VCS Public Health White Paper Event 9 th  March 2011 Jim McManus Joint Director of Public Health The post-transformation w...
Key Issues <ul><li>Issues </li></ul><ul><li>Changed NHS </li></ul><ul><li>Smaller local government </li></ul><ul><li>Compr...
1. Some Key Observations on Public Health Interventions Implications in the new world
Building a “Whole Council Approach” through Domains of Public Health Health  Improvement Health Protection Commissioning p...
Timeframes of impact/yield Years 0 1 5 10 15 Planning Frameworks and Core Strategies Education  Vitamin Supplements Decent...
A new care model & public health Citizen purchased care – state resources Enablement Prevention Universal offer Citizen (p...
2. Getting yourself ready for the new world Contributions, Stakeholders and Influencing Processes
Choices <ul><li>Prevention </li></ul><ul><li>Care </li></ul><ul><li>Enablement </li></ul><ul><li>All of them? </li></ul><u...
What Outcomes can I contribute to?
Which Stakeholders Influence Money DsPH HWBB GP Consortia LA PHE NHSCB Scrutiny Healthwatch?
Learning the lessons from the National Audit Office 2010 not on course!
Smart Moves <ul><li>Understand the trends and embed them into how you work </li></ul><ul><li>Show you understand how local...
3. Case Study Behaviour Change in Local Government
Life Expectancy by Ward
The drivers for behaviour change  <ul><li>Personalisation </li></ul><ul><li>The White Paper – new strategic role for local...
<ul><li>Understanding these as drivers and intervening variables </li></ul><ul><li>Transit  or  Escalator – move to less d...
The new public health duties <ul><li>Coming into Las where…. </li></ul><ul><li>Money has been removed and services cut. Wh...
Financial Options for Councils <ul><li>Go bust very quickly indeed </li></ul><ul><li>Create parish/town councils and shove...
Birmingham <ul><li>Prediction & Prevention </li></ul><ul><ul><li>Falls prevention in social care </li></ul></ul><ul><ul><l...
The Opportunities <ul><li>Public health delivering outcomes </li></ul><ul><li>Joined up Outcomes </li></ul><ul><li>A balan...
Smart Moves <ul><li>Understand the trends and embed them into how you work </li></ul><ul><li>Show you understand how local...
What does a business case for behaviour change look like? <ul><li>What  are you offering? </li></ul><ul><li>Why  should lo...
Thank you! Jim.mcmanus@birmingham.gov.uk
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9 March West Mids Vcs Public Health Event Mc Manus

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Presentation to West Midlands third sector on getting ready for new world of NHS reforms

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  • I am going to talk about our experience of trying to address issues as they arose In most emergencies issues arise you do not plan for In this flu pandemic, we had neither a slow rising tide nor a flash flood experience but a mix of different issues in different parts of the country and the city I think what comes out of this is the need to seek to predict what systems of the City’s life will be most affected given what we now know, and then seek to make those resilient My guesses are most cities will see schools, nurseries and social care very affected In delivering this I am focusing on Local Authority services because this is a local authority seminar. I will, inevitably, do injustice to NHS family colleagues because of this. Setting up out of hours flu centres, for example, was a valuable experience for us. And the work of BADGER in developing clinical good practice in assessment and response is just one important piece of work from Birmingham I won;’t be able to do justice to. I will also inecvitably underestimate the role of the Birmingham Resilience Team and the multi-agency Birmingham Resilience Group. These have been hugely important and positive experiences.
  • 9 March West Mids Vcs Public Health Event Mc Manus

    1. 1. VCS Public Health White Paper Event 9 th March 2011 Jim McManus Joint Director of Public Health The post-transformation world
    2. 2. Key Issues <ul><li>Issues </li></ul><ul><li>Changed NHS </li></ul><ul><li>Smaller local government </li></ul><ul><li>Comprehensive Spending Review </li></ul><ul><li>The Localism agenda </li></ul><ul><li>Big Society </li></ul><ul><li>JSNA </li></ul><ul><li>Stakeholders </li></ul><ul><li>DsPH </li></ul><ul><li>GP Consortia/Federations </li></ul><ul><li>Local Govt </li></ul><ul><li>Health & Wellbeing Boards </li></ul><ul><li>Scrutiny </li></ul><ul><li>HealthWatch </li></ul><ul><li>Public Health England </li></ul><ul><li>NHS Commissioning Board </li></ul>
    3. 3. 1. Some Key Observations on Public Health Interventions Implications in the new world
    4. 4. Building a “Whole Council Approach” through Domains of Public Health Health Improvement Health Protection Commissioning priorities, Evidence, acting when evidence is silent, making it work, supporting implementation Ensuring we have the right frameworks in place Long term, medium term, short term impacts FALLS PREVENTION Service Quality and Improvement
    5. 5. Timeframes of impact/yield Years 0 1 5 10 15 Planning Frameworks and Core Strategies Education Vitamin Supplements Decent Homes Air Pollution Primary Care Air Pollution Decent Homes Reducing Worklessness Primary Care
    6. 6. A new care model & public health Citizen purchased care – state resources Enablement Prevention Universal offer Citizen (purchased) care – own resources MEANS NEEDS
    7. 7. 2. Getting yourself ready for the new world Contributions, Stakeholders and Influencing Processes
    8. 8. Choices <ul><li>Prevention </li></ul><ul><li>Care </li></ul><ul><li>Enablement </li></ul><ul><li>All of them? </li></ul><ul><li>Outcomes </li></ul><ul><li>Benefits </li></ul>
    9. 9. What Outcomes can I contribute to?
    10. 10. Which Stakeholders Influence Money DsPH HWBB GP Consortia LA PHE NHSCB Scrutiny Healthwatch?
    11. 11. Learning the lessons from the National Audit Office 2010 not on course!
    12. 12. Smart Moves <ul><li>Understand the trends and embed them into how you work </li></ul><ul><li>Show you understand how local government works </li></ul><ul><li>Get to know your GP Commissioning Consortium/a </li></ul><ul><li>Get to know lead elected members </li></ul><ul><li>Understand their agendas </li></ul><ul><li>Address them explicitly – what do health trainers do for them? </li></ul><ul><li>Early discussion at Health and Wellbeing Board </li></ul><ul><li>Don’t waste time meeting the world and its dog </li></ul>
    13. 13. 3. Case Study Behaviour Change in Local Government
    14. 14. Life Expectancy by Ward
    15. 15. The drivers for behaviour change <ul><li>Personalisation </li></ul><ul><li>The White Paper – new strategic role for local government </li></ul><ul><li>Other White Papers </li></ul><ul><ul><li>Children, Public Health, </li></ul></ul><ul><li>The drive to integration </li></ul><ul><li>The Local Government Act 2002 </li></ul><ul><li>The Financial Crisis </li></ul><ul><li>Business Transformation </li></ul><ul><li>Behaviour Change as an economic imperative </li></ul><ul><li>Funding Adult Social Care </li></ul><ul><li>Community cohesion – immigration and TB as examples </li></ul>
    16. 16. <ul><li>Understanding these as drivers and intervening variables </li></ul><ul><li>Transit or Escalator – move to less deprived areas </li></ul><ul><li>Isolate – move to equally or more deprived areas </li></ul>Birmingham by Cadbury Neighbourhood Classifications
    17. 17. The new public health duties <ul><li>Coming into Las where…. </li></ul><ul><li>Money has been removed and services cut. Whole landscape changed </li></ul><ul><li>There’s a ring-fenced budget and everybody wants some of it </li></ul><ul><li>Public health is not a known or necessarily trusted quantity (just how joint is your joint DPH?) </li></ul><ul><li>Implications </li></ul><ul><li>DsPH in the real world please. Address what value you bring </li></ul><ul><li>Identify value and priorities with clear business case linked to core authority priorities </li></ul><ul><li>Identify what you can add to LA core agenda and what outcomes </li></ul>
    18. 18. Financial Options for Councils <ul><li>Go bust very quickly indeed </li></ul><ul><li>Create parish/town councils and shove stuff on them </li></ul><ul><li>Cut, cut, cut – deny people services – 33% less? </li></ul><ul><li>Change your model – targeted services for those with greatest need, preventive and universal for others </li></ul><ul><ul><li>Spread risk and co-produce/outsource </li></ul></ul><ul><li>CAN HEALTH TRAINERS BE AGILE ENOUGH FOR THIS CHALLENGE? </li></ul>
    19. 19. Birmingham <ul><li>Prediction & Prevention </li></ul><ul><ul><li>Falls prevention in social care </li></ul></ul><ul><ul><li>Telecare </li></ul></ul><ul><li>Pro - Environmental Behaviour </li></ul><ul><li>Pro-Social Behaviour </li></ul><ul><li>Obesity in 29 highest priority schools </li></ul><ul><li>Staff Sickness </li></ul><ul><li>Staff Productivity (Smoking Cessation) </li></ul><ul><li>Industrial Disease & Accident Prevention </li></ul>
    20. 20. The Opportunities <ul><li>Public health delivering outcomes </li></ul><ul><li>Joined up Outcomes </li></ul><ul><li>A balanced public health function </li></ul><ul><li>Interface between GPs and Social care to save both sides of the system money </li></ul><ul><li>Behavioural solutions to thorny and expensive problems </li></ul>
    21. 21. Smart Moves <ul><li>Understand the trends and embed them into how you work </li></ul><ul><li>Show you understand how local government works </li></ul><ul><li>Get to know your GP Commissioning Consortium/a </li></ul><ul><li>Get to know lead elected members </li></ul><ul><li>Understand their agendas </li></ul><ul><li>Address them explicitly – what do health trainers do for them? </li></ul><ul><li>Early discussion at Health and Wellbeing Board </li></ul><ul><li>Don’t waste time meeting the world and its dog </li></ul>
    22. 22. What does a business case for behaviour change look like? <ul><li>What are you offering? </li></ul><ul><li>Why should local government care? </li></ul><ul><ul><li>Strategically </li></ul></ul><ul><ul><li>Financially </li></ul></ul><ul><ul><li>Priorities and outcomes </li></ul></ul><ul><li>Show an understanding of the trends this service needs to address </li></ul><ul><ul><li>personalisation, eg </li></ul></ul><ul><li>How can you address these? </li></ul><ul><ul><li>Be specific </li></ul></ul><ul><ul><li>Be SMART </li></ul></ul><ul><li>Identify return on investment in value terms </li></ul><ul><ul><li>Costed investment, </li></ul></ul><ul><ul><li>costed benefit </li></ul></ul><ul><li>Argue for a relationship type which sits well with that council </li></ul>
    23. 23. Thank you! Jim.mcmanus@birmingham.gov.uk
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