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ANNUAL REPORT
Getting in touchPublic Health Agency HeadquartersOrmeau Avenue Unit 18 Ormeau Avenue BELFAST BT2 8HS Tel: 028 9031 1611
Eastern Office12–22 Linenhall Street BELFAST BT2 8BS Tel: 028 9032 1313
Northern OfficeCounty Hall 182 Galgorm Road BALLYMENA BT42 1QB Tel: 028 2531 1000
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Western OfficeGransha Park House 15 Gransha Park Clooney Road LONDONDERRY BT47 6FN Tel: 028 7186 0086
Media line:Tel: 028 9031 1514Media enquiries only
Normal business hours:8.45am–5.00pm Monday–Friday
Website:www.publichealth.hscni.net
BoardThe board of the Public Health Agency (PHA) meets frequently throughout the year and members of the public may attend these meetings. The dates, times and locations of these meetings are advertised in advance in the press and on our main corporate website www.publichealth.hscni.net
Using this reportThis report highlights the broad range of work carried out by the PHA and shows how this work has contributed to meeting our objectives detailed in our Corporate plan 2009–2010. The online Portable Document Format (PDF) file of this report also has live web access to the relevant website.
This report is intended to be an overview of the year’s main accomplishments.
For more detailed information on our work, please visit our corporate website at www.publichealth.hscni.net
Other formatsCopies of this Annual report may be produced in alternative formats on request. A PDF file of this document is also available to download from our corporate website at: www.publichealth.hscni.net
Public Health Agency Annualreport 2009-2010
Contents | 1
Contents
Chair’s statement 2
Management commentary 3
Directors’ report 4
The role of the Public Health Agency
– Publichealth 8
– NursingandAlliedHealthProfessions 15
– Operations 18
Operating and financial review 24
PHA board 36
Acronyms 38
2 | Chair’s statement
My first statement to you as Chair of the PHA follows an exceptionally exciting and challenging period for health and wellbeing in Northern Ireland. We have all come a long way since the Health Minister, Michael McGimpsey, announced
his plans for HSC reform under the RPA, which led to the creation of our organisation in April 2009.
Our businessTacklinghealthandsocialwellbeinginequalities,andpromotingashiftacrossthehealthservicetothepreventionofillness,layattheheartoftheHSCreforms.ThePHAwassetuptoprovidearenewedandenhancedfocusonpublichealthbybringingtogetherawiderangeofpublichealthfunctionsunderoneorganisation,withimprovedhealthandwellbeingasitscorebusiness.
Itwasalsotaskedwithcreatingbetterinter-sectoralworking,includingenhancedpartnershiparrangementswithlocalgovernmenttotackletheunderlyingcausesofpoorhealthandreducehealthinequalities.
Shaping and developing2009–2010wasfundamentallyaboutshapinganddevelopingourneworganisationandsettinglonger-termdirections.Itwasayearoftransitionandmanagingchange,ayearofharmonisinginheritedsystems,ayearofimplementingaframeworkfordesignoftheorganisationand,mostimportantly,ayearoflayingdownfoundationsforafundamentalshiftinwhatweaimtodoandhowwedoit.
Extensive portfolio of workWhileestablishingourselvesasthemajorregionalorganisationforhealthimprovementandhealthprotection,wehadabusyandeventfulfirstyear,deliveringanextensiveportfolioofworkacrossallkeyareasofpublichealthandsocialwellbeing.
TherewasconsiderablecoverageandexposureofthePHA’sworkthroughouttheyear,notleastindealingwiththefirstnewpandemicvirusofthe21stcentury–commonlyreferredtoasswineflu.ThePHAworkedextremelyhard,togetherwitharangeofotherbodiesthroughoutHSC,duringthevariousstagesofthepandemictoensureasuccessfulresponse.
Engaging and joint workingInotherareasofwork,weestablishedengagementapproachestoenableeffectiveinvolvementofcommunities,groupsandindividualsinshapingtheworkofthePHA.ClusterleveljointworkingarrangementsbetweenthePHAandsevendistrictcouncilswereputinplace.Ontheoperationsside,wedeliveredontheinformationgovernanceleafletforallstaff.
Vibrant community sectorAnagencysuchasourscannotfunctionwithoutavibrantcommunityandvoluntarysector.Workingcollaborativelyacrossdisciplinesanddepartments,maximisingandmakingbestuseofavailableresources,wecanmakeadifference.
MyfirstyearhasbeenbusyestablishinglinksacrossNorthernIrelandwithawiderangeofcommunityandvoluntaryorganisationsworkinginsomeofourdisadvantagedareas.Attendinguptofivemeetingsmonthly,Iwasconstantlyimpressedwiththeflexibility,energyandmotivationIencountered.
Change, integration and commitmentOurachievementsareallthemorenoteworthywhensetinthecontextofconsiderablepublicsectorchange.TheintegrationofstaffandworkfromlegacyorganisationsintothePHApresentedmanychallengesandwasaperiodofgreatanxietyanduncertainty.OnbehalfoftheboardIwouldliketocongratulatetheChiefExecutiveandstafffortheirdedicationtoquality,continuedhardworkandcommitment.
A personal wordIwouldalsoliketopersonallythankmembersofourboardfortheirvision,dedicationandsupport,andacknowledgeourcolleaguesinthewiderHSCfamilyandintheDHSSPSfortheirassistanceandadvice.IlookforwardtoworkingwithyoualltoachieveourcommonvisionforahealthierNorthernIreland.
Mary McMahon Chair
Chair’s statement
Public Health Agency Annualreport 2009-2010
Contents | 3
I think it’s fair to say that we all expected the first year of the PHA to throw up many challenges for all our staff. While much groundwork was undertaken to ensure as smooth a transition as possible into the new health and social care system, it was
clear from the outset that considerable work would be necessary internally within each of the organisations to build capacity and develop strong relationships among the new bodies.
However,Idonotbelievethatanyofuscouldhaveanticipatedjusthowmuchwewouldaskofourstaffduringthisinauguralyear,orthelevelofcommitment,professionalismandteamworkthathasbeendemonstratedrightacrosstheAgency.
WehadbarelybeensetupforthreeweekswhentheswinefluissueemergedandIamimmenselyproudofthewaystaffpulledtogethertoensureasuccessfulresponsetothiswhilecarryingouttheirnormalday-to-dayduties.
Inadditiontothese‘new’pressures,staffhavehadtocopewithsubstantialorganisationalchangethathasbeenslowertoresolvethananyofuswouldhaveanticipatedorwished.Yeteachofourareashasseensignificantdevelopmentduringtheyear,settinginplacestrongfoundationsforthefutureofpublichealth.
Wehaveundertakenandsupportedawiderangeofprogrammesandinitiativesacrossallmajorhealthandsocialwellbeingareasinfulfilmentofourcommitmentsandcoreobjectivesdetailedwithinourcorporateplanfor2009/2010–supportingthetargetsdetailedbytheMinisterforHealthaswellasmeetingtheobjectivesidentifiedintheoriginalbusinesscasesforthePHA.
Wecannot,however,achieveouraimsinisolationandourcommitmenttoworkingcollaborativelycannotbeemphasisedenough.Workingwiththelocalcommunityandvoluntarysectors,andthestatutoryandprivatesectors,willcontinuetobecentraltoallourwork.
Withintheareaofhealthprotection,forexample,wesawsubstantialreorganisationandstaffplayingakeyrolewithHSCBcolleaguesinimplementingthestrategicregionalactionplanforthepreventionandcontrolofHCAIsinNorthernIreland.
Withinhealthimprovement,anewPHA-funded‘one-stopshop’drop-incentrewasopenedinBanbridge,providinginformation,supportandeducationtoyoungpeopleandtheirfamiliesaffectedorconcernedbyalcoholanddrugmisuse.
AnothernotableachievementhasbeenthedevelopmentofcloserjointworkingwithlocalgovernmentacrossNorthernIreland.ThefirstinitiativetolaunchunderthesenewarrangementswithlocalcouncilswastheBelfastHealthDevelopmentUnitinMarch,whichwillbefollowedbyotherlaunchesastheinitiativesrolloutacrossNorthernIreland.
Iapplaudthecommitmentofeveryoneinvolvedinsettinguptheunit,whoseworkwillnodoubthelptonarrowthehealthgapbetweendisadvantagedgroupsandcommunities,andimprovehealthoverallbyaddressinginequalities.
Withinnursingandalliedhealthprofessions,wemadesubstantialheadwayindevelopingtheareaofPersonalandPublicInvolvement,includingaformalconsultationscheme,toensureserviceusersandthepublicareinvolvedinthecommissioning,planninganddeliveryofourwork.
OurhighprofileworkthroughpublicinformationcampaignswasrecognisedwithamajormentalhealthmediaawardandtheNorthernIreland“MaternityandFamilyAward”fornormalisingbreastfeedinginthecommunity.Wecontinuetolookatwaysofprovidinginformationandresources,particularlyforhard-to-reachgroups,throughthemosteffectivemethodsandinparticularthroughemerginganddevelopingsocialmediachannels.
Whilewefacednumerouschallengesthisyear,everyoneinvolvedhasrespondedwithenergy,enthusiasmandcommitment,withaclearfocusonmakingthehealthandwellbeingofourcommunitybetter–thankyouforallyourhardwork.OurboardmembershelpedlaythenecessaryfoundationsandIacknowledgetheircommitment,directionandworkovertheentireperiod.
AsweenteranewfinancialyearwefocusonensuringtherightstructuresareinplacetocontinuedeliveringavisionofHSCoutcomesthatareamongthebestintheworld.
Dr Eddie RooneyChief Executive
Management commentary
4 | Directors’ report
ThePHAisanintegralpartoftheHSCsystem,workingwiththeHSCB,BSOandPCC.Itdrivesthepublichealthandsocialwellbeingagenda,bringingtogetherawiderangeoffunctionstogivearenewed,enhancedandsustainedfocusonhealthprotectionandimprovinghealthandwellbeingoutcomes.ThePHAisamulti-disciplinary,multi-professionalbodywithastrongregionalandlocalpresence.Ithasfourkeyfunctions:
• improvementofhealthandsocialwellbeing;
• healthprotection;
• publichealthsupporttocommissioningand policydevelopment;
• HSCresearchanddevelopment.
Thefollowingdiagramhighlightstheorganisationalstructuredowntotierthreeanddetailsthemainareasofactivitywiththoseresponsible.
Directors’ report
Chief ExecutiveDr Eddie Rooney
Director of Nursing and Allied Health
ProfessionsMary Hinds
Assistant Directors
Allied Health Professions and Public Involvement
Michelle Tennyson
Nursing, Safety, Quality and Patient/
Client ExperiencePat Cullen
Director of Public Health/Medical
DirectorDr Carolyn Harper
Assistant Directors
Health ProtectionDr Lorraine Doherty
Health and Social Wellbeing Improvement
Mary Black
Service Development and ScreeningDr Janet Little
HSC R&DDr Michael Neely
Directorof
OperationsEd McClean
Assistant Directors
Planning andCorporate Services
Rosemary Taylor
Communicationand Knowledge
ManagementStephen Wilson
Public Health Agency Annualreport 2009-2010
Directors’ report | 5
Communication
Fromdayone,thePHAwascommittedtoensuringthataccessibleandeffectivecommunicationchannelsunderpinnedourwork.Wecommunicatedemergingandkeyissuestoallofourexternalstakeholdersthroughregularupdatesonournewcorporatewebsitewww.publichealth.hscni.net
Goodinternalcommunicationwaskeyinayearofuncertaintyandchange,andpublicationofamonthlye-bulletinaimedtokeepallemployeeswellinformedaboutdevelopmentsandachievements,particularlyduringroll-outofthenewera.
Inaddition,anewPHAstaffintranetsitewasdevelopedandregularnewsandinformationaddedtokeepeveryoneinformedofinternaldevelopments.Toreflecttheorganisationalchangeandintegrationofstafffromlegacybodies,astandardemailaddresswasalsointroducedandusageguidelinescommunicated.
PublicationofourCorporateplanensuredstaffwereclearaboutthemissionandstrategic
directionofthePHAandhowweintendtofulfilourcommitments.Managementbriefingswerealsoconductedtoensurestaffwerekeptuptodatewithprogressonstructures,andaconsultationpaperonrestructuringwasissuedinconsultationwithtradeunions.
Payroll
Foranumberofmonthsaftertheneworganisationcameintoeffect,payrollarrangementsreflectedthoseofthelegacyorganisationsuntilasinglenewsystembecameoperational.
Equality and human rights policies
ThePHAhaslookedtobuildonthesoundpoliciesandprogrammesputinplacebyeachofthelegacyorganisations.Weareaccountableforensuringthatwecomplyfullywithourlegalresponsibilities,includingSection75oftheNorthernIrelandAct1998andtheHumanRightsAct1998.
Duringtheyear,advice,support,guidanceandtrainingonequality,humanrightsanddiversitywereprovidedtothePHAviatheequalityunitoftheBSO.
Equality of opportunity
InaccordancewithSection75oftheNorthernIrelandAct1998,thePHArecogniseditsobligationstopromoteequalityofopportunitybetween:
• personsofdifferentreligiousbelief,political opinion,racialgroup,nationality,age,marital statusorsexualorientation;
• menandwomengenerally;
• personswithadisabilityandpersonswithout;
• personswithdependantsandpersonswithout.
Indevelopingourpolicies,wewererequiredtoexamineorscreenthemforequalitypurposestoidentifyanythatwerelikelytohaveasignificantimpactonequalityofopportunityand/orgoodrelations.ScreeningalsocoveredissuesinrelationtotheHumanRightsAct1998andtheDisabilityDiscriminationOrder2006.
Inlightofthislegislation,wedevelopedatemplateandguidanceforusebyallstafftoensureconsistencyinapproach.ThisalsoactsasthetoolfordocumentingtheoutcomesofthescreeningandprovidedapapertrailofevidenceforthePHA’sscreeningreport.
6 | Directors’ report
Records management
PHAstaffwereinitiallyusingexistingfileplanswhileanewstandardfilingplanwascreated.Thenewproposedsystemisbeingtrialledtoensurecontinuityandcohesionacrossalllocationsandfunctionsandwillberolledoutoncethetrialhasbeencompletedandrevisedaccordingly.
Business continuity
Communicationsdetailingbusinesscontinuityarrangementsweresenttoallstaff,ensuringeveryonewasclearonwhatwouldhappenfrom1Aprilonwards,whateveryone’srolewouldbeandwhotheyshouldreporttoinlightofanychangesinlinemanagement.
Sick absence data
Forthe2009–2010financialyear,thefollowingsickleavedayswererecorded:
Totalworkingdayslostduetoshort-termsickness=286(0.71%)
Totalworkingdayslostduetolong-termsickness=714.8(1.78%)
Totalworkingdayslostduetosickness=1,000.8(2.50%)
Freedom of Information
ThePHAfulfilleditsobligationsundertheFreedomofInformation(FoI)Act2000bydevelopingandcirculatinganinformation
governanceleafletentitledInformationgovernance:whatyouneedtoknowtoallstaff.ItoutlinedgoodpracticeandguidanceonissuessuchasFoI,confidentialityandinformationsecurity.
Data-related incidents
Therewerenomajordata-relatedincidentsreportedduringtheyear.
ThetheftofalaptopandBlackberryfromanofficeinTowerhill,Armagh,wasreportedtothePSNIandtreatedinternallyasanadverseincident.Bothdeviceswereencryptedandhencethepotentialfordatalosswasminimised.
Follow-upworkconsistedofanimmediateauditofallPHAoffices,theprovisionofsecurityequipmentandadvicewhererequired,andtheintroductionofregular,out-of-hoursofficeinspectionstoalllocalities.
DetailsoftheincidentweresharedacrossallPHA/HSCBofficestoaidorganisation-widelearning.
TwolaptopswerealsostolenfromtheOrmeauAvenueUnitpremises.ThePSNIwasinformedandinvestigationslaunched.
Bothlaptopswereencryptedandnosensitivedataaccessible.Additionalsecuritymeasureswereinstalledandcommunicatedtostaff.
TheInformationgovernanceleafletalsocoveredtheareaofdataprotection.
Comments and complaints
ThePublicHealthAgencyreceivedtwocomplaintsin2009–2010.
Theserelatedtoissuesofcommunicationandprovisionofservicetothepublicandageneralpractitioner.Inbothcasesthecomplaintswereresolved.
Anumberofformalpositivecommentsinrecognitionofourworkwerereceived.
Ifyouwishtomakeaformalcommentorcomplaint,pleasewriteto:
EdmondMcCleanDirectorofOperationsPublicHealthAgencyOrmeauAvenueUnit18OrmeauAvenueBelfastBT28HS.
Public Health Agency Annualreport 2009-2010
Directors’ report | 7
Quality
ThePHAcampaign,‘Don’tcoverupyourproblems’,wonthe‘Raisingpublicawareness’categoryintheMindMentalHealthMediaAwardsduringtheyear.ThecampaignwastakenforwardaspartoftheimplementationoftheNorthernIrelandsuicidepreventionstrategyandincludedTV,radio,outdoorandwashroomadvertising.
ThePHAcampaigntargetedyoungmentoraiseawarenessofmentalhealthandencourageapositiveattitudetoseekinghelp.
AttheNCT(formerlytheNationalChildbirthTrust)NorthernIrelandMaternityandFamilyAwards,thePHAwontheawardfor‘Normalisingbreastfeedinginthecommunity’forthe‘Goodforbaby,goodformum’campaignandforthe‘Breastfeedingawarenessforschools’CD-ROMresource.
AspartofourworktoreduceandpreventHCAIs,ajointPHA/HSCBHCAIpreventionteamwasestablishedtoprogressworkinthisarea.Takingthisworkforward,thePHAisplayingakeyroleinimplementingthestrategicregionalactionplanforthepreventionandcontrolofHCAIsinNorthernIreland,Changingtheculture2010.
Preparation of accounts
ThePHAhaspreparedasetofaccountsfortheyearended31March2010inaccordancewiththerelevantlegislativerequirements.
Summaryfinancialstatementsareincludedinthe‘Operatingandfinancialreview’sectionofthisreportfrompage24.
Dr Eddie Rooney, Chief Executive, PHA, holding the award from the Mind Mental Health Media Awards, along with Health Minister, Michael McGimpsey and Liz Mayne, one of the awards judges.
At the awards, from left, Mary McMahon, Chair, PHA; Janet Calvert, Regional Breastfeeding Coordinator, PHA; Julie Neill, Health Development Officer, PHA; Margaret McCrory, Marketing Manager, PHA and Gail Werkmeister, NCT President.
8 | The role of the Public Health Agency
ThePHAwassetupwiththeexplicitagendato:
• protectpublichealthandimprovethehealthand socialwellbeingofpeopleinNorthernIreland;
• reduceinequalitiesinhealthandsocial wellbeingthroughtargeted,effectiveaction.
Broad range of activity
DuringthepastyearabroadrangeofactivitywasundertakentohelpimprovethehealthofthepopulationofNorthernIreland.Thiswasachievedthrough:
• prevention;
• earlydetection;
• highqualityservices;
• addressinginequalities;
• protectinghealth.
Pandemic response
Lookingbackon2009–2010,itwas,ofcourse,dominatedbytheswineflupandemic–declaredbyWHOon1Juneasthefirstflupandemicfor40years.ThecommitmentanddiligenceofmanypeoplethroughoutHSCoverthepandemicperiodresultedinahighlyeffectiveresponseandgreatlyenhancedpreparednessforthefuture.
IwishtotakethisopportunitytothankeverymemberofstaffinthePHAwhocontributedtothepandemicresponsedirectlyorindirectly.IalsowanttoacknowledgethecontributionofcolleaguesfromtheDHSSPSandotherHSCbodiessuchastheHSCB,BSO,primarycarepractitioners,thefiveHSCtrustsandNIAS.Inaddition,Iwouldliketothankcolleaguesinlocalgovernment,theUKborderagency,thetransportindustryandmanyotherindividualsandorganisationsfromallsectorswhohelpedustacklethismajorchallenge.
Reducing the impact
Togetherweworkedextremelyhardinmanyareastoreducetheimpactofpandemicfluonthepublic,aswellasworkingwithclinicalstaffonmanagementofcasesandtheircontacts.
Theseareasincluded:
• planningtomanagepredictedneedfor healthcareandsupportservices,fromcaring forlargenumbersofpeoplewith uncomplicatedflutoexpandingintensivecare capacity;
• planningforprotectionofHSCstaffwith comprehensiveinfectioncontrolmeasuresand personalprotectiveequipment;
• providinginformation,supportandadviceto theHSCandbeyond,suchastheeducation sector,councils,prisons,portsandairports;
• planningandimplementingthepandemic fluimmunisationprogramme,whichincluded immunisingpregnantwomen;
• communicatingwithstaffandthepublic throughmediainterviews,meetings,bulletins andleaflets;
• liaisingwithnationalgroupssuchasHPA(UK) andcolleaguesintheNHS;
• surveillanceandservicepressuremonitoring inclosecooperationwiththeDHSSPS,HSCB, HPA(UK),alltrustsandindependent providers.
Activity in Northern Ireland
InNorthernIrelandupto17February2010,approximately9%ofthepopulationwereestimatedtohavehadpandemicInfluenzaA(H1N1)2009.
Therewere1,367laboratoryconfirmedcases,577hospitalisedcases,and50intensivecareadmissions.TheGPconsultationrateduringthepeakweekofthepandemicwas281peopleper100,000population,greatlyexceedingtheNorthernIrelandthresholdforseasonalfluactivity.
The role of the Public Health AgencyPublic health - Dr Carolyn Harper
Public Health Agency Annualreport 2009-2010
The role of the Public Health Agency | 9
Protecting health – a frontline service
ThehealthprotectionfunctionprovidedbythePHAisafrontlineacuteresponseserviceofdiseasepreventionandinfectioncontrol,includingoutbreakmanagement,emergencyplanningandenvironmentalhazards.
In2009–2010,thePHAestablishedasingleregion-widehealthprotectionservice,buildingontheachievementsofsixlegacyservicesincludingtheCDSC,formerlypartofHPA(UK).
We’remaintainingourlinkswithHPA(UK)andwithhealthprotectionservicesinScotland,WalesandtheRepublicofIreland,makingbestuseofspecialistskillsandintegratingfunctions.
WearealsolinkedintoEuropeanandUScentresasmanyhealthprotectionthreatsareglobalandrequireinternationalcooperation.
Duringtheyearwerespondedtootherspecificthreatstopublichealthquicklyandeffectively,includingmultipleoutbreaksofnorovirus,clustersofC.difficilecasesinnursinghomes,casesofE.coliinnurseryschoolchildren,andmeningococcaldisease.
InAprilweissuedaboilwaternoticetopeopleinthegreaterBelfastareaandpartsofcountiesAntrimandDown,andwerepartofamulti-agencyresponsetoafour-daytyrefireatCampsie.
Partnership working
AministerialpriorityforpublichealthprotectionisworkingwithtruststoensurePfAtargetsonHCAIssuchasMRSA,MSSAandC.difficilearemet.
Inpursuanceofthis,wesupportedtheHSCBandfromApril2010tookaleadroleinreducingHCAIsthroughpartnershipworkingwithtrusts,primarycareandcommunitycare.ExtensionoftheSSIsurveillanceprogrammesintrustswasalsosuccessfullyimplemented.
Improving user experience
WeworkedwiththeHSCB,trusts,primarycare,andcommunityandvoluntarysectorstoimplementthecardiovascularandrespiratoryframeworks.
Patients,clients,carersandtheirwiderfamilieswillbeabletousetheseserviceframeworkstounderstandthestandardofcaretheycanexpecttoreceive,therebyimprovingtheuserexperience.
Early intervention
Wealsofocusedoureffortsintheareaofearlyinterventionprogrammestochangethelifeexpectancyofchildrenandfamilies.Intensesupportduringearlychildhoodenableschildrentomaximisetheirpotential,bringingbetterhealthandsocialoutcomesforthem.
APHAseminarattendedbyrepresentativesfromacrosspublicsectororganisationspromoteddiscussionanddebateontheearlyinterventions/infantmentalhealthagenda.
Building on the early years intervention seminar looking at best practice and learning from others are, from left, Mary Gordon, founder of Roots of Empathy, Canada; Dr Carolyn Harper, Director of Public Health, PHA; Danny Broderick, Public Health and Clinical Coordination, South Australia; and Mary Black, Assistant Director, Health and Social Wellbeing Improvement, PHA.
10 | The role of the Public Health Agency
Improving mental health and wellbeing
AkeypriorityforthePHAinworkingwiththeDHSSPS,HSCBandtrustsistoimprovementalhealthandwellbeingandensurehighqualityandeffectivecareforthosewhoneedit.ThroughtheBamfordtaskforce,inpartnershipwiththeHSCB,thePHAcontinuedtocontributetowardsimprovingmentalhealthandwellbeing.
Wealsore-ranouraward-winningcampaign“Don’tcoverupyourproblems”asdetailedunderthequalitysectionoftheDirectors’report.On-the-groundprojectsincludedthedeliveryofMHFAtrainingtoanother14instructors,andtheestablishmentofcommunityresponseplansatdistrictcouncillevelacrossthewesternarea,guidedbytheregionalsuicidepreventionstrategy,tohelppreventsuicideclusters.
Tackling inequalities through commissioning
Reducinginequalitiesthroughcommissioningeffective,accessibleprogrammesandinitiativesisalsoapriorityforthePHA.InpartnershipwiththeHSCBanditsLCGs,weadvisedonpublichealthchallengesandprioritiesandensuredformalinputsfromkeyvoluntaryandcommunitysectorstakeholders,includinglocalareapartnerships,toputhealthinequalitiesattheheartofcommissioning.
Tackling inequalities in health
Tacklinghealthinequalitiesinourmostvulnerablecommunitieshasbeenidentifiedasapriorityatministeriallevelandpartofourmandateistoallowtheviewsoflocalgovernmenttoinfluencehealthimprovementprogrammes.
Ourkeyroleinmeetingourtargetsinthisareasawjointworkingarrangementswithlocalgovernmentputinplacetoharnessthewiderangeofprogrammesandpartnershipsthatexisttoimprovehealthandwellbeing.
OneofthekeyobjectivesofHSCreform–andoneofthekeyprioritiesforthePHA–istostrengthenintersectoralworking,particularlybetweenHSCandlocalgovernment.
PublichealthimprovementstafffromthePHAhavebeenfullyinvolvedinshapingnewworkingarrangementswithlocalgovernmentanddevelopingsharedplansfortakingthisinitiativeforward.
New MHFA instructors receiving their certificates from Mary McMahon, Chair, PHA.
At a conference highlighting the challenging issue of health inequalities are, from left, Baroness May Blood; Health Minister, Michael McGimpsey; Mary Hinds, Director of Nursing and Allied Health Professions, PHA, and Barney McGahey, Chairman, Farset International.
Public Health Agency Annualreport 2009-2010
The role of the Public Health Agency | 11
TheestablishmentofaBelfasthealthdevelopmentunitwasthefirstoperationalmanifestationoftheobjectivetoallowtheviewsoflocalgovernmenttoinfluencehealthimprovementprogrammes.
Action on alcohol and drug misuse
TacklingalcoholanddrugmisuseisapriorityfortheDHSSPSanditcontinuestobeakeypartofourwork.Insupportofthis,thePHA:
• launchedaonestopshopinformationand supportcentreinBanbridgeforyoungpeople andtheirfamilies;
• hostedaNDACT“Drugsandalcohol,suicide andself-harm–causeoreffect?”seminar;
• conductedmediacampaignsfeaturing issuessuchaslinksbetweenbreastcancer
andalcohol,and highlightingthe importanceof talkingtoyour childabout alcohol;
• establisheda steeringgroup andcoordinator forthe implementationof theHiddenharm strategy;
• developeda factsheetonlegalhighsinresponseto requestsfromparentsandthoseworkingwith youngpeople.
Health Minister, Michael McGimpsey and Dr Eddie Rooney, Chief Executive, PHA, with speakers from the ‘Drugs alcohol, suicide and self-harm – cause or effect?’ seminar.
12 | The role of the Public Health Agency
Action on smoking
Throughmulti-agencyactionwithkeypartners,wecontinuedimportantworkintheareaofsmokingreduction.WehostedaworkshopforthestatutoryandvoluntarysectorstohelpshapefuturePHApracticeontobaccoandtoprioritisegroupsforattention–suchasmanualworkers,pregnantwomenandyoungpeople.ArangeofspeakersfromacrossthePHA,DHSSPSandHSEtookpart.
A“Doyouwanttobreakfree?”campaignwasalsolaunchedtoencouragesmokerstoquitand,insupportof“NoSmokingDay”inMarch,wepromotedthehelpandsupportavailabletosmokersusingtelevision,posterandpressadvertising.
Sexual health, physical activity and nutrition
SexualhealthisidentifiedasanareatobeaddressedundertheNorthernIrelandpublichealthstrategy,Investingforhealth.Itisanimportantfactoringoodphysicalandmentalhealth,andtheincreasingproblemofsexuallytransmittedinfectionsremainsachallenge.
Wecontinuedtofocusoureffortsonobesityreductionandimprovednutritionwitharangeofprojects.Acampaign“Physicalactivity:italladdsup!”waslaunchedtoencourageparentsandcarerstopromoteactivityinchildren.
InapartnershipbetweenSafefoodandWesternIfH,anall-islandresourcefocusingon“Fieldtofork”wasdevelopedandregionaltrainingwasdeliveredtoHEteachersontheirroleinpromotingnutritionalstandardsforschoolfood.
Tackling fuel poverty
TheimportancethePHAputsoncombatingfuelpovertyandreducingitsimpactonthehealthandwellbeingofhouseholderswasreflectedinaninvestmentof£780,000in2009–2010forourfuelpovertyprogrammes.Thefundingenabledanumberofinitiativesincludingdistributionof“Keepwarm”packstovulnerablepeople,insulationmeasures,andimplementationoflocalactionplans.
Aseminarwehostedonlocalfuelpovertyinthenorthernareaincreasedawarenessamongfrontlinestaffacrossarangeofsectors,localrepresentativesandcommunitystakeholders.
Working in partnership
Webuiltonexistingprogrammesanddevelopednewinitiativesandpartnershipswithlocalgovernment,andcommunity,voluntaryandotherorganisationstoaddressthewiderdeterminantsofhealthandsocialwellbeing,andtargetspecificissues.Weactivelyengagedwithourstakeholdersininformingandshapingprogrammedevelopment.
Amongthemanyactivitiesin2009–2010were:
• supportfortheregionalHLCnetworkinits development;
• agreementwithDARDtoassisttheroll-outof itsregionalruralpovertyprogramme;
• leverageof£800KINTERREGfundingfora communityallotmentwellbeingprojectinthe west;
Public Health Agency Annualreport 2009-2010
The role of the Public Health Agency | 13
• workwiththeCOEonthephysicalactivity andrejuvenationofConnswater(PARC)studyto evaluatetheeffectsoftheConnswater communitygreenwayenvironmentalprojecton localpeople;
• workwithDSDonneighbourhoodregeneration;
• managingahealthimprovementfocusand programmeforTravellers;
• launchbyPHA’sBelfastHAZofaprogramme toimprovethelifechancesofchildrenand youngpeopleinnorthandwestBelfast;
• inputtoNorthernIfHPartnership’slocalhealth improvementplan.
Extending screening
InAugustweaddedanothertesttotherangeofnewbornbloodspotscreeningor“heelprick”tests.ThetestrecognisesMCADD–aninheritedmetabolicdisorderthatcanleadtoseriousillness,disabilityorevendeathinaffectedinfants.Already,newcaseshavebeendetectedandtreated.
Anewelectronicdatatransfersystembetweengeneralpracticesandthediabeticretinopathyscreeningcentrewasalsointroduced.
Information encouraging uptake
DuringtheyearthePHAprovidedinformationtobothhealthprofessionalsandthepublictoencouragetheuptakeofappropriateinterventionsthatwillprotectandmaintainhealth.ExtensiveworkwasundertakentoprepareforthelaunchofabowelscreeningprogrammeinNorthernIrelandfromApril2010inacollaborativeprojectinvolvingthePHA,theHSCBtrustsandtheBSO,withsupportfromNICaN.
Securing safety and quality
ImprovinghealththroughhighqualityservicesisakeyaimofourHealthMinister.
InpartnershipwiththeHSCB,wearedevelopingthefirstjointcommissioningplan.Thisaimstosecurehighquality,safeserviceswhilemeetingpatientandclientneeds.Wealsosoughttobringprofessionalleadership,evidence-basedadviceandexpertiseonthecommissioningofservicesandwiththeHSCsafetyforum.
R&D essential role
HSCR&Ddivisionfunded24newresearchstudiesin2009–2010,representingatotalcommitmentof£5.5million.ThestudiesspanthefullspectrumofHSCR&Dincludingpublichealth,withastrongemphasisonresearchthatsitsclosetotheserviceandtotheserviceuser.
At the funding announcement for PARC are, from left, Dr Michael McBride, Chief Medical Officer; Professor Frank Kee, Director of the Centre of Excellence for Public Health; Dr Carolyn Harper, Director of Public Health, PHA; and Dr Eddie Rooney, Chief Executive, PHA.
Analysing a bowel cancer screening kit.
14 | The role of the Public Health Agency
Commissionedresearchstudieswerefundedintheareasofsuicideprevention,acutelunginjury,pharmacyprescribingandself-managementofdiabetes.Mostofthesearefundedinpartnershipwithotherlocalornationalstakeholders.FundingpartnershipsincludedasecondUS-IrelandR&Dpartnershipawardintheareaofcysticfibrosis.
TheseawardsareassessedinopencompetitionbytheprestigiousUSNationalInstitutesofHealthandrepresentcollaborationbetweenresearchersinIreland,NorthernIrelandandtheUS.WecontinuedourcommitmenttobuildingHSCR&Dcapacity,awardingsixdoctoralfellowships,withprojectsrangingfromdietaryantioxidantsandcardiovascularhealthtoexaminingtheuptakeofdomesticviolencesupportservicesbyviolentmen.
Animportantareaofcapacitydeficitwasaddressedbytheawardofthefirsthealtheconomicsfellowshipin2009–2010.ThisschemeoperatesIreland-wideinpartnershipwiththeHRBinDublinandtheNCIinWashington.
Thetransferofknowledge,generatedbyHSCR&D,intopractice,policyorenterpriseisgainingmoreemphasis.Thisyear,HSCR&Devaluatedthefirstsetofapplicationsunderanewknowledgetransferscheme,makingtwoawardsintheareasofvisualassessmentforchildrenwithneurologicaldisordersande-learningforchildrenwithlearninganddevelopmentaldisabilities.
ThroughouttheyearweworkedtoimproveallaspectsofHSCresearchinfrastructure.TheNICRNgrewsignificantly,withover6,000patientsrecruitedinto93clinicaltrialsincancer,cardiovascular,criticalcare,dementia,diabetes,respiratory,strokeandvision.
TheHSCR&DDivisionalsofinalisedastrategyforPPIinR&D,andhasrecruitedanumberofPPIrepresentativesforinvolvementinHSCR&Ddivisionactivities.
First steps
InthisreportIhavepresentedjustasnapshotofhowthePHAhasworkedinitsfirstyearofoperationtoachieveitsaimofimprovinghealthandwellbeingforeveryoneinNorthernIreland.
Ourremitandresultsaretoowidespreadtodetailmorefullyhere,butareoutlinedinmoredetailinmyfirstDirectorofPublicHealthAnnualreport,availableonthePHAwebsite.
Theexamplesoutlinedabovearejustaflavouroftheworkcompleted.Again,mayIexpresssinceregratitudetoallinvolved,inwhatevercapacity,insupportingthepublichealtharenaofworkandinprogressingourgoalsthispastyear.
Wemadeafirststepandagiantleapinestablishingaregionalunifiedpublichealthservice,buildingontheachievementsofthelegacyorganisations,makingbestuseofspecialistskills,integratingfunctions,andstrengtheningstrategicalliances.
Nextyearwillbringfurtherchallenges,butalsoopportunitiestobuildonthisyearandmakeatangibledifferencetopeople’slives.
Public Health Agency Annualreport 2009-2010
The role of the Public Health Agency | 15
Expectations
“Ihavehighambitionsandhighdemandsforimprovementsintheserviceswedeliver–becausethepeopleweservedeserveandexpectnoless.”ThisexpectationforserviceimprovementbyourHealthMinisterunderpinsourworkintheareasofnursing,patientsafetyandquality,AHPandPPI.
Professionals transforming lives
Thetermnursingincorporatesnursing,midwifery,healthvisiting,healthcareassistantsandothersupportstaff,whileAHPsrepresentdietetics,occupationaltherapy,orthoptics,physiotherapy,podiatry,radiography,andspeechandlanguagetherapy.Allarekeymembersofhealthcare,providinginterventionsthathelpimprovepeople’slives.
Theseprofessionalsworkwithallagegroups,acrossallprogrammesofcareandinarangeofsurroundingsincludinghospitals,people’shomes,clinics,surgeriesandschools.TheyworkinpartnershipwithHSCcolleaguesacrossprimary,secondaryandsocialcare,theindependentandvoluntarysectors,andwithotheragenciessuchasDEandNIHE.
Making quality services safer
OurmandatehereatthePHAistoleadinmakingtheservicesprovidedbyhealthandsocialcaresafer,wheretheexperienceofapatientandthequalityofthatserviceisjustasimportantasthespeedofaccess,andwherecitizensfeeltheyhaveasayinthedesignanddeliveryoftheservicestheyreceive.
Patient/client experience standards
ThenursingandAHPdirectorateisleadingontheimplementationoftheDHSSPSpatient/clientexperiencestandardsthroughoutthetrusts.ThePHA,inpartnershipwiththetrusts,hasdevelopedarangeofmethodologiesformonitoringcomplianceagainstthesestandardsandhasbeguntestingtheseindesignatedareaswithineachtrust.
Thestandardsarebeingtestedinacutemedicalwards,andacuteinpatientandmentalinpatientunits.Plansareinplacetoincludeservicesprovidedforindividualswithalearningdisability.
ThefirstcompositemonitoringreporthasbeensubmittedbythePHAtotheDHSSPS.
ThePHAandHSCBhavejointlyrevisedtheprocessformanagementandreviewofSAIs.ThePHAwiththeDHSSPShascommencedarrangementsforestablishingasystem.ThiswillenabletruststotakenecessaryactionsandlearnfromSAIsacrosstheregion.
Building capacity
Buildingontheworkofourlegacyorganisations,wefurthersupportedanddevelopedcapacityinthisareathroughout2009–2010.Intheareaofelectivecarereform,weachievedthe26weekand13weekwaitingtimetargetsfortreatmentbyAHPsfor2009setbytheHealthMinister,andweareworkingtowardshisnineweekmaximumwaitingtimetarget.
Leading the way for AHPs
ThePHAisalsoleadingaregionalAHPreformprogrammethataimstosecureregionalagreementsonareassuchasAHPtreatmentpathwaysandmodelsofgoodpractice.Oneofthekeyareasoffocusismaximisingtheuseofprofessionalstaffthroughamoreeffectivecombinationofskills,usingassistantsandadministrativestaff.
H1N1 preparations
WeestablishedaregionalAHPgrouptodeveloparegionalguidetohelpHSCtrustsrespondtoapotentialH1N1pandemic.Eachofthesevenprofessionsagreedclinicalpriorities.
Nursing and Allied Health Professions - Mary Hinds
16 | The role of the Public Health Agency
Inotherareasofclinicalpractice,wecontinuedtoleadindevelopinginnovativeandnewservices,andfacilitatechangesandmodernisation.Theseincluded:
• implementationofthereviewofhealthvisiting andcommunitynursing;
• implementationoftheBamfordactionplanfor mentalhealthandlearningdisability;
• nursing/AHPrepresentationonallLCGs;
• nursing/AHPinvolvementandsupportfor serviceframeworks;
• AHPchairoftheNorthernIreland lymphoedemanetwork;
• servicedevelopmentstoenhancepublichealth practitioners’skillsinworkingwithvulnerable childrenandfamilies;
• autismtrainingforallhealthvisitors;
• introductionofauniversalhomevisitforall childrenagedtwoyears;
• developmentofaregionalsafeguardingnursing project;
• developmentoftheDHSSPS10yearquality strategy.
Engaging and developing
DuringAugust2009aseriesofworkshopswereheldacrossNorthernIrelandtoengagewithmembersofthenursingandmidwiferycommunityandotherstakeholdersinthedevelopmentofaregionalstrategyfornursingandmidwifery.
Throughthefiveworkshops,150participantswereaffordedtheopportunitytocontributeandshapethisdocumentunderthefourstrategicthemesof:
• developingpersoncentredcultures;
• supportinglearninganddevelopment;
• promotingsafeandeffectivecare;
• maximisingresourcesforsuccess.
Thiswork,ledbyseniornurses,midwivesandpatientrepresentatives,willbuildonthestrategiesdevelopedbyeachofthetrustsandisanopportunitytorecognisethecontributionmadebythecommunityofnursingandmidwiferytothehealthandwellbeingofourpopulation.
Professional development
TheHealthMinisterlaunchedareviewintothecontributionofhealthvisitorsandschoolnursesinNorthernIrelandandhasaskedthePHAtotakeforwardtheimplementationofthereview.
Inaddition,workgotunderwaytoestablishaprofessionalforumforthosenursesandmidwiveswhoareemployedbythePHAandHSCB,bothwithinandoutsidemydirectorate.Thecorepurposeistomakesureeveryoneisuptodateonprofessional/regulatoryissues,fromapolicy,practiceandprofessionalregulationperspective.
Innovation for the future
ThesmoothhandoverfromtheDHSSPStothePHAoftheECCHsawthecontinuationofacomplexandchallengingservicedesign,procurementandimplementationprocessinpartnershipwiththefiveHSCtrusts.TheprimarypurposeoftheECCHistoimprovethepatientandclientexperience,providingbetterqualityandmoreeffectivecare.
AmongitsfunctionsistopromoteimprovementsinpatientcarethroughtheuseofhealthcaretechnologyandtofasttracknewproductsandinnovationinHSCservices.Thispastyearsawthecontinuationoftheremotetelemonitoringpilotsforpeoplewithseverechronicdiseasesuchascongestiveheartfailure,diabetesandCOPD.
Public Health Agency Annualreport 2009-2010
The role of the Public Health Agency | 17
Meeting priorities
ThePHAcontinuedtoworktomeetPfAprioritiesinrespectofcompliancewithpatientsafetyandquality,andclinicalandsocialcaregovernancerequirements,throughfullimplementationofapprovedqualityimprovementplans,workinginpartnershipwithHSCBandtrusts.
Effective public engagement
TheDHSSPSiscommittedtoastakeholder-ledservicethatiscentredontheneedsofpatients,clients,carersandthewiderpopulation.
ThisisapolicyreflectedinAhealthierfutureandreinforcedbyourHealthMinisterinhisPrioritiesforaction.EffectivePPIiscentraltothedeliveryofsafe,highqualityservicesandisakeyelementofclinicalandsocialcaregovernance.
AkeyactivityofthePHAistobuildeffectivepublicengagementintoourwork–toestablishcoherentapproachestoenableinvolvementofindividuals,communitiesandotherkeystakeholdersinshapingourwork.
Personal and Public Involvement
PPIisaboutpeopleandcommunitiesinfluencingtheplanning,commissioninganddeliveryofhealthandsocialcareservices.Itmeansactivelyengagingwithserviceusersandthepublictodiscuss:
• theirideas,ourplans;
• theirexperiences,ourexperiences;
• whyservicesneedtochange;
• whatpeoplewantfromservices;
• howtomakethebestuseofresources;
• howtoimprovethequalityandsafetyof services.
WhiletheconceptofPPIisnotnew,wehavemadeconsiderableeffortsduring2009–2010tofurtherembedPPIintooureverydaywork.
PPI consultation
TheHSC(Reform)Act2009requiredthePHA,theHSCB,theDHSSPS,HSCtrustsandspecialagenciestoprepareaPPIconsultationschemeforsubmissiontotheDHSSPSbytheendof2009.OurschemewasheavilyinfluencedbytheviewsofavarietyofstakeholdersobtainedthroughajointworkshopwiththeHSCBandaseriesofone-to-onemeetings.ThisisnowwiththeDHSSPSforconsiderationinpartnershipwiththePCC.
Wecontinuedtomakeprogressonanumberofissuesidentifiedbystakeholdersasrequiringaction.ThePHAhostedaworkshopinJanuaryinpartnershipwiththeHSCB.ThisallowedthePHAtoworkwithHSCcolleaguesonclarifyingrolesandresponsibilitiesinrelationtoPPI,toestablisharegionalforumthathelpsorganisationsworkinamorecoordinatedway,andtodeveloparegionalPPIactionplan.
Wealsopilotedaseriesoftwo-daytrainingeventsforsenior,frontlinehealthandsocialcareandvoluntary/communitysectorstaffinengagingwithserviceusersandthepublic.
Measuring the impact
Inpursuanceofactioninourcorporateplan,wecommencedthedevelopmentofarobustapproachtoassistthemeasurementoftheimpactofPPI,inparticularensuringfullengagementandsensitivitytopeopleandcommunitiesexperiencinghealthandwellbeinginequalities.EnsuringPPIinvolvementintheR&DfunctionofthePHAisalsounderway.
Thestakeholderinvolvemente-networkwww.engage.hscni.netcontinuestobeakeycommunicationtoolforinformationsharingandsupportamongstakeholders.
18 | The role of the Public Health Agency
TheoperationsdirectorateofthePHAconcernsprocesses,peopleandresources–allessentialelementsindevelopingafit-for-purposeorganisationthatappliesitsskillsandcapabilitiessuccessfully,inpartnershipwithothers,toplayaleadingroleinthenewhealthstructures.
Corporate plan
Ourfirstcorporateplanfor2009–2010laiddownafirmfoundationonwhichtobuildanddevelopastrongorganisationandinfrastructurethatmanagesresourceseffectively,efficientlyandeconomically–intandemwithrobustaccountablegovernance.Itsetusontherightcourseandgaveusarealsenseofdirectionasweshapedourworkpracticesandfulfilledourcommitments.
Strategic development and governance
Weinheritedmuchgoodworkandpracticefromthelegacyorganisationsandthisstoodusingoodsteadaswebeganourjourneyofrollingoutourorganisation’sdevelopmentstrategy.Developmentofaninterimgovernanceframework–whichconcernsaccountabilitiesandresponsibilitiesandhowwearedirectedandcontrolled–wasacorestepinourworkingin2009–2010.
ThiswillformthebasisofaholisticnewgovernanceframeworkandstrategyforthePHA.AlliedtothiswasinitialworkonthedevelopmentofinternalperformancemonitoringandreportingsystemssupportingthePHAacrossallitsfunctions.
Asuiteofinteriminformationgovernancepoliciesweredevelopedandaninformationgovernanceleafletproducedandcirculatedtoallstaffoutlininggoodpracticeandguidanceonissuessuchasdataprotectionandfreedomofinformation.
ArrangementswereputinplacetoestablishtheChiefExecutiveandChair’soffices,andtoorganiseandprovidesupporttothePHAboardanditscommittees.
Commissioning
AnimportantmechanismforthePHAinconnectingregionalpoliciesandstrategiestolocalactionwasthedevelopmentofajointcommissioningplancoveringthefullPHAbudget.
InpartnershipwiththeHSCB,weagreedaplanthatfocusedonhighquality,safeservicesconsistentwithmeetingpatientandclientneeds,haddueregardtoministerialprioritiesandresourcesavailable,andstrovetoreduceinequalities.
Workbeganduringtheyeartoinitiateajointcommissioningplanfor2010–2011,takingintoaccountprioritiessuchastheNorthernIrelandExecutive’sPFG2008–2011andassociatedpublicserviceagreements,theministerialPfA2009–2010aswellasearlyguidanceonPfA2010–2011,andprevailingfinancialcircumstances.
Riskmanagementprocesseswereestablishedthroughthedevelopmentofaninterimcorporateriskregisteranddirectorateriskregisters.Thesewillbereviewedregularly.
Performance monitoring
TosupportimplementationofourcorporateplanandtimelyreportingonDHSSPSperformancetargets,aweb-basedperformancemonitoringsystemwasdeveloped.Thiswillbefurtherrefinedandrolledoutduring2010–2011.
Financial management
Infulfilmentofourresponsibilitytoachievefinancialbalanceandlivewithinourallocatedresourcesthrougheffectivestewardship,weimplementedfinancialmanagementarrangementswiththeHSCBandBSOandwillcontinuetoexamineanddevelopthesetoensurethatourstrategicfinancialmanagementrequirementsaremetfully.
AmajorpartofthiswasworkingcloselywithPHAprogrammemanagers,HSCBfinancecolleaguesandDHSSPSpolicyandfinancialcolleaguestoprovideaclearanddetailedpictureofcommitmentsandexpenditureagainstalltheprogrammebudgets,enablingtheprovisionoftimelyinformationtosupportAMTdecisionmaking.
Operations - Edmond McClean
Public Health Agency Annualreport 2009-2010
The role of the Public Health Agency | 19
ThePHAalsoledworkincollaborationwiththeHSCBtoreviewtherangeofprocessesusedbythelegacyorganisationstofundvoluntaryandcommunityorganisations,resultinginasingleregionalprocesssupportedbystandarddocumentation.
Interim controls assurance framework
Aninterimassuranceframework,whichoperatestomaintainandhelpprovidereasonableassuranceoftheeffectivenessofinternalcontrolacrossallareasofthePHA’sactivity,wasapprovedbytheboardinOctober.Thisframeworkcoverscorporatecontrol,safetyandquality,finance,operationalperformanceandserviceimprovement.During2010,itwillbereplacedbyanoverarchinggovernanceframeworkcoveringalldomainsofgovernanceandrelatedrequirementsplaceduponitbytheDHSSPS.
ThefollowingtabledetailscontrolsassurancestandardscompliancebythePHAduring2009–2010.
Figure 1: PHA controls assurance compliance 2009–2010
Governance and audit committee
TheinterimframeworkwillcontinuetobereviewedbytheGACandtheboarduntilafullyfunctioningsystemformonitoringthePHA’sinternalcontrolsystemisimplemented.TheGAChelditsfirstmeetinginJune.AsubsequentmeetingwasheldinOctobertoapprovethemid-yearassurancestatementandotherrelevantdocumentsthatsupporttheinternalcontrolsystem.
Accommodation
ThePHAwasaskedatitsoutsettoconsideroptionsforanewheadquartersfortheorganisation.AprojectteamwasestablishedinvolvingstafffromthePHA,healthestatesandHSCBfinancetodevelopabusinesscase.ThefirststageofthisworkhasbeencompletedandconsideredbythePHAboardandisnowawaitingcommentandguidancefromDHSSPS.
AtthesametimetheuseofworkspaceacrossthePHAlocationsinBelfastcitycentrewasreviewed,andsomeadditionalspaceleasedtoaccommodatetheneworganisationandbettersupportourfunctionalneeds.
Standard Progress expected by DHSSPS in 2009–2010
Position recorded by PHA in 2009–2010
Buildings,land,plant,andnon-medicalequipment
Substantive Substantive
Emergencyplanning Substantive Substantive
Environmentalmanagement Substantive Substantive
Financialmanagement Substantive Substantive
Firesafety Substantive Substantive
Governance Substantive Substantive
Healthandsafety Substantive Substantive
Humanresources Substantive Substantive
ICT Substantive Substantive
Purchasingandsupply Substantive Substantive
Recordsmanagement Substantive Moderate
Researchgovernance Substantive Substantive
Riskmanagement Substantive Substantive
Securitymanagement Substantive Substantive
Wastemanagement Substantive Substantive
20 | The role of the Public Health Agency
A competent workforce
Wecontinuedtheworkstartedbyourlegacybodiesingrowingacompetent,confidentworkforcethroughplannedtrainingandsupport.TraininginoperationalproceduresandgovernanceissueswasorganisedforallPHAstaffinpartnershipwiththeHSCB.
WorkshopsfocusingongovernanceissuesorganisedthroughtheBeechesmanagementcentrefacilitatedthedevelopmentofnon-executivemembersoftheboard.Dedicatedcommissionerdevelopmenttrainingalsotookplace.
Toensureclosecollaborationwithallourhealthpartners,regularmeetingstookplacethroughouttheyearataseniorlevelwithallHSCorganisations,includingthechairsofthefiveLCGs,theassistantdirectorsofcommissioningand,insupportofthepartnershipworkingwithlocalgovernment,thechiefexecutivesofalllocalcouncilareas.
Staffing
Staffingstructuresareinplacetotier3level,whiletier4levelandbelowstillremaintobeputinplace.Anumberofstaffhaveavailedoftheopportunitytotakevoluntaryearlyretirementorvoluntaryredundancypackages.
Health intelligence
Responsibilityforhealthintelligencealsolieswithinthisdirectorate.Thisfunction,encompassingknowledgemanagement,facilitatesthecaptureanduseofknowledgeforhealthandwellbeingimprovementandprotection,andtheaddressingofinequalities.Demandsareincreasing–reshapinganddevelopinginlightofourneworganisation’sneeds.
Specialist support
Weprovidespecialistsupportoninformationcollation,analysisandappraisal,researchandevaluationstudies,andinformatics.Inaddition,wearecommittedtotestinganddevelopingnewandinnovativepracticesandseekinggreaterunderstandingaboutthenatureofhealthinequalitiesandtheimpactofaction.
Healthintelligenceisacross-cuttingfunctionacrossalldivisionswithinthePHA.Ourchallengethispastyearhasbeenrealigningthisfunctiontomaximisetheimpactofhighquality,relevantdatabyimprovingaccesstohealthinformationandintelligenceacrossallHSCorganisationsinNorthernIreland.
ApriorityhasalsobeentodevelopconstructiveandeffectivearrangementswiththeHSCdatawarehousetoaccessandshapeservices.
Building capacity
Muchofourtimein2009–2010hasfocusedonservicingthedemandsofprojectscarriedoverfromthelegacyorganisations.Inpursuingouraimtofurtherdevelopourknowledgeandresearchcapacity,workcommencedonthedevelopmentofaknowledgemanagementframeworkinconjunctionwiththenewCOEforpublichealth.
Building relationships
WehaveworkedtobuildcloserworkingrelationshipswithkeyHSC,departmental,academicandlocalgovernmentpartnerstooptimisetheuseofexistingdatasourcesandthecommissioningofnewresearch.Wecontinuedworkonthedevelopmentofaneffectiveandefficientknowledgebasethatenablesflexible,sharedaccesstopublichealthknowledgeandhelpsinfluencethestrategicagendaofotherorganisationsandinterests.
Important work
Keyachievementsthispastyearincludedtheall-Irelandevaluationofappliedsuicideinterventionskillstraining,evaluationofourregionalsuicidehelplineLifeline,andFoodinSchoolsresearch.
Public Health Agency Annualreport 2009-2010
The role of the Public Health Agency | 21
Joint working with local government
Thecommitmenttostrengtheninginter-sectoralworkingsawsubstantialprogressmadeinjointworkingarrangementswithlocalgovernment.Almostallofthe26localcouncilshaveindicatedaninterestinformingjointworkingarrangementswiththePHA.
TheworkindevelopingthejointpilotsisbeingledbyaSteeringGroupcomprisingseniorrepresentativesfromallcommittedgeographicareas.Taskgroupshavealsobeensetuptodevelopaseriesofproductstosupporttheworkofthejointteamsineachlocality.Attimeofwriting,twojointworkinginitiativeshavebeenlaunchedwithmoreplannedoverthecomingmonths.
Communications
ThePHA’scommunicationsfunction–forbothexternalandinternalcommunications–alsofallswithintheoperationsdirectorate.Accurateandrelevanthealthinformationisessentialifindividualsaretomakeimprovementstotheirhealthandwearecommittedtoachievinghighqualitystandardsinallaspectsofourcommunicationspractice.
Fit-for-purpose systems
Fromthestartitbecameapparentthattherealisationofthisnewerareliedinnosmallpartontheneedforfit-for-purposecommunicationsystemstobecomeacornerstoneinthestrategicoperationoftheorganisation.Ourfocustodatehasincludedconsolidationoflegacysystemstogetherwithplanningforthedevelopmentofnewbespokesystems.
A multi-disciplinary team
ThecommunicationsdemandsfacingthePHAtodatehavebeenbothvariedandchallenging,requiringthefullsupportofamulti-disciplinaryteamworkingacrossandsupportingallareasoftheorganisation,andspanningtheareasofpublicationsdevelopment,design,websitedevelopment,marketing,eventmanagement,publicandmediarelations,andcorporatecommunications.
Marketing and PR
Throughouttheyearourmarketingandpublicrelationsfunctionrananumberofmajorpublicinformationcampaignsacrossarangeofmediatoraiseawarenessandchangeattitudes,andhelppromotehealthchoicesanddecisionmaking,intheareasofsmoking,alcohol,physicalactivity,sexualhealthandmentalhealth.
Thecampaign“Reduceyourdrinking,reduceyourriskofbreastcancer”includedtelevision,radio,onlineandpressadvertising,andpostersandleaflets.WashroomandphonekioskpostersandFacebookadvertisingwerealsousedtopromotethe“Sex:don’tjustdoit–thinkitthrough”campaignforyoungpeople.Alongsideourusualpromotiontools,wedevelopedanactivitylogbookforprimaryschoolchildrenandaNewyoumagazineforparentsinsupportofour‘Physicalactivity:italladdsup!’campaign.
Campaign success
OursuccessinourcampaignworkwasreflectedinseveralawardsthataredetailedunderthequalitysectionoftheDirectors’report.
Publications support
Onthepublicationsanddesignside,wedeveloped,producedanddistributedover160resourcesforboththepublicandprofessionalsinsupportofourworkareas.Thisincludedtheproductionofswinefluinformationforthegeneralpublic,parentsofyoungchildren,pregnantwomen,andhealthandsocialcareworkers.
Anothermajorpieceofworkwasthedevelopmentandtestingofinformationforthepublic,andforhealthprofessionals,tosupportthenewbowelscreeningprogramme.Thefourleafletsforthepublicweretranslatedinto10regionalandethniclanguages.
22 | The role of the Public Health Agency
Electronic communications
Developmentofacorporatewebsitewww.publichealth.hscni.nettocommunicatemessagestoourexternalstakeholdersandintegratecontentfromourlegacysystemswasapriorityfortheneworganisation.Anintranetsitewasalsorolledoutasacommunicationschannelforourstaff.
Threenewsiteswww.enjoyhealthyeating.info,www.hphlibrary.comandwww.lifelinehelpline.infowereintroducedinsupportofnutrition,hospitals/healthserviceandmentalhealthwork.
Thewww.breastfedbabies.org,www.getalifegetactive.comandwww.mindingyourhead.infositeswerealsoredeveloped.
Public Health Agency Annualreport 2009-2010
The role of the Public Health Agency | 23
Event management
Anumberofconferences,seminarsandtrainingcourseswereorganisedbythePHAthroughouttheyearontopicssuchasorgandonation,healthcareassociatedinfections,andhealthyworkplaces.
CommunicationssupportwasalsoprovidedatpartnershipeventssuchastheFarsethealthinequalitiesconferenceandatlaunchesoftheintegratedservicesforchildrenandyoungpeopleprogramme,theStJoseph’sprimaryschoolparentsupportprogrammeevaluationreport,andtheBelfastHealthDevelopmentUnit.Wefacilitatedstakeholderengagementforissuessuchassuicideprevention,fuelpovertyandcommunitydevelopmentwork.
Shaping our future
Alongsidetheeverydaycommunicationsactivities,goodprogresshasalsobeenmade,throughvarioustaskandworkinggroups,indevelopingtheprotocolsthatwillshapefuturecommunicationsstrategies.ImportantlinkshavealsobeenmadetoaidcoordinationwithcommunicationspersonnelacrosstheHSCfamilyintheDHSSPS,HSCB,andtrusts.
At the organ donor seminar held during the year are, from left, Dr Eddie Rooney, Chief Executive, Public Health Agency; Mr Chris Rudge, National Clinical Director for Transplantation, Department of Health, London; and Health Minister, Michael McGimpsey.
The staff involved in setting up the Belfast Health Development Unit, back row, from left, Suzanne Wylie, Beverley Smith, Caroline Bloomfield, Tom Crossan, Adele Keys, Margery Magee and Dr Leslie Boydell. Front row, from left, Mary Black, Elaine McCarthy, Valerie Brown, Elma Greer and Martina Smyth.
24 | Operating and financial review
Operating and financial review
Report from the Governance and Audit Committee (GAC)
TheGACwasestablishedtogiveassurancetothePHAboard,basedonanindependentandobjectivereview,thateffectiveriskmanagementandinternalcontrolarrangementsareinplaceforfinance,corporategovernanceandrelatedareas.
TheGACcomprisesfournon-executivedirectorsofthePHA:MrsJErskine(Chair);MrROrr;MrTMahaffy;andCllrSNicholl.Thecommitteeissupportedby:MrEMcClean,DirectorofOperations,PHA;MrPCummings,DirectorofFinance,HSCB;MrsCMcKeown,HeadofInternalAudit,BSO;andtheirrespectivestaff.
RepresentativesoftheNorthernIrelandAuditOfficeandPricewaterhouseCoopersattendasrequired.
TheGACdecidedatanearlystage(inconjunctionwiththeHSCBGAC)torecruituptotwoindependentlayadvisorswithexpertiseinfinanceandgovernance.Interviewshavetakenplaceandanannouncementwillbemadeshortly.
Meetings
TheGACmetonthefollowingdatesduring2009–2010:29June2009,6October2009,14January2010and4March2010.
GAC activities during 2009–2010
During2009/10theGAC:
• Notedthestatementofassuranceprovided bytheauditcommitteeofthelegacyHealth PromotionAgency(HPA)andrecommended theaccountsanddraftannualreportofthe legacyHPAtothePHAboardforapproval.
• Endorsedtheprocessfordevelopinganinterim corporateriskregister,directoraterisk register,andanewcorporateriskregister. Approvedanewriskassessmenttooland subsequentlyapprovedtheinterimcorporate riskregisterandnewdirectorateriskregisters.
• Approvedtheinterimassuranceframework.
• Hadoversightoftheprocessfor self-assessmentofcompliancewithcontrols assurancestandards.
• Agreedthemid-yearassurancestatementand recommendeditsapprovaltotheboard.
• Self-assessedtheGACagainsttheNAO auditcommitteeselfassessmentchecklist forsubmissiontotheDHSSPS,andapproved anactionplanarisingfromthis.
• Approvedasuiteofinteriminformation governancepolicies.
• Approvedtheinternalauditworkplanfor2010–2011 andconsideredthereportsoneachpieceofwork.
• Providedassurancetotheboardthattheannual accountswouldbepreparedinaccordancewith therelevantstatutoryregulations.
• Reviewedthestandingorders.
TheGAClooksforwardtocontinuingitsworkin2010–2011,buildingonrelationshipswithexecutivedirectors,PHAofficers,andinternalandexternalauditorstoensurerobustgovernanceacrossthePHA.
Julie Erskine Chair of Governance and Audit Committee
Overview
TheseaccountshavebeenpreparedinaformdeterminedbytheDHSSPSbasedonguidancefromtheDepartmentofFinanceandPersonnel’sFinancialReportingManual(FReM)andinaccordancewiththerequirementsoftheHealthandSocialCare(Reform)Act(NorthernIreland)2009.
ThissummaryfinancialstatementdoesnotcontainsufficientinformationforafullunderstandingoftheactivitiesandperformanceofthePHA.Forfurtherinformation,thefullaccounts(includingthestatementofinternalcontrol),AnnualReportandAuditor’sReportfortheyearended31March2010shouldbeconsulted.
Copiesofthefullaccountsareavailablefrom:
DirectorofFinanceHealthandSocialCareBoard12–22LinenhallStreetBelfastBT28BS
Public Health Agency Annualreport 2009-2010
Operating and financial review | 25
NET EXPENDITURE ACCOUNT FOR YEAR ENDED 31ST MARCH 2010
Restated 2010 2009 £000s £000s Expenditure Staffcosts (12,988) (13,026) Depreciation (52) (68) Otherexpenditure (29,865) (44,266)
(42,905) (57,360)
Income Incomefromactivities - 419 Otherincome 392 874
392 1,293
Net expenditure (42,513) (56,067)
Credit reversal of notional costs Costofcapital (329) (86) Notionalcosts(auditfees) 26 24
Net expenditure for the financial year (42,816) (56,129)
Summary of Revenue Resource outturn Netexpenditure (42,513) (56,067)
RRLs issued (to) BelfastHSCTrust (9,795) SouthEasternHSCTrust (1,448) SouthernHSCTrust (6,824) NorthernHSCTrust (3,923) WesternHSCTrust (3,669)
Total RRL issued (25,659) -*
Total commissioner resources utilised (68,172) (56,067)
RRLs received from
DHSSPS(cashandnoncash) 68,350 56,067
Surplus/deficit against RRL 178 -
*TheequivalentofRRL’sissuedtoTrustsinthefinancialyearended31March2009areincludedwithinOtherExpenditure.
26 | Operating and financial review
Revenue Resource Limit
ResultingfromtheintroductionoftheNonDepartmentalPublicBody(NDPB)formatofaccounts,theRevenueResourceLimit(RRL)hasbeenintroducedasameansofsettingacashlimittotheamountoffundingtobedrawndirectlyfromtheDHSSPSbythetrustinrelationtothecostsofprovidingservicestoAgencyresidents.ThisRRLmechanismreplacedtheServiceandBudgetAgreementpreviouslyinplace,whichallowedforcashtobepaiddirectlytothetrustsbythelegacyboardsforthecostsofservicesprovidedtothelegacyAgencyresidents.
ThememorandumbelowexpressesthePHA‘NetExpenditureAccount’inatraditionalincomeandexpenditureformat.
SUMMARY FINANCIAL INFORMATION FOR YEAR ENDED 31ST MARCH 2010
Restated 2010 2009 £000s £000s Income RRLreceivedfromDHSSPS 68,350 56,067 Otherincome 392 1,293
68,742 57,360
Expenditure (including RRLs issued to Trusts) Staffcosts (12,988) (13,026) Depreciation (52) (68) Expenditure (55,524) (44,266)
(68,564) (57,360)
Surplus/(deficit) 178 -
Public Health Agency Annualreport 2009-2010
Operating and financial review | 27
STATEMENT OF FINANCIAL POSITION AS AT 31 MARCH 2010
Restated 2010 2009 £000s £000s NON-CURRENT ASSETS Property,plantandequipment 199 108 Intangibleassets 3 6
TOTAL NON-CURRENT ASSETS 202 114
CURRENT ASSETS Inventories - 2 Tradeandotherreceivables 710 485 Othercurrentassets 24 58 Cashandcashequivalents 111 8,155
TOTAL CURRENT ASSETS 845 8,700
TOTAL ASSETS 1,047 8,814
CURRENT LIABILITIES Tradeandotherpayables (16,754) (11,931)
TOTAL CURRENT LIABILITIES (16,754) (11,931)
NON-CURRENT ASSETS PLUS/LESS NET CURRENT ASSETS/ LIABILITIES (15,707) (3,117)
ASSETS LESS LIABILITIES (15,707) (3,117)
RESERVES Revaluationreserve 23 21 Generalreserve (15,730) (3,138)
(15,707) (3,117)
IcertifythattheattachedFinancialStatementsandAnnualReportwereapprovedbytheboardofDirectorson:
Signed: Date:1June2010
28 | Operating and financial review
STATEMENT OF CASHFLOWS FOR THE YEAR ENDED 31 MARCH 2010
Restated 2010 2009 £000s £000s Cashflows from operating activities
Netexpenditureaftercostofcapital andinterest (42,513) (56,067)
Adjustmentsfornoncashcosts (248) 21
(Increase)/decreaseintrade& otherreceivables (191) 20
(Increase)/decreaseininventories 2 2
Increase/(decrease)intradepayables 4,823 790
Lessmovementinpayablesrelatingtocapital - (4)
Net cash outflow from operating activities (38,127) (55,238)
Cashflows from investing activities
Purchaseofproperty,plantandequipment (144) (9)
Purchaseofintangibleassets - -
Proceedsofdisposalofproperty, plantandequipment 3 -
Proceedsondisposalofintangibles - -
Interestreceived - -
Net cash inflow/(Outflow) from investing activities (141) (9)
Cash flows from financing activities Grantinaid 30,224 54,806
Net financing 30,224 54,806
Net increase (decrease) in cash and cash equivalents in the period (8,044) (441)
Cash and cash equivalents at the beginning of the period 8,155 8,596
Cash and cash equivalents at the end of the period 111 8,155
Public Health Agency Annualreport 2009-2010
Operating and financial review | 29
Management board
TheManagementboardresponsibleforsettingthedirectionofthePHAismadeupofthefollowingindividuals:
Executive members:DrEddieRooney(ChiefExecutive)DrCarolynHarperEdmondMcCleanMaryHinds
Non-executive members:MaryMcMahon(Chairperson)JulieErskineDrJeremyHarbisonMiriamKarpThomasMahaffyCllrCathalMullaghanCllrStephenNichollRonnieOrr
Equal opportunities
ThePHAhasinplaceanequalopportunitiespolicytopromoteandprovideequalitybetweenpersonsofdifferentgenders,maritalorfamilystatus,religiousbelieforpoliticalopinion,age,disability,raceorethnicorigin,nationalityorsexualorientation,betweenpersonswithadisabilityandpersonswithout,betweenpersonswithdependentsandpersonswithout,betweenmenandwomengenerally,andirrespectiveofstafforganisationmembership.Thispolicyappliestorecruitment,promotion,training,transferandotherbenefitsandfacilities.
Public sector payment policy – measure of compliance
TheDepartmentrequiresthatthePHApaysitsnon-HSCtradecreditorsinaccordancewiththeCBIpromptpaymentpolicyandgovernmentaccountingrules.ThePHA’spaymentpolicyisconsistentwiththeCBIpromptpaymentcodesandgovernmentaccountingrulesanditsmeasureofcomplianceis:
2010 2009 number number
Totalbillspaid 6,821 7,180
Totalbillspaidwithin30daytarget 6,371 6,866
% of bills paid within 30 day target 93.4% 95.6%
30 | Operating and financial review
Related party transactions
Duringtheyear,noneoftheboardmembers,membersofkeymanagementstafforotherrelatedpartieshasundertakenanymaterialtransactionswiththePHA.
Directors’ interests
Detailsofcompanydirectorshipsorothersignificantinterestsheldbydirectors,wherethosedirectorsarelikelytodobusiness,orarepossiblyseekingtodobusinesswiththePHAwherethismayconflictwiththeirmanagerialresponsibilities,areheldonacentralregister.AcopyisavailablefromEdmondMcClean,PHADirectorofOperations.
Charitable donations
ThePHAdidnotmakeanycharitabledonationsduringthefinancialyear.
Post balance sheet events
Therearenopostbalancesheeteventsthathaveamaterialimpactontheaccounts.
Sickness absence information
Thepercentagefigureforsicknessabsenceforthe2009–2010yearis2.5%.FurtherinformationisdetailedwithintheDirectors’reportsection.
Personal data-related incidents
Therewerenomajorpersonaldatarelatedincidentsrequiringdisclosure.
Audit services
ThePHA’sstatutoryauditwasperformedbyPricewaterhouseCoopersonbehalfoftheNorthernIrelandAuditOffice.Theauditfeefor2009–2010was£26k.
Statement on disclosure of audit information
AlldirectorscanconfirmthattheyarenotawareofanyrelevantauditinformationofwhichthePHA’sauditorsareunaware.
Staff numbers
Theaveragenumberofwholetimeequivalentpersonsemployedduringtheyearwas:
2010 2009
Permanently employed Total no. staff no. Others no. Total no.
Healthcommissioningimprovementandprotection 247 221 26 235
Public Health Agency Annualreport 2009-2010
Operating and financial review | 31
Remuneration report for the year ended 31 March 2010 (audited)
Scope of the report
Article242Bandschedule7AoftheCompanies(NI)Order1986,asinterpretedforthepublicsector,requiresHSCbodiestopreparearemunerationreportcontaininginformationaboutdirectors’remuneration.TheremunerationreportsummarisestheremunerationpolicyofthePHAandparticularlyitsapplicationinconnectionwithseniorexecutives.ThereportalsodescribeshowthePHAappliestheprinciplesofgoodcorporategovernanceinrelationtoseniormanagers’remunerationinaccordancewithHSS(SM)3/2001issuedbytheDHSSPS.
Remuneration committee
TheboardofthePHA,assetoutinitsstandingorders,hasdelegatedcertainfunctionstotheremunerationcommittee.Themembershipofthiscommitteeisasfollows:
Members
MaryMcMahon(Chair)DrJeremyHarbisonMiriamKarpCllrCathalMullaghan
Duringthe2009–2010yearthecommitteemetononeoccasiontoagreeitstermsofreference.
Remuneration policy
1. ThemembershipoftheremunerationcommitteeforthePHAconsistsoftheChairandatleasttwoofitsnon-executives.
2. ThepolicyonremunerationofthePHAseniorexecutivesforcurrentandfuturefinancialyearsistheapplicationoftermsandconditionsofemploymentasprovidedanddeterminedbytheDHSSPS.
3. Performanceofseniorexecutivesisassessedusingaperformancemanagementsystemthatcomprisesindividualappraisalandreview.Theirperformanceisthenconsideredbytheremunerationcommitteeandjudgementsaremadetotheirbandinginlinewiththedepartmentalcontractagainsttheachievementofregionalorganisationandpersonalobjectives.
4. TherelevantimportanceoftheappropriateproportionofremunerationissetbytheDHSSPSundertheperformancemanagementarrangementsforseniorexecutives.
5. Inrelationtothepolicyondurationofcontracts,allcontractsofseniorexecutivesinthePHAarepermanentandcontainanoticeperiodofthreemonths.
32 | Operating and financial review
Service contracts
Seniorexecutivesintheyear2009–2010wereonDHSSPSseniorexecutivecontracts,whicharedetailedandcontainedwithinthecircularHSS(SM)2/2001.
Directors
DrEddieRooney,ChiefExecutive,appointed01April2009.DrCarolynHarper,DirectorofPublicHealth/MedicalDirector,appointed01April2009.EdmondMcClean,DirectorofOperations,appointed01April2009.MaryHinds,DirectorofNursingandAlliedHealthProfessionals,appointed18May2009.
Non-executive directors
TheNon-executivedirectorswereappointedforaperiodoffouryears,witheffectfrom1April2009.
Chair Mary McMahon
Non-executive director Julie Erskine
Non-executive director Dr Jeremy Harbison
Non-executive director Miriam Karp
Non-executive director Thomas Mahaffy
Non-executive director Councillor Cathal Mullaghan
Non-executive director Councillor Stephen Nicholl
Non-executive director Ronnie Orr
Nootherpersonsservedatboarddirectorlevelduring2009–2010.
Anoticeperiodofthreemonthsisprovidedbyeitherpartyexceptintheeventofdismissal.Thereisnothingtopreventeitherpartywaivingtherighttonoticeorfromacceptingpaymentinlieuofnotice.
Retirement age
Currently,employeesarerequiredtoretireatage65althoughemployeescanasktoworkbeyondthisageinaccordancewithEquality(Age)Regulations(NI)2006.
Public Health Agency Annualreport 2009-2010
Operating and financial review | 33
Premature retirement costs
Section16oftheAgendaforChangetermsandconditionshandbook(issued14February2007undercoveroftheDepartment’sGuidanceCircularHSSAfC(4)2007,setsoutthearrangementsforearlyretirementonthegroundsofredundancyandintheinterestofthisservice.FurthercircularshavebeenissuedbytheDepartment–AfC(6)2007andHSSAfC(5)2008setoutchangestothetimescaleforoperationofthetransitionalprotectionunderthesearrangements.
Undersection16oftheAgendaforChangetermsandconditionshandbook,individualswhoweremembersoftheHPSSsuperannuationschemepriorto1October2006,areover50yearsofageandhaveatleastfiveyearsmembershipoftheHPSSsuperannuationscheme,qualifyfortransitionalprotection.Staffwhoqualifyfortransitionalprotectionareentitledtoreceivewhattheywouldhavereceivedbywayofpensionandredundancypaymenthadtheytakenredundancyretirementon30September2006.
Thisincludesenhancementofupto10yearsadditionalservice(reducedbythenumberofyearsbetweenSeptember2006andtheactualdateofretirement)andalumpsumredundancypaymentofupto30weekspay(reducedby30%foreachyearofadditionalserviceover62/3years).Alternatively,staffmaderedundantwhoaremembersoftheHSSpensionsscheme,haveatleasttwoyears’continuousserviceandtwoyears’qualifyingmembership,andhavereachedtheminimumage(currently50years)canopttoretireearlywithoutareductionintheirpensionasaalternativetoalumpsumredundancypaymentofupto24monthspay.
Inthiscase,thecostoftheearlypensionpaymentistakenfromthelumpsumredundancypayment;however,iftheredundancypaymentisnotsufficienttomeettheearlypensionpaymentcost,theemployerisrequiredtomeettheadditionalcosts.
Salary (Audited)
ThesalaryandthevalueofanytaxablebenefitsinkindofthemostseniormembersofthePHAwereasfollows:
2009–2010
Salary, including Benefits in kind performance pay (Rounded to Name £000s nearest £100)
Non-executive members MMcMahon 30-35 - JErskine 5-10 - JHarbison 5-10 - MKarp 5-10 - TMahaffy 5-10 - CMullaghan 5-10 - SNicholl 5-10 - ROrr 5-10 -
Executive members EPRooney 115-120 100 CHarper 130-135 100 EMcClean 75-80 - MHinds 85-90 -
34 | Operating and financial review
Pensions (Audited)
ThepensionentitlementsofthemostseniormembersofthePHAwereasfollows: 2009–2010
Real Total increase in accrued pension and pension at age CETV CETV Real related lump 60 and related at at increase sum at age 60 lump sum 31/3/09 31/3/10 in CETV Name £’000 £’000 £’000
Non-executive members
MMcMahon - - - - - JErskine - - - - - JHarbison - - - - - MKarp - - - - - TMahaffy - - - - - CMullaghan - - - - - SNicholl - - - - - ROrr - - - - -
Executive members
EPRooney *Seenotebelow
CHarper 0-2.5pension 20-25pension 317 353 9 0-2.5lumpsum 60-65lumpsum
EMcClean 0-2.5pension 15-20pension 266 326 35 5-7.5lumpsum 45-50lumpsum
MHinds *Seenotebelow
* EPRooneyandMHindsjoinedtheschemeduringthe2009–2010financialyear.BSO’sSuperannuationBranchhasindicatedthat duetothefactthattheyhavenotcompletedafullyearinthescheme,itwasnotpossibletocalculatetheirpensionentitlements.
AsNon-Executivemembersdonotreceivepensionableremuneration,therewillbenoentriesinrespectofpensionsforNon-Executivemembers.
ACashEquivalentTransferValue(CETV)istheactuariallyassessedcapitalvalueofthepensionschemebenefitsaccruedbyamemberataparticularpointintime.Thebenefitsvaluedarethemember’saccruedbenefitsandanycontingentspouse’spensionpayablefromthescheme.ACETVisapaymentmadebyapensionscheme,orarrangementtosecurepensionbenefitsinanotherpensionschemeorarrangementwhenthememberleavesaschemeandchoosestotransferthebenefitsaccruedintheirformerscheme.Thepensionfiguresshownrelatetothebenefitsthattheindividualhasaccruedasaconsequenceoftheirtotalmembershipofthepensionscheme,notjusttheirserviceinaseniorcapacitytowhichthedisclosureapplies.TheCETVfiguresandtheotherpensiondetails,includethevalueofanypensionbenefitsinanotherschemeorarrangementwhichtheindividualhastransferredtotheHSCpensionscheme.Theyalsoincludeanyadditionalpensionbenefitaccruedtothememberasaresultoftheirpurchasingadditionalyearsofpensionserviceintheschemeattheirowncost.CETVsarecalculatedwithintheguidelinesprescribedbytheInstituteandFacultyofActuaries.
RealIncreaseinCETV-ThisreflectstheincreaseinCETVeffectivelyfundedbytheemployer.Ittakesaccountoftheincreaseinaccruedpensionduetoinflation,contributionspaidbytheemployee(Includingthevalueofanybenefitstransferredfromanotherpensionschemeorarrangement)andusescommonmarketvaluationfactorsforthestartandendoftheperiod.
Public Health Agency Annualreport 2009-2010
Operating and financial review | 35
Statement of the Comptroller and Auditor General to the Northern Ireland Assembly
Ihaveexaminedthesummaryfinancialstatementfortheyearended31March2010assetoutatpages26to28.
Respective responsibilities of the Public Health Agency, Chief Executive and AuditorThePublicHealthAgencyandChiefExecutiveareresponsibleforpreparingthesummaryfinancialstatement.
MyresponsibilityistoreporttoyoumyopinionontheconsistencyofthesummaryfinancialstatementwithintheAnnualReportwiththefullannualfinancialstatements,anditscompliancewiththerelevantrequirementsoftheHealthandSocialCare(Reform)Act(NorthernIreland)2009andDepartmentofHealth,SocialServicesandPublicSafetydirectionsmadethereunder.
IalsoreadtheotherinformationcontainedintheAnnualReport,andconsidertheimplicationsformycertificateifIbecomeawareofanyapparentmisstatementsormaterialinconsistencieswiththesummaryfinancialstatement.TheotherinformationcomprisestheOperatingandfinancialreview.
Basis of audit opinionsIconductedmyworkinaccordancewithBulletin2008/03‘Theauditors’statementonthesummaryfinancialstatementintheUnitedKingdom’issuedbytheAuditingPracticesBoard.MyreportonthePublicHealthAgencyfullannualfinancialstatementsdescribesthebasisofmyauditopinionsonthosefinancialstatementsandthepartoftheRemunerationReporttobeaudited.
OpinionInmyopinion,thesummaryfinancialstatementisconsistentwiththefullannualfinancialstatementsofthePublicHealthAgencyfortheyearended31March2010andcomplieswiththeapplicablerequirementsoftheHealthandSocialCare(Reform)Act(NorthernIreland)2009andDepartmentofHealth,SocialServicesandPublicSafetydirectionsmadethereunder.
KJ Donnelly ComptrollerandAuditorGeneralNorthernIrelandAuditOffice106UniversityStreetBelfastBT71EU
18June2010
36 | PHA board
PHA board
Mary McMahon
MaryisthePHA’sChairandisaself-employedSocialPolicyResearcher.ShewaspreviouslycoordinatorwiththeBelfastTravellerSupportGroupandisamemberofAmnestyInternational(Mid-Downbranch),theCommitteeontheAdministrationofJusticeandalsotheUnitedNationsChildren’sFund(UNICEF).SheisaBelfastHarbourCommissioner.
Dr Eddie Rooney
DrRooneyisChiefExecutiveofthePHAandwasformerlyDeputySecretaryintheDepartmentofEducationwherehisresponsibilitiesincludedleadingpolicyontheRPA.HetransferredtotheOfficeoftheFirstMinisterandDeputyFirstMinisterasEqualityDirectorin2008.
Dr Carolyn Harper
DrHarperisthePHA’sDirectorofPublicHealthandMedicalDirector.ShewaspreviouslyDeputyChiefMedicalOfficerintheDHSSPS.ShetrainedingeneralpracticebeforemovingintopublichealthandalsoworkedasDirectorofQualityImprovementfortheQualityImprovementOrganisationinCalifornia.
Mary Hinds
MaryHindsisthePHA’sDirectorofNursingandAlliedProfessions.ShewaspreviouslyDirectoroftheRoyalCollegeofNursing(RCN)inNorthernIreland.PriortojoiningtheRCN,shewasDirectorofNursingattheMaterHospitalinBelfast.
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Public Health Agency Annualreport 2009-2010
PHA board | 37
Edmond McClean
EdmondMcCleanisthePHA’sDirectorofOperations.HewaspreviouslyleadDirectorsupportingtheinitialdevelopmentofBelfastandEastLCGs.From1997to2007hewasDirectorofStrategicPlanningandCommissioningwiththeNorthernHealthandSocialServicesBoard.Thisrolealsoinvolvedleadingequalityandhumanrightsfunctions,InvestingforHealthandNorthernNeighbourhoodsHealthActionZonesinitiatives.
Paul Cummings
PaulCummingsisDirectorofFinance,HSCB.Paul,oradeputy,willattendallAgencyboardmeetingsandhaveattendanceandspeakingrights.
Julie Erskine
JulieErskineisamemberoftheNorthernIrelandSocialCareCouncilandamemberoftheNorthernIrelandLocalGovernmentOfficers’SuperannuationCommittee.Shehasworkedinthehealthcareserviceindustryforover25yearsandheldthepositionofOperationsDirectorandSupportServicesDirectorwithinaBelfast-basedprivatehealthcarecompany.
Dr Jeremy Harbison
DrHarbisonisaretiredcivilservant.HeisaProChancelloroftheUniversityofUlsterandaTrusteeoftheCommunityFoundationforNorthernIreland.HeisChairoftheNorthernIrelandSocialCareCouncilandaCommissioneroftheNorthernIrelandLegalServicesCommission.
Miriam Karp
MiriamKarpisamemberoftheNorthernIrelandSocialCareCouncil,amemberoftheStatutoryCommittee(Conductcommittee)oftheNorthernIrelandPharmaceuticalSociety,aCouncilMemberoftheNorthernIrelandGeneralTeachingCouncil,amemberoftheSocialCareInstituteOfExcellence(SCIE)Partners’CouncilandaconsultantforArthritisCareUKandtheNationalCancerScreeningProgrammeinIreland.
Councillor Stephen Nicholl
StephenNichollisalocallyelectedrepresentativememberofAntrimBoroughCouncil.HeisemployedasaPolicyAdvisortoJimNicholsonMEPandwaspreviouslySecretaryandProjectManagerfortheNewLodgeDuncairnCommunityHealthPartnership.
Thomas Mahaffy
ThomasMahaffyisemployedbyUNISONasaPolicyOfficerwithresponsibilityforpartnerships,equality,humanrightsandsocialpolicyissueswithinNorthernIreland.HeisaboardmemberoftheNorthernIrelandAnti-PovertyNetworkandHumanRightsConsortium.
Ronnie Orr
RonnieOrrworkedasaSocialServicesOfficerwithDHSSPSuntil2009.HeiscurrentlyamemberoftheIndependentMonitoringBoardforHydebankWoodPrisonandYoungOffendersCentre.
Not pictured
Maeve Hully
MaeveHullyisChiefExecutiveofthePatientandClientCouncil(PCC).ArepresentativefromthePCCwillattendallPHAboardmeetings.
Fionnuala McAndrew
FionnualaMcAndrewisDirectorofSocialCareandChildren,HSCB.Fionnuala,oradeputy,willattendallAgencyboardmeetingsandhaveattendanceandspeakingrights.
Councillor Cathal Mullaghan
CathalMullaghanisalocally-electedrepresentativememberofBelfastCityCouncil.HeisaboardmemberofLibrariesNIfrom1August2009.HealsositsontheNorthernIrelandLocalGovernmentAssociation(NILGA).
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38 | Acronyms
Acronyms
AHPAlliedHealthProfessions
AMTAgencyManagementTeam
BSOBusinessServicesOrganisation
CDSCCommunicableDiseaseSurveillanceCentre
COECentreofExcellence
COPDChronicObstructivePulmonaryDisease
DARDDepartmentofAgricultureandRuralDevelopment
DEDepartmentofEducation
DHSSPSDepartmentofHealth,SocialServicesandPublicSafety
DSDDepartmentforSocialDevelopment
ECCHEuropeanCentreforConnectedHealth
FoIFreedomofInformation
GPGeneralPractitioner
HAZHealthActionZone
HCAIHealthcareAssociatedInfection
HEHomeEconomics
HLCHealthyLivingCentre
HPA (UK)HealthProtectionAgency
HRBHealthResearchBoard
HSCHealthandSocialCare
HSCBHealthandSocialCareBoard
HSEHealthServiceExecutive
IfHInvestingforHealth
INTERREGAcommunityinitiativethataimstostimulateinterregionalcooperationintheEuropeanUnion
LCGLocalCommissioningGroup
MCADDMediumchainacyldehydrogenasedeficiency
MHFAMentalHealthFirstAid
MRSAMethicillin-resistantstaphylococcusaureus
MSSAMethicillin-sensitivestaphylococcusaureus
NCINationalCancerInstitute
NCTNationalChildbirthTrust
NDACTNorthernDrugsandAlcoholCoordinationTeam
NHSNationalHealthService
NIASNorthernIrelandAmbulanceService
NICaNNorthernIrelandCancerNetwork
NICRNNorthernIrelandClinicalResearchNetwork
NIHENorthernIrelandHousingExecutive
NILGANorthernIrelandLocalGovernmentAssociation
PARCPhysicalActivityandRejuvenationofConnswater
PCCPatientandClientCouncil
PfAPrioritiesforAction
PFGProgrammeforGovernment
PHAPublicHealthAgency
PPIPersonalandPublicInvolvement
PSAPublicServiceAgreement
PSNIPoliceServiceofNorthernIreland
R&DResearchandDevelopment
RAILRegionalAdverseIncidentLearning
RPAReviewofPublicAdministration
SAISeriousAdverseIncident
SSISurgicalSiteInfection
USUnitedStates
WHOWorldHealthOrganization
Public Health Agency Annualreport 2009-2010
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