Strategic External Analysis


Political Threat

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A political threat facing PHE at
present is the possibility of budget cuts due to Britain leaving the European
Union. On the 23rd June 2016, Britain voted to leave the European
Union. PHE’s current NET operational budget is £302.3 million. In recent news,
there has been a lot of media attention whereby the NHS has come under scrutiny
due to financial difficulties. When Britain leaves the European Union, the government
in power may decide that some of PHE’s current NET operational budget may be more
financially beneficial elsewhere e.g. within the NHS. This would put a strain
on the organisation and its ability to meet and deliver its objectives. A possible
way to help the organisation absorb the costs and reduce the pressure is to
scrutinise the amount of money spent on travel and accommodation locally over
the financial year. For example, I know of a number of staff members who travel
to London from Newcastle at least twice a week. This involves train fares and
an overnight stay in a hotel. Over the financial year this would mount to a
substantial amount of money being spent on one staff members’ travel. To
overcome this, staff members could look at ways to reduce travelling costs by
either using teleconference or videoconference facilities. PHE rolled out Skype
For Business in 2015 to make it easier to do business. Full use should be made of
these facilities available to reduce travel associated costs.

Another possible way of overcoming
budget cuts is for senior managers to examine the current staffing structure
and determine the minimum staffing numbers required for the team to function.
If applicable, they could then make staff cuts which would in time produce a
saving over the financial year.  







Economic Threat


An economic threat facing the
organisation at present is the increase
in the number of nurses and midwives leaving the Nursing and Midwifery Council (NMC)
register. Figures from The Nursing and Midwifery Council (NMC, 2017) stated that there was an increase in the number of
nurses leaving the register whilst at the same time the numbers joining had
slowed down. In a survey carried out by the NMC in July 2017 (NMC, 2017) it
showed the three main reasons for nurses leaving the profession as poor working
environment including staffing levels, change in personal circumstances e.g.
caring responsibilities and the disappointment in the quality of care given to

organisation employs approximately 340 nurses across the eight centre’s and they
are classed as their ‘frontline staff’. The role of the nurse in the Health
Protection Teams are to advise nurseries, schools, care homes, health
professions and GP’s on exclusion advice and preventative action on the spread
of infectious diseases. It benefits if staff are medically trained to help them
deliver this service although practitioners are also employed in this role. If
figures continued to decline then it could put a strain on recruitment and the
ability for the organisation to meet and deliver its objectives.  A possible way to overcome this reduction and
to stop figures declining even further, is to actively promote the flexible
working and special leave policy. Some staff members feel incapable to use of
it due to the feeling of disapproval from line managers. Staff members need to
be reminded it is available and be encouraged to use it. Line managers need to
encourage staff to use it but also take away the stigma of disapproval. The
policy takes into account caring responsibilities and work patterns/hours can
be adapted to suit individual needs. This may reduce the number of staff
members wanting to leave the organisation but at the same time will encourage
people to want to work for PHE.







Social Threats


social threat facing the organisation at present is the lack of health
consciousness awareness in society today.
The Global Burden of Disease Study shows that many of the risk factors
associated with death and ill health are diet, smoking, high blood pressure,
being overweight and alcohol and drug use. It has been suggested that if we
reduce the risks through prevention then in time this will reduce premature
deaths and long-term illness. Over a period of time this will deliver saving to
the government by reducing treatment and welfare costs and reduce costs to
society by reducing sickness absence and crime. (The Global Burden of Disease
Study 2013 as cited in Public Health England, Strategic Plan for the next four
years: Better outcomes by 2020, April 2016, p.9)

The Wanless Report 2002 estimates that
if the public were fully involved in managing their health and engaged in
prevention activities then savings could reach up to £30 billion a year for the
NHS alone. (The Wanless Report 2002 as quoted in Public Health England,
Strategic Plan for the next four years: Better outcomes by 2020, April 2016,

possible way to overcome this is for the organisation to continue working with
Local Authorities and the NHS to help improve prevention through campaigns. For
example, in January 2009 the Change for Life campaign was first launched. The
aim of this campaign was to reduce obesity and it gave advice and approaches on
how to remain and keep healthy and fit. Since the campaign was launched it has
accomplished the majority of its set targets. In a study carried out by The
National Social Marketing Strategy (n.d) the campaign aimed for 33,333 families to be continuing to
use the material from the campaign six month after their first registration. This
target had been met and 44,833 families were still using the campaign
materials. This shows that the campaign was successful and the organisation
should continue to evolve the campaign to target more specific audiences too.



Technological Threats


of the biggest technological threats facing the organisation at present is the
risk of a cyber security attack. In May 2017, the NHS was hit with the biggest
cyber security attack to date named Wannacry. This affected hospitals and GP
surgeries and some of which had to close and some patients were turned away. Not
only did this have an impact on the day to day running of the NHS, it also had
a huge impact on their reputation. If PHE were to become victim to an attack
then patient identifiable information and other valuable information could be
accessed, stolen and then possibly sold on. This would not only damage the
reputation of the organisation but would also damage its working relationship
with stakeholders such as the NHS and Clinical Commissioning Groups. To reduce
the risk of this occurring, PHE need to keep ensuring that their internet
security and updates on all software applications are current. The mandatory
training schedule should also be revised to include cyber security. Focus needs
to be paid on prevention and staff awareness is key. If all staff members were
trained on how to identify a threat or malicious email, how to act when they become
aware of it and finally how to report it then this would reduce the risk of the
organisation actually falling victim to a cyber-attack.














Legal Threat


A legal threat facing the organisation
at present is the demolishing of the student nurse bursary. The Department of
Health and Social Care agreed that from the 1 August 2017 the bursary would no
longer be offered and instead it would be replaced by loans. I think this could
have an effect on the number of trained and qualified nurses carrying out roles
at PHE. As stated earlier, the Health Protection Team within the organisation benefit
from qualified nurses to deliver their business objectives. An study from the
NMC (NMC,2017) showed that the number of nurses leaving the register had
increased whilst the number joining had slowed down. I think that the
demolishing of the student bursary may be a factor in this reduction of
numbers. People may now not want to carry out their nurse training as they may
now feel they are not fully financially supported to do so, especially from
lower income households. A possible way to overcome this is for PHE to
introduce nursing apprenticeships. Staff members would be trained to become
qualified nurses, in a specialist area of public health, whilst at the same
time earning a wage to fully support their personal circumstances. This would
attract people to want to work for the organisation and at the same time
possibly halt the reduction of numbers leaving/joining the NMC register. The
organisation would have to factor training costs into the contract of
employment. The staff member would be required to work for PHE for a set amount
of time to pay off the training costs or would have to pay back the full amount
upon termination of employment.











Environmental Threat


Air pollution is one of the biggest
environmental threats to the organisation as a whole at present. In a report
from The Royal College of Physicians (The Royal College of Physicians,2016, p.3)
states that each year in the UK, around 40, 000 deaths are attributable to
exposure to outdoor air pollution, with more linked also to exposure to indoor
pollutants. It plays a role in many of major health challenges and has been
linked to cancer, asthma, stroke and heart disease, diabetes, obesity and
changes linked to dementia. Neither the concentration limits set by government
or the World Health Organisation air quality guidelines define levels of
exposure that are entirely safe for the whole population.  To overcome this, the organisation needs to continue
to work with the World Health Organisation to define a healthy level of
concentration and keep it at that level or try to reduce it. Awareness of the
impact day to day activities have on the air pollution level is key and one way
to do this is through campaigns. The cycle to work scheme was first introduced in
1999 but I think staff members need to be reminded that it is still available. When
enrolling onto or advertising the campaign, staff members also need to be made
aware why and how it helps the environment and what part they would be playing
in the reducing the amount of air pollution.














To summarise, I think the main
threat facing the organisation at present is the social threat. There are
currently 27 active campaigns being ran by PHE at present. Out of those 27 campaigns,
14 are related to helping to improve the nation’s health by diet, smoking,
keeping fit etc. Currently 64% of PHE’s social marketing budget is spent on
campaigns related to improving behavioural patterns. PHE need to continue with
their health campaigns to encourage the public to change their unhealthy
lifestyle. If prevention is not acted upon now, then figures will continue to
rise and more of a strain will be put onto PHE and also the NHS in the future.
It may also result in more money being allocated to these health campaigns
which in time may take away vital funding for other equally important campaigns
such as Antimicrobial
Resistance (AMR). Figures have shown that the Change4Life campaign
has been very successful from when it was first launched in 2009. The initial
campaign was aimed at families, particularly those with children aged 11 years
and under. Given the success of the campaign, I think it should continue to expand
and target other specific areas. For example, they could expand to families
with children aged over 11 and also the population of retirement age. 

I think another approach is for the
organisation to work closely with food manufacturing companies to reduce sugar
levels in every day foods. As part of the Change4Life campaign, the Be Food Smart
app was introduced.

Figures from this campaign showed
that school children consume
half the daily recommended sugar intake before the morning school bell rings.
(Public Health England, 3 January 2017). This app was then developed to help
the public identify the quantity of sugar and fats in every day foods and help
them to make healthy choices. Although this app was designed, I still feel that
food manufacturing companies should be made to reduce the unnecessary excessive
sugar quantity in certain foods. This would then stop the public having the
ability to choose unhealthy foods and in time would lead to a healthier


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