Transcript The new public health system
our role in improving and protecting health and wellbeing; and the transition process
This presentation will cover…
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Context of the public health reforms Vision for a new public health system What the new locally-led system will look like Local system transition Workforce and HR issues Discussion
Health and wellbeing reforms: setting the context
Context
Across the health and care system
• Rising demand and treatment costs • Need for improved healthcare services – and reduced variation in health outcomes • Need for better value for money
The modernisation programme will:
• Put clinicians and local communities in the driving seat • Provide a greater voice for patients and the public • Increase accountability – locally and nationally • Support a greater focus on public health
Overview of health and social care structures from April 2013 Ministers and the Department of Health
Public Health Public Health England
(part of DH
) Monitor NHS NHS CB NHS Trust Develop ment Authority Adult Social Care Care Quality Commission, including HealthWatch England National Institute for Health and Clinical Excellence Health and Care Information Centre Local authorities CCGs Local authorities Public health providers Health and Wellbeing Boards (part of local authorities) Local HealthWatch (formerly LINks) NHS providers, inc: •Foundation Trusts & NHS Trusts •Primary care providers •Independent / 3 rd sector providers Social care providers
Patients and the public
Modernisation timeline
Our vision for public health
A powerful case for change The white paper Healthy Lives, Healthy People set out a powerful case for reforming the public health system:
• two out of three adults are overweight or obese • smoking costs the NHS £2.7 billion per year • rates of tuberculosis are rising • inequalities in health remain: people in the poorest areas live on average 7 years fewer than those in the richest • Major health threats, ranging from the risk of new pandemics to the potential impact of terrorist incidents.
We need a new approach to meet these and other public health challenges of the twenty-first century.
The new approach to public health
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Leadership role for local authorities – so services are shaped by local needs Supported by a new integrated public health service, Public Health England Stronger focus health outcomes supported by the public health Outcomes Framework Public health as a clear priority across government The commitment to reduce health inequalities as a priority across the system
An effective public health system…
• • • • • • • Accounts for the changing nature, assets and strengths of the population – is vigilant for new health threats Ensures economic development creates health and wellbeing Advocates wise use of environmental resources Promotes individual and community wellbeing Helps people limit behaviours damaging to their health.
Secures equitable access to good quality health and social care, with prevention incorporated into all contacts.
Systematically works to reduce health inequalities and embeds health and wellbeing in all policies.
the new locally-led public health system
Leadership role for local authorities – so services are shaped by local needs • Drive knowledge and analysis of population
assets
needs.
and • Consider whole population outcomes and set goals.
• Inform all health and social care commissioning using preventive approach.
• Incorporate health and wellbeing across all local authority work – and across the locality.
• Use evidence and return on investment to inform decisions.
• Tackle health inequalities systematically focussed on
People, Place and Power.
An effective public health system New delivery system requiring wide range of partners
–
Government
: DH lead but significant contributions from DCLG, Justice, Home Office, DWP, DfE –
PHE
: Delivering health protection and supporting LAs and the NHS –
Local authorities
: New public health functions build on existing wider role –
NHS
: Delivering health care, every contact counts and specific public health interventions
Roles in the new Public Health System: Local Delivery
Local Authorities • Duty to improve health • Brings together holistic approach to health and wellbeing • Employ DPH • Ringfenced PH budget • Mandated services • Core offer to the NHS, including PH advice on health services CCGs/NHS CB • Commissioning healthcare • Commissioning some public health services PHE (local units) • Local Health Protection Services (functions in development) Health and Wellbeing Board Coordinates local strategy through • JSNA • JSHWS • Review of commissioning plans
Public Health System Updates: autumn 2011
• • • • •
Department of Health is completing the policy design phase Public health Outcomes Framework Operating model for PHE Public health in local government
: including grant conditions, mandatory services, and public health advice to the NHS.
Public health funding
authorities.
: including shadow allocations for local
Workforce strategy and other HR updates
Commitment to co-design We are working with stakeholders to co-design these five system reform updates
• Regular discussions with local government • Regular discussions with the profession •
Public Health Engagement Group
, in autumn 2011, to provide advice and challenge •
Alongside ongoing engagement forums
– including with and via the Regional Directors of Public Health and DsPH group •
NHS Future Forum
review of the NHS’s role in the public’s health (due December)
Timeline
End of 2010: July 2011: By end 2011: Spring 2012: April 2012: April 2013: April 2013: White paper:
Healthy Lives, Healthy People
White paper response, confirming new public health system structure complete the operational design of the new system, including the PHE Operating Model, how the local system will work, and their links into the NHS. chief executive and senior team for Public Health England appointed.
start of transition year Public Health England established Local authorities take on their new public health responsibilities
Key dates and activities
Sept 2011 Baseline assessment Oct 2011 Functions map Nov 2011 HR concordat, Dec 2011 Policy documents published March 2012 PCT cluster transition plan including delivery April 2012 Assessment
Workforce and HR issues
Scope of HR / workforce Work
Local transfer
: establish clarity on principles and terms and conditions of public health staff in LAs
Directors of Public Health
– devising an appropriate employment process
PHE HR regime
and conditions – exploring options for PHE terms
Public Health workforce strategy
– working group developing consultation document
Regulation of non-medically qualified staff
seeking evidence to inform final decision –
Aims of HR strategy
An HR regime and wider workforce strategy which supports • • • • the public health reforms through: A secure transition of staff to PHE and LAs, retaining crucial capacity and expertise in the system Ensuring the supply of all expert staff, including medically qualified public health consultants, nationally and locally both in transition and in the future Supporting the future mobility of public health specialists across the whole of the public health system To create meaningful careers in all settings
Public health reforms: to stay in touch…
• • • Sign-up for the Transforming
Public Health
bulletin: www.dh.gov.uk/health/category/publications/bulletins/pu blic-health-bulletin/ Contact details for workforce and HR issues: – [email protected]
Contact for other transition issues: [email protected]