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Liam Hughes Ageing Well leadership academy presentation


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