Public HealthYorkshire & the Humber

Alison PateyPHE North Region

Origins of Public Health EnglandHealthy Lives, Healthy People white paper– Published November 2010 to set out a new approach to public health– Responsibility for local health improvement returned to local authorities from

1 April 2013– Public Health England is the expert national public health agency which

fulfills 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.

Health and Social Care Act 2012– Set the legislative framework for the changes to the health and care system

that led to the creation of Public Health England as an operationally autonomous executive agency of the Department of Health

– Received Royal Assent 27 March 2012

Our Mission

“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.”

GovernmentDH responsible to parliamentCross-government senior officials

group to improve health outcomes

CMO to provide independent advice to government

Public Health EnglandNew, integrated national expert bodyStrengthened health protection

systemsSupporting whole system with

expertise, evidence and intelligence

NHS EnglandDelivering health care, tackling

inequalitiesMaking every contact count Specific public health interventions,

such as cancer screening

Local authoritiesNew public health functions, helping to

tackle wider determinants of healthLead on improving health and

coordinate protecting healthPromote population health and

wellbeing (DPHs)

The new public health system with an integrated approach

System Leadership: Work transparently, provide government, local government, the NHS, MPs, industry, public health professionals and the public with evidence-based professional, scientific and delivery expertise and advice

Protection: Ensure there are effective national and local arrangements for preparing, planning and responding to health protection concerns and emergencies, including the future impact of climate change

Local Support: Support local authorities and clinical commissioning groups by providing evidence and knowledge on local health needs, alongside practical and professional advice on what to do to improve health

Public Health England delivery model

Our priorities for 2013/14

– 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

Support people to live healthier lives via NHS Health Checks Promote tobacco control and reduce smoking

Promote healthy weight and tackle childhood obesityImprove recovery rates from drug dependencyImprove sexual health and reduce the burden of STIs

Develop a national programme on mental healthLead gold standards for vaccination and screening programmesMake the case for promoting wellbeing, prevention and early intervention as the best approach to improving health

Partner NHS England to maximise improvements in public health

What are our priorities?1

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Our progress to date: Health Marketing

Be clear on cancerNational bowel campaign: 40% rise in two-week referralsRegional lung campaign:14% rise in diagnoses

Smokefree Homes & Cars37% who saw ads reduced their second-hand smoke85,000 smokefree kits distributed

Smart Restart150,000 families (300,000 children) signed upApp downloaded more than 100,000 times

Stoptober700,000 engaged in 2013200,000 registered for support products

Our progress to date: Media

Change4life540 pieces of coverage with a PR value of £1,760,681

Older people310 pieces of coverage with a PR value of £662,784

SmokefreeOver 600 pieces of coverage to date, with a PR value of £1,300,000

Four regions, 15 centresEight Knowledge and Intelligence Teams

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

Other local presence– ten microbiology laboratories– field epidemiology teams

Additional support– Local teams can also draw on national

scientific expertise based at Colindale, Porton Down and Chilton

Local presence

Public health advice

People and communities

Health and wellbeing boards

Local government CCGs & their support

PHEcentre

NHSCB area team

NHS & IS Providers

3rd sector providers

Commissioner of public health services

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

PHE provides expert advice to local government

DsPH have influence across all local government spend

PHE provides local expertise via centres

Embedding ‘making every contact count’

Leverage from the public health ring fence

Influence on wider spendingin commercial and voluntary

sectors

Clinical Commissioning

Groupsand

NHS England

Spending trends:

2003-2012 PCT spending for all health programmes increased by 70% overall

Mental health disorders c.£6bn to c.£12bn

Circulation problems c.£5bn to c.£7bn

Cancer c.£3bn to c.£5.5bn

Dental problems c.£1bn to c.£3.5bn

Wicked problems: Health inequalities

Life expectancy and health life expectancy, and premature mortality rates vary across the country – higher rates strongly linked to socioeconomic deprivation

4.03 - Mortality rate from causes considered preventable (provisional)Age-standardised mortality rate from causes considered preventable per 100,000 population

England 146.1

Yorkshire and The Humber 159.4

Kingston upon Hull, City of 221.0

Doncaster 175.0

North East Lincolnshire 171.9

Leeds 170.1

Bradford 169.5

Calderdale 169.2

Barnsley 167.4

Wakefield 166.7

North Lincolnshire 160.1

Rotherham 159.8

Kirklees 155.6

Sheffield 155.3

York 139.7

East Riding of Yorkshire 133.1

North Yorkshire CC 130.6

Source: Public Health Outcomes Framework (based on ONS source data)

Note this is not the same as the overall premature deaths found in Longer Lives

0 50 100 150 200 250

Preventable Mortality in YH

Health Equity NorthNew effort to confront north-south divide 3 October, 2013 | By Kaye Wiggins

England’s public health body is preparing to “make noise” about the north-south divide in health outcomes.

The Public Health England initiative could extend to taking ministers to task over their approaches to welfare and employment policies, as they are often strongly linked to health.

The new approach is expected to include academic research and the creation of a “commission on health equity” and a range of expert groups formed from key public health figures in the North of England.

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A compelling narrative for health and wellbeing, the current state of health, and the underlying drivers

Credible interventions to improve health and wellbeing at all levels

Model credible future scenarios, and their impact

Shift the debate onto health and wellbeingGalvanise action based on evidenceRecognise the inequalities that affect the most disadvantaged

Propose a Health and Wellbeing Framework for England

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Leverage opportunities for cross-government health agenda

Housing

Work

Crime and violence

Early intervention

• Good housing drives health• 20,000 excess deaths each

winter

• Work a key health determinant• Poor health keeps people out

of work

• Foundations for every aspect of development laid in childhood

• Alcohol a factor in 44% of violent crime

Physical activity

Healthy Food

Smoking

Healthy communit

y

• Reduces risk of illness by up to 50%

• 2/3 of adults obese or overweight

• 1/3 children in Y6 obese or overweight

• Cost of obesity to NHS £5bn a year

• Isolation significant driver of poor health

• Poor environments lead to social isolation

• Leading cause of premature mortality

• Estimate cost to economy £13bn

Contacts

Y&H Centre DirectorStephen.morton@phe.gov.uk

Alison.patey@phe.gov.uk