SERVICE DELIVERY PLAN 2015-16
Public Health
Divisional Director:
Andrew Howe
2015-16
CONTENTS
SECTION (Ctrl + click to follow)
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
PAGE
Overview of Division .......................................................................................................................................................................... 1
Backward Look - Achievements in 2014-15 ...................................................................................................................................... 6
Forward Look - Contextual Change for 2015-16 ............................................................................................................................... 9
Strategic Objectives 2015-16 .......................................................................................................................................................... 10
Budget Overview 2015-16 ............................................................................................................................................................... 21
Consultation and Engagement ........................................................................................................................................................ 23
Health Inequality (Impact) Assessment /Equality Impact Assessment Programme ........................................................................ 26
Divisional Performance Scorecard .................................................................................................................................................. 27
1.0 Overview of Division
Introduction / context
This document provides an overview of the work of the Public Health Division. The Public Health Service provides the Public Health
service to Barnet and Harrow Councils with the staff employed by Harrow Council. As such, this Business Plan represents the work to
be undertaken in both Barnet and Harrow. Both boroughs have similar health profiles and needs and deliver similar services in
responding to these needs. Barnet specific and Harrow specific matters are covered separately where appropriate. The team works
with both councils and organisations within the NHS – Clinical Commissioning Groups, NHS England and Public Health England. The
Public Health team has formal links to all of these organisations in order to fulfil statutory requirements and to ensure effective health
provision for both boroughs.
It is clear that the work of the Public Health Directorate continues to change as the Boroughs develop their visions for Public Health
and Council departments develop new ways of working in line with the Health and Wellbeing Strategies. Our principles are:
o
o
o
o
o
o
o
Empowering the community
Utilising the Marmot life course approach to tackling health inequalities
A focus on chronic and progressive diseases and unemployment
Promoting a culture of evaluation and research
Adopt a ‘primary prevention in the first place’ as a fundamental principle
Rebalance the spend from acute into primary and community care
Prioritise work to compress morbidity – across the wider determinants of health
The public health commissioning intentions and service plan for 2015-16 are focused on the delivery of statutory services and the
prevention of ill health. The latter have been developed with 3 key principles in mind:
Primary prevention extends disease free life and supports the compression of morbidity (i.e. people will be supported to live
healthy lives for longer)
Life expectancy has increased significantly in recent years as has the prevalence of chronic degenerative disease. If life expectancy
increases at a faster rate than increase to disability-free life expectancy (i.e. later onset of chronic disease), the period that people live
with chronic disease and their demands on services will increase. To avoid this there needs to be substantial delays in the onset of
disability in later life. This is achieved through primary prevention that promotes the widespread adoption of healthier lifestyles,
coupled with social changes that support these lifestyles. Investment in secondary prevention, i.e. preventing illness becoming more
severe, aims to prevent deteriorating health and escalating need for services but may lead to an expansion of morbidity (see below):
Public Health Service Plan 2015-16 Page 1
The interventions that compress morbidity, that are supported most strongly by evidence, are (1) Education, (2) Employment, and (3)
Physical activity.
Focusing spend on early years in the life course will deliver greatest returns
Returns on investment in early childhood (0-5 years) are higher than at any other time in the life-course. The positive cumulative
effects of interventions in early years provide a strong argument for investing in 0-5 year olds. Spending is currently invested more
heavily in later periods in the life course and should be redirected towards prenatal and pre-school services (see below):
Supporting elderly people to improve their ability to look after themselves will improve their health and minimise their need
for care outcomes, and allow funding to be re-invested in prevention rather than cure
As set out in the Health and Wellbeing Strategy in Barnet “In both the NHS and Adult Social Care, the spending profile is skewed
towards acute hospital and residential based care. Better care and support can be delivered in people’s own homes avoiding
admissions to hospital, promoting choice in end of life care through integrated working across health and social care, joining up
services around the individual and providing good support to family carers to sustain them in their caring role.”
These principles and the priority areas in Harrow corporate plan are reflected within Public Health commissioning intentions:
Public Health
area
Early years
Public mental
health
Physical activity
Employment
Services expanding/ increasing primary prevention
Development of single children’s health offer (with transition of health visiting to local authorities in 2015):
investing in pre- and post- natal support and develop parenting skills programmes; and tackling obesity in early
years
Coordination of investment including those from public health into building emotional resilience and wellbeing in
schools and communities, building on emotional wellbeing in schools programme and Ageing Well community
networks.
Environmental improvements and behavioural interventions building on current and planned investments,
Healthy Weight initiative in Children’s Centres; appropriate links to primary care
Contributions to educational achievement from better emotional wellbeing, public health supports the
development of targeted services to help people into work with a particular lead on addressing health related
Public Health Service Plan 2015-16 Page 2
Older people
concerns e.g. drugs and alcohol
Contributing investment to delay onset of ill health, supporting expansion of self-care, maintaining mobility and
tackling social isolation
The Service has four key responsibilities:
1.
2.
3.
4.
Leading health Improvement and reducing health inequalities
Health protection and ensuring appropriate plans are in place.
Public health support to health service commissioning and joint commissioning
Providing public health knowledge and intelligence
These responsibilities are discharged through the following activity and services:
Development, commissioning and evaluation of:
Health and wellbeing initiatives & services: tobacco control, alcohol & substance misuse, physical activity, healthy eating,
sexual health, oral health, breastfeeding, obesity, school nursing, NHS health checks, community wellbeing and dental health.
Health & wellbeing initiatives for vulnerable groups
Building policy, programmes & strategic partnerships to promote the health agenda including through the Health & Wellbeing
strategies and Health & Wellbeing Boards
Leading local health information, education and communication by generic and targeted ‘social marketing’
Leading on health intelligence and knowledge management (Joint Strategic Needs Assessment)
Commissioning, monitoring, and supporting secondary and tertiary prevention programmes including expert patient and selfcare programmes
Leading patient, public and community engagement, including commissioning health trainer programmes
Ensuring plans are in place for health protection, screening, infection control and immunisation.
Support service and care pathway redesign and demand management programmes
Support the development of health outcome measures and quality indicators for health services
Ensuring effective and cost effective services
Assessing need, utilisation, demand and outcomes
Public Health Service Plan 2015-16 Page 3
The Division is made up of the following functions:

Director of Public Health role
o Surveillance & assessment of populations’ health and wellbeing
o Assess the evidence of effectiveness of health and social care interventions, programmes and services
o Policy and strategy development and implementation
o Leadership and collaborative working for health

Procurement & commissioning of health improvement services
o Review current services and pathways of care
o Review/ develop service specifications based on evidence of effectiveness and cost effectiveness
o Procurement and contract negotiation
o Contract monitoring and performance assessment
o Commission & performance managing health improvement programmes
o Supporting commissioning activity within CCGs, the NHS England and PHE
o Supporting commissioning activity within the Councils

Health improvement
o Interpretation and application of new policies
o Coordinate health improvement projects and programmes and monitor and evaluate them
o Involve the public in assessing their health and wellbeing needs and identify means to address such needs

Public Health analysis
o Collection & analysis of data on defined populations
o Support identification & evaluation of user strategic need for health data and intelligence and negotiation of
solutions
o Disseminate health data and intelligence from diverse sources to various audiences
o Inform and influence policy and priority setting and performance
o Assess relevance and usability of health data and intelligence, methods and systems
Public Health Service Plan 2015-16 Page 4
PUBLIC HEALTH - Divisional Management Structure (from July 2015)
Note: The structure above was agreed by the Public Health Joint Governance Board in March 2015. It will be implemented in the first
quarter of 2015-16,
Public Health Service Plan 2015-16 Page 5
2.0 Backward Look - Achievements in 2014-15
The year 2014-15 was the second year for the Public Health Service in local government. The Service has been developing and
refining the way it works with two Councils and organisations within the NHS – Clinical commissioning Groups, NHS England and
Public Health England; and how resources are deployed to best effect to support the local populations. This will continue to be an ongoing focus for the Service.
Much work went into preparing for the successful procurement of new contracts for School Nursing, Drug and Alcohol Services. Public
Health provided the lead for work within the West London Alliance to re procure sexual health services in 2017.
The recommendations of the school nursing and health visiting review proposing a new Children’s Health pathway incorporating
Health Visiting services from October 2015 was agreed and published.
The Pharmaceutical Needs Assessment was updated.
The Annual report of the director of Public Health report 'From The Beatles to Beyoncé' looked at the changes in the public’s health
over the lifetime of the Director. The topics covered show immense change over the past 50 years but still present us with challenges
for the future.
Harrow
The Fruitables project has developed commercially competitive stalls in five schools and one community group (Ghurkha Veterans).
The stalls are run by 42 Parent volunteers who received training in business development. Seven volunteers have subsequently found
employment as result of this activity and two new businesses have been created from waste recycled into smoothies and soups. The
Project has received a national recognition award from the Department of Health, was showcased in the Good Food for London
(published by The London Food Board which is charged with overseeing the Mayor of London’s food strategy) and will be profiled at
the Faculty of Public Health Conference in July 2015.
The Community Growing project has achieved a number of successes. It now operates across five sites within the Harrow public
realm and four school sites (Cedars Manor, Kenmore, Wealds and Belmont). 94 volunteers are engaged, exceeding the original target
of 75, volunteers. It has been successfully integrated with Harrow’s long established Harrow Council Estates in Bloom (now re-titled
Harrow in Bloom) annual growing competition (now flowers, fruit and vegetables).
Public Health Service Plan 2015-16 Page 6
The Outdoor Gyms project delivered 12 volunteers (“activators”) trained in lifestyle issues; half of these activators have gone on to
level 3 training. Various events were organised in partnership with schools and children centres in local parks and further sessions
organised with Byron Neighbourhood Resource Centre and Harrow College to support people with disabilities. Overall 507 people
were supported to use the outdoor gyms: 304 parents, older people and young people, 35 people with disabilities, and 168 children.
The Health Champions project has recruited 45 health champions, reflecting the diverse composition of Harrow’s community. All
health champions underwent pre-selection and developmental training to cover their interest and capabilities (i.e. Long Term
Conditions mentors, community educators, community researchers). They have also been deployed to support various Council
initiatives including Warm Homes Healthy People (Winter Well) – referring vulnerable residents to access Harrow Council support and
interventions in relation to heating, accommodation and insulation needs; TB Awareness campaign – helping to raise awareness
amongst those vulnerable and most likely affected groups and communities about TB conditions and its treatment; and integrating
health activity into the wider Community Volunteers Network of the Council
Bespoke mental health awareness training was provided in conjunction with Harrow Council Human Resources for over 250 Harrow
Council staff. This was very positively received by staff as being both timely and helpful, given the prevailing operational and cost
pressures facing the Council. Such was the demand for attendance that the most recent sessions were over subscribed. In addition,
the recent and highly successful collaborative, cross departmental Staff Healthy Selfie event also underscored public health’s
contribution to raising staff health awareness
The long established Harrow Walks scheme continues to grow in popularity and some walks have achieved over 75 participants. A
new walk for people with physical and learning disabilities commenced using Millman’s Resource Centre as the meeting point. Five
volunteers were recruited and trained to support the administration of the programme.
Harrow Cut Films project, an anti-tobacco short film competition, was a big success story last year. Over 800 young people took part
in workshops, 38 films were made and one of these won the national award for the 20 – 25 age group.
Harrow has achieved the UNICEF level 2 baby-friendly accreditation. This recognises best practice by NHS trusts, other health care
facilities and higher education institutions, in enabling informed choices by parents about feeding methods.
Health Visitor Service funding allocations for 2015-16 were announced. Harrow is one of only twelve (of all 152 Local Authorities) that
will receive a growth in funding for Health Visiting services. The Service will join the Council in October 2915.
Public Health Service Plan 2015-16 Page 7
Barnet
Barnet schools and groups did exceptionally well in the Deborah Hutton Campaign, The Barnet Cut Films project, an anti-tobacco
short film competition saw over 800 young people take part in workshops with 47 films made. These won a number of national
awards: National Winner Age 16-19; National Winner Age 12 – 15; Runner up in Age 20 – 25; Best National Short Film, as voted for
by the public (People's Choice), was won by Susie Earnshaw Theatre School with “If you could see it”. Barnet Young Carers and
Siblings won the Young Judges Choices and Under 11 categories with “Something will happen”
As part of the cancer awareness campaign, Cancer Research UK was commissioned to run two Cancer Pop up shops. These
promoted awareness of signs and symptoms of cancer, screening programmes and early detection as well as giving information on
the support available for people with cancer and their relatives. A sun awareness campaign was also promoted.
A very successful employment project (the Motivational and Psychological Support and the Individual Placement and Support service)
for people with mental health difficulties was established in association with the Benefits Taskforce and Job Centre Plus. The pilot
proved extremely successful with 45 people gaining employment. This represented a success rate of 38% at a cost of £1,600 per
employed person compared to the bench mark range of £1,600 - £4,000; thus attaining the highest national average level of
placement at the lowest national average cost.
Working with Public Health, the West London Alliance (WLA) successfully bid for funds (£1.2m from successful Transformation
Challenge Award bid and £1.2m European Social Fund) to develop an integrated mental health and employment initiative. Barnet was
selected as a spearhead borough. It will test whether the Individual Placement & Support model of service – as noted above - can be
extended to support people with lower level mental health needs.
The Breast feeding service attained Level 1 UNICEF accreditation. This recognises best practice by NHS trusts, other health care
facilities and higher education institutions, in enabling informed choices by parents about feeding methods.
Health Visitor Service funding allocations for 2015-16 were announced. Barnet is one of only twelve (of all 152 Local Authorities) that
will receive a growth in funding for Health Visiting services. The Service will join the Council in October 2915.
As part of the Public Health Schools Programme, Barnet schools continue to perform exceptionally well in the Healthy School London
awards. Numbers have increased in all areas with 63 schools registered for the award by the end of March 2015, of the schools
registered 22 have attained the bronze and 6 have achieved the silver award.
Public Health Service Plan 2015-16 Page 8
3.0 Forward Look - Contextual Change for 2015-16
The Department of Health has announced the extension of the Public Health ring fenced grant for a further year to 31st March 2016.
2015 will be the year when Health Visiting responsibilities transfer from the National Health Service to Local Authorities. This will to
coincide with the implementation of the new integrated children’s health pathway which will also include the School Nursing service.
Context Change
Public Health ring fenced
grant
The integrated children’s
health pathway and
preparation for receipt of
Health Visiting services in
October 2015.
Further work with the
West London Alliance
Integrated substance
misuse (Drug and
Alcohol) care pathway
Service Restructure
Implications
This continues for the financial year 2015-16. It will allow continuation of services previously established
Modelling of future service delivery will be required based on possible future financial scenarios.
The School Nursing contract is under tender with the new contract to be operational in September 2015.
Work will continue for receipt of Health Visiting Services in October 2015.
Further examination of the potential for joint commissioning of services, with other councils. In particular
to lead the 22 London Borough programme to re commission GUM services.
Exploration of the option for Harrow to create a commissioning unit to support pan London activity with
other Councils.
A new provider has been commissioned to deliver this service which will commence later in the year.
Changes will be implemented to the care pathway that will provide a more effective service by ensuring
components of the service achieve greater synergy.
The Public Health Joint Governance Board has agreed a new structure for the service. This will be
implemented during the first quarter of the year. The new structure will facilitate closer alignment with
the priorities, commissioning processes and structures of both Councils.
Public Health Service Plan 2015-16 Page 9
4.0 Strategic Objectives 2015-16
Harrow
The five major priorities for Harrow in 2014-15 are:

Assumption of responsibility for commissioning Health Visiting Services from October 2015.

Implementation of agreed review recommendations for the integrated children’s health offer alongside early years work

Agree the refresh of the Health and Wellbeing Strategy and align the work of the Health Improvement team accordingly.

Scope and implement the Schools Health & Wellbeing programme and implement, as appropriate, recommendations from the
children’s section of the obesity health needs assessment.

Complete contract tenders for school nursing services and drug and alcohol services; and, implement the revised drug and
alcohol care pathway.
Other work
● Schools programme including environmental action e.g. on fast food outlets in proximity to schools
● Development of plans to increase physical activity and tackle obesity
● Lead implementation of plans to tackle TB
● Assess the case to establish a ‘Wellness service’ (single point of access and integrated provision for smoking, health check,
weight management, walks, exercise on referral, community dance, outdoor gyms)
● Build on the Community health champions initiative and integrate into the ‘wellness’ service above
Work planned with Harrow Clinical Commissioning Group (HCCG)
JSNA/Health and Wellbeing Strategy
The proposed work plan would be to:
Work with members of the Health and Wellbeing Board to review the current Health and Wellbeing Strategy and the
performance monitoring process.
Jointly design an engagement event which will inform the content of the Health and Wellbeing Strategy.
Develop a revised Health and Wellbeing Strategy by September 2015.
Public Health Service Plan 2015-16 Page 10
Patient engagement
The proposed work plan would be to support CCG work on patient engagement. In particular to:
Consider the extent to which the Public Health Commissioned Expert Patient Programme meets demand for self-care
programmes.
Consider options for collaboration
Implementation of commissioning intentions
Public Health will support the implementation of the CCG commissioning intentions by:
Giving advice on how to ‘make every contact count’ based on evidence of what works
Support a strategic approach to addressing obesity
Joining up Public Health TB awareness campaigns with intentions to develop a latent TB testing programme
Clinical governance
Explore ways of joining up work around clinical governance so public health and the CCG do not operate in isolation.
Health intelligence
Once the JSNA is complete, there will be opportunities for more detailed intelligence to be provided on specific areas. This will
focus on supporting the improvement of value and outcomes. Initial work has commenced on taking action to reduce
emergency admissions for childhood asthma. The main areas where improvement in value and outcomes can be achieved are
in cancer and cardiovascular disease.
Mental health
Work to develop a mental health promotion (mental wellbeing) strategy. The focus of this work is to keep Harrow residents feeling
good and functioning well. It is more than the absence of mental illness – it represents the positive side of mental health and can be
achieved by people with a diagnosis of mental disorder. Public Health is particularly keen to consider the impact of the ‘wider
determinants’ on mental health such as employment, poverty and housing. This work will now interact with the ‘Like Minded’
programme across North West London. The proposed work plan would be to:
Re-establish the suicide prevention group (scheduled for 29 Jan)
Consider bringing all mental health stakeholders together to map all services, understand organisational objectives and
perspectives and discuss opportunities for collaborative working.
Support the work of the Dementia Task and Finish group.
Public Health Service Plan 2015-16 Page 11
Corporate Priority
Making a difference for the vulnerable
Public Health contribution
The mental health and well-being of residents improves
Physical Activity services and support - The Public Health Service for example, recruits
and supports volunteer lead walks programmes which are open to all borough residents
and the provision of specialist physical activity support for people with mental health
problems.
Employment Support - with the lead for addressing health related barriers to entering
employment e.g. drug and alcohol dependence
Mental Health Strategy and Mental Health promotional work – for example, Workplace
Mental Health Training: Bespoke mental health awareness training with Harrow HR for
Harrow Council staff. This In addition, the recent and highly successful collaborative, cross
departmental Staff Healthy Selfie event also underscored public health’s contribution to
raising staff self and health awareness.
Substance Misuse Services
Support for people with long term health conditions
Mental Health promotional work
Minimise health inequalities within the borough
Health protection and health improvement work
Smoking Cessation services
Childhood obesity initiatives in Children’s Centres and Schools – for example the
Fruitables initiative in Primary and Secondary schools.
Production of the Joint Strategic Needs Assessment and the Health and Wellbeing
strategy.
Diabetes self care. Expert patient programme. Winter Warmth.
Employment - public health work includes development of targeted services to help people
into work with the lead for addressing health related barriers to entering employment e.g.
drug and alcohol dependence.
Public Health Service Plan 2015-16 Page 12
Making a difference for communities
Harrow is one of the safest boroughs in London
Substance Misuse Services – the return on investment in terms of reduced costs for local
people and agencies is significant.
Maximise opportunities for volunteering
Public Health provides volunteer lead walks programmes for borough residents.
Public Health supports the training and development of specialist volunteers who support
people with long term conditions.
Currently Public Health, Health Champions volunteers are deployed across Harrow to
support specific Council wide projects such as Warm Homes Healthy People (Winter Well)
– referring vulnerable residents to access Harrow Council support and interventions in
relation to heating, accommodation and insulation needs; TB Awareness campaign –
helping to raise awareness amongst those vulnerable and most likely affected groups and
communities, in raising awareness of TB conditions and its treatment; and integrating
health activity into the wider Community Volunteers Network of the Council
The provision of services (e.g. health checks, smoking cessation, promoting physical
activity)
Making a difference for local
businesses
Supporting business to understand DDA compliance
Working in partnership with Economic Development
Continuing support for implementation of the London Healthy Workplace Charter in
Harrow.
Making a difference for families
Help is targeted at those families most in need of support
Contributions to educational achievement from better emotional wellbeing – schools
programme. Input to early help in Children’s Centres.
Early years - Development of single children’s health offer (with transition of health visiting
from the NHS to local authorities in October 2015): investing in pre- and post- natal support
and develop parenting skills programmes and tackling obesity in early years
Public Health Service Plan 2015-16 Page 13
Barnet
The priorities for Barnet in 2015-16 are:








Assumption of responsibility for commissioning of Health Visiting Services from October 2015.
Procurement of an Integrated Adult Drug and Alcohol Service - October 2015
Completion of re-procurement of the school nursing service
Re-procurement of a new smoking cessation service
Collaborative commissioning of sexual health (Progressing plans for 2017 service re procurement)
Develop a weight management offer for adults
Develop a self care offer
Develop a community mental wellbeing programme
Indicative priorities for work planned with Barnet Clinical Commissioning Group BCCG)



Link BCCG five year and two year plans with London Borough of Barnet Health and Wellbeing strategy and North Central
London (NCL) Health Strategy
Areas for linkage are: (these dovetail with the North Central London wide strategy and the BCCG strategy aims & objectives)
o Better Care Foundation / older people
o Mental Health
o Early Years
o Cancer
o Health and Well Being / Screening
o Acute Pathway Transformation
As a background to all programmes / strategies the following should be included as terms of reference for change: (so public
health is embedded in all change)
o Weight management
o Smoking cessation
o Sexual health
o Screening
o Drugs and alcohol
Public Health Service Plan 2015-16 Page 14
In Barnet, Public Health will make significant contributions to corporate priorities in the following areas:
1. Public Health Commissioning Outcomes 2015-2020 where Public Health is directly responsible
Priority
Enable all children, young
people and adults to
maximise their capabilities
and have control over their
lives
Key Outcomes





Create and develop
healthy and sustainable
places and communities



Outcome measures overseen by PH
People are discouraged from taking up smoking
in the first place, and encouraged and
supported to quit should they wish to.
Children and adults who are overweight and
obese are encouraged and supported to lose
weight.
Children and adults are discouraged from
misusing alcohol and drugs, and encouraged
and supported to quit
Children and young people feel supported to
achieve and engage, while developing their
identities and resilience.
Working age adults and older people are wellconnected to their communities and engage in
activities that they are interested in, and which
keep them well.
The built environment is conducive to healthy
living choices such as walking and the
accessibility of safe open spaces.
The range of green spaces and leisure facilities
in the Borough are used more extensively,
there is more active travel and levels of
physical activity increase.
Social isolation, especially amongst older
people, is reduced through schemes that
enable the sharing of skills and experience.

Smoking prevalence

Excess weight in adults

Excess weight in 4-5 year olds

Excess weight in 10-11 year olds

Substance misuse


Rate of harmful drinking
Percentage of active adults

Physical activity participation

Reducing the proportion of persons
presenting with HIV at a late stage of infection
Reducing repeat Sexually Transmitted
Infections
Successful completion of drug treatment –
opiate users
Successful completion of drug treatment –
non-opiate users
Successful completion of treatment – alcohol




Public Health Service Plan 2015-16 Page 15
Priority
Key Outcomes



Create and develop
healthy and sustainable
places and communities






Outcome measures overseen by PH
Working age adults and older people live a
healthy, full and active life and their
contribution to society is valued and respected.
Sexual ill health and alcohol/substance misuse
are treated early and effectively by robust
services delivered in partnership across the
voluntary sector, the Council, the NHS and
other statutory organisations.
People are given many opportunities for
volunteering, which increases inclusion into
local communities, overcome language barriers
and develop stronger inter-generational
support.
The built environment is conducive to healthy
living choices such as walking and the
accessibility of safe open spaces.
The range of green spaces and leisure facilities
in the Borough are used more extensively,
there is more active travel and levels of
physical activity increase.
Social isolation, especially amongst older
people, is reduced through schemes that
enable the sharing of skills and experience.
Working age adults and older people live a
healthy, full and active life and their
contribution to society is valued and respected.
Sexual ill health and alcohol/substance misuse
are treated early and effectively by robust
services delivered in partnership across the
voluntary sector, the Council, the NHS and
other statutory organisations.
People are given many opportunities for

users
Successful completion of treatment – nonopiate and alcohol users

Physical activity participation

Reducing the proportion of persons
presenting with HIV at a late stage of infection
Reducing repeat Sexually Transmitted
Infections
Successful completion of drug treatment –
opiate users
Successful completion of drug treatment –
non-opiate users
Successful completion of treatment – alcohol
users
Successful completion of treatment – nonopiate and alcohol users





Public Health Service Plan 2015-16 Page 16
Priority
Key Outcomes
Outcome measures overseen by PH
volunteering, which increases inclusion into
local communities, overcome language barriers
and develop stronger inter-generational
support.
Below are the performance indicators identified in the Joint Public Service 15-16 Management Agreement with Barnet Council.
Strategic Performance Indicators
These are the measures used to monitor the progress against the Corporate Plan. These will be reported in their entirety to the Performance and
Contract Management Committee.
Give every child the best start in life
Measure
2015/16 target
2020 target
Smoking status at time of delivery
5%
3%
Excess weight in 4-5 year olds (overweight or obese)
21.0%
20%
Excess weight in 10-11 year olds (overweight or obese)
34.4%
33.4%
Enable all children, young people and adults to have control over their lives
Measure
2015/16 target
2020 target
Rate of hospital admissions related to alcohol
458.76 per 100,000
458.76 per 100,000
Smoking Prevalence
15%
13.5%
Create fair employment and good work for all
Measure
2015/16 target
2020 target
Public Health Service Plan 2015-16 Page 17
Number of people with mental health problems who have accessed Pilot
employment support programme
To be established
Create and develop healthy and sustainable places and communities
Measure
2015/16 target
2020 target
Physical activity participation
54%
55.6%
Strengthen the role and impact of ill health prevention
Measure
2015/16 target
2020 target
Cumulative percentage of the eligible population aged 40-74 who
have received an NHS Health Check
9,000
(8%
population)
of
eligible 10% of eligible population
Critical Performance Indicators
These are the indicators which are critical in monitoring the effective delivery of the Public Health Management Agreement.
Barnet
Prevalence of 4-5 year olds classified as overweight
Prevalence of 4-5 year olds classified as obese
Prevalence of 10-11 year olds classified as overweight
Prevalence of 10-11 year olds classified as obese
Reduction in numbers of mothers that smoke at time of delivery
Number of eligible people receiving health checks
Number of people setting a quit date with SC services who successfully quit at 4 weeks
Latest data
9.4%
11.6%
19.4%
15.0%
4.4%
expected
out turn
~9000
Target for
14-15
(amended)
is 642?
Public Health Service Plan 2015-16 Page 18
Target for
2015-6
9.4%
11.6%
19.4%
15.0%
<=5%
9,000
604
q1
q2
q3
q4
11.1%
9.3%
20.8%
15.9%
<=5%
<=5%
<=5%
<=5%
2,500
2,000
2,000
2,500
100
150
150
204
Barnet
Latest data
% of people with needs relating to STIs contacting a service who are offered to be seen or assessed
with an appointment or as a ‘walk-in’ within two working days of first contacting the service.
Target for
2015-6
q1
q2
q3
q4
98%
98%
98%
98%
98%
97%
97%
97%
97%
97%
80%
80%
80%
80%
80%
87% (Q2)
% of people with needs relating to STIs who are offered an HIV test at first attendance (excluding
those already diagnosed HIV positive).
% of people with needs relating to STIs who have a record of having an HIV test at first attendance
(excluding those already diagnosed HIV positive).
97.3% (Q2)
92.1% (Q2)
45%
(i.e. > Eng
43.8%)
Percentage of eligible new presentations YtD who accepted HBV vaccinations
Percentage of drug users successfully completing drug/alcohol treatment - opiate users (as per
DOMES report)
Not
available
due to ongoing
upgrades
and
enhancem
ents to the
National
Drug
Treatment
Monitoring
System
Percentage of drug users successfully completing drug/alcohol treatment - non-opiate users (as per
DOMES report)
“
Percentage of drug users successfully completing drug/alcohol treatment - alcohol users (as per
DOMES report)
“
Percentage of drug users successfully completing drug/alcohol treatment - non-opiate and alcohol
users (as per DOMES report)
“
Percentage of service users re-presenting to the drug/alcohol treatment services - opiate users (as
per DOMES report)
“
Public Health Service Plan 2015-16 Page 19
45%
45%
45%
45%
11%
11%
11%
11%
44%
 4
0
%
44%
 4
0
%
44%
 4
0
%
44%
 4
0
%
45%
45%
45%
45%
45%
13%
13%
13%
13%
13%
11%
44%
 4
0
%
Barnet
Percentage of service users re-presenting to the drug/alcohol treatment services - non-opiate users
(as per DOMES report)
Latest data
“
Percentage of service users re-presenting to the drug/alcohol treatment services - alcohol users (as
per DOMES report)
“
Percentage of service users re-presenting to the drug/alcohol treatment services - non-opiate and
alcohol users (as per DOMES report)
“
Estimated
out turn
1400
Number of people receiving brief advice about alcohol (ABI)
Target for
2015-6
Number of schools registered for the Healthy Schools London Awards - a) primary
68
Number of schools registered for the Healthy Schools London Awards - b) secondary
3
Number of schools reaching bronze award
22
q1
q2
q3
q4
2%
2%
2%
2%
2%
11%
11%
11%
11%
11%
3%
3%
3%
3%
3%
1400
24 (total
will be 92)
11 (1/2 of
secondary
schools)
35 (total
will be 57
schools)
21 (total
will be
350
350
350
350
15
3
3
4
2
2
3
3
12
3
10
10
7
3
4
7
Number of schools reaching silver award
8
Number of schools reaching gold award
0
9
3
0
3
3
Number healthy eating workshops provided in children centres
82
78 (2
workshops
per CC per
term)
14
10
22
32
Number of children’s centres undertaking supervised tooth brushing programme
9
9
3
0
3
3
3
0
3
3
Number of schools undertaking supervised tooth brushing programme
Number of professional/community representatives in contact with vulnerable groups training in
recognising and tackling self harm/suicide prevention
9
N/A
300
300 MaPS
100
75
100
75
100
75
0
75
180 IPS
36
36
36
36
N/A
Number of people with mental health problems who have accessed employment support programme
Public Health Service Plan 2015-16 Page 20
Barnet
Other emotional wellbeing - indicators tbc (still currently under development)
Latest data
TBC
Target for
2015-6
q1
q2
5.0 Budget Overview 2015-16
These are the elements of the Harrow Public Health Budget:
£k
Health Checks
Sexual Health
Young Peoples Health
Drug Misuse & Alcohol Misuse
Tobacco control
Physical Activity
Wider Health Improvement
Wider determinants of health
Staffing and Support
Budget
9,146
These are the elements of the Barnet Public Health Budget:
£k
Health Checks
Sexual Health
Drug Misuse & Alcohol Misuse
Wider Health improvement
Tobacco control
Public Health Service Plan 2015-16 Page 21
q3
q4
Physical Activity
Young Peoples Public Health
Wider determinants of health
Staffing and Support
Budget
Public Health Service Plan 2015-16 Page 22
14,423
6.0 Consultation and Engagement
Outcomes of 2014-15 Engagement
Harrow:
Community Asset Assessment - originally conceived as part of the Joint Strategic Needs Assessment it was postponed. It will be
taken forward in 2015-16.
Alcohol treatment systems review – taken forward and the outcomes incorporated in the tender for D & A services
Unemployment and Health - originally intended to commence during Autumn/Winter 2014-15, as part of the original Harrow Public
Health stake holder engagement focus for this project. However, since the subsequent development and alignment with the
‘Trailblazer’ activity currently being conducted by Barnet Public Health in relation to mental health and employment (as part of the WLA
Mental Health and Employment Integration Project) the consultation will now be developed and implemented during 2015-16 following
the trailblazer evaluation.
Community Dance - informal consultation at the Under One Sky event in September 2014. Feedback was received on existing
service provision, cost for users, barriers in participation, and dance styles in demand by local users. The result of the feedback was
fed into the Community Dance Business Case.
Consultation and Engagement Programme for 2015-16
Consultation or
Engagement Activity
Community Asset
Assessment will be
undertaken by the Health
Champions provider,
Social Action for Health
Planned
start
Date
Date tbc
Planned
Completio
n Date
Date tbc
Rationale for the Activity
Public Health Service Plan 2015-16 Page 23
How is the information planned to
be used?
Link to
Service Plan
Project
Healthy Catering
Commitment: the project
will be refocused to
include consultation with
targeted local companies/
suppliers/ organisations
during 2015-16
Date tbc
Date tbc
Unemployment and
Health aligned with the
‘Trailblazer’ activity as
part of the WLA Mental
Health and Employment
Integration Project will
commence after
evaluation of the pilot.
Date tbc
Date tbc
Community Champions to look at the Community
Champions scheme
Date tbc
Date tbc
Obesity – Healthy Weight
Consultation . . .
Date tbc
Date tbc
Mental Health Promotion Date tbc
and Wellbeing Strategy . .
.
Date tbc
To identify how its user
base might be diversified
and grown and how its
activities might be
enhanced to appeal to new
user groups
Public Health Service Plan 2015-16 Page 24
Barnet
Outcomes of 2014-15 Engagement
Alcohol treatment systems review – taken forward and the outcomes incorporated in the tender for D & A services. The alcohol
treatment review pointed primarily to challenges of service fragmentation for Barnet. This is being addressed in the specification for
the re commissioned service. It also pointed to some specific challenges for dual diagnosis patients (those who have Mental Health
concerns as well) and we have funded specific support work in this area in response.
Self Harm Cyber Bullying Awareness Consultation completed in January 2014 and outcomes incorporated in Schools programme
work. The self harm consultation was conducted by CommUNITY Barnet who conducted focus groups with young people and their
views about self harm, cyber bullying and proposed solutions. The team has commissioned training on self harm to be provided
across the borough to those who work with vulnerable groups.
Marked and Measured routes and outdoor gyms (undertaken by Barnet Council Streetscene on behalf of the Public Health Service) to
assist in decision making on locating these new facilities.
Consultation and Engagement Programme for 2015-16
Consultation or
Engagement Activity
Consultation on sexual
health provision.
Planned
start
Date
Date tbc
Planned
Completi
on Date
Date tbc
Rationale for the Activity
How is the information planned to
be used?
To inform the re procurement of
sexual health services in 2017
Public Health Service Plan 2015-16 Page 25
Link to
Service Plan
Project
7.0
Health Inequality (Impact) Assessment /Equality Impact Assessment Programme
Project
Officer responsible for HIIA/ EqIA
Public Health Service Plan 2015-16 Page 26
Target completion
date
8.0
Divisional Performance Scorecard
Below are the Harrow measures for 2015-16
2015/16 Targets
Making a Difference for
the Vulnerable
Equalities
objective
Directorate
2015/16
Q1
2015/16
Q2
2015/16
Q3
The mental health and
well-being of residents
improves
Self-reported well-being People with a low
satisfaction score
E&E CHW Res
CS
2015/16
Q1
2015/16
Q2
2015/16
Q3
CHW/PH
6.7%
Self-reported well-being People with a low
worthwhile score
CHW/PH
4.1%
Self-reported well-being People with a low
happiness score
CHW/PH
10.5%
Self-reported well-being People with a high
anxiety score
Percentage of drug users
successfully completing
drug/alcohol treatment opiate users
CHW/PH
12.6%
CHW/PH
14%
14%
14%
2015/16
Year end
2015/16
Year end
14%
2016/17
2017/18
2018/19
2016/17
2017/18
2018/19
This indicator is updated
annually but if the respondent
levels are low, the data is
suppressed by PHE - not able
to report 2013/4 data for this
reason. Target is same as
2012/13
This indicator is updated
annually but if the respondent
levels are low, the data is
suppressed by PHE - not able
to report 2013/4 data for this
reason. In 2011/12 and
2012/13 data was combined
with all other outer London
boroughs to give a single score.
This indicator is updated
annually but if the respondent
levels are low, the data is
suppressed by PHE - not able
to report 2013/4 data for this
reason. Target is same as
2012/13
Target based on 2013/14 data
for Harrow
14%
Public Health Service Plan 2015-16 Page 27
14%
14%
Targets based on the upper
quartile outcomes in our peer
group
Percentage of drug users
successfully completing
drug/alcohol treatment non-opiate users
Percentage of drug
users successfully
completing drug/alcohol
treatment - alcohol users
Percentage of drug users
successfully completing
drug/alcohol treatment non-opiate and alcohol
users
Minimise health
inequalities within the
borough
Healthy life expectancy at
birth (Male) (equalities
measure)
Healthy life expectancy at
birth (Female) (equalities
measure)
Life expectancy at birth
(Male) (equalities
measure)
Life expectancy at birth
(Female) (equalities
measure)
Slope index of inequality
in life expectancy at birth
(Male) (equalities
measure)
Slope index of inequality
in life expectancy at birth
(Female) (equalities
measure)
Number of eligible people
receiving health checks
(cumulative data)
Number of children
registered with a dentist
CHW/PH
51%
51%
51%
51%
51%
51%
51%
Targets based on the upper
quartile outcomes in our peer
group
CHW/PH
40%
40%
40%
40%
40%
40%
40%
Targets based on the upper
quartile outcomes in our peer
group
CHW/PH
47%
47%
47%
47%
47%
47%
47%
Targets based on the upper
quartile outcomes in our peer
group
Recent data for England shows
a reduction in life expectancy
for the first time. Targets have
been set to maintain current life
expectancy measures.
1.b) &
3.b)
CHW/PH
63.6
63.6
63.6
63.6
1.b) &
3.b)
CHW/PH
67.1
67.1
67.1
67.1
1.b) &
3.b)
CHW/PH
82.4
82.4
82.4
82.4
1.b) &
3.b)
CHW/PH
85.9
85.9
85.9
85.9
1.b) &
3.b)
CHW/PH
6
9
9
9
1.b) &
3.b)
CHW/PH
5
6.6
6.6
6.6
CHW/PH
1250
2650
3650
5160
CHW/PH
Public Health Service Plan 2015-16 Page 28
Budgets for public health for
future years are not yet
established and therefore no
future targets set
We do not have any baseline
data for this indicator yet. It is
not routinely published but NHS
England London team have
said that they will ask the BDS
for data quarterly from Q1.
Number of people setting
a quit date with Smoking
Cessation services who
successfully quit at 4
weeks (cumulative data)
Number of mothers that
smoke at time of delivery
(2014/15 target >= 5%)
(equalities measure)
Proportion of children
aged 4-5 classified as
overweight (equalities
measure)
Proportion of children
aged 4-5 classified as
obese (equalities
measure)
Proportion of children
aged 10-11 classified as
overweight (equalities
measure)
Proportion of children
aged 10-11 classified as
obese (equalities
measure)
CHW/PH
114
214
314
454
Budgets for public health for
future years are not yet
established and therefore no
future targets set
1.b) &
3.b)
CHW/PH
1.b) &
3.b)
CHW/PH
11.1%
11.1%
11.1%
11.1%
1.b) &
3.b)
CHW/PH
9.3%
9.3%
9.3%
9.3%
1.b) &
3.b)
CHW/PH
20.8%
20.8%
20.8%
20.8%
1.b) &
3.b)
CHW/PH
15.9%
15.9%
15.9%
15.9%
>= 5%
>= 5%
>= 5%
>= 5%
>= 5%
Public Health Service Plan 2015-16 Page 29
>= 5%
>= 5%
1. Making a Difference
for the Most
Vulnerable
2. Making a Difference
for Communities
•a)Protect vulnerable
people from the
harmful impact of
crime, anti-social
behaviour, stigma and
abuse
•b) Minimise health
inequalities and
deprivation in the
borough.
• a) Ensure all services,
delivered by or on
behalf of the Council,
are accessible and
responsive to the
needs and aspirations
of all communities
•b) Encourage pride in
the diversity of our
borough
3. Making a Difference
for Families
•a) Improve
opportunities for
vulnerable young
people
4. Making a Difference
for Businesses
•a) Improve the skills
and employment
opportunities for
disadvantaged groups.
• b) Minimise health
inequalities and
deprivation in the
borough.
Other reporting
The team provides information on performance to the Public Health Joint Governance Board on a quarterly basis and to Barnet
Council.
Public Health Service Plan 2015-16 Page 30