At the Public Sector Show 2018, Government Europa caught up with Deborah Mckenzie, Chief People Officer from Public Health England, to talk about her role and the organisation’s future ambitions.
Public Health England is an agency of the Department of Health and Social Care in the United Kingdom. Its ambition is to protect and improve the nation’s health, prevent public health hazards and emergencies, and address health inequalities; for example, by tackling the differences between the lifestyles and health problems that are typical of different groups.
Deborah McKenzie is the Chief People Officer at Public Health England and Government Europa spoke to her at the Public Sector Show 2018 – held in London, UK, in June – in order to form a greater understanding of the role the organisation plays in the UK’s healthcare system, and its initiatives and ambitions for the future.
What are your responsibilities within Public Health England?
I am the Chief People Officer, so I have this amazing role that covers everything from recruiting people, payroll, pensions, change and continuous improvement, staff engagement, organisational development, workforce development, leadership development, learning and development, occupational health, and HR policy development.
What are Public Health England’s main ambitions? How is the organisation working across communities in order to achieve them?
We are very focused on population health and what matters for us is how we help people stay well for as long as they possibly can. We work with the NHS to provide services and support for people to do that.
One area of focus currently is work around air quality, which is an area that is affecting communities; whether it is children walking to school, people going to work, and so on. We are currently working with other government departments on this.
Sugar and obesity is also an important topic, and we are exploring how we can help people maintain a healthy weight. The government’s second obesity strategy was published recently. This sets out a whole series of initiatives that really matter to us.
We also continue to care about helping people to stop smoking because we know that it is one of the major determinants of long term health and wellbeing.
We work very closely with local government because, in the context of public health care, housing and having a safe place to live is extremely important. The same is true of having meaningful work, whether that work is paid or unpaid.
How do you aim to provide leadership on areas such as talent, performance, culture and behaviour?
This is a big question. On the leadership side, we firmly believe in systems leadership. From research we have been involved in we know that what makes a difference is having a shared ambition, created together with our partners in other organisations. We do our best to create a culture which is organisationally agnostic. What matters is the outcome that we are trying to achieve for a community. Whilst it’s important to recognise and work within the governance of our organisations, we seek to do this without being constrained by it.
We have several leadership development programmes to enable people to work across organisations and systems with confidence. They range from a public health programme which we commissioned the University of Birmingham to develop and run for us, all the way through to internal programmes.
Regarding talent management, we prefer to frame this as career conversations because each person who works for us has talent, and it is our role to help them do their best work. We try to give development opportunities to every single individual, and we have adopted the 70/20/10 approach to achieve that.
These numbers are broadly right and precisely wrong; the smallest amount of support, some 10%, sees people being sent on a course to give them fresh ideas or approaches. The next 20% concerns how they then begin to think differently about their role and includes shadowing people or being coached and mentored or going on a peer visit to explore other parts of their world to see what they can do differently. The remaining 70% refers to taking what they learn on the course – and by talking to and observing others – and applying it to their day job to improve outcomes.
What are the main barriers to institutional and cultural change? How can these
The sheer amount of change that we experience each year is truly fascinating. I see people who are very change-fatigued, and this can be a barrier as they don’t feel they have the resilience to deal with another change
One of the ways that we work here is to think about this as continuous improvement; indeed, not all change has to be really big or disruptive. It is about getting people to help identify what the changes need to be; involving them in that identification and in then determining how we are going to make the change happen.
Another barrier to change also concerns capacity. For all of our major changes, we have used our own internal group of change agents and change enablers to work alongside the business to deliver the change.
How are inequalities being addressed?
This is happening at many levels. First, we look at the macro societal inequalities and we work very closely with our colleagues in local government to look at where those inequalities exist. We have a programme of work called ‘Well North’, as the inequality gap is broadly greater in the north than it is in the south (although, of course, there are pockets of inequality everywhere, broadly speaking). We put resource into that and conduct research to look at what is going to make a difference.
With the advent of the sustainability and transformation areas, as well as integrated care systems, people are coming together at a local level – GPs, hospital trusts, local government, third sector, and so on – and they are doing huge amounts of work around what that inequality gap looks like and what can they do practically to make a difference. We are partnering with them through our own local centres/organisations to see how we can help.
With regard to the micro inequalities, we need to understand how we make sure that people have the same recruitment opportunities and how we can make sure they have the same promotion opportunities. We have a lot of practices in place to achieve this. For example, in recruitment, applications remain anonymous because we remove the person’s name and age when they are shortlisted for interview. The person responsible for hiring for the role is only presented with information on what the applicant has done in the past and how well they fit the role.
What are your hopes for the future, short and long term?
A lot of what we have done is because there is a phenomenal coalition of people who deeply care about the health of local communities. It would be wonderful if we could work on generational change, to think more about how we can make things better for children being born today, and how can we make it better for people as you reach, or come closer to, retirement.
We are really looking forward to the improvements taking place in the NHS in England, as the national bodies come closer together. In addition, there is a settlement coming through from government, which is all around extra investment to improve health outcomes. Prime Minister Theresa May has highlighted prevention as being an area that she wants to see better supported, and we would love to increasingly bring our relationship with social care closer together because, for us, we are all part of the solution.
This article will appear in Government Europa Quarterly 27, available in October.