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