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A new online service should benefit public health practitioners and GPs involved in commissioning
On 1 July 2007 smoking will be banned from most enclosed public places and workplaces in England, with fines for people who break the law.1 The government of the United Kingdom estimates that this will result in a fall of 1.7 percentage points in the prevalence of smoking in England and an estimated annual saving of £100m (€147m; $200m) to the National Health Service.2
National legislation inevitably puts pressure on local health services to deliver its promises. Yet timely and reliable information to help implement and monitor public health policies like smoking cessation is not always easy to find. Public health information exists in many forms in disparate locations. The UK government recognises the lack of a comprehensive collection of information for public health, and attempts are being made to rectify this.3
Data, evidence, and narrative information form the three main types of public health information. Data—which is quantitative—usually describes a health service by its inputs (such as financial), outputs (such as hospital activity), and outcomes (such as survival rates). When displayed as trends over time or comparisons between places such data can be powerful. Secondly we have evidence, which comes from published research. Finally, we have narrative—qualitative information based on the experience and insights of people who use and provide a health service—the equivalent of a patient's history as recorded by a doctor.
Information on public health is less readily accessible than that available to colleagues working in more clinical settings, and it is time consuming to find. Practising public health practitioners also need tools and worked examples that can be applied to their local situation.
A new online service from the BMJ Publishing Group, BMJ Health Intelligence, aims to fill this gap. It takes essential public health topics and “unpacks” them, putting data, evidence, and examples of good practice into context in a way that is easy to find and apply. This same easy approach is being developed by BMJ Health Intelligence to support commissioning, especially for general practitioners (GPs) who have little experience in this area.
As gatekeepers to secondary care and with a commitment to a defined practice population, GPs can exert considerable influence over hospital referrals and activity in secondary health care. They also have access to accurate information about the numbers and types of referrals from their computerised information systems and have considerable knowledge about the health of the local population.
The Department of Health in England has recognised GPs' vantage point and given them a lead role in practice based commissioning. This makes it even more important for GPs to see their acutely ill patients within the wider context of the whole population. Despite this obligation to get involved in commissioning, many GPs have little time to consider these wider health issues. To overcome this, interested GP should be encouraged to acquire public health skills and work alongside their public health colleagues.4 BMJ Health Intelligence is also developing support for GP commissioners with easy access to evidence, data, tools, and examples of good practice. This will help establish the necessary long term relationships between primary and secondary health care and shape local patient pathways within a finite budget.5
In clinical medicine, an intervention cannot be promoted without some evidence of effectiveness. In public health, where funding is even more limited than in other specialties, it is even more imperative that interventions are both cost effective and clinically effective. Evidence is not always available, but where it does exist the service offered by BMJ Health Intelligence classifies it into what works, what may work, and what doesn't work.
The service—which launches this month—has been built with contributions from practitioners, and it will continue to evolve with users' feedback. When the smoking ban comes into force on 1 July 2007, those who provide services for smokers will be better prepared.
Competing interests: AW is the editor of BMJ Health Intelligence. PB is a contributor to BMJ Health Intelligence.
Provenance and peer review: Non-commissioned; not externally peer reviewed.