A core element of public health is to improve health and reduce inequalities in the populations we serve. In order to do that, it is important that the public health profession also examines itself for inequalities across its workforce and education and training.

The FPH’s ambition is to develop a workforce that is representative of the diversity of the communities that we, as a profession, serve. As part of an ambitious programme of work the FPH launched the “Fair Training Culture” initiative, a multi-phased programme of work to look at public health training across the UK through a diversity and inclusion lens. The programme has looked at both inequalities in recruitment and more recently, at differential attainment in exams.

A report on differential attainment in public health recruitment was completed in 2022 and published on the FPH website. A subsequent action plan focused on the most significant inequalities which appeared between ethnic groups at the Assessment Centre.

Further updates on FPH work following the report included a blog by FPH President Professor Kevin Fenton followed by a further update from the Faculty in 2023.

Focusing on differences between ethnic groups, the following actions were taken during the 2024 recruitment round:

1. The FPH, working with NHS England’s Workforce, Training and Education Directorate [NHSE WTE] separated the assessment centre (AC) scores from the Selection Centre (SC) so there is no carry through of the biases at AC into final scores.
2. We further developed the information hub including links to Regional recruitment events taster days.
3. More work was undertaken to improve the Situational Judgement Test (SJT) using a wider range of people from different backgrounds who provided diversity of thought and opinion. We also worked to make more examples available for applicants to prepare with, in advance of the recruitment process.
4. Training for Selection Centre assessors and Selection Centre materials continued to be refined.
5. Kent, Surry and Sussex (KSS) Specialty Registrars (SpRs) piloted a buddy scheme for applicants to the public health training programme from Black and Asian backgrounds based in the region. This proved popular and the qualitative evaluation was good, though it involved significant resource and of the 18 people who applied only one was appointed.

Following the 2024 recruitment round, the outcomes were broadly in line with previous years but of note:

• The Assessment Centre: Differential attainment between ethnic groups was similar to the previous year although there was a reduction in differential between professional groups in the SJT which could have been as a result of improvements made.
• The Selection Centre: “No significant difference found between White and Non-White candidates and appointability”. This suggests the separation of AC and SC scores, the training of SC assessors and the use of a Selection Centre has been successful in making this part of the process fair.

Next steps for the 2025 recruitment round include the following:

1. NHSE WTE has commissioned the Work Psychology Group to review the tests at Assessment Centre to see if there are ways of making this fairer.
2. Work will continue to broaden out the SJT development group to improve this test.
3. The KSS pilot will be further reviewed for potential roll-out more widely.
4. Information available to all candidates will be reviewed, with the aim of making as much support available as possible.

Work on phase 2 of the Fair Training initiative has also been completed and this looks at differential attainment across both the FPH diplomate and membership exams.

The report on Fair Exams will be launched at a webinar on 4 November 2024, open to all.

The FPH’s ultimate aim is to have a fair training culture, fair career structure, and support equitable training opportunities for all who work in public health.

Dr. Samia Latif
Chair, FPH Equity, Diversity and Inclusion Committee

Dr. David Chappel
Immediate-past FPH Academic Registrar