Oh, you’ve been playing in the Sandpit again?

Posted by Avril Rhodes

When you mention to colleagues or to your nearest and dearest that you’ve spent your working day going around country hotels trying to find the best venue for the Fuse Sandpit residential training event some really sceptical looks are forthcoming. They don’t say it, but each is thinking “What a waste of time – hasn’t she anything better to do?” But, honestly, it really is hard work.

When M’Lord was building his country seat, he thought about creating spectacular grounds, rooms for an army of servants, stable blocks, fine dining rooms and a grand entrance. Strangely, he did not think about the post-aristocratic world of conferencing, or even imagine electricity and internet access. Consequently, whilst ambience, embossed wallpaper, log fires, wonderful views, and curtains that could be turned into seven man (sorry, person) tents are there in abundance, they do not necessarily make for suitable workshop or break out rooms. Country house eccentricity, whilst good for life-size Cluedo (was it Professor Plum in the drawing room with the digital projector or Research Assistant Scarlett in the library with the flip chart?), doesn’t always readily adapt to one’s conference needs.

The final decision: Linden Hall

Some of the country hotels adapted for conference purposes seem to have lost their individuality. The brochure might show a glorious Adam frontage or Palladian columns, but your event mysteriously turns out to be in a windowless, purpose-built block with polystyrene roof tiles, refreshment points (read rubbish coffee machines) or in a wing that separates you from other patrons as if you were somehow infectious.

Never mind, these monstrosities shouldered aside, we have a lovely venue which oozes individuality and charm. Now to envision our use of the space… Yes - the lounge makes a good plenary room, until you realise the public are going to troop through to the dining room. Yes – the library makes a good workshop, until you realise that it only has one socket. Yes – the so-and-so suite would be good until you realise that it’s the wrong shape or size, or might be cold, or doesn’t have enough clear wall space, or is miles away from the other workshop rooms. Debates break out like, “Well, if we use room A for B and space D for C, then we could use room E for G and that will still leave the informal seating area F untouched”, only for someone else to undermine everything you’ve said.

In the end if we’re going to invest properly in the Sandpit style of training, it is worth the effort to get things as right as possible, even if that involves some of us sinking, once again, into the period sofas, or forcing ourselves into yet another lunch in the conservatory. Get the venue right - then the creative juices will flow. The incisive ideas for responding to real problems out there in public health will come, and, everyone will be guaranteed a fun experience that truly beats your average university seminar room and is memorable for years to come!

Ahh… I think it’s time for afternoon tea. Earl Grey, Professor?

Just trying to make the world a better place

Posted by Jean Adams

People who work in public health research seem to have a universal desire to make the world a better place.

Mostly they also have that innate finding-out-new-stuff-is-cool streak that unites scientists of every flavour. But in public health research, getting out of bed seems more about working out how (health) things could be better. 

We just want to make the world a better place....

Which is what Fuse is all about: not just finding out how we could, under ideal circumstances, improve people’s health; but also working out how we can ‘translate’ public health research evidence into public health policy and practice to make it more ‘evidence-based’. To use the jargon.

I am grateful to Fuse. Not just because they have paid my salary for the last few years, but also for getting me to think more about the problem of evidence-based policy.

I was also really pleased to be invited to a workshop on Economic Evaluation of Population Health Interventions in Glasgow last week. Admittedly, I was pretty apprehensive before-hand: all I know about health economics, I learnt during an MSc module led by one of the guys who organised the workshop. What could I usefully contribute?

Perhaps I didn’t contribute anything useful. But I did enjoy the workshop – which was very trendily multidisciplinary (maybe I was just a token public health rep?). I particularly enjoyed chatting to an ex-academic, now working for the Scottish Government, who gave me a very candid window into how government works.

Way back when, before I had really thought about it much, I thought evidence-based public health policy was all about educating the policy makers – about what scientific evidence is, how us scientists generate it, and how the policy makers should use it. If we just shouted louder, maybe they would hear us.

This is not an unreasonable approach. So much so, that an eminent science writer has just written a, much-praised, book about it. But it only takes a minute reflecting on the minimal effectiveness of health education in changing behaviour, to work out why it might not work.

Of course policy makers, and politicians in particular, take more into account than just scientific evidence of what ‘works’ when they make decisions about what they should spend our money on. Which is where the health economists come in. If we can’t convince them with straight-up ‘what works’ arguments, perhaps we can appeal to their mercenary instincts and convince them with arguments about what might save money. But this is just more-better education.

So what can we do? My first suggestion is that instead of trying to get policy-makers to think more like scientists, us scientists need to start thinking a bit more like policy-makers. And what my loose tongued academic-turned-civil-servant-health-economist reminded me of last week, was that we don’t elect our politicians on the basis of whether or not they are the sort that might be ‘evidence-based’. We elect them on the basis of ideology.

Perhaps, the only way to change policy is to appeal to ideology. Blitz the broccoli-evidence, mix it up with some yummy-ideology, and slip it down the hatch airplane style.