hi everyone uh welcome to this latest nesta talks to event uh in an age of complex challenges and overabundance of information is hard to know where we can turn to try and best make sense of the world around us and to know how we can help play our part in shaping our collective futures to help guide us towards some answers and likely even more questions more often than not this series of events is all about talking to today's leading thinkers community builders practitioners and innovators who are working to understand the world around us and what our future may look like this is why i am delighted and really pleased today to welcome manira ahmad chief officer of public health scotland for today's event we will be chatting about a range of issues relating to public health data and innovation in scotland but that will hopefully have relevance and insight for similar work across the uk and i hope internationally as well i'll be chatting to manual for the first half or so of today's event on a range of topical and interesting hopefully uh questions and issues about things relating to public health and data in scotland but we're really keen throughout to ensure that we get a good level of engagement from all of you in attendance today across the various platforms that we're streaming so we want to make sure we leave a good amount of time in the second half of today to get responses to questions that you submit so i would please encourage you all to do so via via the comments function uh on on the browser or the app that you're watching from and we also have some questions that have been submitted in advance that we will try and get to either as we go through or at the end of the session now i will note at the start that we have in the past had a huge number of questions submitted for these kind of events and just on a purely logistical level it can be really hard to get to them all so i do apologize if um you submit a question and we're not able to get it but we'll do our best to maybe try and group some if there's some similar themes emerging so without further ado uh we're going to crack on and chat to manira so can i start uh by welcoming manira for being with us today i know that you are incredibly busy and there's many demands in your time so thank you for being with us um to kick us off as our first question for today to get straight into it can you please uh briefly explain to us what the role of public health scotland is and why it was established as a relatively new public agency just a couple of years ago oh thank you very much adam and everybody else adam if you don't mind i'm going to just pause and reflect just for a minute or so to thank you and the team at nestor to invite me along for this afternoon's conversation it is certainly a real true honor and before i start if you don't mind adam as i said i'd like to thank and appreciate everyone that has joined today i understand many if not all of us are very busy responding to the needs of our nation the pandemic and many other things and time is such a precious commodity whatever you're doing right now either if it's sitting at your desks taking this opportunity to go for a walk and listening making a cuppa or having your lunch i truly appreciate you taking the time to spend with myself and adam this afternoon what i was positively overwhelmed by was the rich and diverse range of individuals we have joining us today so a quick shout out to everybody that has joining us from health and social care settings from frontline colleagues operational planners territorial boards special boards academia voluntary and third sector organizations private sector local and national government community planning and like me data and digital enthusiasts plus many others alongside that adam i noticed that we have individuals that have joined us today from across the uk but also in fact from across the world including belgium denmark's and with singapore's name just some so like i said it's a true honor to spend the next 60 minutes talking about things that are so passionate to me i also wanted to pause for a few seconds to appreciate the diversity and the amount of knowledge and experience we have this afternoon as a collective online forum i guess i'd like to start by sharing with who i am and so i'm a mom my daughter a sister a friend and why is this important to know well for me adam is important because if we wish to co-design and deliver place-based services and support communities across our nations to thrive we need to understand lived experience and what makes us us and that includes everyone here virtually today and my role as one of the chief officers at public health school scotland includes leading a number of diverse work programmes facilitating and influencing through networks to ensure open collaboration between partners and consultant team through technical advice including connecting contacts and partners to overcome barriers to delivery and all under the ambition of creating a scotland where everybody thrives and this really nicely kind of takes me into why public health scotland and for this at him i think i need to cast year and others minds back to a good few years to the start of the public health reform journey and i appreciate the number of us joining today will have contributed to that journey and the subsequent exploration that has led us to where we are so public health scotland was established because we know scotland faces considerable health and well-being challenges we've had covert for the last 22 months our relatively poor life expectancy health inequalities and climate change to name just a few if we as a society continue to do the same thing the same way we will not address these multi-faceted challenges so the role of public health scotland is building a new approach to public health in scotland now we want to see scotland of flourishing communities communities need health and well-being to succeed and we all know that this is complex meaning we live and breathe it every day and the different roles that we do however what we do know also know is the foundations of flourishing communities include an inclusive economy so good work quality housing and education looking at the attainment gaps accessible to effective health and social care services for all clean open spaces water sanitation to name just just a few and public health scotland's mission is to lay some of the solid foundation that supports long-lasting good health and well-being for all our communities especially adam those that are most disadvantaged a whole system of people organizations and the groups are responsible for different parts of the foundations of community well-being and for me just seeing some of the different representations are being on the scope that are on this call today it shows that there's so many of us that are needed to really make change happen and we can do this by working really closely with each other with different sectors and like i say all of us on this virtual session today but scotland where everybody thrives all joined forces to create foundations for communities to flourish is really at the heart of public health scotland and just to kind of finish off in this part around public health scotland and and why we were formed we also understand and appreciate there are many opportunities are done we have in scotland we nev we could never be in a better position to work together to improve its health and well-being and just to share a few salient areas which start to knit together for me and for others the whole system's thinking so we have a national performance framework which you know many will be well versed with it describes the scotland we want to create it uses an outcome-focused based approach that reflects both our values and aspirations of our people we have our scotland's public health priorities and these are defined across six priority areas for organizations and groups to come together to really start to look at and improve the health and well-being of our communities we've got a very strong community focus and i say this because we have the community empowerment act of 2015 which established very clearly community planning as a basis of public service and provides us a framework to work together with local communities to shape and deliver better services my own favorite passion data and analytics so there's lots of advances in computing and increasingly our reliance on technology means well analyzed data now has a potential to offer more intelligence and actionable insights than ever before and to finish this bit off our joint sponsorship so public health scotland is jointly sponsored by scottish government and koslan that's the convention of scottish local authorities so this shows a commitment from both spheres of the government both at a local level and the national level so putting this all together it recognizes that with public health scotland in the mix of all of this it will certainly um support um local regional and national partners support the ambition of communities and everybody to thrive within these communities thanks adam thank you very much a really comprehensive overview both of the the history of where public health scotland's come from the challenges we're all grappling with as a nation and and some really kind of inspiring words about where we want to get to with our approach to public health now we're going to come on as you've alluded to we're going to come on to chat about the role of data in public health but just before we do um we had asked those who had registered for today's event to submit some responses to a word cloud that we're trying to create where you asked them about anything that had changed in their behaviors or in their um working patterns or or life patterns as a result of the pandemic over the last couple of years and i wonder if colleagues behind the scenes would be able to share uh the of where that is uh where the responses to that are so these are these are as up-to-date as we can get them and i i thought this was a great idea of yours mirror because we're going to talk about data and the the many challenges around data the many um issues and and competing demands of qualitative quantitative data etc etc but this is just i thought this was a really nice way of uh engaging people and it's quite funny on a very personal level to see some of these responses because if i was to do my own word cloud this is pretty much exactly what mine would look like so i'm interested to know if if that sort of has a has a resonance across the board but i mean what were your thoughts uh on what we're seeing here and does this resonate for you and and your colleagues in public health scotland yeah so so thank you firstly a massive thank you to everybody for taking the time just to respond to this adam i was very much like yourself i mean i could certainly have added much more to that but everything that i've seen on this um reflects my own personal journey and i guess um you know this adam and a number of colleagues have joined us today will know this as well you know my journey has seen um also um the loss of loved ones and through the the course of the pandemic um and to see our next generation go through really emotional times um has been um quite profounding and has changed my life forever and i guess you know keeping it light-hearted for the now you know one of the things that i really missed was getting physical you know in a sense physical activity get my words out right there around physical activity and some of you will see if you can see in my background if i move this way i have a treadmill in the in the background um and um you know and what i've managed to do over the last you know um period of being working at home is that i've seen myself on that treadmill joining meetings you know and would have ever thought about it and i was a and and just a quick reflection and just yesterday if you follow me online you would have seen me tweet about this i was joining one of the regular updates from my cheap exec and with her pace of her um conversation she made me beat my own personal best at doing 5.4 miles within like 40 minutes i'm like where did that come from so i i guess these ups and downs for everyone within the the course of the last 20 to 23 months and the main reason for me to start with this um adam was because all of this needs to be really openly reflected when we come together to start to think about what our nation needs we bring to the table really really powerful experiences that sometimes we lose with our passion of service you know the focus of others but actually collectively our experience are the others and and and again thank you for everybody for taking the time and and to share that with us so when you're building on that then can you tell us about how public health scotland is using data at the moment to generate insight and inform decision making in relation to those challenges that you mentioned earlier about the public health priorities that we have how are you using data at the moment in public health scotland big question but just a just a sort of an overview yeah how long have you got ads on that that could be for the rest of the session but no i'll give you some really succinct um responses to that so so so adam as many and we'll know we produce official statistics so we're regulated by the uk statistics authority and we see ourselves as a truly data intelligence driven organization it really is at the heart of a lot of what we do but as we all know data comes in very different forms and formats and different guises so we have access to and collaborate on an enormous range of data both at scotland's health and wellbeing and on health and social care services it includes a wealth of data intelligence vital to helping people access quality services such as our cancer services data just to name just some anatomy as part of this we have over a hundred data sets which range from pre-birth to end of life and again we have a really beautiful visual that kind of starts to explain that cradle to to to end of life journey which i know um your colleagues nesta is going to share afterwards um now how are we generating insights again a really good and uh question again there i wouldn't say there's a right or wrong way but there is a a more improved way of doing it so you will where we continue to develop and improve quality and linkages between different sets of data we're developing new whole system models to support local leaders clinicians planners and more adam to understand service user pathways so the better use of predictions to support joint decision making for service redesign locally regionally and also nationally we're also using our wealth of data and connecting this into community settings so working together on hard hitting topic areas impacting local systems so furthermore we have colleagues and you know this adam because we've had quite a few conversations around this as we have colleagues that are virtually deployed into local systems so they share their knowledge and skills as well as open up roots and accessibility into the wealth of data held nationally so for example you know we have what we call our list service that's the local intelligence support team where analysts and data managers work with health and social care partnerships local health boards and community organizations and more to connect data with from different parts of a single system and then translate that into actionable insights and that's really important for me it has to be actionable something that is so what what do we do next and i don't we know that no one has ever changed because of a number people generally need a story so in public health scotland we continue to develop different ways to make insights actionable through the power of storytelling thanks adam thank you manira i think that you've touched on a whole range of really interesting stuff there and i know that from my own experience in the past one of the one of the great advantages to a a nation of scotland's size which is a relatively small uh population nation in the scheme of things is that uh ability as you've alluded to to for data linkage uh and i think one of the really interesting examples of that from recent years is the linking of homelessness and health data from a few years ago which generates a huge amount of insight and i'm really excited about the potential for what similar exercises and a number of different fronts as you've referenced will mean for the future of insight generation and ultimately trying to make an impact um so if that's kind of where we are at the moment if i can ask you to if we can think reflectively and this isn't like this isn't a critiquing question but it's more a sense of what's working well with our use of data and you may be alluded to some of that already um given that we do have these really significant um public health inequalities in scotland you know we we we've performed quite poorly at a national level compared to other comparable uh european countries or oecd nations so what's working well and some of that you've touched on but also crucially where do we want to see improvements what would be your wish list in terms of where you want to take public health scotland on this journey oh thank you adam and i love when somebody asks me for my wish list and so so adam and this our data uh like you said has been combined and it's been linked into a single platform now we're developing what's called the whole systems modeling and i touched a little bit about that in the the previous answer and that's just one of the examples where we're bringing together information from a whole range of different sectors to help with prediction to help with joint decision making but also to help with service redesign by using data together and bringing together and multi-disciplinary teams at both a local and a regional as well as a national level to do that and at public health scotland working with these partners we want to lead and support work in scotland to prevent disease so prolong life and improve health so you talked you asked me about my wish list and what all that means for all of us so for me that would mean if we do this really well we do this together and we do this in a way that is actionable and meaningful for everybody then fewer people especially in the most deprived communities adam getting um vaccine preventable diseases like covered nineteen so prevent that fewer people losing um health to infectious and uh diseases and hazards um and which we know and all two um sadly all too soon have experienced over the last two years um that scotland is ready for future pandemics you know um who knows what's around the corner but we want to be fully prepared for that fewer people dying from drug alcohol and tobacco use fewer people dying from cancer and we have more people that are satisfied by the quality of public services and you'll see adam i say public services because it's not just health and care services of health and well-being so it's all public services and which i add to my my wish list more people over say 55 say their health is good or very good and we have fewer children living in poverty more people describing their neighborhoods as very good places to live in uh we've improved mental well-being and we have a smaller um income inequalities now there's much more i would add to that adam but for me those are sort of the kind of the dozen of the hard-hitting items that are really a motive to not just myself but a lot of my colleagues in public health scotland as we work to really improve the health and well-being of scotland's nation and and and support communities to thrive thanks thanks man there's a great question that's come in in the chat uh from jan which will maybe sort of weave in if i may just know because i think to your point i think you you mentioned this earlier saying can can you help bring that to life with us because you've set some really admirable ambitions there and ones that you know would be hard to disagree with for anyone but how can you give us an example of how public health scotland or as you say public services in general have translated data into actionable insight what's a good example of that to help bring that concept to life uh for for the full joining us today oh great did you see jan had put that question in yeah in the comments i'm putting you on the spot there but yeah it is

great thank you very much i was going to say john thank you very much a lovely question and it's great to like back to one of my points i said you know people don't jim change because of a number they really need a story to evoke those emotions so which one do i choose from so i'll probably talk a little bit about um the drug deaths example um so we provide national leadership and tackling the harms associated with drugs use which includes support and to the scottish drug death task force leading the evaluation rights in respect to recovery working in conjunction with police scotland um and developing national standards for consistent delivery of no barrier medication medication assisted treatment and sharing data as well so um some of that work included an example around the early warning system so this is actually working within not just the national context at a policy level but a local context so the early one one thing that's all about preventing drug related deaths um to identify problems on early stage and intervene quickly and so we worked with police scotland to develop the system for drug deaths and in the past what would happen there would be a time lag of several weeks between initial arising in communities um and the data being available to partners so this meant it was often too late to take action to make a difference adam and save lives so we used um our monitoring and surveillance expertise to develop a new approach whereby partners were able to identify within a matter of days if there was an issue that needed attention so what we did in public health scotland with our partners is develop a robust data sharing arrangement that enabled partners to build a more comprehensive picture what was happening in their local areas and if data on suspected drug deaths from police scotland together with data from the scottish ambulance service on drug related emergency signals and that there was an issue in the local area than working with the local community so this is actually with the the local organizations as well we came together to take action to prevent harm now this is very uh innovative and collaborative action it showed that we can be more impactful in public health when we work across the system we adam pool our expertise and share our intelligence and this new wheel working there's a lot we can learn and then replicate into other areas and make it sustainable um so this tool was used to assess the situation back in august just last year um and uh and and with great success and working not just internally across our nation but also um looking at what other nations have done within the uk as well we were able to develop this early warning systems now adam that's one example in many and we do have this literature and our stories that are being produced on work that we have done locally and maybe i can share that with you and the team to share a bit wider afterwards as well but again another great question john thank you very much for that so if i can you set out in that response than the one before sort of it's great examples of what's happening just now and and some of the really good stuff as well as your ambitions of if you know if we could wave a wand or or whatever make a wish about where we want to be but if if you were to to assess where scotland is just now in that broad sense across all our services what's not working as well as it should be or could be in terms of data and public health is there is some areas that we really need to see quite fast improvement on yeah so that's another great question adam so what's for me not working well i guess i wouldn't say as much as not working well but actually more opportunities in certain fields in certain areas of work um i think for me there's still a level of data maturity that we need to get um right and support um a lot of different sectors so i'm thinking about the community and the voluntary sector there's a lot of rich data especially around the lived experience and amongst us so one of our big focus areas is how do we support that sector to be able to get data into us and to format that allows us to connect and link that to data that we already hold and that as they attached a bit on that and previous responses so for me that's a massive opportunity that not just ourselves yourselves that nest us and public health scotland but everybody around this virtual table can help us can help us do and there's lots of programs both government-wide and at local level that started in and around data maturity i guess the other thing for me as well which is equally important the actionable insights the so what the storytelling and we have lots of expertise and knowledge of bringing data together of linking data together of understanding a bigger picture and what we again another opportunity for us is to be able to make that meaningful for the majority so for citizens and right through the ranks to people that are in professions as well that when they look at information when they look at what's happening within their local or regional or national systems that's very easy to understand it's very easy for them to understand what action then they need to take that will then have a consequence impact to the rest of the system and the other bits for me in and amongst all of us again another opportunity that we have is how we can work more in a multi-agency approach now i touched a little bit upon that in previous questions i know again adam we've talked about this island there's so much passion will and commitment in all the organizations that we hear representing in this virtual audience and those are not even here um there's so much passion and will and determination so we all have a role in our own leadership to bring that together to really kind of raise our heads to look across the areas we work in as who else needs to be in the species we are in or who isn't and should be what are the unknowns and how do we get to uh answer some of those unknown questions and and then for me and it's not the fact that people don't want to do it it's been able and to understand the complex multifaceted world we live in with so much going on and and the question you asked about can you give me an example and adam i had i have hundreds of examples to share in this back to this point which one has evoked a reaction the name which one do i share and again this is what's so important to understand who we are in the system what we're trying to help especially in the life of data and digital so that's just some of these i mean we could talk at length at this adam but that's just some of the opportunities i think they'll lie ahead of us in the very immediate future thank you so there's a couple of great questions that have come into the chat but there was also a question i was going to ask that i'll try and weave them together if i may and apologies to those in the comments if i do a disservice to your question um one of the things that comes up a lot when we talk to stakeholders and i know as a priority for yourself and scottish government more generally is the idea of putting people in control of their own data or the ambition of trying to be better at putting people in control of their own data and that there's a few uh questions in the comments that are around this topic as well so can you can you tell us what ambitions does public health scotland have in this space around citizens being more in control of their own data and and this this sort of ambition that we've seen in in other nations if we look internationally of trying to empower individuals and citizens to be the holders of their own data in some form or another and at different times allow access to different people agencies or services and it goes to the some of the point and you've alluded to in earlier answers which we know is a long-standing challenge in scotland that when people individuals feel they are moved between services in a way where they have to repeatedly tell their story which can not always but can at times be difficult for them or traumatic or very personal it it immediately sort of disempowers people and disengages folk from the system so what's the ambitions that public health scotland has around this agenda of putting people more in control of their own data and where are we on that on that ambition or on that journey at the moment so it's adam you for me and for many um having access and being able to be in control of your own journey and even if i speak as a citizen so that really is something that starts to support individuals to take control of their own health and well-being and that has been our ambition i mean i've been in copious amounts of discussions over the past years and even before the pandemic of the ambition to move us into that space and actually a lot has happened so i would start by seeing highly accessible and consumable open data to support effective decision-making an individual community local government and national government levels is where we need to be and it has to be in that open format and here i would talk a little bit about the nanes digital service or the nds or some people might know us was set up by the scottish government back in june 2018 following the publication of the digital health and care strategy for scotland and again if you haven't had a chance to read the digital health and care strategy i think that is a fabulous piece of work adam and there's a things i've just even just happened in the last few months in their in the digital health and care strategy but there were three main objectives and i think they really sing true adam to the ambition of public health scotland as to where we want to be around putting people in control of their own data is that um we want to enable excellent care by making sure health and care practitioners can capture and access that special information they need to do their jobs exactly what you've talked about why do citizens need to have to tell the story over and over and over again how can we use the infrastructure and the models that we've got to be able to share that information capture it at once then share it with who needs to see it giving them the right access of data and a lot of that's progressing like i say through the the nes digital service to provide tools and services which allow um nhs scotland and leuder colleagues and third parties to build valuable products and services on a shared national infrastructure so again i'm back to this point that we're going to be able to really bring to life putting people at the heart of us and giving them the control of their own data we need to be cognizant of the infrastructures that we've got and we're not fortunate as other countries and nations have done is that we can wipe the slate clean and build a new infrastructure we have to work with what we have the bespoke applications and infrastructures we've got and build on top of that but as i said earlier you know we're in an environment where technology is moving so examples and the ways of working and adopting that is really moving our pace and then i would say to create an architecture to support key research agendas for better decision making and service improvement and why do i bring this up the reason i bring this bit off and again it is very important you know data consumable data at point of collection and usable and using that is great it's fabulous but then it has several other uses as well and one of them includes the research agenda how can we use what we've collected and compare that against historic and predictive analytics and then be able to really jump into the preventative sphere across all the sectors and for me being able to do all of that and as i see the digital health and care strategy for scotland um is championing all of this um coupled with and so this is not only coupled with putting the user at the heart of service design and and you know within our adam's colleagues from our digital office we have that now built up as a very strong team but putting users at the heart will end up allowing us to really move our technical architecture to ensure that key things are only done in one way across scotland so it's not that well i've just told my doctor then i've just had to tell my social worker then i've had to tell my home carer we've had we collect it once and share it and there's some really great examples that have emerged even during the pandemic and that has been cut across bureaucracy and governance and allowed us to really do innovative stuff and people are identified and where clinical data stored for me and adam um that we avoid having different logins for every system as well so this duplication of information um so both for citizens but also for the users of that data so either you are working at the front line or if you're a planner or if you work at a policy level and everything in between the how we um build infrastructures that reduce the duplication so for me having all of that and again adam i've just touched on some of these things this is so complex but if we touching them and we bring together those elements it'll make it little bit more easier to be able to put people in control and kind of um of their own health and well-being thanks adam thank you so there's i've got a sort of a a final kind of question for from myself and then there's quite a lot now coming into the comments and chat so i'll try and leave some of that in and then after i've asked this kind of last question we'll come back to the chat and try and get some uh some responses to some of the things that are being raised i will try and group them together as best i can um but this is maybe trying to weave a couple of things together here but one of the really interesting things to my mind about the way public health scotland has been constructed set up is that there's a really big and prominent focus on place and well-being which i think talks as you've alluded to to the many uh shared priorities we have from the national performance framework down across public services in scotland but um so my original question was going to ask you a little bit more about why that decision was taken but if i may add to that slightly just to bring in some of the comments you so i'm really interested in public health scotland as to why that was taken what he tells the rationale for that but can you also if you're able to can you bring in any sense of what data you're looking to use in that sort of focus on place and well-being because again as you've sort of alluded to manira that one of the things we've got we are a small country but we do have quite a lot of structures and quite a lot of different types of data collection as you write we say because of the legacy of where many of our systems have come from and we know that things like interoperability or access are a challenge and so can can you chat to us about why the rationale for place and well being so prominent in public health scotland and in relation to that what are you looking at in terms of data in relation to that agenda

great thank you very much and hopefully maybe some of that will touch on the and you see some of the questions i've reason they're really interesting questions that coming up adam so you're doing a great job of weaving them into what we're talking about so um i'll take it in two parts um so the first part around you know the focus within that kind of local context so what we know adam is national policy and our strategic plan both recognize that local systems are fundamental to driving employment and health and well-being of the population fundamental they are this alongside rather than instead of so working in collaboration and so public health scotland was set up to be a national and local organization i recognize and i talked a lot about this earlier about our dual sponsorship between scottish government and cosla now the clear policy direction from both national local government is a stronger focus on place and supporting local systems adam to improve community health and well-being and the local government and blueprint affirms this and reaffirms this i should say so that's causeless position that public health reform must progress to deliver support for local government and bring about a recovery that tackles both poverty intersectional inequality enhances community well-being because of this we are redesigning our local approach so that's just some of again the policy context why we're taking an uh a place based uh approach now some of the details are shared earlier about knowing where we are and knowing that wish list that you asked me for well a lot of that um can be influenced within local systems more than it can be influenced just in national systems so being closer aligned with local governments and the proximity to communities will enable public health scotland to be more impactful and influential across the social determinants of the wider public sector decision making processes back to this point that multi-agency approach and working with those and that are able to make and really influential service design decisions within their communities also by supporting adoption and implementation of intelligence of activist data but um but when i talk about intelligence i talk about research and evaluation from these insights for the scaling and learning and opportunities and so being able to take best practice and being able to support the scalability of it um across our nation where appropriate um and that can't just happen from a national footing you need to be within that local and regional space to support and complement the actions are happening it's also taking a place-based approach also allows an easier and simpler access to the range of public health knowledge and expertise to support the local system so i i said i touched one of the examples around the local intelligence support team that they are now virtually locally based um but what they also do not just support local systems but open up the access into the knowledge and expertise that's much wider that make up public health scotland which ensures that outcomes are designed by taking that multidisciplinary approach and for maximum impact so for example improving mental health reducing violence and harm or substance misuse and and supports and being place based supports a more improved coordination of national support so um we there's lots of what passion and well within other national organizations as well and coming together and coordinating that and coordinating that in conjunction with local leaders allows us to build strong advocacy for a public health approach so together together we are better than the the some of our parts um and also it supports with the distribution of resource fairly and equitably in the past i've seen that you know national organizations would come into an area and really focus on all the determinants of all the kind of challenges that media is focusing on and sometimes at the detriment of focusing on any other areas but with now our revised focus on working together a revised focus and collaboration what we're doing is using that part of the multi-disciplinary teams to work alongside the local systems to organize our assets and resources better than thus we become more impactful in communities in place so like i say fundamentally you know our ambition says it's about the communities thriving well how can we do that by just being national we need to look across the whole spectrum national regional and local and on your kind of second point you talked about um what sort of kind of kind of information or data would you be looking for well actually it's as wide as it can be so it's not just the traditional health social care primary care but it's much much wider than that and you said a lovely example about health and housing um and i remember vividly being part of that very early exploration and looking at um house homelessness applications they were coming in and one of them all in one of the areas and connecting that to the services around health and housing and and it's so insightful and bringing that that multi-agency approach together but we'll be looking at pop transport you know from right from truck

i think and data around not just housing but the wider community employability um around play and recreation education and again people are thinking i've heard this before and it's because this is what makes up for national performance framework you know everything comes together and that is our aspiration and ambition how we can work within local and regional systems and with other national bodies to really bring together the the rich data that sits in different aspects of our sectors to really show uh the the full picture what's happening within community and start to show those links um there's a lot more that i can say about this but what i'll do adam i'll share a few more details after this call so delegates can see what that what the links i'm referring to and and our ambition around our data capture as well thanks adam thank you there's a question that's coming that i think is is a good one to follow that up with it's come from um tom james who i think is watching via youtube if i if i'm getting my wii logos correct um the the question that tom's asking if i understand it correctly here is the challenges around the prevention which you've talked about a lot and the role of data particularly in relation to informing and driving action on prevention and we know that prevention has been a long-standing agenda in scotland going back you know well since the inception of many of these services and evolution but particularly you know we're now 10 years or so on from the christie commission which is all about upstreaming and trying to get uh prevention of public services and joined up approaches and tom alludes to a really interesting part of that challenge because at its heart some of that comes down to disinvesting in some areas and investing in others and i just wonder if you could share any reflections of your own manira from your role and your experience about how that plays out operationally and the difficulty and and how you're finding that in terms of operating uh navigating through that um journey i suppose again of of we are going to need to disinvest from some things in order to invest in others probably uh public health is one of the best examples of where that's going to be a priority where are the tensions in that at the moment in scotland and how's that from your reflection how's that sort of ambition being realized at the moment that that's a great um question from tom and i can see tom's put a few other suggestions and just thoughts in the chat as well um um uh and um just reflecting a little bit on this and being honest as we're we're we're amongst uh kind of a very kind of a an environment that has a lot of different representations here to the adam for me we are in a political landscape we can't forget that we can't figure that at all um but even political will is really wanting scotland to be a very flourishing nation and right down to its individual citizens we also have really robust research and evidence that tells us where the focus areas are so you know if we were to um stop or focus in on a few areas of work the impact it would have the longevity of the impact it would have on people's health and people living longer people living longer and healthier lives within our homely setting or the equivalent so we have a lot of our research that has been built up not just from the public health reform journey but much previous to that as well so a lot of that and we're confident by knowing what kind we can do but there's a flip side to that and i can see where tom kind of has that has got his question from there's a flip side to that where you know there's a lot that we're going on and a lot of what we do is the long game adam you know a lot of interventions or a lot of work we do you will not see a difference in the population potentially might not even be in this generation and moving into the next generation so it brings me back to the point is through our political realm and those are working within the system how do we come together to really start to explain the difference we want to make in scotland so back to this point you know we're not just going to change of a number we need to have that narrative that story to really open up our minds about what we need to do and we need to focus on in public health scholarly when we came together and i think there was a mention of it in the chat that we came together during a pandemic we didn't come together because of the pandemic which some people think we came together and it's always in plan and what we had was we had a panic pandemic thrown into the mix during it and public health schooling itself it was coming together of kind of three legacy organizations and some of the earlier conversations and even some of what we're trying to do now is grapple with what do we stop doing to be more impactful and what do we do more of and our chief executive is really really clear with us and and as we are with each other is that we need to be focusing on things that are going to have an impact and improve outcomes now that could be outcomes immediately or that could be outcomes in 10 or 20 years time but we need to be focusing on what makes a stronger and more meaningful impact and impact is very different depending on where you come from but if we kind of can throw back and you ask me for my wish list if we look at some of that which is all research based if you look at some of that it gives us a solid core foundation to come together to focus on joint initiatives so we talked about poverty i talked about employability i talked about economy um and even just general services now they are at heart or if not majority all of the communities in scotland so coming together under that narrative and being able to understand and articulate what can we do and the impact that's going to make i'm not saying it makes it's an easier conversation but it does make it easier but we really need to be true to ourselves there are things we will have to stop adam because we don't we have limited resource we have limited budgets um and that's not just within public health scotland you know that's for all of us in the totality of scotland and for other nations as well so the power for me is not just about setting outcomes and objectives as an organization how can we do that pan organization you know how can we do that even at our local community level there's there'll be hundreds of local community organizations supporting those communities how do we bring how do we master the energy to bring those communities together to plan organizational commitments so we don't have individual ones but ones that we can pool and push our resource together bring us skills and expertise together and back to um the usual saying we become more powerful we do in our own rights adam thank you thanks manila one of the questions again this is an attempt to weave together a few things that have been referenced in the comments um can you share any insight or or views uh from your role at the moment on how public health scotland is working to make uh data available to i suppose i i use innovators in the broadest sense because as you said some of that can come at times from the third sector or the private sector or indeed within the public sector but how how are we making or trying to make uh data available obviously in a you know an anonymous way if you like you know we're not sharing information that would is in any way breach of any regulations but how is data being made available to help drive innovation from other sectors out with kind of primary care or health research alone um where are we with that at the moment in scotland and what are some of the observations and reflections about that at the moment oh great question there's actually been quite a lot of movement even just during the years of the pandemic that i can share a little bit about and again i'm happy to follow up with some more detail if that would be helpful so i talked about you know the accessibility to data um both at a granular level and aggregated um means different things to different people but if you go talking walk through just some of those examples so i get kind of a granular level you know our focus around that place based approach so moving uh supporting local systems by moving our skills and expertise closer to them uh opening up our data and sources opening up information and insights and actually connecting more of that together so that continues to happen adam and that and we will grow on that and as we start to develop our revised approach to the local system now kind of bringing that back out to the anonymized part now even before the pandemic you know information can be accessed through safe havens so working very closely with academia and other institutions to to allow that to happen and other research data organizations as well but what we've done over the pandemic is we've looked again at the government of cv this is collectively uh both a national uh and down to a local level looked at the governance around safe havens you know what's needed and the process to apply to access data um and i'm not saying we're 100 there but i know from what mother what my colleagues have been leading on and doing there's been much change and how quickly and people can access information and what format they can ask the support they can get to interrogate that information because it's not just about the accessibility adam it's about supporting individuals as well as you know and we've talked about this before supporting individuals understand um the information and how best to use it and also there's been a massive push on open data you know the cover dashboard itself is a great example when we've got citizens we've got citizens that take that data and bring their own version to life um and i follow some of them as well and sometimes they're my go-to um and it's great to see the open data sources are starting to get into a place that citizens are being um more brave more innovative and creative and using that but then again i think from my personal opinion and great work my colleagues have been doing in the background around this i think there's more we can do to make it more accessible easier to use um and that will come in time there's something around the lag of technology and how we can make that happen this there's a lag around accessibility and the level of data and the infrastructure we've got so there's a few things for me that need to come together some with our control some out with our control but working together across the wider digital health and care strategy then that for me i'm really positive the movement even in the last 22 months have happened the way citizens and people are using our data that's already out there the number of hits we get and the of the information that we produce um regularly and that really really excites me but also um challenges me personally to say what more can be done how how how better can we be closer to those individuals are making those decisions and i guess adam that's my call to action for everybody around this table because for me it's not just public health scotland it's everybody's role in the little or large that they contribute to how we can come up with some of those solutions and ideas thanks adam so monera were rapidly running out of time um and clearly an hour isn't enough um i need to book a day of your time for the next one um but the if i if i may ask you a final question and we really only do have a couple of minutes left but what's we've had a huge range of questions today it's been brilliant and thank you to everyone in the comments and in the chat who's who submitted something i'm sorry if we've not been able to get to some of the key ones um but if i may take the progressive to ask the last one what what's a question that you've not been asked today that you would love to answer if you could think of anything that you and your role with the view that you have across where public health scotland's going what's a question you've not been asked that you would love to answer in the last couple of minutes um that's a great question adam and thank you for putting me on the spot and that's how i come up with my best uh output i think for me would be what's been my biggest regret um want me to go ahead and answer that adam please yeah all right okay so um probably i probably have two so i'll start with the later one first so when i was younger adam i didn't listen to my mom when she told me not to pluck my eyebrows too thin as they indeed took indies to go back in so listen for me there is mum usually knows best um and secondly and probably more importantly for me it's probably the importance of self and and i guess that kind of relates to how we started our session today isn't it adam so self in all we do so the fact that we need to pause i think and we don't do enough of that i think adam because of our passion to support and respond and help others but we need to pause to reflect in order to fully respond with the intent opposed to sometimes and i find myself doing this as well just reacting so we sometimes forget in the heat of the moment that helping others uh that we are part of the others and we bring a lot of diverse lived experience into these virtual rooms and in hindsight i wish i'd grasped that ideology much earlier in my life journey so the lesson for me in this is that it's important to acknowledge who we are what we do away from our day jobs and reflecting internally makes us stronger i would see adam and more focused to respond to the tasks in hand so our lived experience for these invaluable insights and when joined up with others um it just becomes very powerful so um my aim is to keep that in mind throughout my onward journey adam and supporting our communities to thrive thanks adam not so that's a great response and it's yeah it's a great idea to think about how systems which are historically transactional can move towards being more relational by taking in some of those human elements around things as you say maybe pausing and reflection before we default to kind of those quick responses well we've come to the end of our time uh almost exactly so i just want to take a couple of moments at the end here uh firstly manera to thank you for uh spending so much time with us today i've been so open and sharing your insight your knowledge and your experience um and candidly as well that's that's hugely appreciated so thank you very much um but also to thank everybody who has joined us for this session today we had over 200 people register and join us and we've had a huge level of engagement in the comments so thank you to everybody we are going to be sharing uh a sort of a follow-on uh feedback summary in which we will also make sure to include feedback from uh sorry additional links as monira has alluded to today there's various documents that we'll want to send on to people that expand further on some of the points that many have mentioned or touched on today that we didn't have time to go into in detail so thank you very much to everybody it's been a great pleasure and we hope to see you at the next nesta talks to event manira thank you and everyone attending thank you very much thank you adam

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