Public Health
Yorkshire & the Humber
Alison Patey
PHE North Region
Origins of Public Health England
Healthy Lives, Healthy People white paper
– Published November 2010 to set out a new approach to public health
– Responsibility for local health improvement returned to local authorities from
1 April 2013
– Public Health England is the expert national public health agency which
fulfills the Secretary of State for Health’s statutory duty to protect health and
address inequalities, and executes his power to promote the health and
wellbeing of the nation.
Health and Social Care Act 2012
– Set the legislative framework for the changes to the health and care system
that led to the creation of Public Health England as an operationally
autonomous executive agency of the Department of Health
– Received Royal Assent 27 March 2012
Our Mission
“To protect and improve the nation’s
health and to address inequalities,
working with national and local
government, the NHS, industry,
academia, the public and the voluntary
and community sector.”
The new public health system with an
integrated approach
Government
Local authorities
DH responsible to parliament
New public health functions, helping to
tackle wider determinants of health
Cross-government senior officials
group to improve health outcomes
CMO to provide independent advice
to government
Public Health England
Lead on improving health and
coordinate protecting health
Promote population health and
wellbeing (DPHs)
New, integrated national expert body
NHS England
Strengthened health protection
systems
Delivering health care, tackling
inequalities
Supporting whole system with
expertise, evidence and intelligence
Making every contact count
Specific public health interventions,
such as cancer screening
Public Health England delivery model
System Leadership: Work transparently, provide government, local
government, the NHS, MPs, industry, public health professionals and the
public with evidence-based professional, scientific and delivery expertise and
advice
Protection: Ensure there are effective national and local
arrangements for preparing, planning and responding to health protection
concerns and emergencies, including the future impact of climate change
Local Support: Support local authorities and clinical
commissioning groups by providing evidence and knowledge on local health
needs, alongside practical and professional advice on what to do to improve
health
Our priorities for
2013/14
– Sets out Public Health England’s
priorities and actions for the first
year of our existence
– Five outcome-focused priorities –
what we want to achieve
– Two supporting priorities –
how we will achieve it
– 27 key actions to take now
– The start of the conversation – a
three-year corporate plan will follow
What are our priorities?
1 Support people to live healthier lives via NHS Health Checks
2 Promote tobacco control and reduce smoking
3 Promote healthy weight and tackle childhood obesity
4 Improve recovery rates from drug dependency
5 Improve sexual health and reduce the burden of STIs
6 Develop a national programme on mental health
7 Lead gold standards for vaccination and screening programmes
8 Make the case for promoting wellbeing, prevention and early
intervention as the best approach to improving health
9 Partner NHS England to maximise improvements in public health
Our progress to date:
Health Marketing
Be clear on cancer
National bowel
campaign: 40% rise
in two-week referrals
Regional lung
campaign:14% rise
in diagnoses
Smokefree Homes
& Cars
37% who saw ads
reduced their
second-hand smoke
85,000 smokefree
kits distributed
Smart Restart
Stoptober
150,000 families
(300,000 children)
signed up
700,000 engaged in
2013
App downloaded
more than 100,000
times
200,000 registered
for support products
Our progress to date:
Media
Older people
Change4life
Smokefree
310 pieces of
coverage with a
PR value of
£662,784
540 pieces of
coverage with a
PR value of
£1,760,681
Over 600 pieces of
coverage to date,
with a PR value of
£1,300,000
Local presence
Four regions, 15 centres
Eight Knowledge and
Intelligence Teams
– London
– South West
– South East
– West Midlands
– East Midlands
– North West
– Northern and Yorkshire
– East
Other local presence
– ten microbiology laboratories
– field epidemiology teams
Additional support
– Local teams can also draw on national
scientific expertise based at Colindale,
Porton Down and Chilton
Sources of public health advice in the ‘Place-based’
approach to local public health
3rd sector
providers
People and communities
NHS & IS
Providers
Health and wellbeing boards
PHE
centre
Public health advice
Local government
CCGs
& their
support
NHSCB
area team
Commissioner of public health services
Leverage from the public health
ring fence
Influence on wider
spending
in commercial and
voluntary sectors
DsPH have
influence
across all
local
government
spend
PHE
provides
expert
advice
to local
government
PHE provides local
expertise
via centres
Clinical
Commissioning
Groups
and
NHS
England
Embedding ‘making
every contact count’
Spending trends:
2003-2012 PCT spending for all health
programmes increased by 70% overall
Mental health disorders c.£6bn to c.£12bn
Circulation problems c.£5bn to c.£7bn
Cancer c.£3bn to c.£5.5bn
Dental problems c.£1bn to c.£3.5bn
Wicked problems:
Health inequalities
Age
100
90
80
Life expectancy
70
60
Disability-free life expectancy
50
40
30
20
10
0
Most deprived
Least deprived
Neighbourhood income deprivation
Life expectancy and health life expectancy, and premature mortality
rates vary across the country – higher rates strongly linked to
socioeconomic deprivation
Preventable Mortality in YH
4.03 - Mortality rate from causes considered preventable (provisional)
Age-standardised mortality rate from causes considered preventable per 100,000 population
England
146.1
Yorkshire and The Humber
159.4
Kingston upon Hull, City of
221.0
Doncaster
175.0
North East Lincolnshire
171.9
Leeds
170.1
Bradford
169.5
Calderdale
169.2
Barnsley
167.4
Wakefield
166.7
North Lincolnshire
160.1
Rotherham
159.8
Kirklees
155.6
Sheffield
155.3
York
139.7
East Riding of Yorkshire
133.1
North Yorkshire CC
130.6
0
50
100
150
Source: Public Health Outcomes Framework (based on ONS source data)
Note this is not the same as the overall premature deaths found in Longer Lives
200
250
16
Health Equity North
New effort to confront north-south divide
3 October, 2013 | By Kaye Wiggins
England’s public health body is preparing to “make noise” about the northsouth divide in health outcomes.
The Public Health England initiative could extend to taking ministers to task
over their approaches to welfare and employment policies, as they are often
strongly linked to health.
The new approach is expected to include academic research and the creation
of a “commission on health equity” and a range of expert groups formed
from key public health figures in the North of England.
Presentation title - edit in Header and Footer
Propose a Health and Wellbeing
Framework for England
1
A compelling narrative for health and wellbeing, the current
state of health, and the underlying drivers
2
Credible interventions to improve health and wellbeing at all
levels
3
Model credible future scenarios, and their impact
Shift the debate onto health and wellbeing
Galvanise action based on evidence
Recognise the inequalities that affect the most disadvantaged
Leverage opportunities for crossgovernment health agenda
Housing
Work
Crime and
violence
Early
intervention
• Good housing drives health
• 20,000 excess deaths each
winter
Physical
activity
• Reduces risk of illness by
up to 50%
• 2/3 of adults obese or overweight
• Work a key health determinant
• Poor health keeps people out
of work
Healthy
Food
• 1/3 children in Y6 obese or
overweight
• Cost of obesity to NHS £5bn a year
• Alcohol a factor in 44% of
violent crime
Smoking
• Leading cause of premature
mortality
• Estimate cost to economy £13bn
• Foundations for every
aspect of development laid
in childhood
Healthy
communit
y
• Isolation significant driver of poor
health
• Poor environments lead to social
isolation
Contacts
Y&H Centre Director
Stephen.morton@phe.gov.uk
Alison.patey@phe.gov.uk