Public Health and Ageing Well - what will “good” look like? Liam Hughes, National Adviser for Healthy Communities 16/12/2010
Public Health and Ageing Well – what will “good” look like? <ul><li>The new context </li></ul><ul><li>Public health is com...
The new context <ul><li>Fiscal pressure and reduced public expenditure  </li></ul><ul><li>The Coalition Programme </li></u...
The White Papers, Command Paper and Outcome Frameworks….
The Health White Paper <ul><li>Patients and Carers (Health Watch) </li></ul><ul><li>Standards (CQC and NICE) </li></ul><ul...
The LGA View <ul><li>Huge potential – public health has come home! </li></ul><ul><li>Not local enough! Not soon enough! </...
“ Public health is coming home to local councils!” <ul><li>Not the same public health! </li></ul><ul><li>Not the same coun...
Public health is coming home, but what is public health? <ul><li>What do you think it is? </li></ul><ul><li>How well do yo...
Public Health is contested territory! <ul><li>Tackling the wider determinants of health </li></ul><ul><li>Promoting health...
Why should local councils take it on? <ul><li>The new statutory duty – a legal obligation </li></ul><ul><li>The moral argu...
Health improvement and health inequalities – what do you think? <ul><li>- “The health of the population is getting better!...
Improving health, not reducing health inequalities  – still a long way to go!
What will “good” look like?  <ul><li>Telling the story of local health and wellbeing  </li></ul><ul><li>(the JSNA – defici...
Health and Wellbeing Boards  - the key to success <ul><li>Strategic and inclusive partnerships </li></ul><ul><li>Providing...
Six things councils can do to support health improvement and the reduction in health inequalities <ul><li>1)Support the wi...
The Marmot Report on Health Inequalities <ul><li>The wider determinants of health – this is what councils do! </li></ul><u...
Helping people change their behaviours <ul><li>Councils already do this: </li></ul><ul><li>Regulation and enforcement </li...
What does it mean for older people? <ul><li>Knowing the local community - does the JSNA  demonstrate that it is well infor...
Good investments for local councils <ul><li>“ Pensions protect health!” – council staff and </li></ul><ul><li>SMEs </li></...
Some risks? <ul><li>The “cloak of invisibility” surrounding old age </li></ul><ul><li>Older people are more than their def...
Partnerships depend on Trust
Some issues <ul><li>What will local councils look like in five years time and what will council-led PH look like?  </li></...
Health, democracy and civil society <ul><li>Community leadership in hard times – putting democracy back into health </li><...
Making the jigsaw fit at local level: what help is available?
The Offer from the Local Government Group  <ul><li>Supporting sector–led improvement </li></ul><ul><li>Community-based bud...
Sector-led improvement
The Local Government Group <ul><li>The LGA </li></ul><ul><li>Local Government Employers </li></ul><ul><li>Local Government...
The Healthy Communities Programme <ul><li>Funded by DH to autumn 2011 </li></ul><ul><li>Endorsed by the LGA </li></ul><ul>...
The Healthy Community Programme  <ul><li>Leadership and Partnership </li></ul><ul><li>Local Councils and GP Consortia </li...
Contacts <ul><li>Healthy Communities Team at LGID </li></ul><ul><li>(“funded by DH to help councils tackle health inequali...
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Liam Hughes Ageing Well leadership academy presentation

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Liam Hughes Ageing Well leadership academy presentation

  1. 1. Public Health and Ageing Well - what will “good” look like? Liam Hughes, National Adviser for Healthy Communities 16/12/2010
  2. 2. Public Health and Ageing Well – what will “good” look like? <ul><li>The new context </li></ul><ul><li>Public health is coming home! </li></ul><ul><li>Why should councils take it on? </li></ul><ul><li>What will “good” look like? </li></ul><ul><li>Public health and ageing well </li></ul><ul><li>Six things that councils can do to help </li></ul><ul><li>Health, democracy and civil society </li></ul>
  3. 3. The new context <ul><li>Fiscal pressure and reduced public expenditure </li></ul><ul><li>The Coalition Programme </li></ul><ul><li>Rebalancing state, business and civil society </li></ul><ul><li>Service transformation, productivity and efficiency </li></ul><ul><li>Sector-led improvement and the LGG offer </li></ul><ul><li>Localism and democratic pressure on performance </li></ul>
  4. 4. The White Papers, Command Paper and Outcome Frameworks….
  5. 5. The Health White Paper <ul><li>Patients and Carers (Health Watch) </li></ul><ul><li>Standards (CQC and NICE) </li></ul><ul><li>Managing the market (Monitor) </li></ul><ul><li>“ Any Willing Provider” </li></ul><ul><li>The NHS Commissioning Board </li></ul><ul><li>GP Commissioning Consortia </li></ul><ul><li>Health and Wellbeing Boards </li></ul><ul><li>Public Health England and </li></ul><ul><li>Local Public Health </li></ul>
  6. 6. The LGA View <ul><li>Huge potential – public health has come home! </li></ul><ul><li>Not local enough! Not soon enough! </li></ul><ul><li>Not enough cash! Too many hands on the money! </li></ul><ul><li>Opposition to ring-fenced and reward monies! </li></ul><ul><li>Transferring the PH staff - councils should choose! </li></ul><ul><li>Influencing GP-Consortia- via the NHS C. Board? </li></ul><ul><li>Overview and Scrutiny!!! –a misunderstanding!!! </li></ul>
  7. 7. “ Public health is coming home to local councils!” <ul><li>Not the same public health! </li></ul><ul><li>Not the same councils! </li></ul><ul><li>Not the same public! </li></ul><ul><li>Not all parts of public health will return! </li></ul><ul><li>Some parts never left! </li></ul>
  8. 8. Public health is coming home, but what is public health? <ul><li>What do you think it is? </li></ul><ul><li>How well do you know your DPH and the team? </li></ul><ul><li>What do you know about their education and training? </li></ul><ul><li>Have you talked to them about older people and active ageing? </li></ul>
  9. 9. Public Health is contested territory! <ul><li>Tackling the wider determinants of health </li></ul><ul><li>Promoting health supporting behaviours </li></ul><ul><li>Securing improvements in health services </li></ul><ul><li>Protecting the health of the population </li></ul><ul><li>Regulation, education, social marketing, community health development, “nudge” and “push”! </li></ul><ul><li>System, scale and energy – large scale change! </li></ul><ul><li>The links with wider social and economic conditions – fairness and inequalities. </li></ul>
  10. 10. Why should local councils take it on? <ul><li>The new statutory duty – a legal obligation </li></ul><ul><li>The moral argument – health inequalities are unfair </li></ul><ul><li>The business case – it is a good investment </li></ul><ul><li>The argument from community leadership </li></ul><ul><li>- people, places and local democracy </li></ul><ul><li>- the life course approach </li></ul>
  11. 11. Health improvement and health inequalities – what do you think? <ul><li>- “The health of the population is getting better!” </li></ul><ul><li>- “Health inequalities are not reducing and may soon widen further!”. </li></ul><ul><li>“ The focus over the last decade has been on “tackling the tail” – the places where health risks are greatest – and progress has been limited!” </li></ul><ul><li>“ Poor health can be found everywhere – health inequalities are at their widest in more affluent areas” </li></ul><ul><li>- “Levelling the health gradient would produce better health for everyone!” </li></ul>
  12. 12. Improving health, not reducing health inequalities – still a long way to go!
  13. 13. What will “good” look like? <ul><li>Telling the story of local health and wellbeing </li></ul><ul><li>(the JSNA – deficits and assets) </li></ul><ul><li>Leadership and vision </li></ul><ul><li>(the Health and Wellbeing Strategy) </li></ul><ul><li>Whole council, whole system approach </li></ul><ul><li>(Total Place and Community Budgeting) </li></ul><ul><li>Partnerships for better outcomes </li></ul><ul><li>(Health and Wellbeing Boards) </li></ul><ul><li>Quality, Improvement, Productivity, Partnership </li></ul><ul><li>(Accelerating the QIPP) </li></ul>
  14. 14. Health and Wellbeing Boards - the key to success <ul><li>Strategic and inclusive partnerships </li></ul><ul><li>Providing the local “adhesive” for local improvements in health and wellbeing </li></ul><ul><li>Knowing the local community (JSNAs) </li></ul><ul><li>Closer integration of children`s services, adult social care and public health </li></ul><ul><li>Participation of GP-Consortia </li></ul><ul><li>Districts and boroughs? </li></ul>
  15. 15. Six things councils can do to support health improvement and the reduction in health inequalities <ul><li>1)Support the wider determinants of health </li></ul><ul><li>2)Help change behaviours </li></ul><ul><li>3)Work to integrate health and social care </li></ul><ul><li>4)Make use of Overview and Scrutiny </li></ul><ul><li>5)Build up local resilience – the health protection system </li></ul><ul><li>6)Strengthen civil society </li></ul>
  16. 16. The Marmot Report on Health Inequalities <ul><li>The wider determinants of health – this is what councils do! </li></ul><ul><li>“ Social Justice with Evidence!” </li></ul><ul><li>The life-course approach </li></ul><ul><li>Handling transitions </li></ul><ul><li>Rather thin on ageing well </li></ul><ul><li>Staying active and engaged beyond 50! </li></ul>
  17. 17. Helping people change their behaviours <ul><li>Councils already do this: </li></ul><ul><li>Regulation and enforcement </li></ul><ul><li>Health education and health promotion </li></ul><ul><li>Social marketing </li></ul><ul><li>Community health development </li></ul><ul><li>“ Nudge” and “push” </li></ul>
  18. 18. What does it mean for older people? <ul><li>Knowing the local community - does the JSNA demonstrate that it is well informed about older people, their needs, aspirations and resources ? </li></ul><ul><li>Strategy: do the Health and Wellbeing Board and the Health and Wellbeing Plan show that they are tackling the agenda for active ageing? </li></ul><ul><li>Is there a whole council, whole systems approach? </li></ul><ul><li>Is there action on all six steps together? </li></ul><ul><li>Is there a local grip on the Outcomes Frameworks and QIPP? </li></ul>
  19. 19. Good investments for local councils <ul><li>“ Pensions protect health!” – council staff and </li></ul><ul><li>SMEs </li></ul><ul><li>“ Walking and talking your way to health!” </li></ul><ul><li>“ Keeping warm, keeping cool!” </li></ul><ul><li>“ Starting early, but it is never too late to </li></ul><ul><li>change!”. </li></ul>
  20. 20. Some risks? <ul><li>The “cloak of invisibility” surrounding old age </li></ul><ul><li>Older people are more than their deficits – building on the assets that people bring! </li></ul><ul><li>Intergenerational ignorance and tension </li></ul><ul><li>The infrastructure of support is fragile </li></ul><ul><li>Lack of trust and cultural differences between GPs and Councillors </li></ul>
  21. 21. Partnerships depend on Trust
  22. 22. Some issues <ul><li>What will local councils look like in five years time and what will council-led PH look like? </li></ul><ul><li>Central/local tensions? </li></ul><ul><li>The Health and Wellbeing platform carries a heavy load </li></ul><ul><li>Public health staff are right in the middle! </li></ul><ul><li>The “Harry Potter” effect! </li></ul>
  23. 23. Health, democracy and civil society <ul><li>Community leadership in hard times – putting democracy back into health </li></ul><ul><li>The debate about the Big Society and the Good Society </li></ul><ul><li>HealthWatch and Scrutiny </li></ul><ul><li>“ Co-design and co-production” </li></ul><ul><li>“ Innovation out of adversity” – the silver lining? </li></ul>
  24. 24. Making the jigsaw fit at local level: what help is available?
  25. 25. The Offer from the Local Government Group <ul><li>Supporting sector–led improvement </li></ul><ul><li>Community-based budgeting </li></ul><ul><li>Productivity and efficiency </li></ul><ul><li>Transformation and new organisational forms </li></ul><ul><li>Healthy Communities, Ageing Well, Social Care, Third Sector, Culture and Sport… </li></ul>
  26. 26. Sector-led improvement
  27. 27. The Local Government Group <ul><li>The LGA </li></ul><ul><li>Local Government Employers </li></ul><ul><li>Local Government Regulation </li></ul><ul><li>Local Partners </li></ul><ul><li>Local Government Improvement and Development </li></ul><ul><li>Centre for Public Scrutiny </li></ul>
  28. 28. The Healthy Communities Programme <ul><li>Funded by DH to autumn 2011 </li></ul><ul><li>Endorsed by the LGA </li></ul><ul><li>Building capacity for health improvement in local government </li></ul><ul><li>Focusing on health inequalities </li></ul><ul><li>New workstreams: </li></ul><ul><li>- Health and Wellbeing Boards </li></ul><ul><li>- JSNAs </li></ul><ul><li>- GP Consortia and LAs </li></ul>
  29. 29. The Healthy Community Programme <ul><li>Leadership and Partnership </li></ul><ul><li>Local Councils and GP Consortia </li></ul><ul><li>Partnerships </li></ul><ul><li>Health and Wellbeing Boards </li></ul><ul><li>JSNAs – Telling the Local Story </li></ul><ul><li>Overview and Scrutiny – the Centre for Public Scrutiny </li></ul><ul><li>Community Engagement and Community Asset-Mapping </li></ul><ul><li>Workforce Health </li></ul><ul><li>The Business Case for Improving Health </li></ul><ul><li>Knowledge Website and Communities of Practice </li></ul>
  30. 30. Contacts <ul><li>Healthy Communities Team at LGID </li></ul><ul><li>(“funded by DH to help councils tackle health inequalities”) </li></ul><ul><li>[email_address] </li></ul><ul><li>Liam Hughes (Msc,MEd,MBA), </li></ul><ul><li>National Adviser, Healthy Communities </li></ul><ul><li>[email_address] </li></ul>
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