the new public health system dr rashmi shukla cbe, director of public health public health england...
TRANSCRIPT
The New Public Health System
Dr Rashmi Shukla CBE, Director of Public Health Public Health England Transition Team
2
leadership role for local authorities and partners
working alongside the NHS, with its continuing role of promoting health through clinical services. And other agencies and sectors
stronger focus on health outcomes, supported by the Public Health Outcomes Framework
supported by a new integrated public health service, Public Health England
public health as a clear priority for Government, backed by ring fenced resources
The new public health system
new roles and responsibilities
clear priorities
Roles in the new public health system
Local Authorities
CCGs/NHS Commissioning
Board
Public Health England
• Duty to improve health• Brings together holistic approach to
health and wellbeing• Employ DPH and PH staff• Ring fenced PH budget• Mandated services
• Commissioning healthcare• Commissioning some public health
services• Duty to reduce inequalities
Supporting local authorities and others by:• Delivering services• Leading for public health• Developing the workforce
Population health advice to the NHS, including advice on health services
Health and Wellbeing Board
Coordinates local strategy through:• Joint Strategic Needs Assessment• Joint Health and Wellbeing Strategy• review of commissioning plans
A stronger focus on outcomes....
The Public Health Outcomes Framework
• sets the scope of public health
• focuses on outcomes not targets
• alignment & integration across public health, the NHS and social care
• takes a life-course approach
• designed to also address the causes of the causes of ill health
A pathway from causes of illness to caring for people
Causes of illness to caring for people ….
19th century urban improvement – sewers / housing
LifestylesWellbeing
Germ theory and modern medicine
NHS Commissioning•New public health responsibilities
Opportunities for prevention •Build prevention of poor health into day-to-day business
Make every contact count•Use every contact to improve wellbeing, mental and physical health
NHS workforce•1.4 million staff as advocates for changes for better health and wellbeing
The role of the NHS ….
April 2013
• DH – to set public health policy (and PHOF)• PHE* – to support delivery (through LG and the
NHS, and other partners) and links to NHS CB– PHE functions: Health Protection: Health
Improvement; Information, Intelligence and Evidence
• Local Health and Wellbeing Boards (links to CCGs) – JSNAs and Health & Wellbeing Strategies
• Local Government – local public health delivery
*Structure of PHE published on 26 July 2012
What is PHE?
Public Health England has been established to protect and improve the nation’s health and wellbeing, and to reduce health inequalities.
PHE will provide national leadership for the delivery of improved public health. Working with key delivery partners including local government, and the NHS, to secure improved health outcomes
PHE will:• provide the evidence, intelligence and professional leadership
• work through partners and directly with the public to promote healthier lifestyles
• act as an advocate for the public’s health and transparent reporting through publication of the PH Outcomes Framework
• provide a nationwide service to protect the public from threats to health
• deliver a programme of world class research in support of protecting and improving health
Objectives for Public Health England and Models for Change
To improve and protect health and wellbeing, and reduce inequalities
Improvement
across the PHOF• wider determinants
•health improvement
•health protection
•health care
Mission Outcomes Levers/Delivery Models
Health Protection• end to end delivery chains• clear command structure to SoS• expertise in large scale response
Health Improvement• supporting LA, intelligence, evidence into practice• advocacy and publication of outcomes• professional relationship• limited national interventions
Health Care• specific PH specialist contributions• section 7A management• supporting NHS, intelligence, evidence into practice• advocacy and publication of outcomes
Key task
•Ensure credible and consistent local delivery
•Retain international reputation
•Build new 21st century capability in support of LA in holistic response to health and wellbeing
•Establish explicit PH support to NHS from current implicit practice
Public Health England’s remit spans full range of public’s health. The delivery chains differ and will require different relationships, levers and ways of working. The maturity and history of the different delivery chains mean PHE will face very different tasks in establishing itself as a credible full spectrum PH body.
Taking Shape: Senior Leadership
Taking Shape: National Presence
PHE delivery structures: 4 Regions, 15 Centres
North East
Midlands and East of
England
South of England
London
Eight Network Team areas
• Knowledge and intelligence teams (drawing on capacity from the public health observatories and the cancer registries) providing analytical and knowledge management support and advice to PHE and partners
• Cancer registration and NDTMS teams collecting and quality assuring data from service providers
• Quality Assurance teams for cancer and non-cancer screening (based on QARCs, and a new function for PHE) assuring safe and effective screening for a range of diseases
• Network teams: all the above, plus colleagues in Regions and Centres as appropriate, within a particular geographical area cooperating and collaborating on corporate aspects (e.g. estates, IT), resources (e.g. shared administrative support) and/or specific projects (e.g. children and maternity; liver disease etc.)
Northern and Yorkshire
North West
West Midlands
East Midlands
South West
South East
London
East of England
LOCAL – Health and Wellbeing Boards• Joint Strategic Needs Assessment (includes
assets)• Joint Health and Wellbeing Strategies• Key Local Priorities – and links to Outcome
Frameworks• Links to Clinical Commissioning Groups• Local Public Health Departments – links to LA
functions and Primary Care and Communities
_ _ _ Support for PCTs and Local Authorities during the transitional phase _ _ _
From transition to transformation ….
Public Health England Transition Team
Communication and data sharing infrastructures
Web resources Assuring local transition plans
Finalising policy