Back to Supporting the Development of Placements for Allied Health Professional Students in Public Health Settings
However, there are barriers to offering and utilising public health-focused placements which have been identified by students, education institutions, people who co-ordinate student placements, private and voluntary sector organisations, and NHS Trusts alike. The Royal Society for Public Health (RSPH; 2021) conducted focus groups with those stakeholders and presented a report on their findings. They found that whilst there was support for AHP students undertaking public health placements, the opportunities for these placements are limited. Organisations may not understand how they can support a student AHP or what they can offer in order to aid their education. The integration of public health into curricula varies across the professions and the opportunities to achieve learning objectives and Standards of Proficiency/Practice Standards needed for registration may not align with the opportunities afforded in public health settings.
The work in this document was funded through the Health Education England (HEE) clinical placement expansion programme. This toolkit seeks to offer solutions to some of the barriers through aligning placement opportunities to learning areas that are mapped to the Public Health Skills and Knowledge Framework (PHSKF) and the Standards of Proficiency/Practice Standards, and reducing the administrative burden of organising public health placements. It is intended to support student AHPs at all levels of their study, education institutions and potential placement providers to offer and undertake placements with a public health focus.
The UK Allied Health Professions Public Health Strategic Framework 2019-2024 is the first UK wide strategic plan that aims to set out the role of AHPs in delivering the public health agenda including the importance of their contribution to reducing health inequalities. The framework discussed how “AHPs themselves… highlighted improving health and wellbeing of individuals and communities as one of the four major transformational impacts they can make” (Allied Health Professions Federation [AHPF], 2019). Developing opportunities for student AHPs to undertake placements with a public health focus will help to achieve the goals set out in the strategic framework, specifically goal 1 shown below;
“Developing the AHP workforce to have the skills, knowledge and behaviours to promote, improve and protect the health and wellbeing of individuals, communities and populations” (AHPF, 2019).
In order to achieve this goal, the strategic framework outlines the importance of “working with education institutions, regulators, employers and professional bodies to ensure public health, prevention and reducing health inequalities are further integrated into AHP pre-and post-registration education, including practice-based education” (AHPF, 2019). Placements (practice-based learning opportunities) that focus on the public health and prevention agenda will enable students to gain hands-on experience of working with populations to address their needs and develop the skills and knowledge needed for their future professions. Students undertaking placements in public health arenas will help to increase the awareness of what their profession can bring to improving public health and preventing health inequalities. Students will develop an understanding of how they can aid with this and organisations will experience the benefits AHPs can bring.
What do we mean when we talk about a public health placement? This question was asked during the RSPH focus groups and we established the following working definition to aid with the development of such placements.
“A placement which enables individuals to develop knowledge, skills, awareness, and attributes in one or more of the four domains of public health: improving the wider determinants of health, health improvement, health protection, and healthcare public health.
Placement providers may be broader than traditional health and social care settings and include charities, social enterprises, private sector organisations, or the wider public sector.
Public health placements may include undertaking an activity, project or clearly defined piece of work which adds value to the placement provider whilst simultaneously enabling the student to experience the work of the organisation and practise generic skills such as leadership, communication and partnership working in an environment that provides exposure to people impacted by the social determinants of health and/or public health related activities.
Placements may consist of registered and/or unregistered professionals from a wide range of disciplines, promoting interdisciplinary working, who can support and assess learners.
The placement will contribute to developing public health awareness and meeting competencies required for AHP registration”.
Placements could be virtual, or face to face where the student is working from a base, or bases, of the organisation. This toolkit considers both types of placement. Placements may also be referred to as “practice-based learning” within documents by HEE or education institutions.
The RSPH (2021) report describes how the expectations of both student AHPs and organisations that could offer public health placements can be a barrier to these placements being provided. In particular, both groups may be unsure about what they can offer, what they will gain or what the student will do whilst on placement.
The definition above helps to illustrate the expectations of the placement; students will develop knowledge, skills, awareness and attributes in areas related to one or more of the four domains of public health. An organisation that works with local communities, groups and populations will enable students to learn about the needs of that population and how to effectively work within these to help promote health and prevent ill health. The organisation does not need to employ AHPs in order to support students as long as they are willing to support and work towards assessing the student. The expectations of students on placement are often driven by achieving their competencies and proficiencies in order to pass their placement assessments and become registered professionals. The section in the toolkits exploring learning areas helps to demonstrate how public health placements can meet these needs and facilitate a discussion on how public health focused placements can develop the skills needed as a registered AHP. Students should expect to work within the organisations to explore the wider determinants of health, health promotion, or prevention initiatives. These placements may involve directly working with people, but could also include working to research and develop ideas without implementing the initiatives. Further examples are explored in the section of the toolkits which discuss what students may do whilst on placement.
The RSPH (2021) report provides rich detail on the benefits public health placements can bring to the students, the wider healthcare system and the placement providers (organisations). Below is a summary of the range of benefits from the perspectives of students, education institutions, people who co-ordinate student placements, private and voluntary sector organisations, and NHS Trusts. Their views and/or experiences of public health placements for AHP students have helped to understand the potential benefits to the students, the wider healthcare system, and to organisations that may provide a placement. Further detail can be found in the RSPH report here.
The student AHPs identified that public health placements provided a chance to enhance their skillset which would ultimately improve their patient/client care. They stated that public health was a part of all AHPs work and placements could help to increase their understanding of the four public health domains, with health promotion, prevention, and understanding the wider determinants of health being referred to the most. Investigating and understanding the health needs of a local area, exploring and analysing local health data, and becoming familiar with local services helped them to enhance their ability to “make every contact count” and improve their patient care. The “mindset shift” that occurred helped to develop empathy amongst the students towards their patients/clients, potentially helping them to develop cultural sensitivity and better communication skills. Working with a “very hard-to-reach, very diverse community” enabled a realistic understanding of who their patients/clients were and some of the challenges they may face when accessing health and social care. This resulted in students “stepping out of their comfort zone, learning to use their skills in a non-traditional setting” raising their confidence. Transferable skills such as “leadership, autonomy, project planning and management skills, research, communication skills, creativity in problem-solving, and skills in developing partnerships and working collaboratively” were identified as being a benefit of completing public health placements which aided their professional development and meeting the requirements for registration.
Professionals working within healthcare systems acknowledged that public health placements could help create flexible and creative leaders, and may support in raising the profile of AHPs, which helped to encourage multidisciplinary team working and partnerships. These placements “present an opportunity to build stronger links between the NHS, local government, charities and other health-related groups and organisations in the community”. This may aid with the ability of AHPs to provide holistic person-centred care. It was recognised that AHPs could work in a preventative way in these placements, and not just at the “point of crisis”, helping to improve health outcomes for the population which the students may not have experienced if they had only been exposed to clinical settings.
Providers that had supported a placement explained it was an opportunity to have someone look at their service from outside and provide a new perspective that may identify gaps or new ideas for service delivery. They acknowledged the ability of students to add value in terms of developing interventions to address areas they identified, or to work on projects, ideas or initiatives that the organisation would have liked to develop but had not had the capacity to do so. Providers discussed gaining knowledge on the latest research and best practice advice through the students which they may not have had the ability to access. These placements enabled exploration of what AHPs could add to their service and in some cases, resulted in students developing business cases for the employment of an AHP in the organisation. This in turn could help with the recruitment of new staff, especially if students had experienced working with the organisation as they may return on an employed or voluntary basis, which increased the organisations capacity beyond the scope of the placement.
AHPs: Allied Health Professionals
14 professions make up the allied health professions: Art therapists, Drama therapists, Music therapists, Chiropodists/podiatrists, Dietitians, Occupational therapists, Operating department practitioners, Orthoptists, Osteopaths, Paramedics, Physiotherapists, Prosthetists and Orthotists, Radiographers, and Speech and language therapists. For more information visit the NHS website.
AHPF: Allied Health Professions Federation
The Allied Health Professions Federation consists of twelve professional bodies who represent the AHPs and aim to improve the mental and physical health and wellbeing of the population through influencing national policy and guidance. For more information visit the AHPF website.
An establishment that is validated to deliver programmes to students that result in the students’ ability to apply for registration as one of the AHPs. This is usually a university or college that delivers higher education courses.
HCPC: Health and Care Professions Council
The HCPC are the regulatory body for 13 of the 14 AHPs. They are responsible for setting standards for education, practice, and training, approve programmes delivered by education institutions, keep a register of professionals who have met the standards, and take action against any registrant that does not uphold the standards. For more information visit the HCPC website.
HEE: Health Education England
Health Education England is a non-departmental public body and is part of the NHS. They work with partners to help produce a skilled workforce for the NHS through education and training, as well as helping to plan and recruit individuals into the many professions across the NHS. For more information visit the HEE website.
Long-arm supervision/mentoring or teaching
This term refers to a person who supports an on-site supervisor and student with the placement. This person is likely to be registered with the HCPC or General Osteopathic Council and may be employed by another organisation or education institution.
MECC: Making Every Contact Count
Making every contact count is an initiative that uses day-to-day interactions people have with one another in order to help facilitate behaviour changes that can assist people with leading healthier lives. For more information visit the MECC website.
This term refers to a person that will take responsibility for the student and their learning during the placement. It will be a member of staff employed by the organisation hosting the placement and the student will have the ability to contact this person with any questions they may have and to access support mechanisms. The on-site supervisor will have knowledge of the organisation and the work they undertake and can support the student in their activities. The on-site supervisor is likely to be supported by a long-arm mentor/supervisor/teacher that may have specific knowledge of the profession and the education institutions requirements.
PE: Practice educator
A practice educator is a person who is involved in the teaching, assessing or supporting of students in the practice environment. This is a role explained with the HCPC Standards for Education and Training. They will have been trained to undertake this role and will be registered with the HCPC to support students who register with this body. For more information visit the HCPC website.
Placements/practice-based learning opportunities
These terms are used interchangeably and refer to a period of time where students are undertaking their learning in a practice environment. A placement provider is an organisation that is providing the practice-based learning opportunity to the student, and in the context of this document, would be the organisation within the public health arena.
The Practice Standards apply to osteopaths and are outlined by the General Osteopathic Council. They set out the expectations of osteopaths (students and registered) to ensure quality care is provided to patients. Students are expected to achieve these standards during their course in order to register with this body. For more information the GOC practice pages.
PHSKF: Public Health Skills and Knowledge Framework
The Public Health Skills and Knowledge Framework is a document that helps to identify the activities that people may undertake in order to help promote and protect the public’s health. The document can be used as an aid to review how an individual’s skill-set meets the aims of public health and to develop these in order to support their career development and progression. For more information access the Public Health Skills and Knowledge Framework.
RSPH: Royal Society for Public Health
An independent health education charity that works to help improve and protect the health of people in the UK and globally through campaigns and education. For more information visit the RSPH site.
Social determinants of health
The World Health Organisation (WHO) defines the social determinants of health as “the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems”. For more information visit the WHO social determinants of health page.
SOPs: Standards of Proficiency
The Standards of Proficiency are outlined by the Health and Care Professions Council and outline the professional standards that all students must achieve in order to register with this body under their chosen profession and continue to uphold during their course of practice. These SOPs cover 13 of the 14 AHPs with Osteopathy having separate Practice Standards set by their registering body. For more information visit the HCPC Standards of Proficiency page.