09 Mar 2016 Students Spend A Week Shadowing Policy Advisors At The Department of Health
Some of our prospective medicine students recently spent a week at the Department of Health shadowing the work of a policy advisor to Jeremy Hunt (Secretary of State for Health). This was an incredibly rare opportunity for our students to gain an insight into the inner workings of Government and the structure of our national health service. Two of the group have written their view of the week’s work experience arranged by The NCS.
The student view – Sherrice (Year 12)
Whilst pursuing a medical career is of importance to me and is a goal which I hold dearly and requires in depth scientific knowledge, I also recognise the importance of understanding the non – clinical side of the NHS. This includes understanding the structure of the NHS and how it is run, as well as the different groups of people who all contribute to ensuring that the NHS is as efficient as possible. These are all things which I gained an insight into after spending a week at the Department of Health accompanied by a fellow student, Nadia.
The week began with a rather enjoyable commute into Westminster; as a student who lives locally to college this journey was something of a novelty for me ! I throughly enjoyed the voyage into Central London as the scenery of Westminster was truly magnificent; being constantly surrounded by it during the working day instilled a sense of culture and an admiration for the city which I live in.
After our arrival, we were whisked to a talk about Health and Terror in which an external company educated us on how they identify patients who present symptoms of mental illness. They aim to tackle and aid the patients recovery before they present a serious risk to the general public. Following this, we spoke to a policy advisor who works on devolution and how these systems affect the interaction betweenEngland, Scotland, Northern Ireland and Wales with regards to the healthcare system. Amidst this, we completed an online introductory course to the Civil Service which gave us a basic understanding of how the Civil Service run and the structures that exist within it.
On the second day, we were taken over to the Treasury and spoke to someone who was directly involved with budgeting for the NHS. This was extremely interesting as we spoke about the financial issues facing the NHS and how the government is trying to tackle these problems. Not only this, but the building was extremely beautiful and had mesmerising architecture which definitely added to the enjoyment of the experience. Later on in the day we spoke with an end of life care policy advisor who briefed us on his line of work, as well as discussing the ethical issues which relate to this policy making, something which was thought provoking and emotive. The day ended with a visit to the London Ambulance Service where we discussed ambulance targets and how the service attempts to cope with the immense pressure being placed on the system. We came up with our own suggestions as to what might enable the service to work more efficiently.
The wealth of information gained will definitely set me in good stead when applying to universities in September as learning about the other side of the NHS is vital to ensuring that we a successful NHS in the future.
Our third day at the department was the most action packed and exciting one, shadowing Jane Ellison MP and Minister of Public Health. We accompanied her to a conference in Victoria where she addressed the Local Authority Association on how a more efficient NHS could be created by focusing on the prevention of diseases as oppose to cure. Following this, we then attended the House of Commons where she also addressed a group of senior clinicians at a diabetes conference. We then attended a talk on transmissible cancers in Tasmanian Devils; as a budding scientist this was something which I found highly enjoyable! To end the day we spoke to various people who worked in cancer, mental health policy and the legal team.
Thursday also began by shadowing a minister, Ben Gummer MP. We attended his meeting with Chief Executives of hospitals under special measures. The strains of taking on such a task were discussed as well as possible ways to encourage other senior people in the NHS to step up into similar, challenging roles. We also visited the House of Commons and listened to a live debate about Yemen as well as going to the House of Lords where we listened to Lord Prior’s debate about tackling drugs in the UK.
Our last day consisted of talking to a policy advisor who works on the NHS Constitution; the importance of this document was highlighted as it outlines both our rights as patients as well as duties which we will be obliged to carry out if we become doctors. As well as this, we discussed how data collected is used to influence policy with an analyst. Following a talk on the EU we spoke to someone who was concerned with saving money in the NHS, to make it the most efficient yet cost effective service. We discussed possible methods to tackle this problem as well as the drawbacks of some of these methods. As we discovered, it is a very complex problem which does not have a clear cut solution; various groups of people need to be considered when making such important decisions.
This concluded my week at the Department of Health and I was sad to finally leave at the end of such an informative, enjoyable and eye – opening experience. The wealth of information gained will definitely set me in good stead when applying to universities in September as learning about the other side of the NHS is vital to ensuring that we a successful NHS in the future.
I would like to thank NCS Mentor Janani for being a brilliant mentor during this week and providing me with such an insightful experience, as well as Mr Ismail for providing me with this great opportunity.
– by Sherrice (Year 12)
NCS students meet Ben Gummer MP during their work experience at the Department of Health
The student view – Nadia (Year 12)
During my time at the Department of Health, Whitehall, we spent a week with Janani, policy advisor to Jeremy Hunt MP, who helped me develop my knowledge not only of government but of how the NHS is run. It was very interesting to spend time with the people who affect the policies and constitution of the NHS, as well as their policy areas. On our first day we attended a meeting about terrorism in the healthcare system and to our surprise it was mainly speaking about untreated people with mental disorders. The motivations for many of these attacks are resent, intimacy seeking, help seeking and publicity seeking. The behavioural pathway can be seen by the Calhoun and Weston model. You can often spot whether an attack will take place due to warning behaviours exhibited by the person carrying out the attack. Psychotic attacks, though often disorganised, are usually pre-planned therefore attacks can often be prevented by finding previous emails or letters to the person being attacked that are threatening. However, it is impossible to predict every attack so it is important to look out for warning signs.
It was very interesting to spend time with the people who affect the policies and constitution of the NHS, as well as their policy areas.
We also learnt that there have been significant changes to the NHS and how it is run. There has been an improvement in the treatment of patients and life expectancy is higher but this brings greater pressure on services to maintain patient quality. NHS England’s vision for the Five Year Forward View is to close 3 gaps; the variation in people’s health, differing standards of care and the financial demands off and on an effective and affordable system. Their ambition is for high quality health and care services. The system can be viewed at a local or national level. At a local level, you have health and care services like GP surgeries, home care, community services, ambulance services, hospitals, mental health services and care homes. Most people need the support of at least one of these services in their lives. Local authorities are responsible for funding care and support services. Leadership on improving health and wellbeing is provided by Public Health England (PHE). PHE also provides the national infrastructure for health protection and supports the NHS in responding to emergency. At a national level, they are responsible for managing the NHS budget, planning and delivery of services, funding Clinical Commissioning Groups (CCG) and for funding and contracting primary health care services. The NHS is run by all these groups and many more.
We spoke to the Association of Ambulance Chief Executives (AACE). They told us about the difficulties of the ambulance services. One misconception that they made us aware of is that many people think that all hospitals specialise in everything, however, hospitals specialise in different things and the paramedics have to make the decision where to take patients. Diagnostics have to be quick and precise. Paramedics are trained for the worst – even though they mainly get called to elderly people who feel ill, this is another example of where diagnostics are key. They have to develop a critical eye as people don’t always answer questions correctly as they may give loose answers. The biggest challenges facing the ambulance services are meeting demands and not having enough resources. The standard for ambulances to reach their destination in emergencies is 8 minutes, however, time is not important if they did not make a difference but it is difficult to separate what the ambulance services did at the site from the work done at the hospital. Emergencies are different for every person so education about different emergencies are key.
In a talk with Elizabeth Murchison we were told about the transferable cancers in Tasmanian Devils called Devil Facial Tumour Disease (DFTD). Tasmanian Devils are the largest carnivorous marsupial that are only found on the island of Tasmania. In 1996, a devil was found with a tumour on his face. Scientists thought it was a solitary incident, however, it is now believed to be the first sighting of DFTD, which has now spread all over Tasmania. After studies of the chromosomes, it was discovered that all the tumours had similar chromosomes. In a usual cancer, the cancer should be genetically similar to the host only differing by mutation. All the tumours on the devils were genetically similar to each other and genetically different to the host and therefore, they all came from one host originally. The tumours grow very rapidly and this is the first cancer to threaten an entire species as they were listed as endangered in 2008. At the end of last year, another transmittable cancer was discovered in Tasmanian Devils called DFT2. These tumours consists of sheets of cells as opposed to a group of cells like DFTD. This is threatening them even more.
As well as these scientific talks, we also spent half a day in the private office of Jane Ellison MP who is the Under Secretary of State for Public Health. She has been in this role since 2013 and deals with many issues including trying to promote prevention. When we were with her, we went to a couple of her talks including one in the Houses of Parliament where she spoke about diabetes and how we need to reduce the number of cases. After this we spent a day in the private office of Ben Gummer MP, who is the Under Secretary of State for Care Quality. We observed a couple of his meetings and spent some time doing some of the work in his office, preparing for his speech being read the next day. We visited the House of Commons and watched a debate about Yemen as well as watching a debate in the House of Lords about drugs. It was an interesting experience that was very fast paced and engaging the whole time we were there.
I want to thank everyone who made this opportunity possible for this truly amazing experience.
We had private meetings with various policy advisors and learnt about the different opportunities and areas which are involved with the Department of Health. These areas include, end of life care, delocalisation, analysis, cancer, mental health, efficiency, law and the constitution. All of these were incredibly interesting and inspiring.
I want to thank everyone who made this opportunity possible for this truly amazing experience.
– by Nadia (Year 12)