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People & Communities (Public Health)
Service Action Plan
2013/14
This plan is an active document that will be reported against every six months via the Service Delivery Programme performance report. All staff that are part of the Service should have an opportunity to contribute to its creation and any new staff joining the Service should be made aware of this document as part of their induction.
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Introduction
Divisional Director Dr Bruce Laurence
Lead Portfolio Holder Councillor Simon Allen
Staffing Establishment (FTE) (2013/14 @ March 2013)
11.66WTE
Scope of Service (size, proportions and activities) – linked to current MTSRP proposals
Responsibility for Public Health transferred to the local authority on April 1st 2013 in accordance with the Health and Social Care Act 2012. The Public Health Commissioning team have now transferred to the Local Authority and therefore this is a new service plan area. This service plan covers the three main functions of public health which are: 1. Health improvement 2. Health protection 3. Providing public health information and advice to service commissioners This includes services commissioned directly by the public health division and also considers the broader opportunities created across the whole council for health improvement when the local authority takes on this new responsibility in April 2013. Within these broad functions, the key responsibilities are:
Health Improvement NHS Health Checks programme
National Child Measurement Programme (height and weight)
Reducing smoking prevalence (tobacco control work and commissioning NHS Stop smoking services)
Reducing alcohol and drug misuse ( including test purchasing and licencing )
Reducing Injury prevention ( including trading standards and domestic violence)
Improve healthy weight
Increasing physical activity (including links to wider determinants of transport, spatial planning and green spaces )
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Improving children‟s public health (5-19 years)across the range of health improvement issues, including HPV vaccination
Improving dental public health
Developing locally led nutrition initiatives including breastfeeding
Improving workplace health
Suicide prevention, self-harm and mental wellbeing.
Health protection and emergency preparedness
Statutory duty to ensure plans are in place, and training and exercises carried out, to protect the health of the population in B&NES
Deputy co-chair for the Avon and Somerset Health Resilience Partnership (with the NHS Commissioning Board)
Coordinate local response to outbreaks of infectious disease or environmental hazards, and liaise with Public Health England
Overview and scrutiny function of immunisations and screening programmes, and infection prevention and control
Support new receiver organisations in their screening and immunisation commissioning responsibilities as part of transition
Statutory duty to commission a range of sexual health services (including testing and treatment for sexually transmitted infections, contraception outside of GP contract and sexual health promotion and disease prevention). Includes chlamydia screening and teenage pregnancy.
Support and review local work to tackle environmental risks, including adaptation to climate change, air pollution and noise pollution.
Public health information and advice to commissioners Statutory duty to provide specialist public health advice to the CCG (strategic needs assessment, health impact assessment,
service review, evidence of effectiveness, prioritisation, planning, evaluation and public and patient views).
Provide specialist public health advice to wider commissioning team across the council (same tasks as above).
Lead production of Joint Strategic Needs Assessment (JSNA)
Co-develop Joint Health and Wellbeing Strategy, and Action Plan
Public health input to broad Strategic Partnerships, including: o Health and Wellbeing Board o Clinical Commissioning Committee o Children‟s Trust Board o Responsible Authorities Group o Environmental Sustainability Partnership Board o West of England Child Death Overview Panel o Children and Adults Safeguarding Board
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o Complex Families Panel
Develop collaborative commission arrangements with: o other council divisions and directorates o Clinical Commissioning Group, NHS Commissioning Board, Public Health England
Ensure commissioning across the council address inequalities and narrows the gap for groups with the worst health and social outcomes
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Current Management Structure of Service
Currently host 2 Public Health Specialty Registrars – Kate Burton (1.0) & Amy McCullough (0.6)
Dr Bruce Laurence (1.0)
Paul Scott (Interim Acting)
Director of Public Health
Paul Scott (1.0)
Jean Gladwin - Interim (0.8)
Consultant in Public Health
Lauren Tew (0.4)
Louise French (1.0)
Infection Prevention Control Nurse
Sophie Knight (0.4)
Resilience Manager
Daniel Messom (1.0)
Commissioning & Development Manager
Helen Tapson (1.0)
Public Health Intelligence Manager
Denice Burton (0.8)
Assistant Director - Health Improvement
Cathy McMahon (1.0)
Jo Lewitt (0.6)
Sarah Heathcote (0.6)
Commissioning & Development
Manager
Shelley Oake (0.8)
Personal Assistant
Angela White (0.6)
Directorate Secretary
Angela White - Interim (0.2)
Vacant - 0.6 Contract Monitoring
Support
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Commissioning Manager Functions
Name of Manager Name of Manager Name of Manager
Name of Manager
Name of Manager
Name of Manager
Name of Manager
Name of Manager
Name of Manager
Bruce Laurence
( Paul Scott interim )
Paul Scott (Jean Gladwin interim)
Denice Burton Helen Tapson Cathy McMahon
Sarah Heathcote
Jo Lewitt Daniel Messom
Sophie Knight
Responsible for leading and
delivering statutory public
health services to the local
population
Specialist advice to commissioners. (The „Core Offer‟)
Health Improvement lead
JSNA / intelligence
Alcohol Children and young people 5 -19
Breast-feeding
Sexual Health
Preparing for the public health effects of emergenc-ies
Strategic lead for public
health, and principle adviser
to the council on health
issues and tackling health
inequalities.
Intelligence and performance lead Affordable Warmth Lead
Commissioning and finance lead
Tobacco control
Dental public health
Childhood healthy weight
Health checks
Maximising opportunities to
promote public health within
the services of the council
and across other
organisations.
Suicide prevention, self-harm and mental wellbeing
Physical activity / food policy / adult healthy weight / workplace health
Injury prevention
NCMP Screening assurance
Statutory member of the
Health and Wellbeing Board
and other key strategic
partnerships.
Leading response to health protection incidents, with Public Health England. Emergency Planning and Resilience: Health
Vulnerable groups
Assurance and Scrutiny of
screening and immunisation
programmes, and infection
and control
Temporary support to CCG & NHS England Area Team on a number of public health areas. These organisations will take back once up to capacity (Oct 2013).
Workforce development Social marketing
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There is a vacant post in the process of recruitment, which will fulfill a number of key commissionign responsiblities that are currently being managed by the team but this is not an effective or sustainable way to continue.
There are a number of staff who are situated within other council directorates or the CCG, who lead on the commissioning functions for specific public health programme areas such as substance misuse, infection control, school nursing, child health, etc. A number of these posts are funded by the public health allocation. The commissioning of services for children aged 0-5 years has transferred to NHS England but will return to the responsibility of the Local Authority in 2015. In the interim period, there is a process of transition to NHS England, with a view to the Local Authority retaining an important role in influencing this work until it returns.
Customer Profile
Outline who your main customers are, e.g., service users, residents, other council services, officers, members, partners etc.
Service users, residents, other council officers and members, Clinical Commissioning Group (CCG) colleagues
Are there any specific customer needs that require your service to change?
Residents‟ needs The Public Health service is reorienting it‟s work to ensure it is meeting the priority issues for local residents, that have been set out in the Joint Strategic needs Assessment (JSNA) and the Health and Wellbeing Strategy. Partner‟s needs The public health service has a duty to provide public health information, evidence and advice to a range of partners. These include advice about strategic, commissioning and health protection decisions. For example, the development of the CCG has led to a statutory duty for the local authority to provide public health advice to the CCG. Similarly, the Director of Public Health is now the lead on behalf of the local authority in fulfilling the statutory duty to ensure plans are in place to protection the health of the local population. The People and Communities directorate are undergoing a change whereby there is a single integrated commissioning support function and this is leading us to change the way we function and allocate some of our commissioning resource.
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Two new national organisations, Public Health England and NHS England, have started from 1 April 2013. This is leading the local authority to have an assurance role for some key programmes such as screening and immunisation, requiring a slight shift in the current roles of the public health team. However, these new organisations are not yet at full capacity and so we are continuing to undertake interim support for these functions as part of a transition handover until October 2013, to ensure the safety of these programmes for local residents.
Service Delivery
Planned Changes to service delivery in 2013/14 (Service Impact Statements (SIS) to be attached in Appendix 2)
Public Health commissioning has transferred into the Local Authority from NHS B&NES from April 1st 2013. The following changes to implementation of the commissioning function are planned:
A number of services which were commissioned services will now become internal service level agreements.
Some services due to transfer to new organisations such as NHS England need to fully transfer
All contracts with providers external to the Council will need to transfer onto council terms and conditions during 2013/14
New arrangements for the delivery of emergency preparedness. Current arrangement for a shared service with RUH will cease and we will instead focus on building a collaborative arrangement for this work area within the council and the existing council emergency preparedness team.
A review of the clinical infection control function, to develop the health protection aspects of this work.
An internal service level agreement for commissioning support from a centralised team in People and Communities will be established
A shared work programme across West of England to be established where economies of scale can be identified.
Areas of the Service that are to be stopped or reduced in 2013/14 (due to budget pressures / change in focus etc.)
Some service areas such as screening, immunisations, 0-5 public health have transferred to NHS England therefore the LA now have an assurance role rather than a commissioning role.
There are no changes in service due to Public Health budget pressures; however budget cuts across wider council services impact on achievement of public health outcomes. These include changes across all three council directorates (including public protection, children‟s services, youth service provision, social aspects of housing services, etc.)
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External influences / pressures / legislative changes that could impact on service delivery during 2013/14 (excluding budget pressures)
Development of One Council approach across the council.
Restructuring and potential commissioner / provider separation in council.
Development of integrated commissioning
Impact of other partner‟s commissioning intentions on services in block contracts
Impacts of welfare changes on mental and physical health of vulnerable groups in our population
Capacity issues within the public health team, as a risk to delivering our statutory duties.
Changes within emerging organisations and how responsibilities are shared or led between each of us.
Potential introduction of tariff based system for sexual health services (based on payment for each appointment with a risk of performance beyond what was expected at the start of the year and subsequent cost pressures).
Introduction of new NICE or other health guidance (including new immunisations or other public health programmes)
Introduction of new health legislation (tobacco control, alcohol minimum pricing).
Service Budgets and Costs
Explanation of Service costs (including areas of high spend and growth / investment)
The Public Health grant for 2013/14 is £7,183,000. This is a ring-fenced grant, allocated directly to the local authority from Public Health England.
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Value for Money improvements - planned efficiencies / savings to be made during 2013/14
We are contributing to the shared commissioning function across the new People and Communities Directorate, which will provide greater efficiency across all the service areas. The public health allocation is fully committed for 13/14 and will remain within the ring-fenced budget.
£- £100,000 £200,000 £300,000 £400,000 £500,000 £600,000 £700,000 £800,000 £900,000
£1,000,000 £1,100,000 £1,200,000 £1,300,000 £1,400,000 £1,500,000 £1,600,000 £1,700,000 £1,800,000 £1,900,000 £2,000,000 £2,100,000 £2,200,000 £2,300,000 £2,400,000 £2,500,000
Annual Budget £7,183,000
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Summary from Medium Term Service & Resource Plan (add hyperlink to relevant web page for more detailed information)
MTS&RP Items Finance Staff to complete
2012/13 (for comparison) £’000
2013/14 £’000
2014/15 £’000
2015/16 £’000
Opening Budget N/A new budget for
LA 7183 7384 Not known
Removal of one-offs N/A
Service Proposed Base Reductions to Balance Budgets
N/A
Service Proposed Growth N/A
Proposed Base Budget 7183 7384
Target Budget 7183 7384
Deficit / (Surplus) N/A
Additional Stretch Reductions N/A
In Year Adjustments N/A
Proposed Overall Budget 7183 7384 Not known
Workforce Planning & Development
It is important that we develop a workforce of the right size and with the necessary skills and capabilities to deliver the service our citizens require both now and as the Council„s future role in the community develops. People are a key driver for transformation and improvement. Please set out below workforce planning and development actions already underway or planned to address your service needs. If your service has developed a specific workforce development plan, please attach in Appendix 4 of this Service Plan.
Questions Comments
Organisational Design & Development: Implementation of “future organisational model”
Review of portfolios within the staff structure
Develop working arrangement with commissioning support function.
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… designing & implementing new workforce structures and ways of working in support of new operating models
Reviewing the health protection role of the infection prevention and control functions
Clarifying arrangements between the public health and the overall council emergency preparedness functions.
Leadership and Management Development
…developing visionary and ambitious leadership, which make best
use of the political and managerial role, in a partnership context
Support the management team to undertake leadership opportunities as appropriate.
Host and supervise public health registrars who are training to become consultants, and eventually directors, of public health.
Skills …identifying & developing skills and knowledge requirements in an innovative, high performance, multi-agency context
Support staff towards defined registration status with the UK Public Health (UKPHR) Register and enable them to work towards the relevant competencies.
Support our administrative staff to develop additional technical skills in line with their role.
Ensure all staff have undertaken annual appraisals the development of a professional development plan.
Recruitment and Retention …work to address potential skill shortages, promoting careers,
developing talent and addressing diversity issues
See above about supporting competency development to promote careers and develop talent.
Plans to recruit to vacant public health manager post as well as additional public health specialist capacity to deliver key local priorities and statutory functions, in particular the core offer of public health advice to the CCG
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Equalities
We are committed to the Council's core value of ensuring there is equality of opportunity through employment and service delivery. We are committed to promoting equality and eliminating discrimination on the grounds of age, disability, faith/religion or belief, gender including transgender, marital / civil partnership status, race, colour, ethnic or national origin and sexual orientation. Equality Impact Assessments (EIA) are carried out on all service changes and actions to mitigate impacts.
Under the general equality duty (Equality Act 2010), B&NES Council must have „due regard to the need to eliminate unlawful discrimination, harassment and victimisation as well as advance equality of opportunity and foster good relations between people who share a protected characteristic and those who do not.‟
The law requires us to demonstrate this in our decision making processes and, as officers, we must assist decision-makers to make sure that:
the process followed to assess the impact on equality of financial proposals is robust; and the impact financial proposals could have on protected groups is thoroughly considered before any decisions are arrived at
Assessing the potential impact on equality of proposed changes to policies, procedures and practices – communicated through all the service planning processes - is a key way of demonstrating that we have had due regard to the aims of the equality duty, in other words – listing what we have done to promote equality – and what we have done to mitigate any negative impacts our decisions may have. The EHRC guidance can be found here: www.equalityhumanrights.com/advice-and-guidance/public-sector-equality-duty/using-the-equality-duty-to-make-fair-financial-decisions/ Contact Samantha Jones for further guidance and assistance on 6364 or 8643. Please add your EIA in Appendix 3.
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Key Service Priorities 2013/14
It is important to show how each service priority links to the new Corporate Plan, in particular the three strategic objectives and high level outcomes set out in the table below. At the end of each priority, services must indicate whether it will contribute to an objective and add the reference letter for each outcome it will help to deliver.
Objectives Outcomes Ref
1. Promoting independence and positive lives for everyone
The people most in need are supported to live full active lives A
Older people are supported to live independently B
Children and young people enjoy their childhood and are prepared for adult life C
Schools develop and extend their role in the local community D
There are activities and opportunities to help young people to make a positive difference to their lives and communities
E
People have developed their skills and used them to improve their community F
Everyone has the opportunity to participate in sports, leisure and cultural activities G
Everyone has the opportunity to enjoy a healthy lifestyle H
2. Creating neighbourhoods where people are proud to live
Where people feel safe A
There are decent affordable homes in private and social sector B
Clean streets and open spaces C
Where local people actively lead the delivery of improvements in their community D
Where decisions are made as locally as possible E
Where there is easy access to public services and local amenities F
Reduced inequality between communities across Bath & North East Somerset G
Communities that have adapted to changes in our climate and are not dependent on high carbon energy
H
Recycling and reduction in waste continues to be extended with residents increasing their responsibility to minimising waste
I
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3. Building a stronger economy
With a broad range of job and employment opportunities that recognises the different need of rural, town and local communities
A
Where people are able to travel easily with reduced traffic congestion and pollution B
With a strong local business sector, tourism, and local shopping C
The quality of the environment is maintained or enhanced D
Key development sites are delivered to increase the number of local businesses E
A diverse economy with growth in the low carbon, knowledge creative, and ICT industries F
4. Listening Council (values)
A Council which operates efficiently:
An open and engaging Council that empowers Communities
An enabling Council making things happen
A Council that is positive about working with others
In partnership with a range of public, private and voluntary organisations
A Council that makes decisions at the right time and level
A Council that makes services easy to reach
An organisation that encourages continuous learning and improvement
A
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Priority 1: to meet our mandatory service obligations
Details of Service Priority The local authority is required to provide the following services under the requirements of the Health and Social care act.
Impact on local community
The actions will ensure that there is continued access to sexual health services which are free at the point of contact. More members of the population will be able to access a free health check and follow up support Parents of children will have access to information about their child‟s weight and supportive interventions The public will be assured that systems are in pace to deal with emergencies and protect them from risk All commissioning decisions will be based on accurate intelligence
Groups of service users affected
Adults aged 40- 74 accessing a health check Families with young children receiving the NCMP Adults and young people seeking sexual health advice and support All members of the public in receipt of commissioned services Other commissioners
Key Activities (add more lines as appropriate) Timescales Performance Measures
Provide appropriate access to sexual health services:
Re commission CASH and enhanced sexual health services (out of schools) services and possibly GUM
Increase number of SAFE branded services
Establish new contractual arrangements for national Chlamydia screening programme and ensure programme is embedded in core services
Introduce new contract for primary care providers for the provision of enhanced sexual health services
April 2014
New CaSH contract in place by April 2014 New contract in place with community pharmacy and general practice by April 2014
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Deliver NHS Health Check assessment
Implement planned programme to increase numbers receiving health check
Pilot introduction of alcohol screening and provide training for providers.
Introduction of dementia awareness raising and signposting to memory clinics
March 2014
Increase uptake across B&NES to 55% on average, with greater increase in areas with low uptake Introduction of new elements of the programme by March 2014
Ensure implementation of the National Child Measurement Programme
Performance monitoring process the NCM Programme, including proactive follow
up of children
Ensure intelligence from the NCMP is shared appropriately
March 2014 Quarterly on-going March 2014
Achieved target coverage rate Performance monitoring process adhered to, Briefing paper on outcome of programme circulated
Coordinate local response to outbreaks of disease or environmental hazards
Lead response to outbreaks of disease or incidences re chemical, biological or radiological threats in conjunction with partners
Ensure that health/social care services commissioned by the local authority have included contribution to incident response in the specifications
March 2014
Coordinated response delivered Service specifications include contribution to incidence response
Ensure effective health resilience planning to protect the health of the population of B&NES
Contribute to health resilience planning and testing of health plans in B&NES council
Ensure that health/social services commissioned by the local authority have business continuity plans
March 2014
Updated plans and agreements in place Tested the plans by training and exercises
Ensure NHS commissioners receive the public health advice they need
Develop and deliver a 2013/14 Action plan for the core offer
April 2014
2013/14 Annual plan developed, agreed Public health advice delivered
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Ensure JSNA – (Joint Strategic Needs Assessment) is fit for purpose
Contribute to the annual work programme updating the JSNA
Commission new research and health needs assessment
Develop plans to ensure that the community voice is considered where possible
Contribute to making the JSNA more accessible
July 2013 March 2014 March 2014 March 2014
JSNA available in WIKI format Usage monitored Number of briefings delivered to users Completing the annual work programme
Contribution to Strategic Objectives – please indicate which of the Corporate Plan objectives and outcomes this priority will contribute to:
Strategic Objective Contributes – Y/N? Relevant Outcomes
1. Promoting independence and positive lives for everyone Y A,B,C,D,G,E,H
2. Creating neighbourhoods where people are proud to live Y F,G
3. Building a stronger economy N
4. Listening Council (values) Y A
Priority 2: to implement the priorities of the JSNA, Health and Wellbeing Strategies and Director of Public Health Report
Details of Service Priority
The Health and Wellbeing strategy has identified Alcohol, Mental wellbeing and Childhood Weight as three areas for particular action in 13/14. The DPH report and JSNA further identifies Physical activity and tobacco control as areas where significant public health gain can be made.
Impact on local community Services will be commissioned within a clear framework and strategy Services will be in place to support lifestyle behaviour change
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Access to and quality of services will improve
Groups of service users affected All adults and children Adults and Children accessing commissioned services
Key Activities Timescales Performance Measures
Implement Health and Wellbeing Strategy
Lead the public health aspects of the Health and Wellbeing Strategy Delivery Plan
March 2014 Delivery plan of H&W Strategy includes public health actions
Contribute to improvements in mental wellbeing and suicide prevention:
On-going monitoring and completion of tasks in the suicide prevention action plan, including: A) completion of suicide audit to cover time period 2009-11; B) support the setting up of deliberate self-harm register at RUH
Scope the feasibility of developing a mental well-being college service
July 2013 July 2013 Sept 2013
Suicide audit to cover time period 2009-11 reported. Register established and proving monthly and annual deliberate self-harm report from register. Report/business case developed
Improve healthy weight in childhood Continue to commission and monitor related healthy weight services, and review and re- or de-commission where necessary : Launch and disseminate the healthy weight pathways Re-establish the healthy weight strategy group and agree Healthy Weight Action plan for 13/14 Ensure healthy weight is embedded into other relevant strategic groups
Quarterly throughout 13/14 to end 14/15 By September 2013 Sept
All contracts for commissioned services updated and signed off. Outcomes delivered as per each contract Some relevant contracts recommissioned Healthy Weight pathway completed (links/pdfs on website) Group re-established / other strategic groups prioritising excess weight
Promote sensible drinking and reduce alcohol misuse
Refresh Alcohol Harm Reduction Strategy and Action Plan 13/14
September 2013
Updated Strategy; Action Plan agreed
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Introduce Alcohol Risk Assessment into the NHS Health Check
Pilot approach to systematic screening for alcohol misuse within Primary Care
Establish/embed the role/representation of Public Health/Health bodies in Licensing policy/process
September 2013 March 2014 February 2014
All GP practices offering alcohol risk assessment as part of the NHS Health Check by 2014 Evaluation Report of pilot and proposal for implementation 14/15 Guidelines to support decision making for licencing bodies
Increase physical activity Complete and disseminate results of Passport to Health research Continue to commission and monitor related physical activity services, and review and re- or de-commission where necessary : Review need for re-establishment of Get Active Partnership and the Get Active Strategy
Contribute to development and implementation of Leisure Strategy Promote cycling via Cycling Working Group – and small grants Contribute to Sustainable Transport Work stream
March 14 Quarterly Sept 13 March 14 March 14 March 14
Report produced Outcomes delivered as per each contract Monitoring completed as per monitoring schedule Partnership re-established if required Service specification for Leisure providers includes key public health requirements Small grants awarded and delivered Contributions made
Reduce smoking prevalence: Undertake Peer Assessment of Tobacco Control work Finalise Tobacco Control Strategy and Develop and implement an Action Plan 2013 – 2015
Peer assessment completed and recommendations included into Tobacco Control strategy Tobacco Control Strategy developed and Action Plan agreed
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Continue to commission and monitor related tobacco control services, and review and re- or de-commission where necessary :
Outcomes delivered as per each contract. Monitoring completed as per monitoring schedule
Improve health of children 0 to 19 years Refresh local action plan to improve dental health Transfer breast feeding service commissioning responsibilities to receiver organisations Finalise commissioning arrangements for Food in Education Settings service Develop the DPH Awards policies on budget allocation, evidence base and website Quality assure the DPH Award process Continue to extend the DPH Award to early years and FE settings
March 2014 Dec 2013 2013 Sept 2013 Regular meetings throughout year Dec 2013
Local plan agreed Safe transition completed Commissioning arrangements finalised Policies developed Meetings of Quality Assurance group
Plans and processes fully completed
Improve Workplace Health Expand the engagement with the workplace charter via commissioned services
March 2014 Commissioned service delivering outcomes as per contract
Develop locally led nutrition initiatives Recruit Food policy worker Establish food policy steering group and develop food policy and action plan
March 2014 Food policy developed Steering group in place
Reduce injury Continue to commission, transfer to council contracts, and monitor services :
March 2013 Services delivered to target
Reduce drug misuse Actions relating to drug treatment services are in the Adult Service Plan – not in Public Health service plan
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Contribution to Strategic Objectives – please indicate which of the Corporate Plan objectives and outcomes this priority will contribute to:
Strategic Objective Contributes – Y/N? Relevant Outcomes
1. Promoting independence and positive lives for everyone Y A C D E G H
2. Creating neighbourhoods where people are proud to live Y A F G
3. Building a stronger economy N
4. Listening Council (values) Y A
Priority 3: to ensure that the new Public health system in B&NES is fit for purpose
Details of Service Priority
Following the restructure of the NHS a number of new organisations have been established which have a role to play in Public Health and responsibility for Public Health outcomes has transferred into the Council. This now requires a range of actions to ensure the roles and responsibilities and relationships are strengthened to maximise the opportunities for Public Health
Impact on local community The public can be assured that the restructuring has not impacted negatively on the access to intelligence, health protection systems and provision of services.
Groups of service users affected All adults and children in B&NES Other commissioning organisations
Key Activities Timescales Performance Measures
Ensure all Public Health contracts are aligned to local authority commissioning processes:
Contribute to the establishment of a commissioning support function
July 2013
Agreed and monitored SLA on the commissioning support function Commissioning plan is signed off
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Develop and implement a commissioning plan
July 2013 March 2014
All eligible contracts have been transferred to council terms and conditions
Develop assurance and scrutiny function of immunisations and screening programmes, and infection prevention and control Develop scrutiny mechanisms including: a health protection sub-committee of the health and wellbeing board in conjunction with partners
August 2013
HP subcommittee set up; TOR and membership agreed Other scrutiny mechanisms agreed
Strengthen infection prevention control structures
Ensure safe system for delivery of a response to communicable disease incidences in conjunction with partners and ensure that relevant partners are aware of system
Develop plans to broaden the remit of the infection control nurses beyond a focus on health care associated infection – to include a broader health protection remit
Continuous i– there will be
different systems at different times – see end note March 2014
Description of system available and agreed MOU with partners Development of new JD for infection prevention control nurses Action plan for infection control nurse that include health protection
Strengthen effective response to chemical, biological and radiological incidences
Develop plans and agreements in conjunction with partners and ensure that relevant partners are aware of system
March 2014 Description of system and agreements in place
Strengthen effective response to non-communicable disease (chemical, biological and radiological)
Develop plans and agreements in conjunction with partners and ensure that relevant partners are aware of system
March 2014 Description of system available and partners aware
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Transfer screening and immunisation commissioning responsibilities to receiver organisations
Complete safe transition of immunisation programmes to NHS England and Public Health England
Complete safe transition of cancer and non-cancer screening programmes to NHS England and Public Health England
Develop overview and assurance system for immunisation and other health protection issues
March 2014
Agreed transfer of responsibilities Description of system available and partners aware
Develop link to NCB in relation to 0-5 agenda returning to local authority in 2015 Establish communication and assurance processes with the Public Health lead in NHS England
March 2014 Processes agreed and in place
Support and review local work to tackle environmental risks, including adaption to climate change, air pollution, and noise pollution
Review areas for Public Health input Deliver Public health input to priority areas
March 2014
Review conducted Input to specific areas delivered
Contribution to Strategic Objectives – please indicate which of the Corporate Plan objectives and outcomes this priority will contribute to:
Strategic Objective Contributes – Y/N? Relevant Outcomes
1. Promoting independence and positive lives for everyone Y C
2. Creating neighbourhoods where people are proud to live Y A H
3. Building a stronger economy Y D
4. Listening Council (values) N
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Priority 4: to influence the wider work of B&NES Council to impact on the social and economic determinants of health and health inequalities
Details of Service Priority
The transfer of public health responsibilities to the Local Authority provides an opportunity to provide public health advice into wider commissioning decisions and to engage in activities which improve the wider determinants of health. Developmental work is required to ensure all council staff are aware of the contribution they can make and to provide the knowledge and skills to maximise their role.
Impact on local community
Council staff will be making the most of every opportunity to improve public health either when providing or commissioning services Quality of services will improve and be targeted appropriately Decisions will consider the impact on health and inequalities
Groups of service users affected Council staff All adults and children in receipt of council services
Key Activities Timescales Performance Measures
Support council officers, elected members and wider workforce to understand and maximise their influence on public health and health inequalities
Provide series of briefings and updates to range of councillors and officers about role of public health and JSNA
PH team meet with officers to discuss their outcomes and impact on public health, and develop joint working.
Develop and implement Public Health Communication Plan - to include DPH report, website, Council Connect Welcome page, and develop a “Bruce‟s Blog”
Produce summary briefings on each Public Health Outcome – to include the evidence base
Deliver „Introduction to Public Health‟ as part of the Induction and Core Annual Training
Establish public health seminar programme
March 2014
Number of briefings delivered Records of meetings attended Communication plan developed Summary briefings developed Introduction to Public health developed PH Seminars delivered
Links established
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Establish links with training department to identify training needs and provision
Expand awareness and uptake of Public Health Practitioner programme
Number of people working towards practitioner registration
Ensure that key decisions of the cabinet have included an assessment of the evidence base, and impact on public health and health inequalities of the decision options (as per MARMOT review)
Work with decision-makers to agree HIA/HNA, and evidence base is part of key decisions
Develop policy and processes to establish use of HIA, HEA and evidence –base
Produce summary of the evidence base, including economic evaluation for each outcome
Trial this and agree draft processes and paperwork
March 2014
Policy and processes agreed Templates agreed Report of pilot of policy and processes written Summaries of evidence produced
Contribute to and influence wider commissioning decisions and ensure that the council addresses inequalities and narrows the gap for groups with the worst health and social outcomes
Participate in integrated commissioning programme in People and Communities directorate
Participate in commissioning decisions in several directorates and influence using JSNA, other data/evidence
Contribute to partnership working e.g. Environmental Sustainability Partnership agenda, Children‟s trust etc.
Map the contributions of the wider council to the public health outcomes
March 2014
Evidence of integrated commissioning Evidence of wider councils and strategies demonstrated public health content Commissioning decisions demonstrate public health influence – re JSNA, data, evidence etc.; Monitor health and social outcomes Evidence of partnership working Map completed
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Contribution to Strategic Objectives – please indicate which of the Corporate Plan objectives and outcomes this priority will contribute to:
Strategic Objective Contributes – Y/N? Relevant Outcomes
1. Promoting independence and positive lives for everyone N
2. Creating neighbourhoods where people are proud to live Y G
3. Building a stronger economy N
4. Listening Council (values) Y A
Appendix 1 – Key Performance Measures and Targets 2013/14
Service Priority Key Measure(s) 2013/14 Target(s) Strategic Objective(s) Outcomes(s)
Priority 1: to meet our mandatory service obligations
New CaSH contract in place by April 2014
New service starts April 14
th
Promoting independence and positive lives for everyone
Creating neighbourhoods where people are proud to live
Listening Council (values)
A F H
F
A
Priority 1: to meet our mandatory service obligations
Increase uptake of health checks across B&NES, with greater increase in areas of low uptake
55% uptake
Promoting independence and positive lives for everyone
Creating neighbourhoods where people are proud to live
Listening Council (values)
A F H
F G
A
Priority 2: to implement the priorities of the JSNA, Health and Wellbeing Strategies, and Director of Public Health Report
Tobacco control strategy and implementation
Tobacco control strategy and action plan agreed
and implementation underway, including
recommendations from the „Clear Assessment‟
Promoting independence and positive lives for everyone
Creating neighbourhoods where people are proud to live
A FG H
G
Priority 1: to meet our mandatory service obligations
JSNA available in “wiki” format
All JSNA subjects in “wiki” format and on
council internet
Promoting independence and positive lives for everyone
Creating neighbourhoods where people are proud to live
A H
G
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Priority 2: to implement the priorities of the JSNA, Health and Wellbeing Strategies, and Director of Public Health Report
Healthy weight pathways Healthy weight pathways
completed and utilised
Promoting independence and positive lives for everyone
Creating neighbourhoods where people are proud to live
Building a stronger economy
A H
F G
B
Priority 2: to implement the priorities of the JSNA, Health and Wellbeing Strategies, and Director of Public Health Report
Set up and make use of self-harm register at RUH
emergency department Self-harm register utilised
Promoting independence and positive lives for everyone
Creating neighbourhoods where people are proud to live
A
G
Priority 2: to implement the priorities of the JSNA, Health and Wellbeing Strategies, and Director of Public Health Report
Delivery plan of H&W Strategy and public health
actions
Delivery plan of H&W Strategy includes of public health actions
Promoting independence and positive lives for everyone
Creating neighbourhoods where people are proud to live
Building a stronger economy
Listening Council (values)
A B C D E F G H
F G
B
A
Priority 3: To ensure that the new Public Health system in B&NES is fit for purpose
Assurance and scrutiny function for immunisations,
screening, emergency planning and resilience
Assurance and scrutiny function for
immunisations, screening, emergency
planning and resilience in place
Promoting independence and positive lives for everyone
Creating neighbourhoods where people are proud to live
Listening Council (values)
H
A F G
A
Priority 4: to influence the wider work of B&NES council to impact on the social and economic determinants of health and health inequalities
Contribution of all council directorates to Public Health
outcomes
Improved understanding and agreements in place
with each council directorate for their
contribution to each PH outcome
Promoting independence and positive lives for everyone
Creating neighbourhoods where people are proud to live
Building a stronger economy
Listening Council (values)
A B C D E G H
A F G
B
A
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Appendix 2 – Service Impact Statement
Please add your SIS to this Appendix.
Appendix 3 – Equality Impact Assessment
Please add your EIA to this Appendix.
We have focused our priories for 2013/14 on the key groups identified in the JSNA and Health and Wellbeing Strategy, which included an analysis of key issue for different vulnerable groups within our population, many of which are reflected in the protected characteristics of the equalities legislation.
Require commissioned services to produce an equality impact assessment of their provided service as part of our contract monitoring service.
We have undertaken an equalities impact assessment of the transition of public health responsibilities from NHS B&NES to the local authority from April 2013
Appendix 4 – Workforce Planning
Please see earlier section on Workforce Planning and Development. i Continuous – there will be different systems at different times during the coming year – depending upon when receiver organisations have the staff resource to contribute; in the meantime PS and JG provide a response