Transcript Slide 1

The New PH System, National and Local.
Maintaining a Focus on Children and Young People
Dr Ann Hoskins
Interim Regional Director of Public Health /
Director of Children, Young People and Maternity Services
Healthier Horizons
There Remains a Powerful Case for Change
All Cause mortality in Children in European Countries
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Health Inequalities
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Consequences of inaction
• More than half of 15 – 16 year olds had
consumed more than five alcoholic drinks in the
previous month
• Half of life time mental illness starts by the age
of 14
• More than 8 out of 10 adults who have ever
smoked regularly start before 19
• 8 out of 10 obese teenagers go on to be obese
adults.
Strategic shift from healthier habit
Healthy Lives, Healthy People: Our
Strategy for Public Health in England
The Government aims to:
• empower local leadership to strengthen health and
wellbeing
• support self esteem, increased confidence and
personal responsibility
• promote healthier behaviour and lifestyles
• change the environment to support healthier choices
• protect the public from threats to health.
Following extensive consultation, further details
published in July 2011’s Update and Way Forward
December 2011: finalising key elements of
the design of the new public health system
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The New Approach to
Public Health
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Leadership role for local authorities – so
services are shaped by local needs
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Supported by a new integrated public health
service, Public Health England
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Stronger focus health outcomes supported
by the public health Outcomes Framework
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Public health as a clear priority across
government
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The commitment to reduce health
inequalities as a priority across the system
Local Government Leadership
Local government should lead for public health
because of its:
• Population focus, as the democratically accountable
stewards of local health and wellbeing
• Role as the shapers of place
• Ability to address many of the wider social
determinants of health, and
• Experience of, and ability to tackle, inequalities in
health.
Factsheet: local government
leading for public health
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Local Government’s New Functions
New duty to improve the health of the population:
• Commissioning services from a range of providers
• Working with clinical commissioning groups to integrate care
pathways
• Using health and wellbeing board to integrate commissioning
approaches
• Providing population healthcare advice to the NHS
• Duty to ensure plans in place to protect health.
Local political leadership critical to making this work.
Factsheet: local government’s
new public health functions
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Local Authority Commissioning
Responsibilities (1)
• Tobacco control &
smoking cessation
•Alcohol and drug
misuse
•Services for
children 5-19
•National Child
Measurement
Programme*
•Obesity and
weight
management
•Local nutrition
services
•Increasing
physical activity
• NHS Health
Checks*
•Public mental
health services
•Dental public
health services
•Injury prevention
•Birth defect
prevention
•Behavioural and
lifestyle
campaigns to
prevent LTCs
•Local initiatives on
workplace health
• Support and
challenge of NHS
services (imms
and screening)
•Public health
advice to NHS*
•Sexual health
services*
•Seasonal mortality
initiatives
•Local role in health
protection
incidents*
•Community safety
•Social exclusion
* Indicates mandated services
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Local Leadership For Health
Protection
 Secretary of State responsible for health protection via PHE
 Local authority under a duty to ensure plans are in place to protect
the local population
Local authority role
Ensuring plans in
place for:
•outbreaks and
emergencies; and
preventing them
occurring
•immunisation and
screening
•infection control
Factsheet: commissioning
responsibilities
How the role will work
• DPH leadership, rather than managerial role to
highlight, advise, challenge and advocate.
•Supported by PHE expertise and infrastructure
•NHS commissioners duty to cooperate
•Lead DPH to co-ordinate local authority public
health input to LRF emergency planning and
response
•DPH challenge and advice to NHS on local
screening and immunisation plans
•Professional relationship between DsPH and the
Chief Medical Officer
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Population Health Advice to the
NHS
Local authorities will provide population healthcare
advice to the NHS
• To support healthcare commissioners, including via the
JSNA, with strategic population data from many sources
• Applying skills to interpret data
• Advice at all stages of the commissioning cycle alongside:
• advice from new commissioning support organisations,
which will focus on processes and clinical systems
• PHE role through information and intelligence service to
LAs e.g. by providing baseline data
• Further work on role for supporting the NHS Commissioning
Board and how this advice will meet the needs of CCGs
Factsheet: public health advice
to NHS commissioners
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PHE’s National Office
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PHE’s national office will act as the service centre for the
organisation and provide leadership, strategic direction and support
the overall public health system.
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PHE will build the current system’s centres of professional, scientific
and analytical expertise with national centres of expertise and
excellence.
PHE will distribute a small number of national office functions
across four regions that are coterminous with the NHS
Commissioning Board’s sectors and DCLG resilience hubs.
Each hub will:
• Ensure PHE’s emergency preparedness, resilience and
response plans are in place
• Quality assure services delivered by centres
• Ensure high-quality advice to the NHS commissioning board
• Support transparency and accountability across the system
• Offer professional support to directors of public health.
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Senior Leadership Team
Distributed Evidence and Intelligence
Teams
Chief Operating Officer
PHE centre
• Develop and maintain key relationships with local government
and provide professional support to enable LAs and other
partners maximise health improvement of local population
• Provide health protection services
• Provide local NHS with public health advice, including
supporting DPH in their relationship with NHS
• Employment and professional development of immunisation
and screening teams
• Development of specialist wider PH workforce to support LAs
and manage relationship with local health and education
boards (LETBs)
• Provide specialist PH support specialised commissioning and
dental commissioning
• Oversee drug and alcohol services
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Public Health System Updates
The new public health system factsheets are available at
http://healthandcare.dh.gov.uk/publichealth
Sign-up to our regular Transforming Public Health bulletin
http://phbulletin.dh.gov.uk/
Contact the DH Public Health England transition team
[email protected]
Contact the DH Public Health Development Unit
[email protected]
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Commissioning responsibilities for children, young people and maternal health services in 2013, as of 17 July 2012
Department of Health
Public Health England
(National and Regional)
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National Health Service Commissioning Board
• Neonatal care and Screening (ante/post natal)
• Immunisation and vaccination (incl. school-based programmes)
Delivers national health promotion and prevention campaigns
• Healthy Child Programme 0-5 years including Health Visiting and
Infectious diseases national overview
Family Nurse Partnership (transfers to Local Authorities in 2015)
Child and Maternal Health Observatory (CHIMAT)
Joint Working
• Child health information service
Inform regional strategic commissioning with NHSCB
• Primary care including GP contraception
• HIV/infectious diseases treatment
• Health care in secure settings - Youth Offending Institutes, secure
children’s homes and training centres
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Community healthcare for military families
Public Health Centres
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Sexual assault and referral centres
Support partnerships locally to improve public health
• Specialised commissioning
outcomes
• Health protection services
• Employ and develop immunisation and screening teams in
LATs
• Specialist support to dental and specialised commissioning
• Oversee delivery of drug and alcohol services
NHSCB Local Area Teams (LATs)
Clinical Commissioning Groups
Local Authority (Public Health)
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• Core functions include CCG development and assurance,
quality and safety, partnerships, system oversight
• Commissioning GP services, dental, pharmacy, prison
health. Some LATs host specialised commissioning teams
Joint Working
Healthy Child Programme 5-19 years (incl. school nurses)
National child measurement programme
Tackling obesity/increasing physical activity
Sexual health services inc teenage pregnancy
Substance misuse services (incl. alcohol)
Public mental health services
Community safety/violence prevention /accident prevention
Joint Working
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Maternity services
Elective hospital treatment/rehabilitative care
Emergency and urgent care
Community health services i.e. speech and language
Mental health including CAMHS, learning disabilities services
Secondary health care accessed by those in secure settings
Continuing healthcare
Wheelchair services
Health and Wellbeing Boards
Health And Wellbeing Boards and Children,
Young People and Families
Vision
“That Health and Wellbeing Boards make an
effective contribution to improving health and
wellbeing outcomes for children and young people”
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Key Success Factors
• Governance of HAWB should link into CYP partnership
• Holistic Commissioning i.e. commissioning of NHS services for CYP
must sit alongside commissioning of all services for CYP
• HAWB should prioritise proven interventions
• Commissioning of services should be informed by engagement of
CYP, parents and families
• HAWBs should focus on early intervention, within an overall “life
course” approach
Key Strategic Questions &
Challenges for HAWBs
• Are there effective links between HAWB, Children’s Trust,
Safeguarding Board & CCGs?
• Does HAWB have an agreed process to ensure Children’s issues
receive sufficient focus?
• Has the HAWB contributed to defining the early help offer (as
recommended by Professor Monro)?
• Is HAWB really listening to views of CYP, parents and families?
• Does JHWS prioritise health needs of children and describe
success?
• Have views of frontline staff & clinicians been factored into HAWBs
planning?
• Has HAWB got a clear plan to maximise use of public assets to
improve health outcomes for CYP?
• Is the HAWB satisfied that the common assessment framework is
sufficiently embedded in the local partnership?
Questions?
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