Why the sudden need for an evidence base? Senior CIEH staff explains the rationale behind the Make Your Case campaign
Graham Jukes, chief executive
If you suffer an infectious disease outbreak on your patch, it is often clear-cut what has to be done. Swabs are taken, the infection root is established, the source is isolated and contacts are traced. There is a scientific link between the spread of disease and the control mechanisms that we put in place.
Unfortunately this is not the case with all aspects of environmental health. Proof that our interventions achieve what they set out to achieve can sometimes be patchy. This often hinders our attempts to influence government policy, gain academic credibility or access resources.
The time has come for us to unequivocally demonstrate what we can achieve by writing up tried and tested methods in a way that provides an evidence base for colleagues so we are not perpetually reinventing the wheel or having to prove our case again and again.
The need for an evidence base has become more important with the government proposing changes to the local government landscape. The better regulation agenda is creating a framework against which the delivery of environmental health is likely to be judged.
As this culture grows we are increasingly going to be required to demonstrate the positive effects of environmental health.
For those colleagues working in primary care trusts and the Health Protection Agency, they are joining a culture where evidence underlines strategy. They are going to need support as they argue their case with our clinical colleagues.
An evidence base will also support our colleagues in the commercial sector. We have EHPs working in organisations as diverse as British Airways, Manchester United football club and the supermarket chains. They equally need to be able to make the case to their employers that by taking a precautionary approach you are helping stimulate the economy not dampening it, as has been suggested in the Hampton review.
Regulation is a tool not an end in itself. If it does not work we need to know. Equally if it is effective we need to be able to make the case. We must no longer be on the back foot. We need the evidence that if you get rid of regulation it will impact on wellbeing, as long as that is the case.
If the CIEH is to raise the profile of environmental health we really need participation, the evidence lies in the work you do and we need you to share your experiences with us.
Ian Foulkes, policy director
When we are trying to influence government policy we need evidence to prove our case. Otherwise all we are expressing is our opinion, which is challengeable, and may not result in us achieving the outcomes we seek.
This is something we have learnt from experience. For example, when we campaigned on pest control and public health around the 2012 vision document we were able to point to hard evidence that backed up our case. This made our position very powerful compared to that of other organisations.
In the policy team we hear about important, innovative and challenging work carried out by EHPs across the country. This often informs our opinion but unless that work is properly evaluated, and the lessons learned from it effectively captured, it often leaves us with nothing concrete to support our view. For us to garner the influence that the membership expects of us we need that evidence.
We need to take the view that all EHPs are science graduates and so understand how to design an experiment, which includes the proper evaluation of results. It is time we introduced that discipline back into the day-to-day work routine to the benefit of everyone in the EH community.
This has become particularly important over the past few years as a result of a cultural shift in the running of the civil service. In the past a civil servant would work in the same department for 30 years. They knew everything that had happened historically in their area. Now the civil service is much more dynamic. Civil servants are in and out of a ministry in two years and every time you get a change-over, policy goes backwards as the wheel gets reinvented.
The CIEH has a role in stopping this happening, a task made much easier if we can point to evidence of a strategy working or failing. A CIEH view, supported by evidence, will ultimately make the policy process more productive. Instead of endlessly going over old ground we will be driving policy forward.
The CIEH recognises a need to change local government's attitude towards staff training and research. We are working with the Employers' Association, Lacors and the LGA to generate change, to bring local government more in line with the NHS. But it will take time, which should not prevent environmental health acting as the vanguard and building up its evidence base, with a comprehensive suite of case studies.
Michael Dunmore, communications director
Two years ago we asked you what you wanted from the CIEH. Following extensive research with members, ex-members, employers and government we produced the policy document, Leading Environmental Health into the Future.
You identified four key aims. You wanted greater recognition of your contribution to improving environmental health and your professional status to be raised.
You wanted us to promote improvements in environmental health policy and you wanted us to ensure high professional standards.
In short, you felt that you were not getting the recognition that you deserved and that as a result you risked losing your professional status. The Make Your Case initiative, launched this month, aims to address your concerns.
The CIEH has raised the profession's profile in the media. We now need hard evidence to prove that anyone investing in environmental health will not only get soft benefits but hard, demonstrable returns.
By pointing to case studies and research we will be able to demonstrate that environmental health will not only provide measurable returns to employer's organisations but also to whole communities.
An evidence base will provide us with the ammunition to communicate the efficacy of environmental health, whether that is to chief executives of companies, the elected members of local authorities, stakeholders, government or the general public.
Case studies will demonstrate the breadth and depth of the work done by EHPs and that, as a profession, you are involved in initiatives far beyond what most think of as the traditional remit of environmental health.
The aim of the national training courses, along with our toolkit, is to equip CIEH members with the skills to access research funding, to place articles in the specialist press, to write up research and to put together case studies.
We will be helping you to get your message over to the local press, providing a website to post your case studies and the research journal to publish peer reviewed research.
We will also be developing the work done in Wales and Northern Ireland across the new regions, encouraging stakeholders and elected councillors to learn the true value of environmental health.
You are our members and we need your participation because the evidence lies in your work and experiences.
Paul Robinson, education director
Academics in the field of environmental health research are caught in a chicken and egg situation.
On the one hand they struggle to receive appropriate recognition and public funding for their research because within the research assessment framework, environmental health is not recognised as a discrete research area like medicine, geography or physics. On the other hand, environmental health is not considered a subject area in its own right because it lacks a large enough evidence base.
Some funded research is taking place in environmental health subjects. But for the purpose of the government's research assessment exercise it has to be linked to other recognised research areas, such as "subjects allied to medicine" or "the built environment".
We need to be able to argue the case that environmental health should be recognised as a research subject in its own right. However, we are not going to achieve this without being able to present a significant body of evidence proving the need. What better place to start than to have a database of research including case studies, peer-reviewed research and examples of initiatives that have already attracted research funding?
We need to establish a firm academic footing if the profession is to move forward. Something that the Make Your Case initiative aims to provide. The CIEH will be equipping members with the tools to create that evidence base by helping you produce a mixture of case studies identifying best practice, research-based articles and papers along with presentations to conferences and seminars.
Those EHPs who have participated in the programme will be equipped to take their research skills to the next level, enabling them to work with academic colleagues in their local universities to produce publishable research and to potentially register for M Phil and PhDs and, or, post-graduate doctorates.
