The New Public Health SystemFederation of Sports & Play AssociationsChris WrightProject Manager - HealthYouth Sport Trust
The session will cover...• Create an understanding of the public health context.• Your understanding of the new Public Health system.• What elements of Public Health relate to your organisation(s)• Identify the implications and opportunities for Sport and Play.• Share examples of YST interventions.• Provoke some thinking and action.
Understanding Public Health andits significance.
“physical inactivity should be appropriately described as apandemic, with far-reaching health, economic, environmental,and social consequencesinactivity causes 9% of premature mortality which is equal tothe same number of deaths as tobaccoThe Lancet (July 2012)“
The cost of physical inactivity• The 2011/12 evaluation by The National Obesity Observatory shows:One in five children in Reception is overweight or obese (boys 23.5%, girls 21.6%)One in three children in Year 6 is overweight or obese (boys 35.4%, girls 32.4%)• Impacts on self-esteem and emotional wellbeing (mental health of young people)• Reduces risk of over 20 health conditions including cardiovascular disease andsome cancers• Increases Confidence and competence to be physically active as adults• Positive links between movement, activity and educational attainment
The physical inactivity cycleEarlyChildhoodAdolescence AdulthoodPhysically inactivechildren19.2% Year 6Obese£21bn cost toNHS2 extra days ayear missedfrom school£1750 ayear extrahealthcostsChildren withinactive parentsare far less likelyto be active andtwice as likely tobe obeseLowerattainment
A New Public Health SystemImage Image Image• Public Health England – a national public health service• A return of public health leadership to Local Government• Dedicated resources for Public Health Nationally and Locally• Health & Wellbeing Boards in operation from April 2013• Strong relationship between Public Health, NHS and SocialCare ( Health prevention, clinical commissioning and socialcare commissioning)• Focus on outcomes and evidence based practice supportedby co-ordinated information and intelligence system.
Health & Wellbeing BoardsImage Image Image• Health & Wellbeing Boards in every upper tier local authority (150).• Prepare a Joint Strategic Needs Assessment (JSNA) working with GPConsortia and local authorities.• Develop a Health and Wellbeing Strategy based on needs identifiedthrough the JSNA.• Commission services to deliver the strategy through individualcommissioning plans.“H&WB’s will have a duty to promote integrated working betweenhealth and social care commissioners that will impact on widerdeterminants i.e. Housing and education” (DH 2012)
The role of the Local AuthorityImage Image Image• Local authorities will have a duty to take steps to improvethe health of the people in their area• Regulations will prescribe certain steps local authoritiesmust take (mandatory functions)– NHS Health Checks– National Child Measurement Programme– Sexual health – testing and treatment of STIs and provision ofcontraception– Ensuring health protection plans are in place– Providing healthcare public health advice to CCGs.• The commissioning of other services will be discretionaryincluding (non-exhaustive)– Interventions to tackle obesity, physical activity– Tobacco control– Drugs and alcohol misuse– Children’s public health services for 5-19 year olds
Public health funding and commissioningImage Image ImageDepartment of HealthPublic HealthEngland (within theDepartment of Health)LocalAuthoritiesNHScommissioningarchitecture(CommissioningBoard andConsortia)Providers(inc schoolsand GPs)NHSbudgetHealth andwellbeing boardsJSNA & Joint StrategicHealth and WellbeingPlansPublichealthbudgetRing-fencedpublichealthgrantFunding for commissioningspecific public healthservicesintegration integration
Evidence & Commissioning• All Health & Wellbeing Boards will be advising the commissioning ofpublic health services on the basis of outcomes and evidence.• Local partners (statutory and non-statutory) will have to evidencetheir work in a more detailed and prescriptive way i.e. RCTs.• Partnership will be central to effective and cost efficient delivery asopposed to lobbying and ‘shouting the loudest’.• Some services and programmes will be predetermined and fundedstraight ‘from source’.• All of the funding provided to support the delivery of health preventionwork locally will come through Local Authorities and their new publichealth teams.
Connecting Sport, PhysicalActivity and Play with PublicHealth
Implications for Sport & PlayImage Image Image• Sport and Play Industry are not statutory partners on Health andWellbeing Boards and these remain discretionary.• Public Health commissioning through credible ‘local’ partners with nocentralised funding.• Children & Young People health outcome priorities determined locally.• You will need to be credible partners at a local level with evidence.• Repositioning national programmes and services to fit locallydetermined priorities.
Consider the following 3 areas...Image Image ImageAdvocate and influence•How are you going to communicate your role and contribution?•How do you get that contribution recognised?•What are the local health networks you need to work through?Creating new partnerships•What good partnerships do you have currently?•Are you involved in any forums currently that link to this agenda?•What are the key groups and agencies you need to work with on this agenda? (Isschools one of them?)Programme delivery and demonstrating impact•Do you know which health outcomes your product/services relate to?•How will you go about positioning these as an intervention?•How does this fit with your organisational outcomes as well as localhealth outcomes?
What has the YST done?Image Image ImageAdvocate and influence•Developed a national model for sport and physical activity in schools.•Created membership offers and health related products and programmes.•Created a network of schools to work directly with Local Authorities.Creating new partnerships•Created new partnerships and strengthened others i.e. YMCA and PHT•Revisited our Local Authority engagement and health related work.•Developed a stronger working relationship with Change4Life/Dept. HealthProgramme delivery and demonstrating impact•Repositioned programmes against health outcomes.•Developing a knowledge bank and evidence around the health agenda.•Positioned whole school and health outcomes together.
PHYSICALEDUCATIONDELIVEREDDuring curriculum timeLITERACYLEARNINGLEADERSHIPHEALTHYACTIVELIFESTYLESDELIVEREDOutside curriculum timeENJOYMENTENGAGEMENTEXERCISECOMPETITIVESCHOOLSPORTDELIVEREDOutside curriculum timeCOACHINGCOMPETITIONCLUBSCOMMUNITYPROVISIONPay and playLeisure and recreationactivitiesCLUB SPORT(NGBs)Clubs and teamsCoachingTalent development
Bupa Start 2 Move(KS1)Matalan TOPs(KS2)C4L Sports Clubs& HLCsSainsbury’s School GamesSchool Sport Clubs &Coaching
What the evidence says……Image Image Image• More physically fit children have been found to have improved brainfunction, higher academic achievement scores and superior cognitiveperformance than less fit children - Chaddock et al (2012) Journal ofSports Science• Female adolescents who participated in sports were less likely than theirnon-athletic peers to engage in sexual activity and / or report a pregnancy– Sabo D et al (1999) Journal of Adolescent Health•Academic reviews are in agreement that physical activity improves selfesteem but opinion varies on which types of activity give the greatestbenefit most show that fitness focused activity and programmes thatencourage skill development i.e. rock climbing rather than competition! –Biddle, Fox and Boutcher (2000), Physical Activity and PsychologicalWell-Being
Local Example of this working...Image Image• Hull City Council local Obesity strategy.• Additional funding secured through YST Lead Partner Health &Wellbeing Schools.• Change4Life Sports Club in every primary school.• Partner funding through YST for clubs using Dept. Healthinvestment.• Programme evaluation around physical activity and wellbeingthrough SPEAR.• Independently evaluated through Local Authority directive andNCMP.• Sustainability through internal workforce and pupil premiumspend.
What Next?? :-www.dh.gov.uk/health/tag/public-health-englandwww.youthsporttrust.org- We’re keen to here from you…Chris.email@example.com