Leading Through Change – The Developing Role of Public Health England

Paul Johnstone Regional Director PHE North of England

• Progress and challenges for Public Health England

• ‘own personal leadership journey through all of this’

Localism

Health and Social Care Act (2012)

Sources of public health advice in the ‘Place-based’ approach to local public health

Public health advice

People and communities

Health and wellbeing boards

Local government CCGs & their support

PHEcentre

NHSE area team

NHS & IS Providers

3rd sector providers

Commissioner of public health services

What is Public Health England?

“Public Health England (PHE) is the expert national public health agency which fulfils the Secretary of State for Health’s statutory duty to protect health and address

inequalities, and executes his power to promote the health and wellbeing of the nation.”

It has three key roles

• To protect the public’s health• To improve the public’s health• To reduce health inequalities

PHE Mission

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“To protect and improve the nation’s health and to address inequalities, working with national and local government, the NHS, industry, academia, the public and the voluntary and community sector.”

What we do

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Public Health England:

– works transparently, proactively providing government, local government, the NHS, MPs, industry, public health professionals and the public with evidence-based professional, scientific and delivery expertise and advice

– ensures there are effective arrangements in place nationally and locally for preparing, planning and responding to health protection concerns and emergencies, including the future impact of climate change

– supports local authorities, and through them clinical commissioning groups, by providing evidence and knowledge on local health needs, alongside practical and professional advice on what to do to improve health, and by taking action nationally where it makes sense to do so

What PHE offers

• Professional support the DPH and their team

• Advice to the Chief Executive and the corporate team

• Support to the Health and Wellbeing Board

• Benchmarking data in partnership with the NHSCB

• Embedded staff for Screening & Immunisation & Specialised Commissioning

• Advice on offender public health, 0-5 healthy child programme, dental PH and primary care

• Support for wider health improvement agenda and health strategy

• Partner in EPPR and specialist role in health protection

THE NHSCB AREA TEAMS LOCAL GOVERNMENT

Tailored, bespoke agreements with

A national agreement with

CLINICAL COMMISSIONING GROUPS• Contribute to development of national resources which set

out the evidence base • Development support and expert advice on high impact

public health interventions and strategies• Locally relevant benchmarking data and intelligence to

inform commissioning decisions

Public health advice to CCGs

comes from the DPH

Four outcomes frameworks

Adult Social Care Outcomes Framework

NHS Outcomes Framework

Children’s Outcomes Framework

Public Health Outcomes Framework

Supporting local priorities

PHE has a key role in supporting the delivery of local priorities – we are ensuring there is local capacity and capability within PHE to provide this, through the 15 PHE Centres, across the four domains of the Public Health Outcomes Framework

“Public Health England will exist to serve the system, a system led locally by elected members”

Duncan Selbie’s vision for PHE

Our priorities for 2013/14

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– Sets out Public Health England’s priorities and actions for the first year of our existence

– Five outcome-focused priorities – what we want to achieve

– Two supporting priorities – how we will achieve it

– 27 key actions to take now– The start of the conversation – a

three-year corporate plan will follow

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PHE’s National PrioritiesREDUCING PREVENTABLE DEATHS

Helping people to live longer by reducing preventable deaths fromconditions such as heart disease, stroke, cancer and liver disease

REDUCING THE BURDEN OF DISEASE Increasing healthy life expectancy by tackling conditions which place a

burden on many lives, such as anxiety, depression and back pain

PROTECTING THE COUNTRY’S HEALTHProtecting the population from infectious diseases and environmental hazards,including emerging risks and the growing problem of antimicrobial resistance

GIVING CHILDREN AND YOUNG PEOPLE THE BEST POSSIBLE STARTSupporting families to give children the best start in life, through working with

health visitors, Family Nurse Partnerships and the Troubled Families Programme

IMPROVING HEALTH IN THE WORKPLACEHelping employers to facilitate and encourage their staff to make healthy choices

PHE’s local presence

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– Four regions, fifteen centres– Eight Knowledge and Intelligence Hubs

– London– South West– South East– West Midlands– East Midlands– North West– Northern and Yorkshire– East

– Other local presence– ten microbiology laboratories– field epidemiology teams– Centre for Radiation, Chemicals and

Environmental Hazards units

A structure based on professional public health leadership

Chief Executive

Director of HealthProtection and

Medical Director

Director of Healthand Wellbeing

Chief KnowledgeOfficer

Director ofNursing

Director ofStrategy

Chief Operating

Officer

Director ofProgrammes

Finance andCommercial

Director

Director ofHuman

Resources

Regional and CentreDirectors and Microbiology Services

Advisory Board

Local focus

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– Led by a senior public health professional

– Ensure quality and consistency and responsiveness of centres’ services and advice

– Support transparency and accountability of the system

– Assurance of emergency planning and response

– Workforce development

– Contribute to the national public health agenda

– Led by a senior public health professional

– Deliver services and advice around the three domains of public health

– Support local government and local NHS action to improve and protect health and reduce inequalities with intelligence and evidence

– Deliver the local input to emergency preparedness, resilience and response

15 CENTRES 4 REGIONS

Reflections

• 2012 Reforms- biggest since 1948 and 1974• Opportunities and threats• Localism/ Local Gvt• test for national behaviours

– Role of national organisations in local delivery– Role of Govt in protecting the public’s health

• Requires completely different leadership style at every level

Behaviours (Duncan Selbie)–Our effectiveness depends on how we behave, so we will:

• consistently spend our time on what we say we care about

• work together, not undermine each other

• speak well of each other, in public and in private

• behave well, especially when things go wrong

• keep our promises, small and large

• speak with candour and courage

Personal

• Realistic positive thinking

• Resilience: ‘Ability to bounce back from adversity (Brooks)’

• Challenge, Control, Commitment (S Kobasa)

Personal ResilienceThe 3 Cs (S Kobasa)

• Challenge- change as a chance to grow, positives, confront and master not avoid

• Control- believe you can change your situation for the better, focus on what you can control

• Commitment- passionate in pursuit and remember the big picture. When you have purpose and vision you are have sight on why you are doing what you are doing- triggers energy and passion