Public health successes and challenges

Public health successes and challenges

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  www.hertsdirect.org Public Health Successes andChallenges Teresa Heritage, Executive Member Public Health, Localism and Libraries Jim McManus Director of Public Health
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  www.hertsdirect.org What we do •Public health approaches can be thought of as “public good” – better working of the system had a wider impact on people – Better coverage of immunisation gives immunity benefit to whole population – better control – Better control of screening reduces significant cost and death to NHS • Almost all of what PH does has an element of public good and system/population good rather than an individual offer • We think there is an opportunity here to bring this approach to bear on local authority commissioning
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  www.hertsdirect.org Some of whatPH does in numbers from last year • 4,000 people in drug and alcohol treatment • 60,000 contacts with sexual health services • 20,000 women accessing contraception • 35,000 school nursing appointments • 27,000 NHS health checks • 32,000 people + went on a health walk • 6,700 hours of public health advice to NHS commissioners • 5,200 hours of advice to HCC commissioners
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  www.hertsdirect.org SLI • This “populationgood” approach is reflected in the LGA/ADPH approach to Sector Led Improvement (next slide)
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  www.hertsdirect.org What good lookslike Improving the Public’s Health is integral to the work of public services in this place Safe Informed Embedded Empowered Criterion: The core services and functions and well delivered and effective Criterion: The system understands why the Population’s health is important Criterion: Public Health skills and tools are in use and being embedded across the system Criterion: The wider workforce are actively contributing to a public health agenda • Services in place • Contracts • Clinical Governance and quality • Access • Monitoring • Best Value Safe • Process for regular review of services against need and evidence • System understands that a sick population is a costly population • Articulate prevention across primary, secondary and tertiary prevention • Benefits to system of a PH approach is understood – pathways, outcomes, cost savings • Barriers to growth are understood • The narrative of why Public Health is important is understood • You could stop anyone in the organisation and ask why public health is important to their job • There is a prevention strategy across services with clear aims • Workforce health programmes in place • There is a commissioning cycle and PH concepts and tools are a core part of this • People in the system think about inequality and equity in the work they do • The Principles of • Need, • Equity, • Evidence, • Evaluation, • Impact and • Change • are embedded within the skill set of officers Transactional Transformational © Copyright, ADPH, 2015 Evidence of leadership for public health being built from officers to members, at all levels
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  www.hertsdirect.org Some work we’vedone • Look at our successes • Articulate what we think is the PH role in system leadership alongside the role of others • Articulate what we want from others in the system
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  www.hertsdirect.org 14/15 Successes 1. HealthWeight Strategy 2. District Offer getting districts providing work alongside NHS and CC services 3. Health Checks at run rate 4. Workplace Offer – employers value our work 5. Do Something Different helps people cope with long term conditions 6. Health Protection Work recognised as good 7. Infection prevention in care homes reducing hospital admissions 8. 40% of adults in structured drug and alcohol treatment successfully complete (up from 35% last year) acquisitive crime due to addiction down 9. Good rate of getting people through drug/alcohol services successfully 1. Redesign sexual health service – new service started 1st April 2. Collaborative working with teenage pregnancy team, and integrated health improvement strategy. 3. Strong contract management of school nurse contract led to improvements 4. Beezee bodies weight management for children/families working closely with childrens services and used with thriving families too 5. Pastoral leads model in schools on mental health 6. Partnership working on young peoples health 7. CAMHS Review
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  www.hertsdirect.org 14/15 Successes 2 1.MoU with CCGs 2. User pathways being developed (stroke ESD and others in place) 3. PH indicators in some quality contracts between CCGs and NHS Providers 4. Integration work on Health and Social Care – prevention, self management and multimorbidity 5. Advice to commissioners in HCC ranging from tree health to mental health 6. Input on Dementia Strategy and prevention strategy for HCS 7. Advice on community navigators roll out 8. Pharmacy medication review 9. Tartan Rug on health challenges being used by commissioners 10. Adverse Childhood Experience study 1. Year on year decreases in adult smoking prevalence 2. Met HWB ambitions for adult prevalence of smoking 3. Engagement with partners on health and place agenda 4. Programme management methodology embedded 5. Central repository of work 6. Forward planning for committee process 7. Facilitating evidence-based practice in districts 8. Matrix working in intelligence 9. Closer working with CCGs
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  www.hertsdirect.org Challenges and Opportunities (someof those identified by scrutiny) • Intelligence and Information – making the JSNA and joined up intelligence really drive commissioning • Influence NHS Commissioning to ensure reduction in cost impact on social care • Better use of pharmacies across the county with minor ailments • Better mental health system
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  www.hertsdirect.org Some suggested corepriorities for PH 1. JSNA to further develop to deliver what commissioners need 2. Squeezing further value from the commissioned services (cost value, outcome value, join up with pathways) 3. Influencing for value and evidence across the system 4. Helping where evidence is silent on how you evaluate/measure/determine what good investment is 5. Young People 6. Supporting MH Commissioners 7. Prevention of avoidable illness and cost 8. Supporting health and social care integration through PH approaches
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  www.hertsdirect.org Our Ambitions • Preventionof avoidable expensive illness and disability in NHS and social care • A population mindset across all commissioners – What population (where are we?) – What issue/need (Where do we want to be?) – What outcomes do we want (How do we get there?) – What interventions do we buy (What gets us there?) – How do we know it’s working (are we there yet?)
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  www.hertsdirect.org Some challenges • Austerityclimate, we need to do more joined up together • Govt announces consultation on 7% cuts to public health budgets - we all need to input to the consultation • Joining up preventive action to save public money and keep people better longer • Preventable disease still going up • Significant avoidable cost in NHS, lower productivity despite growth in finance
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  www.hertsdirect.org Premature death inHertfordshire • The causes of premature mortality can be grouped into four main conditions which account for around 80% of premature deaths. These are: • cancer • heart disease and stroke • lung disease • liver disease