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