Historic changes in Public Health
Our approach in Kent
Graham Gibbens
Cabinet member Adult Social Services and Public Health
Meradin Peachey
Director of Public Health
Andrew Scott-Clark
Director of Health Improvement
Eastern and Coastal Kent
& West Kent
Our approach in Kent
• We have a substantial and experienced public health workforce in
Kent consisting of 9 Public Health consultants who we all work with
• KCC and NHS keen to start moving responsibility for Public Health
to members this year ahead of the timetable
• Recognise the importance of local action to improve inequalities in
health so plan to keep money with districts
• Working with GPs – we are already meeting with the GP Consortia
• Working with Districts now that elections are over
• The need to work with other agencies eg; Police, Fire etc to use
resources together to address issues around Prevention and
Health Inequalities
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health
What we do know
the Public Health reforms
• Historical move of Public health back to Local Government but
very different this time
• DPH the champion of healthy living working with communities
managing a ring fenced budget
• Health and Well-Being board will be the driver for integrated better
quality services across health and social care and reducing health
inequalities
• Joint Strategic Needs Assessment and the HWBB responsibility of
upper tier authorities
• Public Health England established responsible to the Secretary of
State
• Public Health cabinet sub committee established
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health
What we do know
public health reforms
• Commissioning health improvement moves to Local Authority
• Health Protection responsibilities for Local Authority
• Health Care responsibilities for Local Authority
• Command paper expected July 11 to confirm
MODERNISE THE WAY WE COMMUNICATE HEALTH MESSAGES
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health
“House has helped
me cut down
smoking and stop
drinking”
What Young
People Think…..
Gravesend
“Its useful to gain
info about health
risks”
“it’s a great place
to go with friends
and gain helpful
information”
“I’ve come to
House to have fun
and sort my
problems out”
“House has
helped to keep
meEastern
out
of Kent
and Coastal
& West Kent
trouble”
“It’s helped
me quit
smoking”
“They have helped
me by talking to
me about sexual
health”
“It’s
a welcoming
environment…..
and opened my
eyes to diversity”
“made me
aware of
c card and
chlamydia”
Kent Department of Public Health
What does Public Health currently do in Kent
• Health Improvement
• Health Protection
• Health Care (and social care)
• All supported with Public Health Intelligence
www.kmpho.nhs.uk
• We support everyone in the system!
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health
The Timetable
• Public Health coming together as one Kent team June 2011
• Memorandum of Understanding between KCC and the NHS to full
Council July 2011
• Shadow Public Health England June 12 (dependent on command
paper)
• Shadow Public Health in LAs April 12
• Shadow budgets for LAs April 12
• Transfer of budgets and responsibilities for Public Health April 13
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health
Local Authority Proposed Responsibilities
• Sexual health services (apart from contraceptive services)
• School immunisation programmes
• Local initiatives to reduce seasonal mortality excess deaths
• Local initiatives such as falls prevention services
• Mental health promotion, mental illness and suicide prevention
• Local activity to promote physical activity
• Local programmes to prevent/address obesity
• Drug & alcohol misuse services, prevention and treatment
• Tobacco control
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health
Local Authority Proposed Responsibilities
• NHS Health Check Programme (assessment & lifestyle
intervention only)
• Local initiatives to promote health in the workplace
• Reducing and preventing birth defects (jointly with PHE)
• Campaigns and services to promote prevention & early
presentation of cancer and long-term conditions
• Dental public health (supported by PHE for coordination of
surveys)
• Specialist domestic violence services
• Support for families with multiple problems
• Health intelligence and information (jointly with PHE)
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health
Public Health: Commissioning and Funding Routes
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health
What allocation might we get in Kent?
• Likely to be around 4% of PCT Total Budgets
• In Kent the total amount is likely to be around £60-70m
• PCTs going through an iterative financial process to ensure we get the
PH funding returns as accurate as possible
– Internal consistency check for Kent and Medway
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health
The Kent Public Health Prevention Budget for 11/12
•Budget for PH prevention in Kent is approx £17m
•Budget covers provision of specific services and individual lifestyle
behavioural support including:
–Sexual health services
–Sexual Health promotion
–Healthy Weight interventions
–Stop smoking
–Health trainers
–Healthy schools
•Further money also spent on other Public Health prevention programmes
including:
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health
Current Situation
•
Differences in the approach between Eastern and Coastal Kent and
West Kent PCTs
•
Services currently commissioned through the new Kent Community
Health Care NHS Trust
–
Amalgamation of West Kent Community Services and Eastern and Coastal Kent
Community Services.
•
Each service has a contract with work now focussed on bringing Eastern
and Coastal Kent and West Kent contracts together to ensure
consistency.
•
No plans to change what is already being commissioned.
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health
Opportunities
How do we reflect local needs in taking forward health improvement and
what would the governance look like?
•
Commission county wide services (to gain efficiency of provision) but
set local targets to reflect need:
–
Range of smoking prevalence 15% to 30% per District
–
Quit targets to be based on this prevalence (NICE recommendation)
–
Potential to segment targets for smaller populations
•
Decommission some programmes and recommission jointly with
County/Districts/GPCC.
•
How do you want to progress locality commissioning?
Eastern and Coastal Kent
& West Kent
Kent Department of Public Health