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The New Public Health System Dr Alison Barnett -Director of Public Health 24th January 2012 Public Health White Paper Public Health White Paper • Why? – Significant challenges to public’s health and wellbeing • • • • Obesity Misuse of drugs and alcohol Sexually transmitted infections Threats from infectious disease – Impact • Health and life expectancy • Economic burden Government approach • Improve public health by • Strengthened local action • Supporting self esteem and behavioural change • Promoting healthy choices • Changing the environment to support healthier lives Summary of the Reforms • Local Authorities • Public Health England • NHS Local Authorities • Lead for • Improving health • Co-ordinating local efforts to protect health • Ensuring health services promote health • Health and Wellbeing Board • Director of Public Health • Putting public health into policies and decisions • Ring fenced public health grant Local authority mandatory services • Appropriate access to sexual health services • Steps to be taken to protect the health of the population, in particular giving the LA a duty to ensure there are plans in place to protect the health of the population. This will include outbreaks, emergencies, immunisation, screening and infection control in acute providers • Ensuring NHS commissioners receive the public health advice they need • The National Child Measurement Programme • NHS Health Check assessment Commissioning responsibilities • Tobacco control and smoking cessation services • Alcohol and drug misuse services • Public health services for children and young people aged 5-19 and in the longer term all public health services for children and young people • Interventions to tackle obesity and nutrition initiatives • Dental public health services • Accidental injury prevention • Population level interventions to reduce and prevent birth defects • Supporting, reviewing and challenging delivery of key public health funded and NHS delivered services such as immunisation and screening programmes • Comprehensive sexual health services • The local authority role in dealing with health protection incidents, outbreaks and emergencies • Public health aspects of local initiatives to tackle social exclusion Public Health England • A new executive agency • Deliver services • Health protection • Public health intelligence and information • Public services – through social marketing and behavioural insight • Lead for public health • Workforce development • Dental Public Health Specialist Public Health NHS • Continue to play a full role in • Providing care • Tackling inequalities • Ensuring every clinical contact counts Clinical Commissioning Groups • Commission health services for the local population • Eg maternity, paediatrics, community paediatrics, therapies, CAMHS NHS Commissioning Board Will commission: • Antenatal and newborn screening programmes • Immunisation programmes • PHE to ensure specialist advice is provided for screening and imms • Specialist services • Primary care • Public health funded services for under 5s eg HVs, FNP until 2015 • Child Health Information System • SARCs Public Health Outcomes Framework • Focus on achieving positive health outcomes and reducing health inequalities • Not process targets, not for performance management • Covers wider determinants of health over the life course • Aligns with NHS and adult social care OFs • Health Premium to incentivise action Three parts Two high-level outcomes • Increased healthy life expectancy • Reduced differences in life expectancy and healthy life expectancy between communities Domain 1: improving the wider determinants of health • Children in poverty • School readiness (placeholder) • Pupil absence • First-time entrants into the youth justice system • 16-18 year olds not in education, employment or training Domain 2: Health improvement • • • • • • • Low birth weight of term babies Breastfeeding Smoking status at time of delivery Under 18 conceptions Child development at 2-2.5 years (place holder) Excess weight in 4-5 and 10-11 year olds Hospital admissions caused by unintentional and deliberate injuries in under 18s • Emotional well-being of looked-after children (place holder) • Smoking prevalence in 15 year olds Domain 3: Health protection • Chlamydia diagnoses (15-24 year olds) • Population vaccination coverage Domain 4: healthcare public health and preventing premature mortality • Infant mortality • Tooth decay in children aged 5