Evaluate population behaviour as it impacts on the prioritisation of ambulance deployment.

Population Health
This essay guidance has been designed for you to be able to achieve the learning outcomes you will be assessed against as below:
1. Analyse models of health and illness and critically discuss the impact of social, cultural, psychological, economic and lifestyle factors on the mental and physical health of populations and individuals.
2. Examine the complex role that paramedics play in a multi-agency approach to safeguarding, the prevention of ill health and the promotion of physical and mental wellbeing.
3. Evaluate the opportunities to provide health advice to service users and their families and integrate these in to care and treatment selecting appropriate approaches to modifying health behaviour and providing signposting to other agencies where appropriate.
4. Evaluate population behaviour as it impacts on the prioritisation of ambulance deployment.

The essay will demonstrate your ability to critically evaluate the literature (including books) in line with JRCALC-informed practice within a policy context, including:
• London Ambulance Service Strategic Intent (Session 5 Learning Materials)
• Ambulance Response Programme (Session 5 Learning Materials)
• Carter Report (Session 1 Learning Materials)
• NHS Long Term Plan -https://www.longtermplan.nhs.uk/publication/nhs-long-term-plan/).

You have up to 4000 words for this essay excluding the reference list.

Essay Plan
Introduction (approx. 100 words)
• What is this assignment going to cover?
• Remember to inform the reader of what to expect. You are trying to entice the reader into wanting to read more.
Models of Health and Illness and the Role of the Paramedic (LO1, LO2) (approx. 950 words)
• Define health. You should start with the World Health Organisation (1946) definition of health. Does this definition still hold up today? What has changed?
• What is the paramedic role in safeguarding, preventing ill health and promotion of physical and mental wellbeing? You could look at how the profession emerged since the 1970s and before ‘lift and shift’ to now, a regulated profession, especially look at professionalism literature.
• Try and find a definition on episodic care and explore what this means in patient care from both an individual and population level, through the three models of health (biomedical, biopsychosocial and public health).
• Evaluate each of the models of health in terms of:
o The advantages or disadvantage of each.
o What does the literature say for each? Comparing and contrasting between the literature.
o How can each model support or limit paramedic practice?
• You may want to finish off and summarise this section by discussing sociological explanations for illness including the factors that affect people’s sense of wellbeing.

Assessing your Local Authority Health Profile (Havering)
(LO1, LO3) (approx. 1500 words)
• Define what a health profile is. Why do we need to understand the needs of a community? Briefly describe the area you have chosen and rationale. You can find your chosen Local Authority Health Profile here: https://fingertips.phe.org.uk/profile/health-profiles
• You may want to start off this section with the demographic make-up, what has changed over the last few years (or more)?
• Outline the indicators you have chosen with a small rationale for why you have chosen the indicators. You may want to elaborate on why they are important public health issues in ambulance practice using the literature to support you.
• Start a new paragraph per indicator.
o What is the indicator measuring? Is the indicator better or worst then England’s average?
o Who does the indicator mostly affect in the population i.e. the demography?
o How does this indicator interact with your health profile’s demography? Remember to critically discuss the impact of social, cultural, psychological, economic and lifestyle factors involved in each indicator. You will not be able to cover all aspects but what are the important factors. You may want to look at Dhalgren and Whitehead’s (1991) model of determinants of health to help you conceptualise this (Session 7).
o Links on Dhalgren and Whitehead’s model: https://esrc.ukri.org/about-us/50-years-of-esrc/50-achievements/the-dahlgren-whitehead-rainbow/ and https://jech.bmj.com/content/jech/64/4/284.full.pdf – however there are tons of literature on this!
o How could this indicator be measured in paramedic practice? What are the limitations of measuring this indicator on both individual and population levels?
o What are the consequences of the indicator or what is the indicator a consequence of i.e. the epidemiology? What diseases, disorders or disabilities emerge as consequences?
• What wider data is available to support your indicator? You may want to look at other epidemiological data in the literature.
o For example, if you chose to look at Indicator 4: Mortality rate from all cardiovascular diseases, you may want to look at data available from NICOR on myocardial ischaemia: https://www.nicor.org.uk/national-cardiac-audit-programme/myocardial-ischaemia-minap-heart-attack-audit/ .
o Another example, If you chose to look at Indicator 24: Deprivation Score (IMD 2015), you may want to look at data available from Trust for London: https://www.trustforlondon.org.uk/data/

Paramedic opportunities to provide health advice including recognising and modifying health behaviour and signposting (LO3) (700 words)

• Drawing on what you have discussed so far in your essay, in the first two parts, think about the opportunities you will have in practice pertinent to your three indicators.
• What health behaviours are associated with your indicators? How can they be recognised?
• Can these be explained through the role of stress and coping?
• Can these be explained through theories of health promotion / behaviour change?
• Can these be explained through the role of individual genetics?
• What health promotion / behavioural change interventions can be used in paramedic episodic care to address / modify behaviours.
• Who else might need to be involved? Other professionals?

Ambulance Deployment Policy (LO4) (450 words)
• Discuss the policy on ambulance deployment i.e. Ambulance Response Programme and Carter Report in relation to the first three parts of your essay.
• How do your indicators impact on the prioritisation of ambulance deployment?
• You will not be able to cover everything mentioned in the policies but what do you feel are the most important points within this? How do these policies influence paramedic practice?

Conclusion (300 words)
• What did the essay cover?
• What were your main findings or overarching themes?
• What is the future role of the paramedic? You should relate this to the HCPC (2014) Standards of Proficiency for Paramedics

Please see Module Study Guide for advice on referencing.