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The new public health systemour role in improving and protecting health and
wellbeing; and the transition process
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This presentation will cover
1. Context of the public health reforms
2. Vision for a new public health system
3. What the new locally-led system will look like
4. Local system transition5. Workforce and HR issues
6. Discussion
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Health andwellbeing
reforms:
setting thecontext
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Across the health and care system
Rising demand and treatment costs
Need for improved healthcare services and reduced
variation in health outcomes
Need for better value for money
The modernisation programme will:
Put clinicians and local communities in the driving seat
Provide a greater voice for patients and the public Increase accountability locally and nationally
Support a greater focus on public health
Context
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Ministers and the Department of Health
nationa
l
local
Patients and the public
Public Health NHS Adult Social Care
Overview of health and social care structures from April 2013
Public Health
England (part of DH)
Care Quality Commission, including HealthWatch England
Social
care
providers
NHS providers, inc:
Foundation Trusts & NHS Trusts
Primary care providers
Independent / 3rd sector providers
Local
authorities
NHS CB
NHS Trust
Develop-
ment
Authority
Monitor
CCGsLocal
authorities
National Institute for Health and Clinical Excellence
Health and Care Information Centre
Public
health
providers
Local HealthWatch (formerly LINks)
Health and Wellbeing Boards (part of local authorities)
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Modernisation timeline
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Our visionfor public
health
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A powerful case for change
The white paperHealthy Liv es, Healthy Peop leset out a
powerful case for reforming the public health system:
two out of three adults are overweight or obese
smoking costs the NHS 2.7 billion per year rates of tuberculosis are rising
inequalities in health remain: people in the poorest areas
live on average 7 years fewer than those in the richest
Major health threats, ranging from the risk of newpandemics to the potential impact of terrorist incidents.
We need a new approach to meet these and other public
health challenges of the twenty-first century.
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Leadership role for local authorities soservices are shaped by local needs
Stronger focus health outcomes supported
by the public health Outcomes Framework
Public health as a clear priority acrossgovernment
Supported by a new integrated public health
service, Public Health England
The commitment to reduce health
inequalities as a priority across the system
1
5
4
3
2
The new approach to public health
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An effective public health system
Accounts for the changing nature, assets and strengths ofthe population is vigilant for new health threats
Ensures economic development creates health and
wellbeing
Advocates wise use of environmental resources Promotes individual and community wellbeing
Helps people limit behaviours damaging to their health.
Secures equitable access to good quality health and social
care, with prevention incorporated into all contacts.
Systematically works to reduce health inequalities andembeds health and wellbeing in all policies.
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the newlocally-led
public
healthsystem
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Drive knowledge and analysis of population assets andneeds.
Consider whole population outcomes and set goals.
Inform all health and social care commissioning using
preventive approach. Incorporate health and wellbeing across all local
authority work and across the locality.
Use evidence and return on investment to inform
decisions. Tackle health inequalities systematically focussed on
People, Place and Power.
Leadership role for local authorities so services are
shaped by local needs
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New delivery system requiring wide range of
partners
Government: DH lead but significant contributions
from DCLG, Justice, Home Office, DWP, DfE PHE: Delivering health protection and supporting LAs
and the NHS
Local authorities: New public health functions build
on existing wider role NHS: Delivering health care, every contact counts
and specific public health interventions
An effective public health system
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Roles in the new Public Health System:
Local Delivery
Local Authorities
CCGs/NHS CB
PHE (local units)
Duty to improve health
Brings together holistic approach
to health and wellbeing Employ DPH
Ringfenced PH budget
Mandated services
Commissioning healthcare Commissioning some public health
services
Local Health Protection Services
(functions in development)
Core offer to the NHS, including
PH advice on health services
Health and Wellbeing
Board
Coordinates local strategy through
JSNA
JSHWS
Review of commissioning plans
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Public Health System Updates:
autumn 2011
Department of Health is completing the policy design phase
Public health Outcomes Framework
Operating model for PHE
Public health in local government: including grantconditions, mandatory services, and public health advice to
the NHS.
Public health funding: including shadow allocations for local
authorities. Workforce strategy and other HR updates
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Commitment to co-design
We are working with stakeholders to co-design these
five system reform updates
Regular discussions with local government
Regular discussions with the profession
Public Health Engagement Group, in autumn 2011,
to provide advice and challenge
Alongside ongoing engagement forums including
with and via the Regional Directors of Public Health
and DsPH group
NHS Future Forumreview of the NHSs role in the
publics health (due December)
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Timeline
End of 2010: White paper: Healthy Lives, Healthy People
July 2011: White paper response, confirming new public health
system structure
By end 2011: complete the operational design of the new system,
including the PHE Operating Model, how the
local system will work, and their links into the NHS.Spring 2012: chief executive and senior team for Public Health
England appointed.
April 2012: start of transition year
April 2013: Public Health England establishedApril 2013: Local authorities take on their new public health
responsibilities
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Key dates and activities
Baseline
assessment
Sept 2011
Functions
map
Oct 2011
Policy documents published
Dec 2011
PCT cluster transition
plan including delivery
March 2012
Assessment
April 2012
HR
concordat,
Nov 2011
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Workforceand HR
issues
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PHE HR regime exploring options for PHE termsand conditions
Directors of Public Health devising anappropriate employment process
Regulationof non-medically qualified staffseeking evidence to inform final decision
Public Health workforce strategy workinggroup developing consultation document
Local transfer: establish clarity on principles andterms and conditions of public health staff in LAs
Scope of HR / workforce Work
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Aims of HR strategy
An HR regime and wider workforce strategy which supports
the public health reforms through:
A secure transition of staff to PHE and LAs, retainingcrucial capacity and expertise in the system
Ensuring the supply of all expert staff, includingmedically qualified public health consultants, nationallyand locally both in transition and in the future
Supporting the future mobility of public health
specialists across the whole of the public healthsystem
To create meaningful careers in all settings
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Public health reforms: to stay in touch
Sign-up for the Transforming Public Health bulletin:
www.dh.gov.uk/health/category/publications/bulletins/pu
blic-health-bulletin/
Contact details for workforce and HR issues: [email protected]
Contact for other transition issues:
Questions and discussion
http://www.dh.gov.uk/health/category/publications/bulletins/public-health-bulletin/http://www.dh.gov.uk/health/category/publications/bulletins/public-health-bulletin/mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]://www.dh.gov.uk/health/category/publications/bulletins/public-health-bulletin/http://www.dh.gov.uk/health/category/publications/bulletins/public-health-bulletin/http://www.dh.gov.uk/health/category/publications/bulletins/public-health-bulletin/http://www.dh.gov.uk/health/category/publications/bulletins/public-health-bulletin/http://www.dh.gov.uk/health/category/publications/bulletins/public-health-bulletin/http://www.dh.gov.uk/health/category/publications/bulletins/public-health-bulletin/
