Training Programme

 Section C - Human Resources

 

Section A - The Public Health Specialty Training Programme 

Introduction 

The South West Public Health Specialty Training Programme is a South West regional specialty. It provides a combination of academic training, service experience and skills based training in public health.

A Reference Guide for Postgraduate Specialty Training in the UK, The Gold Guide, Eighth Edition, March 2020 sets out national arrangements for specialty training programmes for Specialty Registrars appointed since August 2007.

The Faculty of Public Health, (FPH) develops the General Medical Council, (GMC) approved curriculum that the training programme delivers. The current Public Health Specialty Training Curriculum, 2015 can be found on the Faculty of Public Health web-site.

Training is open to applicants from a range of disciplines provided the FPH eligibility criteria are met. All appointees are referred to as Specialty Registrars (StRs).

Full-time training for trainees in public health usually takes five years starting in August of each year. However for some individuals with specific prior experience or who have already completed a Masters in Public Health, this total training time may be reduced.

At the start of the first academic year of their training most trainees will begin studying for a Masters in Public Health (MSc or MPH). They will then spend the remainder of their training in at least two different training locations. During this time they will also prepare for their Faculty of Public Health membership examinations.

This Public Health Specialty Training Programme Policy describes the structure of possible training programmes for trainees in the South West. It includes arrangements for academic and educational supervision, provision of trainer development, information about training locations, induction programmes for new trainees, opportunities for external attachments, arrangements for rotation between training locations, study leave and performance assessment processes.

All Specialty Registrars and supervisors are expected to be fully conversant and work within this policy, the Gold Guide and the FPH curriculum.

What Is Public Health? 

Because of the wide range of organisations and disciplines that contribute to improving the health of the population, it can be difficult to reach a definition of ‘public health’ which everyone will feel comfortable with.

Sir Donald Acheson, in his report on the public health function in 1988 defined public health as “the science and art of preventing disease, prolonging life and promoting health through the organised efforts of society”. This definition reflects the multi-disciplinary basis of public health practice, and recognises the broad public health responsibilities of a wide range of organisations, including central government and local authorities as well as the National Health Service and academic departments of public health, health policy, health promotion and environmental health.

(Source: Exploring Public Health Career Paths; Published by NHS Executive. Authors: Yvonne Cornish, Teri Knight & Janet Baker in association with Professor Rod Griffiths).

The training programme develops one group within the wider public health workforce – Public Health Specialists who will be appointable to Consultant grade posts.

Key Areas Of Public Health 

The Faculty of Public Health has identified nine key areas for public health practice across the three domains of public health (health protection, health improvement and service quality), as well as ethical and professional practice. These form the basis of all Faculty development of standards and provide the framework for the competencies which all trainees in public health should achieve during their training.

Eight Key Areas of Public Health

  1. Use of Public Health intelligence to survey and assess a population's health and well-being
  2. Assessing the evidence of effectiveness of interventions, programmes and services intended to improve the health or wellbeing of individuals or populations
  3. Policy and strategy development and implementation
  4. Strategic leadership and collaborative working for health
  5. Health Improvement, Determinants of Health and Health Communication
  6. Health Protection
  7. Health and Care Public Health
  8. Academic Public Health

In addition there are two further areas that StRs should develop in:

        9.Professional personal and ethical development

       10.Integration and Application of Competences for Consultant Practice 

Access To The Public Health Specialty Training Programme 

The South West Public Health Specialty Training Programme is an integrated programme for trainees in public health. Trainees are recruited from a wide range of professional backgrounds but must comply with the FPH required levels of experience and qualifications. The programme aims to provide equal opportunities and high quality training for generalist, health protection and academic training.

In addition, the programme offers placements to postgraduate medical trainees in the second year of their Foundation Programme (F2s) but only in the Peninsula area of our geography.

National Institute for Health Research (NIHR) funded Academic Clinical Fellows, ACFs are recruited at local level but are expected to meet the required standard in the national assessment process before being given a formal offer of an ACF post.  They are appointed on three year contracts with the expectation of submitting a research fellowship at the end and taking time Out of Programme for Research (OOPR).  If Academic Clinical Fellows fail to gain a post-doctoral fellowship they can be converted to Service Registrars and continue to train as a Service Registrar with no academic time included in their contract provided they are successful in the DFPH and MFPH examinations of the Faculty of Public Health Medicine and a satisfactory progression through ARCP (Annual Review of Competence Progression) at expected rate of 75% of time on a pro rata basis, during each year of training as required in the terms of their employment.   This policy also applies to ACF who have completed their OOPR and are returning to the training programme to complete their service training.

Locally funded lecturer posts allow trainees to develop their research or teaching skills alongside their public health training.

Trainees in dental public health are also supported with their programmes which are led by the Dental School at Health Education England working in partnership with the Public Health training programme.

Aims And Objectives Of The Programme 

For Specialty Registrars

Aims

  • To equip trainees with the appropriate training to obtain a consultant or equivalent post in public health
  • To equip those in lecturer and academic posts with the appropriate training to obtain a substantive academic post in public health

Objectives

  • To provide up to five years training in public health
  • To support trainees in the acquisition of Membership of the Faculty of Public Health by examination
  • To achieve a Certificate of Completion of Training (CCT) on satisfactory completion of the training programme
  • To achieve registration as public health specialists on either the General Medical Council’s (GMC) Specialist Register or the UK Public Health Register

For Postgraduate Medical Trainees in Foundation Year 2 (F2s)

Aim

  • To provide F2 trainees with an introductory experience of public health

Objectives

  • To provide short term public health attachments, usually of four months duration
  • To provide sufficient, suitable experience for F2 trainees to gain an understanding of and gain practical skills and competencies in public health

For Specialty Registrars in Dental Public Health

To work with the Dental School to achieve the following:

Aim

  • To equip trainees with the appropriate training to obtain a consultant or equivalent post in dental public health

Objectives

  • To provide up to five years training through the specialist registrar grade in dental public health
  • To support trainees in the acquisition of a formal academic qualification in dental public health at masters level or equivalent
  • To award all trainees a Certificate of Completion of Training (CCT) in dental public health on the satisfactory completion of the training programme
  • To see all trainees achieve registration as specialists in dental public health on the General Dental Council’s (GDC) Specialist Register

 

Section B - The Organisation of the Training Programme 

Training Timetable 

Overview

Training on the Public Health Specialty Training Programme consists of two phases of learning. These phases are defined by successful acquisition of learning outcomes defined for each phase, rather than by time. Movement to successive phases is dependent on success both in examination and in achievement of learning outcomes.

Phase One

During Phase One, most trainees will follow a course of academic study on an MSc or MPH programme. These studies will provide the basis of knowledge required for taking the DFPH examinations of the Membership of the Faculty of Public Health (MFPH).

Trainees are expected to start their MSc/MPH programme in the September after joining the scheme and sit DFPH in the June of the following calendar year.

Throughout this phase trainees will be based at their first training location and will return to this location when not attending university. During this time they will be exposed to varied public health experiences relevant to DFPH studies including shadowing members of the public health team.

Achievement of Phase One requires passing the DFPH examination, completion of a mandatory period of Health Protection training, passing the MFPH examination and satisfactory assessment of Phase One learning outcomes in the workplace.

During Phase Two trainees will consolidate core skills in public health practice, have the opportunity to develop specific areas of interest and be encouraged to take up other placements to broaden their public health experience.  Achievement of Phase Two requires satisfactory assessment of learning outcomes in the workplace.

Timely progression through training

The FPH curriculum includes a diagram of the training pathway and timescales for phases one and two. Progression between phases is dependant upon both exam success and achievement of learning outcomes. The timing is not exact, but provides a useful indication of expected progression.

To achieve progress against the expectations for phase progression, DFPH and MFPH should be taken during the respective phases, not at the end. Accordingly the SW PH Specialty Training Programme expects:

StRs will aim to pass DFPH by early ST2. This means there will still be time to resit if needed, before expected completion of all Phase One learning outcomes. StRs will aim to pass MFPH during ST2. Phase one is ideally completed by end ST2 year and no later than the end of ST3.   This is midway through training for full time StRs on standard 5 yr training contracts. At the latest, phase 2 should be completed by the midway between ST4 and ST5.

Pro-rata adjustments must be made to these expectations for flexible working StRs.

Timing of Health Protection Attachment

Following Phase 1 and the successful completion of DFPH, trainees must undertake an attachment to a health protection unit. This attachment is for a minimum of a three month period where they will be expected to acquire many of the public health skills required to deal with health protection issues. Following completion of the attachment, trainees will be assessed to ensure that they are competent to go on to the on-call rota. Guidance on the assessment of competence to start supervised on-call duties can be found in the Health Protection Training policy.

Duration Of Training 

For Speciality Registrars, public health training is normally full-time for five years. Part-time training is proportionately longer. Training time may be reduced where applicants have previously completed a relevant masters qualification. Eligibility for a reduction in training time will be decided through individual assessment.

Academic Year 

The first year of training will usually be spent in academic study towards DFPH of the membership examination of the Faculty of Public Health (MFPH), through undertaking an appropriate Masters in Public Health (MSc or MPH) course.

Arrangements for enrolling onto an academic course will need to be made by the trainee prior to the August start date of their first year on the programme.

It is expected that all Specialty Registrars will attend either the University of Bristol, University of Exeter or University of West of England to complete the masters programme. Exceptions will be made for those wishing to study part-time or request attendance at a different masters course for well founded personal reasons. This will be agreed with the Training Programme Director once an offer of employment has been made.

Specialty Registrars who have met the criteria to have a shorter contract may be required to undertake some top up study in preparation for DFPH. The nature of this and the relevant institution will be discussed with both Educational and Academic Supervisor’s and will be approved by the Training Programme Director, once an offer of employment has been made.

StRs having previously gained DFPH and a Public Health masters qualification would not normally have an academic year.

Assessment 

Overview

Assessment during training incorporates:

  • workplace assessment of competence to do the job and
  • timely progression through the training programme, including achievement of MFPH.

Workplace based assessment – StRs and supervisors should work to the FPH curriculum.

The assessment of timely progression through the training programme is via the Annual Review of Competence Progression (ARCP).

Membership to the Faculty of Public Health consists of DFPH and MFPH examinations. Success in the DFPH examination leads to Diplomate Membership of the Faculty. Success in the MFPH examination leads to full Membership of the Faculty.

The DFPH examination is intended to test candidates’ knowledge and understanding of the scientific bases of public health and covers a broad syllabus which is set out on the Faculty website. An MSc or MPH helps prepare the student for the examination. Trainees will also need to be able to apply this theoretical learning to a service situation.

The MFPH examination consists of an Objective Structured Public Health Examination (OSPHE). It is designed as a ‘show how’ assessment of the candidate's ability to apply relevant knowledge, skills and attitudes to the practice of public health. It tests the trainee’s ability to communicate effectively both verbally and non-verbally; assimilate and utilise relevant information; provide appropriate responses and judgements; handle challenges and manage conflict.

Annual Review

The assessment of satisfactory progress in the training programme is undertaken at an annual review via the ARCP.

As detailed in the Gold Guide, ‘The panel has two objectives:

  • to consider and approve the adequacy of the evidence and documentation provided by the trainee, which at a minimum must consist of a review of the trainee’s portfolio through a structured report from the educational supervisor, documenting assessments (as required by the specialty curriculum) and achievements. The panel should provide comment and feedback where applicable on the quality of the structured educational supervisor’s report or assessor’s documentation;
  • provided that adequate documentation has been presented, to make a judgement about the trainee’s suitability to progress to the next stage of training or confirm training has been satisfactorily been completed’.

All trainees must record evidence of their training progress in an individual electronic Portfolio. The portfolio will include evidence to reflect the work completed by the trainee and the competencies that they have achieved. Trainees must demonstrate all of the public health competencies to a satisfactory standard by the end of their training programme. Each competency will require sign-off by their educational supervisor.

F2 Trainees

F2 trainees will have their progress reviewed after the first four months of their placement. A full assessment will be undertaken at 12 months.

Specialty Registrars in Dental Public Health

Dental trainees have a similar assessment process but will report to their dental Training Programme Director, Educational supervisor and Dental ARCP.

Training Locations and Placements 

Rotations

Specialty Registrars are expected to gain experience in at least two different training locations, in addition to health protection experience, in order to be exposed to a wide range of organisational cultures and public health issues.

The training programme runs on a system of rotation zones, with each zone including three or four potential locations. Trainees are appointed to a training location at recruitment stage which determines the zone they are placed in.

The current Rotation Zones are:

  • East Zone 
    • Gloucestershire County Council
    • Wiltshire County Council
    • Swindon Borough Council
    • Bath and North East Somerset Council
  • South Zone 
    • Cornwall Council
    • Plymouth Council
    • Devon County Council
    • Torbay Council
    • Somerset Council
  • North Zone 
    • Gloucestershire County Council
    • South Gloucestershire County Council
    • Bristol City Council
    • North Somerset County Council
    • Somerset Council
  •  Academic Institutions
    • University of Bristol
    • University of the West of England
    • University of Exeter

All trainees are expected to remain in their agreed rotation zone. Exceptional circumstances to this will be considered on an individual basis.

Trainees usually remain in their initial training placement until at least completion of Phase 1 of their training.

Placements

Trainees are encouraged to undertake a variety of approved additional placements to enhance their experience or to pursue special interest options. This includes working at a regional level at some point during their training, most specialist placements would take place during phase 2.

Initially trainees should discuss possible placements with their educational supervisor to ensure its relevance to their training needs. A clear outline of the expected work programme and the way in which it will address the trainee’s training needs and enhance their experience should then be submitted to Training Programme Director for formal approval before commencing the attachment.

Options for general and special interest placements within the South West region include:

Academic Public Health

Placements are available in three public health academic training locations: the University of Bristol, the University of the West of England and the University of Exeter.

Health Protection

Placement are available for all trainees and those wishing to specialise in Health Protection. StRs should discuss current opportunities with one of the PHE Specialty Tutors.

Public Health Information

For trainees wishing to achieve additional experience within public health information, placements may be available within other Public Health settings.

Regional working

Placements are available within the regional Department of Health and Social Care, Health Education England and Public Health England.

Health Services Public Health

Acute Trust placements are currently available at Gloucestershire Hospitals NHS Foundation Trust and North Bristol NHS Trust.

Review of Training Locations

The Training Programme Director will aim to informally visit each of the main training locations regularly. When visiting training locations the Training Programme Director takes account of issues arising from the National trainee survey conducted by the GMC and as part of the Quality Panel process. If trainees have any concerns they should raise them with the Training Programme team.

Time Out Of Programme (OOP) 

There may be a variety of reasons why a Specialty Registrar may seek to take time out of the specialty training programme. There are four categories of out of programme time defined in the Gold Guide and all must be agreed by the Training Programme Director prior to seeking approval from the Postgraduate Dean. Applications should be made following the Severn Postgraduate Medical Education guidance and must be made at least six months in advance. Where time out of programme is requested to count towards CCT, Faculty of Public Health approval must also be sought. Therefore, early discussion of proposals must take place as early as possible.

Taking time out of programme for approved training (OOPT)

This allows a Specialty Registrar to gain experience which is not part of the specialty training programme and must be prospectively approved by the GMC and the FPH as training which will count towards CCT.

Taking time out of programme for research (OOPR)

To allow time to be taken to undertake a period research. This type of time out of programme may be counted towards CCT.

Taking time out of programme for experience (OOPE)

This allows a Specialty Registrar to gain experience which is not part of the specialty training programme which is not approved by the GMC or the FPH as training which will count towards CCT. However, it may allow a StR to pursue a special interest.

Taking time of programme for a career break (OOPC)

Educational Roles and Expectations 

In line with FPH guidelines and the Gold Guide, an Educational Supervisor is appointed to each trainee with responsibility for planning, co-ordinating and supervising training. Each trainee must also have regular access to a named academic supervisor. There may also be times when the educational supervisor co-ordinates the work of other designated activity supervisors. 

Progression through training is assessed by ‘Annual Review of Competence Progression (ARCP) panels’ who look to academic, educational and activity supervisors to play distinct roles in assessing evidence and providing reports on a specialty registrar’s progress. In addition to the above, each training location has a Specialty Tutor who supports quality of training in each location. Zone Lead Supervisors represent one of the four geographical zones or the Health Protection regions. They support all supervisors within their zone and ensure quality training standards are met.

Educational Supervisors

The FPH definition: ‘A trainer who is appointed and appropriately trained to be responsible for the overall supervision, management and assessment of a specified registrar's educational progress during a training placement or series of placements. They are responsible for assessing and confirming acquisition of learning outcomes and competences’.

Key elements of the role are to be committed to actively providing high quality training and timely supervision, processing documentation for ARCPs in a timely manner and conducting appraisals for registrars.

Educational supervisors have a longitudinal overview of the training of each trainee appointed. They are responsible for supervising the service experience, for ensuring that adequate resources are available to the trainee for that purpose, and for monitoring the adequacy of the programme.

Educational supervisors are responsible for providing a structured report of evidence of progress in training prior to the annual review process (ARCP) via e-portfolio. This report will be read by the ARCP panel and must have been discussed with the StR.

Educational supervisors will:

  • Assess the learning needs of trainees attached to them on an individual basis and draw up a realistic and achievable learning agreement with them.
  • Be readily accessible to the trainees for whom they have been appointed supervisor.
  • Use a written framework for training with regular review and constructive feedback. Be able and willing to identify and ensure delegation of appropriate tasks and responsibilities to the Trainee.
  • Ensure that all ARCP competences are met and signed off
  • Provide support for trainees taking the DFPH examination and preparing for the MFPH.
  • Facilitate learning opportunities not available locally to ensure exposure to the full range of required competencies.
  • Encourage, support and offer the trainee constructive feedback.

Frequency of meetings between educational supervisor and specialty registrar

Throughout their time on the programme StRs will require different levels of input from their educational supervisor. As a guide the FPH suggests progress should be reviewed initially weekly, (with a minimum of 1 hour protected time) in addition to frequent informal contact. During the StRs first 18 months on the training programme this could equate to one hour per week prior to the masters programme, during academic holidays and on their return to the training location following the end of the masters course. Contact after the initial 18 month period will be negotiated between the StR and supervisor according to StRs training needs and should be documented in the learning agreement. GMC guidance states that StRs must meet regularly at least every three months to discuss their progress, outstanding learning needs and how to meet them.

All educational supervisors must meet the following FPH criteria in order to be considered for the role:

  • be on the Specialist Register or the UKPHR of public health specialists or the dental equivalent
  • be a consultant or senior professional working in an area relevant to public health.
  • meet the requirements of the local deanery training programme and has attended Supervisor training.
  • keep up to date with the curriculum and assessment systems.
  • participate in FPH CPD or equivalent scheme.
  • have a commitment to delivering high quality training eg. by undertaking a higher qualification in teaching or education for health professionals

Academic Supervisors

Each trainee has a nominated academic supervisor who is responsible for providing supervision, support and advice on an ongoing basis and for helping prepare trainees for their MFPH examinations (DFPH and MFPH).

Trainees will be allocated to an academic supervisor at one of the three academic centres in the region – University of Bristol, University of the West of England and the University of Exeter. This allocation will be made before the trainee starts the programme and will take account of the trainee’s initial training location, past experience, career intentions and the current workload of all academic supervisors.

The main responsibility of academic supervisors is to ensure that trainees achieve competency in the academic disciplines that are central to providing evidence based public health and health commissioning.

Academic supervisors will:

  • Assess the learning needs of trainees attached to them on an individual basis and draw up a realistic and achievable learning agreement with them.
  • Be readily accessible to the trainees for whom they have been appointed supervisor.
  • Use a written framework for training with regular review and constructive feedback. Be able and willing to identify and ensure delegation of appropriate tasks and responsibilities to the Trainee.
  • Ensure that all ARCP competences are met and signed off.
  • Provide support for trainees taking the DFPH examination and preparing for the MFPH.
  • Facilitate learning opportunities not available locally to ensure exposure to the full range of required competencies.
  • Encourage, support and offer the trainee constructive feedback.
  • Provide support with writing papers for peer review in journals or at conference presentations
  • Advise on training opportunities in academic public health
  • Provide specific supervision for trainees who become lecturers or academic trainees.

The academic and educational supervisors with the trainee will agree a programme for academic supervision during the formal academic training period. A copy will be sent to the Training Programme Director.

Academic supervisors are responsible for providing a structured report of evidence of progress in training prior to the annual review process (ARCP) via e-portfolio. This report will be read by the ARCP panel and must have been discussed with the StR.

Frequency of meetings between academic supervisor and specialty registrar

It is expected that every trainee meets with their academic supervisor on appointment and has a minimum of three face to face meetings with their academic supervisor each year, at least one of these should be a three-way face to face meeting with their educational supervisor and academic supervisor each year.  

Activity Supervisors

Trainees may undertake a variety of work under an Activity supervisor other than their educational supervisor. This will be agreed in discussion with their educational supervisor as part of their work programme. Task contracts may be helpful in setting aims, objectives, scope and duration of pieces of work.

Activity supervisors should:

  • have a broad understanding of public health, though not necessarily a public health qualification
  • understand the relevance of the project in meeting the trainee’s required learning outcomes
  • be committed to providing high quality training and be able to demonstrate it by attending Training the Trainer or other equivalent courses
  • be willing and able to set aside protected time for supervision with the trainee and educational supervisor as appropriate.

Training and selection of supervisors

Competent public health professionals do not automatically have the knowledge, skills and attitudes to train well. Supervisors require initial and continuing education to develop their training competence. Therefore, all new and existing supervisors must meet the five core training requirements developed by the Severn Postgraduate Medical Education to ensure compliance with the General Medical Council (GMC) training requirements. It is a formal requirement to have met all five competencies.

All educational and academic supervisors must have received training in the following core competencies:

  • Training and Trainee supervision
  • Successful learning environments for supervisors
  • Workplace-based assessment, appraisal and feedback
  • Annual Review of Competence Progression (ARCP) processes
  • Equality and Diversity (certificated)
  • How to Support Trainees

Consultants wishing to become educational supervisors should review the FPH requirements and approach their line manager and the Training Programme Director in the first instance. Academics interested in becoming academic supervisors should approach the Specialty Tutor at their institution.

Following agreement of the role and time commitments the above training will need to be undertaken prior to a Specialty Registrar being allocated. It should be noted that StRs will be allocated according to training location and need so not all supervisors will have an StR at all times.

Specialty Tutors

Specialty tutors are a standard feature of all specialty training programmes in the Severn Deanery. Each training location will have a nominated specialty tutor who is identified as an enthusiast to support quality of training in each location to ensure the systematic implementation of the Severn Postgraduate Medical Education Quality Framework.  Specialty tutors are educational or academic supervisors who have achieved all five core competencies required to be an accredited Educational Supervisor by background. University leads provide the specialty tutor role at each of the three locations.

The role of specialty tutors is to help:

  • Maintain an environment within the departmental multi-professional team that supports training and delivers the curriculum and relevant assessments at Specialty levels
  • Support trainees and supervisors
  • Ensure systems are in place for induction, developing the quality of training, delivery of formal education and study leave management
  • Provide a short annual departmental report of training (Severn PGME provides a template for this). This would include reviewing any quality indicators for the department, such as provided by General Medical Council (GMC) and Surveys
  • Act as point of contact for the Training Programme for promotion of training events and other communications where local support is particularly needed.

Specialty tutors support rather than line manage their supervisor colleagues. In some locations DsPH have adopted the specialty tutor role rather than delegating to an educational supervisor in their department.

 Method of appointment: nomination by Director of the training location e.g. DPH.

 Term of office: 3 years can be re-appointed for one term of office.

Zone Lead Supervisors

In the South West region there are three lead supervisors covering their zone ie. North, South and East zones. These roles do not normally feature in the structure of specialty training programmes, but are considered a helpful means of developing closer relationships between the Programme and training locations given the geography of the South West.

Their roles are:

  • To act as a point of contact for supervisors in their geographical area and provide support to colleagues as needed (e.g. mentoring new supervisors)
  • To represent their area on the Academy Board, both to bring items to the committee and feedback outcomes from the committee to colleagues
  • To keep the Training Programme Director up to date of training issues within their area.

 Method of appointment: volunteer – vote if over subscribed; approved by TPD/Head of School

 Term of office: 3 years can be re-appointed for one further term of office.

Induction Programme 

The regional induction programme welcomes all Specialty Registrars, including those from academic and dental disciplines, to the training programme, providing an overview of training in the South West and the local programme arrangements.

This is run through a series of regional induction days which cover the following topics:

  • The role of the Training Programme team
  • Understanding the curriculum
  • Assessment and the ARCP process
  • Building a work-based learning relationship that incorporates not only education and competency issues, but also takes into account the working and personal styles of the supervisor and trainee
  • The academic support available throughout the StR’s training
  • Practical advice about the DFPH examination and an understanding of MFPH
  • Health protection as part of public health training
  • An introduction to key organisations and their involvement in public health

Phase One Of The Training Programme 

All trainees will start their training in August. Trainees undertaking an MSc or MPH will spend around six weeks at their first training location before commencing their academic course. Those trainees who have already completed their masters course will start their training at their first training location.

All trainees will have a local induction programme arranged for them by their supervisors to start at the time they take up appointment in their initial training location. Induction programmes should be tailored to the individual trainees, following a pre-appointment discussion of their training needs with their educational supervisor. However, core components of induction programmes will include:

  • Meeting key members of the public health department, host organisation and partner organisations
  • Attendance at regular public health and host organisation meetings
  • Introduction to NHS and Council structures
  • Introduction to routine information sources
  • Shadowing key members of the public health team
  • Discussion of training needs, in particular any specific ‘know how’ learning needs in preparation for the DFPH examination

Local induction should last no more than six weeks.

During Phase 1 the trainee should meet with their educational supervisor at their initial training location for at least one hour per week.

Expectations of Specialty Registrars whilst attending the academic course

The priority during the academic year is to gain knowledge for the DFPH. However, StRs should remain in contact with their training location whilst attending the academic course and, unless on annual or study leave agreed with their educational supervisor, should attend their training location during the term recesses. Where the StR is attending the academic course will determine whether contact in term time is in person or by e-mail / telephone an individual agreement will be made by the StR, Educational Supervisor and the Training Programme Director. Whilst this contact with the training location will not count towards the 48 months required for CCT, it is an expectation of South West Public Health Training Programme. Maintaining contact will help observe and better understand the theory being taught on the academic course. Attendance at tutorials is encouraged as long as it does not interrupt the academic work. It is expected that the MPH dissertation could be on a topic which links back to the training location to enhance contact time.

It is expected that trainees return to their training location after completion of the taught element of their academic course. However, it is recognised that they will require protected time in order to write up and complete any written assignments and their dissertation in accordance with time requirement stipulated by their relevant academic institution. This ‘protected time’, must be agreed with their educational supervisor.

Annual leave during the academic year must be taken during the term recesses. All leave must be agreed with the educational supervisor.

Within the first three months of joining the Training Programme all trainees are required to enrol with the Faculty of Public Health. Forms will be completed as part of the induction programme.

During Phase 1, the Training Programme will include the following elements:

  • formal academic training for DFPH
  • regional academic events
  • trainee tutorial programme
  • routine department or inter-departmental meetings
  • management training

During Phase 1, trainees are expected to:

  • establish and maintain contact with their academic supervisor
  • attend an appropriate course of academic study. These arrangements must be agreed by the Training Programme Director and educational supervisor
  • consult with their educational supervisor and academic supervisor over the choice of project for any MSc or MPH dissertation
  • pass the DFPH examination
  • identify and maximise opportunities to prepare for taking MFPH
  • take their MFPH approximately six months after passing their DFPH
  • obtain MFPH
  • complete a training portfolio for formal review at their ARCP

Trainees will generally leave their first training location after at least completion of Phase 1 of their training – two to three years into their five year training.

Phase Two Of The Training Programme 

In Phase 2 of their training, the trainee will usually move to their second placement within the same rotation zone. This placement will last until the end of traning.

During this phase, trainees are expected to:

  • attend regional and departmental events
  • complete ARCP documentation and their training portfolio and attend for annual assessments as required
  • obtain varied service experience and consider undertaking specialist placements
  • undertake research and publish findings as appropriate
  • be awarded a CCT and be recommended to the GMC for inclusion on the Specialist Register or be recommended for registration with the UK Public Health Register for Public Health Specialists.

Completion of Training – CCT

The Training Programme recommends that all Specialty Registrars should complete their learning outcomes within six months of their CCT date so that they can spend the final six months of training obtaining experience in an acting up capacity and to focus on making themselves ready to apply for Consultant posts.

Completion of Specialty training in public health is complete when you have had your final ARCP and you have received an Outcome 6 stating that all of the criteria for a Certificate of Completion of Training (CCT) have been achieved.

Once an ARCP outcome 6 form has been completed the Completion of Training Form must be completed, this needs to be signed by the Training Programme Director and then sent to the Faculty of Public Health with the ARCP Outcome form.  This form can be downloaded from the Faculty website. 

Providing the above forms have been completed accurately then the Registrar will be admitted to Membership of the Faculty of Public Health.

On completion of training registrars from a medical background are recommended to the General Medical Council (GMC) for inclusion on the Specialist Register, while those from other disciplines are recommended for registration with the UK Public Health Register (UKPHR).

The Postgraduate Board has approved the introduction of a limit on timeframes within which a doctor is able to apply for a CCT/CP. The limit will be 12 months from the doctors expected end of training date.

It is important that Registrars process their CCT information to the Faculty as soon as possible after they have received their ARCP Outcome 6.  The above process can take a while to go through the Faculty and more importantly in the case of a medical Registrar it has to also be processed by the General Medical Council before an award of a CCT can be given and submission to the relevant register.

A Registrar is unable to commence a Consultant post unless a CCT has been awarded by the Faculty and/or GMC.  To be a Consultant a Registrars name must appear on the applicable register.

The CCT fee is payable to FPH before a recommendation to the regulator is made.  

Applying for Consultant posts

The Faculty of Public Health (FPH) advises that applicants who are Specialty Registrars in public health, but not yet on the GMC Specialist Register, must have fully passed the MFPH examination in order to be eligible to be short-listed for a consultant grade post.

FPH also advises that suitable signed documentary evidence must be provided by such applicants to confirm that they are within six months (i.e. six months beforehand) of being included on the GMC Specialist Register at the date of interview. The documentary evidence should be:

  • either a ARCP 6 (Final Record of Satisfactory Progress) or a letter from the Training Programme specifying the date for completion of training AND
  • a letter from FPH confirming that the applicant has fully passed the MFPH examination.

Remaining in training post after CCT date.

The Gold Guide and the local Postgraduate Dean are the sources of information about the constraints around remaining in a training post after the award of the CCT. 

This is at the discretion of the Training Programme, Registrars are requested to provide documentary evidence to the Head of School and TPD to confirm that the Registrar can provide evidence of applications for Consultant posts.  The Head of School and TPD will need to be updated on a regular basis during the six months as to what progress is being made.

South West Population and Public Health Academy Board 

The Population and Public Health Academy Board is responsible for overseeing the establishment, implementation and monitoring of a comprehensive high quality approach to multidisciplinary public health training and development in the South West. Specifically it is responsible for the running and oversight of a regional training programme for public health specialists.

Membership of the committee includes:

  • Head of School
  • Three or four nominated Zone leads
  • Three Academic leads
  • Faculty Adviser
  • CPD Co-ordinator
  • Lead Health Protection representative
  • Lead Field Services representative
  • Two co-chairs of the StR group
  • Dental Public Health Registrar

Secretarial support for the committee is provided by the Training Programme Office.

Training Programme Support 

Faculty Adviser

The Faculty Adviser is a Member or Fellow of the Faculty of Public Health and is appointed by the Faculty Board. Under the directions of the Faculty Board, the Faculty Adviser shall:

  • promote training and continuing education in public health in the South West region
  • advise on arrangements for the appointment of consultants and on recruitment generally to the specialty of public health with a view to maintaining the highest possible standards of professional competence and practice of public health
  • liaise between the Faculty and its Education Committee on the one hand and the local membership and training organisations on the other
  • shall be available at all times to all trainees in post across the South West region.

Training Programme Director

The Training Programme Director is appointed by the Severn PGME to organise, develop and oversee the running of the public health training programme in the South West. They will work in close collaboration with the Population and Public Health Academy Board and will oversee the work programme of the Training Programme Office.

Training Programme Office

The Training Programme Office is based within Severn Postgraduate Medical Education. The office based team consists of a Head of Specialist Workforce, Training Manager, and Business Support Administrator.

The Training Manager provides the following support for the Training Programme:

  • Administrative support
  • First point of contact for trainees seeking advice
  • Maintenance of the database of trainees and their progress
  • Coordination of the regional tutorial programme
  • Organisation of ARCPs 

The Head of Specialist Workforce is responsible for the provision of the Training Programme’s lead employer service and comprehensive human resources for all trainees, both medical and non medical. All queries regarding personnel issues including sick leave, holiday entitlement and flexible working should be directed to the Head of Public Health Specialist Workforce.

Tutorial Programme And Trainee Meetings 

A programme of tutorials is offered each year. The content is developed by the trainees in consultation with the Training Programme Director and Training Programme Office. All trainees are expected to attend and participate in the tutorial programme.

The Training Manager provides a summary report of the tutorial programme which includes attendance to the ARCP panel.

The trainees regularly audit the whole training programme and their results are received by the Academy Board.

Regional Academic Events 

Regional academic events are held across the South West for those working in public health, including the trainees. Currently there are three key events each year:

  • A one day scientific conference held in the Spring, at which all trainees are expected to submit abstracts of their work, at some point during their training. Abstracts are peer-reviewed before acceptance as presentations.
  • A one day Development school held in the autumn comprising interactive workshops and presentations.
  • A one day Training Conference held in the Summer which provide an annual update for trainees and trainers.

Support For DFPH and MFPH Examinations 

Examiners

Examiners for DFPH and MFPH provide informal support and guidance for trainees undertaking the examinations. Specifically they will help with marking practice questions, commenting on MFPH experience and giving practice oral examinations. Details of examiners within the South West are available on the Faculty of Public Health’s website.

DFPH

Academic training for the DFPH examination will normally involve studying for an MSc or MPH in Public Health. In addition, trainees are encouraged to arrange supplementary tutorials and attend regional revision programmes made available to trainees before taking the examination. They are also required to meet regularly with their academic supervisor whilst studying for their MSc or MPH - at least once before the first term and then during each term or in the following vacation - to review progress towards DFPH and to discuss their dissertation.

MFPH 

Specific training events in relation to the MFPH examination are provided for both trainees and supervisors on an ad hoc basis. Additionally trainees and supervisors are encouraged to utilise the day-to-day working experience to allow as many varied and useful experiences for the trainee. Opportunities to be involved in putting public health skills into practice should be proactively sought by the trainee.

Regular mock MFPH examinations are held within the region for all trainees after completion of their DFPH examination. Mock examinations will consist of a series of scenarios to enable practice role-play experience for the trainees.

Buddying Scheme 

A buddying scheme aims to provide each public health trainee with a more experienced ‘buddy’ who can offer support and advice. The scheme does not replace the relationship a trainee has with their supervisor, but is a complementary, less formal system of support. Buddies will be offered to all new entrants to the programme. 

Existing trainees acting as buddies will usually be post DFPH and normally be based in a different training location although will not be at the opposite end of the region, this does not mean they cannot ask for support and advice from more senior registrars within their placement - meaning they can get support from a number of places.  Participation in the scheme is voluntary but trainees need to commit the necessary time to the task.

New trainees will make contact with their buddy following appointment but before taking up their post. They will arrange to make contact on a regular basis depending on the new trainee’s needs.

All discussions are treated in confidence and not disclosed to anyone else without consent. However it should be clear that if serious issues relating to training arise, these are to be referred to the Training Programme team.

Membership of the Faculty of Public Health and Professional Registration 

After appointment to the Training Programme trainees will be required to enrol with the Faculty of Public Health. An enrolment form may be downloaded from the FPH website. Forms should be completed and sent with supporting documents to the FPH Education and Training Department. This will be done as part of the regional induction programme.

Diplomat membership will then be made open to all trainees once they have passed the DFPH examination.

Full membership of the Faculty is then awarded to those who pass both DFPH and MFPH. 

On completion of their training, the following recommendations will be made:

  • medical doctors will be recommended to the GMC for inclusion on the Specialist Register;
  • dental public health trainees will be recommended for registration with the GDC’s Specialist Register;
  • those from other disciplines will be recommended for specialist registration with the UK Public Health Register.

 

Section C Human Resources 

Recruitment 

Overview

Recruitment takes place early each year for posts commencing in August. This is part of a national process which includes:

  • application through a web-based portal
  • an assessment centre to test for numerical and verbal reasoning
  • a selection centre to demonstrate essential criteria.

The training programme runs on a system of rotation zones, with each zone including three or four potential locations. Trainees are appointed to their first training location as part of the recruitment process, this will dictate which Zone the trainee is placed in. 

Specialty Registrars in Public Health

A national person specification and selection criteria are available each year through the Faculty of Public Health website.

Clinical Lecturer and Academic Clinical Fellowship Posts

Trainee positions for Clinical Lecturers  and Academic Clinical Fellows in public health are available on an ad hoc basis and will be advertised through the Severn PGME website as available.

Specialty Registrars in Dental Public Health

Trainee positions for StRs in Dental Public Health are available on an ad hoc basis and will be advertised through the Severn PGME website.

Inter-Deanery Transfers

Applicants who have completed part of their public health training in other regions and have well-founded reasons for transferring to the South West region will be considered for the regional Public Health Specialty Training Programme. 

Contracts 

All contracts for public health trainees are held by Gloucestershire Hospitals NHS Foundation Trust for the Training Programme. There is dedicated personnel support to administer the contracts from the Head of Public Health Specialist Workforce within the Training Programme Office.

Any changes to terms and conditions, i.e. changes in hours, starting the on-call rota etc must be discussed with the Head of Public Health Specialist Workforce well in advance of any change and no later than a month before the planned change to allow the payroll record to be amended.

Insurance and Professional Indemnity Cover 

The main principle of NHS indemnity is that NHS bodies are vicariously liable for the negligent acts and omissions of their employees and that NHS bodies should have arrangements for meeting this liability. All employers are vicariously liable for the negligent acts of their employees, provided that the employee was acting in the course of their employment. As a result, personal cover, from a defence organisation, trade union or other body, is not required in relation to practice as an employee. Personal cover would only be required in relation to self-employed practice.

Health Education England have purchased Indemnity cover for all Public Health trainees under the auspices that they are NHS employees working within non-NHS organisations.

Annual Leave 

Annual leave entitlements will be in line either with Agenda for Change or Medical and Dental terms and conditions. For all Specialty Registrars the leave year runs from their commencement date.

Multi-disciplinary Specialty Registrars will receive the entitlement to annual leave and general public holidays in line with NHS Agenda for Change terms and conditions of service as follows:

Length of Service Annual

Leave and public holidays

On appointment

27 days + 8 days

On appointment

29 days + 8 days

After 10 years service

33 days + 8 days

Medical Specialty Registrars will receive the entitlement to annual leave and general public holidays in line with 2016 Junior Doctors Contract terms and conditions of service. 

 

Pay scale incremental points

Annual Leave, statutory days and public holidays

On appointment

27 days + 8 days

After five years service

32 days + 8 days

For part-time workers, annual leave should be calculated on a pro-rata basis and be taken in hours with an allocation for a pro-rata amount of bank holidays.

All annual leave should be agreed with educational supervisors in advance. 

Other than under exceptional circumstances, any outstanding annual leave cannot be carried over into the next year. A maximum of a week can be authorised and carried over but this should be agreed with the Educational Supervisor and the Programme Team but will only be for exceptional circumstances.

Whilst StRs are attending their academic course at the beginning of their training, annual leave must be taken during the term recesses. All leave must be agreed with the educational supervisor.

Sickness Leave 

All incidents of sickness should be reported to the trainee’s educational supervisor immediately and the Training Programme office. Details of sickness leave and sickness certificates should then be forwarded to the Training Programme Office as soon as the Registrar has returned to work.  The full policy can be found on the Employment page of the School of Public Health website.   Absence from training, other than for study or annual leave, may have an impact on the trainee's ability to demonstrate competence and the satisfactory completion of the curriculum.  Where a trainee has been absent for a total of 14 days or more in a 12 month period, this will trigger a review of whether the trainee needs to have their CCT date extended. 

Study Leave 

Study leave aims to:

  • Enhance clinical education, training and learning.
  • Be incorporated as an integral part of the education and training process.
  • Provide education and training not easily acquired in the clinical setting e.g. the acquisition of a theoretical knowledge base.
  • Support the delivery of curriculum targets.
  • Be considered as part of the appraisal process between the trainee and their Educational Supervisor.

Policy

The Public Health Training Programme will adhere to the Severn Deanery policy. This policy provides further information on study leave and outlines points to consider when applying for study leave. In brief, Specialty Registrars are entitled to a maximum of 30 days study leave per year. It is expected that half (15 days) of this allowance is used for Tutorials and regional training events for which a study leave application is not required. The other 15 days is for external use. The year’s allocation is calculated from the date of commencement onto the programme. Trainees who are less than full-time will be allocated study leave days on a pro-rata basis.

The study leave allowance is £563 per trainee per year. If you are undertaking a masters course, (or equivalent short-courses) during your first year on the programme, the study leave allowance will be used towards the cost of the masters course. Only external study leave expenses will be deducted from the £563 allowance.

Applying for Study Leave

Time off for study leave should be requested using the online Accent system. You should also include anticipated costs on your application. Study leave applications should be made at least 2 weeks prior to the date the leave is scheduled to take place. Applications made after the deadline may not be authorised.

Study leave applications are not required for the following Regional Public Health Events and related expenses will not be deducted from the study leave allowance;

  • Tutorials
  • Development School 
  • Annual Training Conference
  • Scientific Conference

If you wish to attend any Locally run courses such as those below, a study leave application is required and attendance will be deducted from your 15 days external allocation but any related expenses will not be deducted from your £563 study leave allowance.

  • Short courses run by the Universities (Bristol, Exeter, UWE)
  • DFPH Revision Courses
  • Professional and Generic Skills training
  • Other courses ran locally by institutions linked to the training programme ie.PHE/Severn PGME

For all external courses and conferences, study leave applications are required. External courses are defined as being courses that are not within region ie. FPH conference. External leave also includes exams and private study. Such events will be deducted from the 15 days external study leave Registrars are entitled to and expenses including course/conference fees, travel, accommodation and subsistence will be deducted from the £563 study leave allowance.

Registrars can access their leave and allowance entitlements and remaining balances when logging into the Accent system. If you experience any difficulties accessing the system please contact the Public Health Training Manager.

Once you have submitted your application, you will receive an email notification once leave is approved.

If you need to claim study leave expenses this needs to be done using the Easy expenses system. Study leave expenses will only be authorised if an application has been made for the leave beforehand and anticipated costs were inputted. The deadline for submitted claims is the 5th of each month.

Please contact the Training Programme team should the course provider require a Purchase Order.

  • We cannot pay study leave to trainees whilst they are Out of Programme.
  • We cannot reimburse international flights.
  • We cannot reimburse exam fees.
  • We cannot pay for any claims without proof of payment and and a feedback form.
  • We can only pay up to £55 per night accommodation unless it is in London.

Study Leave Feedback Forms

In line with the Severn PGME Study Leave policy, completion and submission of a Study Leave Feedback form is required following attendance of any external study leave you wish to claim expenses for, this is a quality control measure. Feedback forms should be submitted with or before a claim for expenses is received by the programme team. Feedback forms can be emailed electronically to the Public Health Training Manager or uploaded onto a registrar's ePortfolio, although a registrar must inform the Public Health Training Manager which way they intend to send the form.

Failure to submit feedback may result in expenses not being authorised.

Maternity Leave 

Maternity leave of absence is available up to 52 weeks. However the pay received will be dependent on length of service with the NHS and the intention to return to work.

Occupational Maternity Pay is available for women with at least one year’s continuous service within the NHS at the beginning of the 15th week before the expected week of childbirth.

Statutory Maternity Pay (SMP) rates are set by the Government and are payable for a maximum of 39 weeks from the start of maternity leave. 

The full maternity leave policy can be found on the Employer section of the School of Public Health website. This policy also provides details on adoption and paternity leave.

Absence from training, other than for study or annual leave, may have an impact on the trainee's ability to demonstrate competence and the satisfactory completion of the curriculum.  Where a trainee has been absent for a total of 14 days or more in a 12 month period, this will trigger a review of whether the trainee needs to have their CCT date extended. 

Less Than Full Time Training 

Trainees who have well-founded reasons for doing so may train flexibly. Reasons for working part-time should be discussed with their educational supervisor and the Training Programme Director prior to an application being made to the Severn PGME. If an application is successful, their training duration will be lengthened pro rata to take account of their flexible working.

Homeworking

It is expected that Specialty Registrars in Public Health should use the homeworking policy within their training locations and any homeworking agreements should be discussed with supervisors.  In this instance we will not use the Homeworking policy used by Gloucestershire Hospitals NHS Foundation Trust. 

Feedback On The Training Programme 

To enable an effective evaluation and improvement of the quality of the training programme, Specialty Registrars who have completed the programme will be required to complete a survey.

For individual trainees leaving the training programme, an exit interview will be undertaken with the Head of Public Health Specialist Workforce and the Training Programme Director.

Key Contacts 

A list of key contacts for trainees whilst on the Training Programme is available School of Public Health.

Where a trainee is unsure of who to contact with any enquiry, they should liaise with the Training Programme Office for advice in the first instance.