Charter for International Health Partnerships in Wales
Strong organisational engagement and commitment are essential for successful international health partnerships. This may include support for special leave, provision of resources to support partnership development and executive-level reporting processes on international health partnerships.
In line with existing guidance outlined in the Welsh Health Circular (2006) 070 and the Welsh Government framework document "Health within and beyond Welsh borders: An enabling framework for international health engagement", a policy commitment has been made to support special leave for those involved in projects between sub-Saharan Africa and other developing health systems. Fair consideration will be given to those working in other geographical regions.
Participation in international partnerships approved by the organisation is formally recognised as contributing to Continued Professional Development (CPD), recognizing the professional and leadership development of those involved in international health work. This is not limited to those travelling internationally around the health agenda, but also includes engagement at a distance through activities such as training and research.
There is a longstanding history of supporting special leave for those travelling overseas for international work. Previously this has focused on sub-Saharan Africa, however the Charter suggests this should be widened to consider other developing health systems and placements which enhance the skills of Welsh Health Professionals. Special leave and CPD should be explicitly linked within the Health Board or Trust. Below is an outline of existing guidance upon which the Charter for International Health Partnerships in Wales builds:
2006 the Welsh Health Circular (2006) 070
- Chief Executives and HR Directors are to amend continuing professional development policies to allow visits, secondments, exchanges and the management of projects to be recognised as one of the options allowed to NHS employees.
In February 2012, the Welsh Government formalised its commitment to international health linking by introducing the framework.
- Welsh health workers need to be encouraged and supported to develop appropriate international roles that provide personal and mutual benefits to Wales and international partners across the world.
Pre- and post-assessment forms
In order to determine the impact of international exchanges on staff, a form of pre- and post-assessment should be completed as a condition of granting special leave. This enables the Health Board or Trust to develop a body of evidence to both demonstrate the impact of international work on staff and show how this is beneficial to the skills of health professionals.
Pre- and post-assessment is relatively new for those undertaking international health work. In order to have comparable results across Wales, we advocate the use of the Toolkit for the Collection of Evidence of Knowledge and Skills gained through Involvement in International Health Links, published by Northumbria Healthcare NHS Foundation Trust, 2012. The toolkit has been developed for the collection of evidence of knowledge and skills gained through involvement in international health links, although Welsh specific tools may be developed in due course.
Mutual learning in international partnerships has many benefits: it informs those who are not familiar with the benefits of international work about the impact it has on those who take part, helps ensure that errors are not duplicated, and assists in transferring the knowledge of good practice. We can also learn from similar nations to inform health policy in Wales.
Therefore learning gained from involvement in international health partnerships should be shared within and beyond Welsh borders to increase awareness, reduce duplication and encourage collaborative working. This applies to all parties involved in the partnership.
Sharing lessons learned is also beneficial. In common with NHS Wales, international health partnerships and those signed up to the Charter support an open culture when problems arise. Useful lessons can be learnt if things do not go as planned which, when shared, can reduce the risk of others encountering similar issues and provide assistance when they do.
An online forum will provide a platform for signatories and stakeholders to ask questions and foster shared learning. A forum will be developed to ensure a space for Health Boards and Trusts to discuss international health and the implementation of the Charter, enabling a fluid exchange of information, as well as providing a venue for questions to be asked and answered.
In addition, monthly reporting of international activity should be included in current reporting systems and provided to Chief Executives. An annual report on international activity will be included in current reporting mechanisms; this report must include feedback on outcomes, outputs and impact, and should then be provided to the IHCC.
An open access online forum is available on the IHCC website; this can be accessed from the homepage.
Wales has a conscience regarding environmental sustainability; it is one of the few counties in the world who have defined sustainable development as a core responsibility of the government.
Therefore, although not all international health partnerships involve overseas travel, when travel takes place every effort must be made to ensure interventions are both ecologically and practically sustainable. The signatories of the Charter will adopt equally sustainable practices in accordance with the sustainable development principles.
Sustainable Development defined:
The goal of sustainable development is to “enable all people throughout the world to satisfy their basic needs and enjoy a better quality of life without compromising the quality of life of future generations” (One Wales One Planet 2009 p8)
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According to the World Health Organisation (WHO), acquisition of medical equipment and medical supplies can act as a barrier to effective medical treatment in low-income countries.
Guidelines must be followed regarding the donation of medical equipment and medical supplies to ensure any donation is carried out appropriately and safely. The donation of medical supplies and equipment should be carried out in a consistent manner for a variety of reasons, such as adherence to in-country protocols, donations based on need (not availability) and, with regard to equipment, the machinery is suitable for the location it is being delivered to and can be maintained.
Comprehensive guidance for the donation of medical equipment and medical supplies has been developed by The Tropical Health and Education Trust (THET).
Health worker migration has increased worldwide in recent years, especially from low-income countries with already fragile health systems. The UK, through the Department of Health, is committed to ensuring ethical recruitment practices operate within the NHS through adherence to the Code of Practice (CoP) for International Recruitment. The CoP links to WHO guidance on recruitment. The CoP aims to establish and promote voluntary principles and practices for the ethical international recruitment of health personnel and to facilitate the strengthening of health systems. The IHCC will offer advice on country profiles where required.
The WHO code aims to establish and promote voluntary principles and practices for the ethical international recruitment of health personnel within the member states of the European community.
Emergency Humanitarian Disaster Responses are driven by the need to assist in times of crisis. Charter signatories and stakeholders will give fair consideration to working with Department for International Development (DfID) by engaging in organised, UK-wide efforts to develop a coordinated needs-based response, facilitated by the UK International Trauma Register and hosted by UK-Med (Humanitarian Emergency Response Review 2011). This opportunity will be promoted to staff.
UK-Med provides emergency medical care in the aftermath of large and sudden-onset disasters. Healthcare workers committed to emergency humanitarian response are invited to join the UK-Med Community of Practice. Through the Community of Practice, UK-Med recruits, develops and provides training to clinicians and allied health professionals who volunteer their services to respond at times of crisis and conflict.
UK-Med is a core partner in the delivery of the UK Emergency Medical Team (UKEMT) programme funded by the Department for International Development (DfID). In line with World Health Organisation (WHO) aims, UKEMT members will be trained and prepared to respond to trauma, medical and public health emergencies. As part of this programme, UK-Med hosts registers of trained clinicians and allied health professionals (medical, trauma and public health) within the UK-Med Community of Practice.
The DfID website is a regularly updated source of advice on the humanitarian effort, and is also regularly updated with information about UK AID work in West Africa, such as establishing the Ebola treatment facility at Kerrytown, a focal point for UK AID. Specific advice for Ebola humanitarian aid workers can be found on the GOV.UK website.
A point of contact for international health partnerships to liaise with the IHCC and staff will be nominated. This could be in a voluntary role or paid. This will be supported by an online resource for staff.
The International Health Lead will act as a point of contact for the IHCC and internally within the Health Board and Trust. This person may facilitate meetings to drive forward the international health agenda and be an active participant on the IHCC forum.
Examples of similar roles are in place across Wales, such as with Aneurin Bevan University Health Board, who acts as a lead for projects supported by the Health Board.
A web resource for staff should be made available to ensure they are aware of opportunities available. A draft outline of what a resource should include is provided below:
- Outline of the Health Board/Trusts commitment to International Health Partnerships
- The Charter and action taken towards achieving it
- Known activity within the Health Board/Trust
- Policy documents – special leave policy, volunteering, pre/post assessment forms
- Signposting to other sources of information