Public Health Changes Presentation by Jane Miller for SDP 290311 by UMlK884

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									  Healthy Lives, Healthy People
                          Strategy for Public Health in England
                                     November 2010




                                     Jane Miller
                           Deputy Director of Public Health
                                  NHS Lewisham
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The best possible health and well being for people in Lewisham
What is public health?

• ‘The science and art of promoting and protecting
  health and wellbeing, preventing ill health and
  prolonging life through the organised efforts of society’
  (Faculty of Public Health definition)
    There are three domains to public health;
• Health improvement (including people’s lifestyles as
  well as inequalities in health and the wider social
  influences of health),
• Health protection (including infectious diseases,
  environmental hazards and emergency preparedness)
• Health services (including service planning, efficiency,
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  audit and evaluation).
The best possible health and well being for people in Lewisham
                                     Health Background

  Poor mental health is estimated to be responsible for nearly a quarter of
  the overall burden of long-standing poor health

  Smoking claims over 80,000 lives a year
                                                       05/11/2012
  1.6 million people are dependent on alcohol

  Britain has amongst the worst levels of obesity in the world

  Over half a million new sexually transmitted infections were diagnosed
  last year, and one in ten people getting an infection will be re-infected
  within a year

   People
 05/11/2012 in the poorest areas
05/11/2012
                                            expect to live up to 7 years less than
     05/11/2012
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   people
  05/11/2012 in richer areas
 The best possible health and well being for people in Lewisham
                            A Radical New Approach

• representative – owned by communities and shaped
  by their needs


• resourced – with ring-fenced funding and incentives
  to improve


• rigorous – professionally-led, focused on evidence,
  efficient and effective


• resilient – strengthening protection against current
  and future threats to health.
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The best possible health and well being for people in Lewisham
                                 Public Health Paper

• Commitment to public health
• Inequalities
• Recognition of relationship of mental health to physical
  health
• Recognition of role of local authorities in improving
  health and wellbeing
• National public health service – Public Health England
• Importance of health protection
• Intention to protect public health funding
• Public Health into GP Commissioning




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The best possible health and well being for people in Lewisham
                        A New Public Health System

• Public Health England – a national public health service

• A return to public health leadership to Local Government

• Professional leadership nationally and locally

• Dedicated resources for public health at national and local levels

• Focus on outcomes and evidence based practice

• Maintaining a strong relationship with the NHS, social care and
  civil society

• Set out in the Health and Social Care Bill
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The best possible health and well being for people in Lewisham
                            Working together locally

• Local authorities will lead local action on public health, playing
  an important new role in promoting people’s health and wellbeing,
  with new freedoms to make a major impact on health
  improvement and health inequalities

• Health and Wellbeing Boards - Local authorities will play a
  leading role in driving collaboration

• Directors of Public Health will be the strategic leaders for public
  health and health inequalities in local communities, working in
  partnership with the local NHS and across the public, private and
  voluntary sectors


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The best possible health and well being for people in Lewisham
                              Public Health England

    New public health service directly accountable to the Secretary of
    State for Health with a clear mission to:

      • Achieve measurable improvements in public health outcomes;
        and
      • Provide effective protection from public health threats




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The best possible health and well being for people in Lewisham
                            Director of Public Health


• Will be the principal adviser on health to the local authority,
  elected members and officers, on the range of local authority
  functions and their impact on the health of the local population

• Will be play a key role in the proposed new functions of local
  authorities in promoting integrated working

• With Directors of Adult Social Services and Directors of Children’s
  Services and GP Consortia lead the development of the local
  Joint Strategic Needs Assessment (JSNA) and a Health and
  Wellbeing strategy

• Will continue to be an advocate for the public’s health within the
  community
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The best possible health and well being for people in Lewisham
                            Director of Public Health

• Will be jointly appointed by local authority and Public Health
  England and employed by the local authority with accountability to
  locally elected members and through them to the public.

• Will produce an independent annual report on the health of their
  local population

• Accountable to the Secretary of State for Health for
  responsibilities relating to health protection and professionally
  accountable to the Chief Medical Officer




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The best possible health and well being for people in Lewisham
Public health funding and
commissioning
                           Public
                                     Department of Health
                           health                                                                 NHS
                           budget                                                                budget

      Public Health England                             Funding for commissioning
                                                        specific public health services
     (within the Department of
               Health)
                                                                                                  NHS
                          Ring-                                                              commissioning
                         fenced                                    Providers                   architecture
                         public
                         health
                                                                           GPs              (Commissioning
                          grant                                                                Board and
                                                           Health and                          Consortia)
                                                           wellbeing
         Local authorities                integration
                                                            boards                integration

                                                     JSNA & Joint Strategic
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The best possible health and well being for people in Lewisham
             Outcomes Framework
   Figure 2 – A frame work for public health outcomes
              To improve and protect the nation’s health and well-being and to improve the health of the poorest fastest.
Vision




              •    Increasing healthy life expectancy
              •    Reducing the healthy life expectancy gap between the least deprived and most deprived communities

                                                 Domain 1 – Health protection and resilience
                               Protect the population’s health from major emergencies and remain resilient to harm
Domains




                     DETERMINANTS OF ILL HEALTH                                         OUTCOMES OF ILL HEALTH
               Domain 2 – Tackling              Domain 3 – health              Domain 4 – prevention          Domain 5 - healthy life
              the wider determinants              improvement                      of ill-health                  expectancy and
                     of health                                                                                 preventable mortality

               tackling factors which           Helping people to live        Reducing the number of          Preventing people from
                  affect health and            healthy lifestyles make           people living with            dying prematurely and
                      wellbeing              healthy choices and reduce        preventable ill health         reduce the gap in health
                                            the gap in health inequalities     and reduce the gap in                inequalities
                                                                                health inequalities


              Public health indicators (of which, some will be used locally to attract the Health Premium)
              • The Domains above set out the high-level goals for public health. Each domain will require a national local
                balance for delivery, with an onus on local delivery across the NHS, social care services public health and other
                local partners, and with strong leadership from the Director of Public Health.
Indicators




              • Outcomes for public health will be measured by indicators, which are supported by centrally collated and
                analysed data sets. This should include indicators that target different age groups, and target communities that
                experience differential outcomes in health.
              • It will be for each local area to determine how they will wish to use these indicators for local transparency in
                response to local needs identified through their Joint Strategic Needs Assessment, and considered within their
                local Joint Health and Well-being Strategies.

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             The best possible health and well being for people in Lewisham
Domain 1: Health protection and resilience: protect the

population’s health from major emergencies and remain

resilient to harm.




• Life years lost from air pollution as measured by fine particulate
  matter.

• Public sector organisations with a board approved sustainable
  development management plan.




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The best possible health and well being for people in Lewisham
Domain 2 – Tackling the wider determinants of ill health:

tackling factors which affect health and wellbeing.

•   Children in poverty                              •   Housing overcrowding rates
•   School readiness: foundation                     •   Proportion of people with mental
    stage profile attainment for                         illness and/or disability in settled
    children starting Key Stage 1                        accommodation
•   Rates of adolescents not in                      •   Statutory homeless households
    education employment or training                 •   Fuel poverty
    at 16 and 18 years of age                        •   Access and utilisation of green
•   Truancy rates                                        space
•   First time entrants to the youth                 •   Killed and seriously injured
    justice system                                       casualties on England's roads
•   Proportion of people in long-term                •   Cycling participation
    unemployment
•   Proportion of people with long-
    term conditions
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The best possible health and well being for people in Lewisham
                                     Summary timetable

                (subject to Parliamentary approval of legislation)

 Consultation on:
 • specific questions set out in this White Paper;               Dec 2010–March
 • the public health outcomes framework; and                     2011
 • the funding and commissioning of public health.


 Set up a shadow-form Public Health England within the
 Department of Health Start to set up working arrangements
                                                                 During 2011
 with local authorities, including the matching of PCT
 Directors of Public Health to local authority areas

 Develop the public health professional workforce strategy       Autumn 2011

 Public Health England will take on full responsibilities,
 including the functions of the HPA and the NTA Publish
                                                                 April 2012
 shadow public health ring-fenced allocations to local
 authorities
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 Grant ring-fenced allocations to local authorities              April 2013
The best possible health and well being for people in Lewisham

								
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