Public Health

Caryn CoxDirector of Public Health, Cheshire West & Chester Council

Champs - who we are

• Cheshire & Merseyside public health collaborative service launched April 2013

• Led by nine Cheshire & Merseyside local authority Directors of Public Health

• Key areas of work delivered by local public health teams and facilitated by small support team hosted by Wirral Council

• Builds on success of previous award-winning public health network which collaborated for 10 years within the NHS

What we do

• Improve the quality of services

• Offer value for money

• Achieve better health outcomes

• Reduce health inequalities

We do this by sharing goals, resources and expertise

Our key areas of work

Supporting a safe and resilient health protection system that protects local people’s health through expert leadership and co-ordination

Enabling a unified, dynamic and effective public health system through expert public health leadership and input into strategic partnerships

Improving quality, efficiency and cost-effectiveness by reviewing locally commissioned public health services

Ensuring fair and better quality health care services for local populations by providing expert advice and intelligence to Clinical Commissioning Groups and other NHS organisations

Part of the local authority from April 2013 – part of wider NHS changes

Overall responsibility for the health and wellbeing of populations and communities

Identifying health risks – preparing a Joint Strategic Needs Assessment (JSNA)

Developing plans and commissioning programmes to improve the health of the population as a whole, based on evidence of what works

Who and what is public health?

Three domains of public health

Key essential areas

Longer healthier lives

Start healthy and stay healthy

Narrow the gap between the most and least healthy

Protect communities from harm

Use evidence base

Embed public health everywhere (make every contact count)

Use ‘Lifecourse Approach’ (Marmot)

What do Public Health Commission?• Drug and alcohol services• Children’s public health >5 yrs (school nursing)• Sexual health services• NHS Health Checks• National Child Measurement Programme• Dental public health, oral health promotion• Initiatives to reduce excess deaths• Physical activity• Accidental injury prevention, falls prevention• Mental health promotion• Stop smoking services• Behaviour campaigns• Community infection control

Health and Wellbeing Boards

Boards established in each local authority area (top tier)

Pharmacy Needs Assessment

Health and Wellbeing Strategy

Joint Strategic Needs Assessment (JSNA)Be strategicLook beyond needs (assets based approaches)Understand inequalitiesJointly prioritiseExamine all factors of ill-healthProvide impartial evidence

Public Health Outcomes Framework

Picture of Health? Good or bad?

Picture of Health? Obesity

Picture of Health? Alcohol

Picture of Health?

Picture of Health?

Picture of Health? We know the answers

Housing and healthSource: Barton and Grant (2006)

How important?

40% - Socioeconomic factorseducation, employment, income, family/social support, community safety

30% - Health behavioursalcohol, tobacco, sexual health, diet/exercise

20% - Clinical carequality and access to healthcare

10% - Built environmentbuilt environment, environmental quality

Factors vary through life

What makes a difference to health?

EMPLOYMENT

(MEANINGFUL ACTIVITY)

DECENT HOUSING

STOP SMOKING

Key drivers – a few examples

• Fiscal challenge

• Welfare reform

• Increasing community capacity/resilience

• Integration Transformation Fund (ITF)

• Pioneer Status – Pan Cheshire

• Care Bill - April 2015

• Ageing demographic

Housing & health – what is happening already?

• Warrington

• Developing a housing and health strategy

• Using RSLs to identify vulnerable individuals

• Mapping health improvement activities of RSLs

• Mapping homes where more energy improvement needed

• Cheshire

• Snow Angels

• Altogether Better programme eg early support, working well

Housing and health – opportunities?

• Employment/meaningful activity

• Energy efficient homes/affordable warmth – tackling fuel poverty

• Personal resilience

• Early identification of vulnerable individuals to provide early support

• Good mental health and wellbeing – all ages

• Building social cohesion/communities

• Housing data into the Joint Strategic Needs Assessment (JSNA)

• Health and Wellbeing Strategy - contributing

• Annual public health report

• Capturing voice of communities

• Making Every Contact Count

Contacts

caryn.cox@cheshirewestandchester.gov.uk

@DPHcheshirewest

Champs

@CMPHN

Thank you – any questions?