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Healthy Lives, Healthy people Dr Jane Halpin : Chief Executive NHS Hertfordshire 28th February 2011 High level aims Build on the known link between socioeconomic deprivation and ill health • • • • Maternal and child health Adults of working age Those with LTCs Frail elderly Architecture • Health & Wellbeing Board • High level strategy, reflecting JSNA • DsPH – in local government, principal adviser on health across LG functions • DsPH also part of PH England (health protection) and accountable to PHE and to Secretary of State for Health • PH funding (but scope unclear) • Annual report Other elements PH Outcomes framework Health & Social care outcomes frameworks Joint work across housing, environment, transport, planning, children’s services, social care, environment & leisure Hertfordshire: context • Existing relationships strong – and strengthened by the changes • Joint Executive Group in place – avoid inertia • Budgetary pressures for both LG and NHS – opportunity to do things differently – be bold • History of Joint Commissioning (Mental Health, Learning Disability, Substance Misuse) with some joint provision • Already working jointly on “Intermediate Care/ Reablement” and Carers support • Faster progress on joint equipment services, voluntary sector funding Social Care Complex / multiple conditions Risk of losing independenc e Enabling to promote independence Health Acute Complex / multiple conditions LTC management High risk Managed care Universal Prevention & Health Promotion Supported self care Health improvemen t Hertfordshire: next steps • Increasing levels of physical activity • Universal 0-19 services – greater integration • Sexual health (beyond “teenage pregnancy”) • Falls services • End of Life Care Previous governance structures Board , NHS Hertfordshire & Cabinet, Hertfordshire County Council Joint Commissioning Partnership Board JC Team Mental Health Children’s trust Partnership Board Safeguarding LD Substance misuse CDOP County-wide LSP Stronger & safer Healthy Communities Other Many Others… Performance tracking Revised governance structures Health and Wellbeing Board GP consortia leads/PCT Elected members DASS/DCS/DPH Health Watch District Reps? Remit Health & Wellbeing Strategy Consider commissioning plans Agree joint commissioning plans Oversight of performance Agree allocations to local areas Stakeholder Forum(s) Joint Commissioning executive Various commissioning groups / strands District LSPs Providers User/Carer Other agencies e.g. police/probation GPs Challenges • • • • Different cultures, language (NHS, LG) Mixed messages from Government Depts Gap between rhetoric & reality Building & sustaining trust – eligibility criteria • Growing demand, limited resources • PH support to NHS as well as LG • Pace of change and loss of staff