Hurrah for EHRNet & a King’s Fund urgent recommendation for EH research!

The Kings Fund has just published The District Council Contribution to Public Health: a time of challenge and opportunity.

The first “hurrrah” is the extent to which environmental health is mentioned.

The second “hurrah” is for the reference list. Check it out! Caroline’s work on HMOs features, as does EHRNet’s An introduction to evidence based environmental health. The latter is of particular interest because is shows that blogs present a creditable way of disseminating open access information.

The CIEH/BRE work is also there, plus work by David Ormandy and colleagues (Braubach and Jacobs) on the health effects of inadequate housing.

For environmental health to have a real influence, there is an ongoing need to publish widely, most particularly in peer reviewed journals where it can be more systematically accessed and reviewed.

I am now feeling more inspired today!


Rob adds:

Further to Jill’s post above I admit I haven’t yet read the whole of the King’s Fund’s report but senior EHPs including Graham Jukes and Ian Gray of the CIEH were involved in its development and it includes the following key messages and recommendations:

“…there is little published evidence on the effectiveness or cost-effectiveness of environmental health interventions. In a period when spending is being cut – particularly, it seems, in environmental health – this kind of evidence is urgently required to better inform difficult decisions about local priorities and to ensure value for money.” (page 7)

“Recommendation 8: The Chartered Institute of Environmental Health should, as a matter of urgency, work with the DCN (District Councils’ Network) and other relevant parties to better understand the cost-effectiveness and return on investment of environmental health services.” (page 9)

In response to the report, CIEH Chief Exec. Graham Jukes commented:

“Environmental health is also recognised within the report as a major factor in determining people’s health and wellbeing and rightly so. We agree that further evidence on the effectiveness of environmental health interventions need to be made and as the report recommends, we would welcome the opportunity to work with the DCN and other stakeholders to highlight the substantial positive return when you properly invest in environmental health services.” (see:

As a researcher I would argue that it’s up to us, as EHPs, to prove whether this ‘substantial positive return’ from our work can be demonstrated (or not). Further, I know from experience how difficult and complex this is and that it will require funding for research that is hard to come by at the best of times. Forecasts about next week’s UK Government Spending Review suggest this could be one of the worst times for expenditure on public health related services in recent history.

Lastly, ‘welcoming the opportunity to work with the DCN…’ doesn’t convey to me any great sense of urgency from the CIEH towards engaging with the considerable challenges set by Recommendation 8. Therefore I look forward to seeing what happens next and (hopefully) being proved wrong.

With best wishes, Rob

Towards ‘doing and thinking’: Surindar and Jill’s latest paper on evidence based EH

I was feeling quite deflated earlier this morning. My latest elective brain scan (a very long story – it’s still there, more a chronic plumbing problem!!!) recently scuppered my attendance at this Thursday’s CIEH workshop on bridging policy and practice with research (see blog below – though the rest of us will be there).

Further, I’ve just learned that my latest attempt to build a bridge with more established public health research colleagues has fallen at the first hurdle… then I received an email from Jill singing Surindar’s praises following publication of their new paper on the perceptions and experiences of EHPs about evidence based environmental health (EBEH).

This is available for free (hurrah) via:

I will ask Surindar and Jill to introduce it better soon, but from my first lunch time reading a number of issues spring to mind. First, I’m so relieved Surindar and Jill were able to publish this on Sage Open. Therefore all EHPs will be able to benefit, including those outside England where most of these arguments still apply. Further, by publishing in a non EH journal I hope that these arguments will reach a wider audience whose knowledge we could benefit from.

Second, the paper forms a solid foundation for a more informed debate about EBEH, not least by engaging with the complex and politically charged policy context in which it has emerged. Stuck in my PhD writing up cave I’m not the most policy-engaged EHP currently, but I know a few who are and I continue to be amazed by the apparent lack of EBEH debate amongst EHPs.

Third, Surindar’s PhD findings on the perceptions of EHPs and the practical challenges they face in moving towards a more EBEH provide such fertile ground for us EHRNetters, indeed in some ways they reinforce the need for our very existence. Indeed, the self-identification of EHPs in the paper as ‘doers’ – in contrast to their ‘thinking’ public health colleagues – suggests we still have a long way to go. When we started EHRNet in 2011 we speculated that it could take decades before EHPs were persuaded by EBEH, if they could be persuaded at all, though the challenges described by the pioneers of evidence based medicine continue to provide  comfort (see

We will therefore continue to publish and advocate for EBEH via workshops, meetings and our growing network of friends and colleagues. Further, I will escape the PhD cave soon and would love to develop and run some EBEH workshops…

Many thanks and best wishes,


Environmental health research at the helm

portrait poster template jpegLast week was busy with overlapping conferences highlighting environmental health research at the heart of public health. The 115th Chartered Institute of Environmental Health Annual Conference at Nottingham promoted research with varied presentations and poster sessions. Some of the posters are to will be available to view at the Middlesex research event outlined by Rob below. My poster focused on the ongoing work I am involved in around ageing in place and enhanced integrated services.

Meanwhile at the King’s Fund, London, a separate event entitled “Bringing together housing and public health: Enabling better health and wellbeing” included environmental health led presentations from David Arkle, Housing Manager, Amber Valley Borough Council on (see also Effective Strategies and Interventions) as well as John Kolm-Murray, Seasonal Health and Affordable Warmth Co-ordinator, and Ellis Turner, Principal Environmental Health Officer, at the London Borough of Islington. SHINE – Islington’s Seasonal Health Interventions Network, is a multi-agency single point of access (more information on SHINE to follow another time).

This event also referred to the following excellent documents:

Sitra and NHS Alliance (2015) Housing: Just what the doctor ordered

Housing Sector (2014) A Memorandum of Understanding (MoU) to support joint action on improving health through the home

Local Government Association and Sitra (2015) A home is much more than a house: Integrated approaches for the housing, health and care needs of vulnerable adults

Onwards and upwards indeed.

Best wishes, Jill

Bridging policy & practice with research – 12th Nov. 2015 CIEH conference at Middlesex University

Alan has been assisting the CIEH Education and Research Special Interest Group with the organisation of its annual research conference.

He’s hosting the all day event at Middlesex University on 12th November 2015:

“Environmental Health Practitioners have a wealth of work experience, which often goes unshared with colleagues within their field.

Many believe research and publication is only for academics but your professional experiences will be of value in informing professional practice articles, local presentations, posting case studies and story-telling.

This conference is aimed at EHPs and EH students, to demonstrate why we need research skills to evidence base our work, to share our experiences, and practical ideas on where to start”

For further information please visit:

We hope to see you there…

With best wishes, Rob

How do I offer a room to a refugee?

The situation is Calais is just one representation of the massive human migration we are currently witnessing and Rob’s blog, based on Surindar and her colleagues’ work (click here) helps us all to understand a bit more about the desperate situation thousands of people continue to face.

The thing is, we can individually feel pretty helpless to know what best we can do about it and how we can help both the immediate and long term situation. For those wanting to do something, the Guardian’s article How do I offer room to a refugee? offers some pointers on practical options and well as influencing longer term policy change.

With best wishes, Jill

Managing Houses in Multiple Occupation – Caroline’s latest paper…

Although Houses in Multiple Occupation (HMOs) are becoming the subject of growing academic research, what is known about how HMOs are managed and run remains very limited.   HMOs are often viewed as a problematic housing type associated with ‘studentification’ in communities located close to universities and anti-social behaviour in deprived seaside towns.  However HMOs are housing an increasing proportion of vulnerable adults who have limited affordable housing options. Furthermore Local Authorities use considerable resources in the licensing and monitoring of these types of properties, trying to hold landlords to account and minimise the negative impact of poorly run HMOs on local communities.

Understanding more about how HMOs are managed and the impact this has on tenants is important for environmental health and housing professionals who are making decisions about the strategic management of HMOs and assisting people to find appropriate housing.

In our most recent paper in the journal Housing Studies we try to address this knowledge gap using data collected from HMO landlords and managers and their tenants. We describe how the property landlords and managers control tenants through various means but how this also manifests as care and support. We illustrate the complex relationship between care and control and the extent to which both are integral to the housing management of vulnerable tenants living in HMOs.

Further, we think the paper raises interesting questions about what it means to be a ‘good landlord’ that are worthy of discussion, particularly as HMO licensing conditions may go beyond the realm of property management into social control.

The full reference for the journal is:

Green, G., Barratt, C and M. Wiltshire. 2015. Control and care: landlords and the governance of vulnerable tenants in houses in multiple occupation. Housing Studies 0(0), pp. 1–18.

For those fortunate to be attached to Universities who subscribe to Housing Studies our paper can be accessed via:

Others without subscriptions can read the abstract here too and see the references but all, particularly housing practitioners, are welcome to contact me (via: and I can send you a copy of our paper.

We hope you find the paper insightful and welcome questions and comments.

With best wishes, Caroline

Of interest? Funded PhD opportunities at the Open University

The OU is currently offering the following opportunity:

4 full-time funded PhD Studentships commencing February 2016

Faculty of Health & Social Care, Based in Milton Keynes
Approximate annual stipend of £14,057
closing date : 29/10/2015
Achieving good health and wellbeing for all is essential to achieving social justice, and this lies at the heart of the Open University’s mission. Building on existing cross-disciplinary intellectual capacity, an evidenced commitment to social justice and existing local, regional, national and international collaborations and networks, the University is making a further investment in the field of health and wellbeing which includes funding of 4 PhD studentships. Existing research strengths within the University map across a range of disciplines and fields including: sociology of health; public policy and management; critical health psychology; biomedical sciences; health services research; human computer interaction, personal informatics and wearable technologies; health economics; medical statistics; health communication; public health and health promotion; social marketing; mental health; and the medical humanities.

We are keen to attract students to work with us on research that locates the experiences of patients, carers, family members and practitioners at the forefront of inquiries. We place value on participatory and inclusive research particularly with individuals that are marginalised, ‘hard to reach’ or have complex needs. Applications are invited on one or more of the following themes: – age, ageing and later life; children, young people, parenting and families; death, dying and bereavement; disability and long-term conditions or reproductive and sexual health

These are four full-time 3 year studentships which covers all fees, living expenses and fieldwork costs. Please note you will need to be educated to Masters’ level qualification to apply and would be required to live in the UK close to the university campus in Milton Keynes.

For more information go to: