The Future of the Faculty Progress Report was presented to the Board of the Royal Australasian College of Physicians by Emergence International Pty Ltd on 10 July 2018.

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Background | Current position | Opportunities | Implications

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This progress report provides information on inquiries and discussions undertaken to follow up on the recommendations contained in the Australasian Faculty of Public Health Medicine (the Faculty) Future of the Faculty Working Group Report (the Report).

While current activity has focused on the Faculty it is recognised that some of the issues raised by the Report have the potential for whole of College impact.

Background

1. The Report recommended that the Faculty engage with the College in a process of collegial discussion to negotiate a model for more autonomy for the Faculty and that the other Faculties be invited to be part of the discussions.


2. It contained a number of recommendations to guide those discussions, particularly relating to:
   
   1. The ability of the Faculty to advocate publicly on matters of importance to the Faculty.
   2. The ability of the Faculty to advocate to government on matters relating to the future of the public health medicine workforce.
   3. Staffing support provided to the Faculty.
   4. The budget for the work of the Faculty.
   5. Recognition of the unique requirements of the public health medicine advanced training program.
   6. Support for trainees and supervisors.
   7. The ability of the Faculty to support public health medicine in the Pacific.
   8. The ability of the Faculty to make formal agreements for partnerships with like-minded organisations.
3. The Report was presented to the Board in September 2017.


4. A Board Working Party was subsequently established to review the issues raised by the Report and to consider in more detail, in the context of the whole of College impact, a number of specific issues relating to education/training, policy and advocacy, financial flexibility, and governance arrangements.


5. The Working Party met in December 2017 but was unable to reach immediate agreement on a suitable Chair or on the best means to achieve its mandate.


6. The Board subsequently agreed to the engagement of a consultant to engage with members of the Faculty and College staff to examine whether there were ways in which any or all of the recommendations could be progressed under existing authorities and arrangements and to advise the Board on any larger issues that might remain and on any whole of College implications.


7. Mr Phillip Bonser of Emergence International Pty Ltd was engaged to undertake this work and commenced on 10th May, 2018. Mr Bonser was previously involved in the Working Together project conducted by WhyteCo, which was reported to the Board in December, 2014. He therefore has a reasonable understanding of the workings of the College and its various bodies.

Current Position

1. Discussions have been held with a range of stakeholders including the out-going and incoming Presidents of the Faculty, the Chairs of each of the Faculty Committees, College staff, trainees and the members of the original Working Party.


2. A range of documents relating to the work of the Faculty and the specific issues raised by the Report and in discussions have also been reviewed.


3. The focus of these discussions and inquiries has been to explore the nature of any difficulties being faced by the Faculty in fulfilling its role within the College, especially as these difficulties relate to the matters raised in the Report, to explore with staff any challenges they experience in supporting the Faculty. They have also considered any practical action that stakeholders believe can be taken, within existing authorities and arrangements and consistent with College wide policies and practices, to mitigate or overcome these difficulties and challenges.


4. It is important to note that Faculty members and College staff involved in these discussions have displayed a willingness to change and significant enthusiasm for engaging more fully to consider opportunities and design viable ways forward.


5. Analysis of the outcomes of these discussions and the review of documentation suggests that in addition to the issues raised in the report:


6. A number of opportunities to progress some of the recommendations contained in the Report have therefore been identified. Some can be progressed by staff under existing arrangements, some require consideration and decision by AFPHM Council and some may require additional consultation and further advice to the Board. These opportunities are currently being pursued in further discussions with the AFPHM President and Council and with senior staff of the College.


7. Subsequent to the drafting of this report Mr Bonser will be attending the AFPHM Council Planning Day on 18th July. This is intended to enable some of the opportunities which have been identified to be considered as part of the Faculty’s forward planning and priority setting.

Opportunities

The following opportunities are the subject of ongoing discussions with the AFPHM President and Council in collaboration with relevant College staff.

It should be noted that consideration of how these opportunities might be realised is ongoing and has currently been progressed further in some areas than others.

Policy and Advocacy

To enable the Faculty and its members to be more active and visible in promoting public debate on matters of public health and to act as an authoritative source of advice within the College in connection with public health medicine the opportunity appears to exist for the Faculty Council to:

1. Establish Faculty clear priorities in the area of policy and advocacy as a basis for seeking approval to advocate on matters that are of strategic importance to the Faculty and as a guide for the work of the Policy and Advocacy Committee.


2. Ensure the Faculty has appropriate governance mechanisms in place to support any request for approval to advocate on particular matters of strategic importance to the Faculty or requiring expertise that is unique to the Faculty.


3. Ultimately seek approval under the existing provision in the College Constitution (7.5), for the authority to represent the College before any government or governmental body or committee, particularly on matters relating to the future public health medicine workforce.


4. Determine how the existing Policy Reference Group process could be promoted to AFPHM members to broaden the input of the Faculty to requests for comment and/or policy development in matters of population health.

Resourcing the Faculty

To provide support to the Faculty President, Council and Committees that is fit for purpose and maximises the value gained from the engagement and input of Members the opportunity exists for the staff, in consultation with the Faculty, to:

1. Clarify the roles and responsibilities of the Executive Officer and Senior Executive Officer.


2. Map the support available to the Faculty from specialised areas of the College, especially in communications, event planning, education and policy and advocacy, in order to improve coordination and timeliness of access.


3. Hold discussions with each Chair about the nature of the Committee's work and priorities and the best (most practical) way for the Chair and Committee and the EO/SEO to work together and to access the expertise they need from other areas within the College.


4. Review budgeting arrangements and delegations related to the Faculty to identify current processes for managing business-as-usual, developmental and discretionary funding.


5. Explore what would be required to provide an allocation of discretionary funding in the Faculty budget, supported by the development of an appropriate process for the Council to determine how such funds can be expended and the establishment of appropriate delegations to staff to make such expenditure, once agreed by Council in order to make an informed decision before proposing any changes.

Training and support to trainees and supervisors

To ensure that decisions about training and assessment requirements and processes are appropriately aligned with the nature of the public health medicine training program and the specific needs of trainees and supervisors generated by that program the opportunity exists to:

1. Map the specific nature of the public health medicine advanced training curriculum and program to determine:
   
   1. The primary factors that would need to be considered when proposing changes that impact on the program.
   2. The extent to which the program requires different arrangements when contrasted with other programs run by the College.
2. Clearly articulate the differences inherent in the public health medicine training program and identify the impact of those differences on the experience of trainees and supervisors as an agreed point of reference when designing changes to programs.


3. In addition, further discussions may need to be held to establish if consultation mechanisms are robust and occur early enough in the process for changes to be considered by the Faculty Education Committee and Council.


4. Review the support currently available to trainees and supervisors and commence discussions about possible improvements where a need is identified.

Partnerships with and support to like-minded organisations, particularly in the Pacific region

To enable the Faculty to formally establish strategic connections and partnerships with and, where appropriate, support to like-minded organisations both nationally and internationally, especially in the Pacific region, there is an opportunity to:

1. Develop specific proposals for strategic partnerships with like-minded national and international bodies, including the identified benefits and associated costs.


2. Identify the process required for approval of formal agreements with other organisations.


3. Review the reasons for and practicalities of providing support to Public Health Medicine in the Pacific Region, in consort with the New Zealand College of Public Health Medicine in the light of the College International Strategy, noting that this matter already forms part of the AFPHM Council agenda.

Implications

1. All of these opportunities require further discussion and the development of more specific strategies.


2. The matters relating to support structures and processes, the Faculty training program, support for trainees and supervisors and the development of partnerships with like-minded organisations are very likely to be able to be progressed in discussions between the Faculty and the relevant College areas and staff.


3. The matters relating to the authority to represent the College on specific policy and advocacy matters and any significant proposal to change current budgeting allocations or arrangements would have significant College wide implications and would require detailed exploration and further advice to the Board.