Transcript Slide 1

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
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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
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Tobacco control and smoking cessation services
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Alcohol and drug misuse services
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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
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Interventions to tackle obesity and nutrition initiatives
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Dental public health services
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Accidental injury prevention
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Population level interventions to reduce and prevent birth defects
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Supporting, reviewing and challenging delivery of key public health
funded and NHS delivered services such as immunisation and
screening programmes
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Comprehensive sexual health services
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The local authority role in dealing with health protection incidents,
outbreaks and emergencies
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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
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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