According to the Faculty of Public Health’s careers booklet, the speciality is all about focusing on “the bigger picture.” It describes us as taking action to “promote healthy lifestyles, prevent disease, protect and improve general health, and improve healthcare services.” I’ve been back at the PCT for a couple of months now, after my MSc, and this brief snapshot alone has demonstrated to me the diversity of the work that goes on behind the scenes of the NHS.
I suspect to the man on the street, the main business of the PCT is denying needy patients expensive drugs, and I’ve certainly been involved with exceptional treatment panels, referral management meetings etc. I doubt I’ll manage to quash the myth single-handedly, but it has been only a tiny part of the work.

When I sat the first part of my membership exams, the statistics and epidemiology skills all seemed very abstract. However, they came into their own when I was asked to write a report on a set of local health statistics. I’ve also been involved in planning various community services for cardiovascular patients and the elderly, at the same time as editing undergraduate teaching materials.

The bigger picture hit home particularly at a meeting to discuss the plans of a large supermarket chain to build new a new store in the borough. Putting aside personal views, the PCT group had to review everything from the safety of pedestrians visiting the store, to the impact the facilities might have on nearby general practices. Added to this were issues such as noise and air pollution, the knock-on effect on local businesses, as well as the provision of green space – all the wider determinants of health. It remains to be seen whether the plans are approved, but it demonstrates nicely that promoting health in a population is about much more than curing illness.

As I am an academic trainee my timetable for the next couple of years is quite bitty, so I’ve just been at the PCT for a brief spell this time. I return here next year for a longer period though, and I’m sure the work then will be even more diverse. In the meantime, I’m off to the Health Protection Agency next week, which will be another perspective again.

Helen Barratt, 14 November 2008