Hertfordshire parish conference april 2014 public health

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The presentation for a plenary session with parish and town councils on their role in public health (followed by a workshop)

The presentation for a plenary session with parish and town councils on their role in public health (followed by a workshop)

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  • 1. www.hertsdirect.org Jim McManus, OCDS, CPsychol, CSci, AFBPsS ,FFPH, FCIEH, FRSPH Director of Public Health, Hertfordshire County Council 7thApril 2014, Hertfordshire Parish Conference Parish and Town Councils: A Public Health role
  • 2. www.hertsdirect.org Some background reading for Public Health People on Parish and Town Councils • NALC Website http://www.nalc.gov.uk/ • NALC guide http://www.townforum.org.uk/servicesstructure/parish • Functions and powers of parish councils • http://www.sstaffs.gov.uk/your_council/parish_counci
  • 3. www.hertsdirect.org Some background Reading for Parishes • Hertfordshire public health strategy http://www.hertspublichealth.co.uk/files/Healthier%20Herts%20Public%20Health%20Strategy • District Councils Network public health pages http://districtcouncils.info/?s=public+health • Public Health case study Hertfordshire http://www.local.gov.uk/documents/10180/11493/Hertfordshire+County+Council.pdf/31d6e95 • If I could do one thing... • LGA http://www.local.gov.uk/web/guest/health-and-well-being- research/-/journal_content/56/10180/5945025/ARTICLE • Herts County Council Public Health learning portal www.hertsdirect.org/phelearn • Kings Fund guide to local authorities and public health http://www.kingsfund.org.uk/projects/improving-publics-health? gclid=COKssoyuzL0CFUTMtAodAwcAOg
  • 4. www.hertsdirect.org Three Questions • How do you improve the health of your population? – Connectedness, resilience, healthy living • How do you protect the health of your population? – Hazards and threats to health (eg crime prevention) • What is it you can do that others cannot?
  • 5. www.hertsdirect.org Local government’s new public health functions • commissioning a range of services from a range of providers from different sectors • tackling the causes of ill-health & reducing health inequalities eg the way they operate the planning system • promoting and protecting health • promoting social justice and safer communities • key partnerships with other agencies
  • 6. www.hertsdirect.org What is Public Health about then? • Health Protection • Health Improvement • Healthcare Public Health • Reducing Health Inequalities..what do we mean by that?
  • 7. www.hertsdirect.org
  • 8. www.hertsdirect.org What about the way PH works? • Basic science is Epidemiology – Who gets What and Where and When and How! • Foundation stones are – Assessing population need – Using evidence of what works – The social determinants of health are paramount – Prevention is better than cure – Many outcomes can only be achieved by working with others
  • 9. www.hertsdirect.org Contributors to overall health outcomes and why elected councillors are important leaders Smoking 10% Diet/Exercise 10% Alcohol use 5% Poor sexual health 5% Health Behaviours 30% Education 10% Employment 10% Income 10% Family/Social Support 5% Community Safety 5% Socioeconomic Factors 40% Access to care 10% Quality of care 10% Clinical Care 20% Environmental Quality 5% Built Environment 5% Built Environment 10% Source: Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute. Used in US to rank counties by health status While this is from a US context it does have significant resonance with UK Evidence, though I would want to increase the contribution of housing to health outcomes from a UK perspective.
  • 10. www.hertsdirect.org Phasing and Layering....
  • 11. www.hertsdirect.org The Lifecourse • Phasing across the lifecourse and time Working age Accumulation Of risk in Late working age Good early Years outcomes For lifetime Mental health
  • 12. www.hertsdirect.org Layering across our lived realities
  • 13. www.hertsdirect.org Healthier Herts: A Public Health Strategy for Hertfordshire OUR PURPOSE to work together to improve the health and wellbeing of the people of Hertfordshire, based on best practice and best evidence OUR VISION: A Healthy, Happy Hertfordshire: everyone in Hertfordshire is born healthy, and lives full, healthy and happy lives. We compare well with England and every area in Hertfordshire compares well against Hertfordshire Priority 5: We understand what’s needed and we do what works Priority 6: We make public health everybody’s business and work together HOW WE WILL WORK TOGETHER (our strategic priorities: how we do it for our County) The Public Health Outcomes Framework (the national PHOF will Help us measure Our success) WHAT WE WILL ACHIEVE WORKING FOR AND WITH OUR RESIDENTS (our strategic priorities: what we achieve for our County) Priority 1: Our residents live Longer, Healthier Lives Priority 2: Our residents Starts Life Healthy and Stays Healthy Priority 3: We narrow the gap in life expectancy and health between most and least healthy Priority 4: We protect our communities from harm (chemical, biological, radiological and environmental) Building Blocks For the Public Health Family Strong Leadership Capable, Skilled People Co-production with citizens Effective Partnerships Evidence and Knowledge Driven Plan and Deliver for Localism Whole System Approaches Making better use of behavioural sciences at individual, interpersonal, community and service levels
  • 14. www.hertsdirect.org Back to the Three Questions • How do you improve the health of your population? – Connectedness, resilience, healthy living • How do you protect the health of your population? – Hazards and threats to health (eg crime prevention) • What is it you can do that others cannot?
  • 15. www.hertsdirect.org Using Obesity as an Example • What can we do about Obesity? • It’s not just about exercise • And it certainly isn’t just about education or willpower • What’s the parish role? • Think through public health challenges to arrive at parish roles
  • 16. www.hertsdirect.org Systems thinking on wider determinants Getting everyone on the same systems page The wider determinants of Health and Local Government functions (Must adopt a Lifecourse approach!) – obesogenic environment The Lives people lead and whether LA functions help or hinder healthy lifestyles (policy, service quality, access, behavioural economics, behavioural sciences) – obesogenic context and community, obesogenic lifestyle The services people access such as primary care (high quality, easy access, good follow up, behavioural and lifestyle pathways wrap around) – do services help or hinder?
  • 17. www.hertsdirect.org Average BMI Underweight Healthy weight Overweight Obese Average BMI Underweight Healthy weight Overweight Obese Fewer overweight Fewer obese Reduce average BMI Fewer underweight Maximise proportion at a healthy weight Minimise proportion at an unhealthy weight a new approach is needed, focus on shifting weight distribution in the population Make more people a healthy weight, not just fewer people obese
  • 18. www.hertsdirect.org Some Answers • How do you address obesity in your parish? – Making healthy eating easy and second nature • The public realm, the shops, social opportunities, – Making self-propelled transport and physical activity second nature , safe and easy • The public realm, the social environment, amenities • Work across your planning,amenity, provision and other powers and duties
  • 19. www.hertsdirect.org 15 Actions on Obesity so far (more will be done) 1. New weight management service already commissioned and reached 1st 1,000 referrals in three months, more will be commissioned 2. Obesity pathway in place for tiers 1 -3 obesity care. Revision late 2014 3. New lifestyle partnership launched with lifestyle offer for Herts residents to be ready by Easter for phased roll out 4. New online lifestyle service launched in February 5. Workplace physical activity challenge funded and running (Herts Sports Partnership) 6. Workplace Health improvement programme running (Business in the Community) 7. 93% of GPs in Herts now doing NHS HealthChecks 1. Obesity Plan approval by Cabinet due March 2014 2. New child weight management service to be commissioned in 2014 3. Broxbourne whole area obesity pilot underway with Borough and County Council, schools and NHS 4. Fast food takeaway restrictions 5. Countryside walks scheme 6. Year of Cycling launching May 2014 7. Funding for District Councils to work on health improvement agreed and each District working out its plans 8. Continue child weight measurement programme
  • 20. www.hertsdirect.org Some shared goals for Partnership Working • the best start in life • healthy schools and pupils • helping people find good jobs and stay in work • active and safe travel • warmer and safer homes • access to green and open spaces and the role of leisure services • strong communities, wellbeing and resilience • public protection and regulatory services (including takeaway/fast food, air pollution, and fire safety) • health and spatial planning.
  • 21. www.hertsdirect.org Some enablers we need to work on together • Data and JSNA • Working with Districts, Boroughs and County • Workforce Development and learning www.hertsdirect.org/phelearn • Communication and Strategy • Delivery Partnerships • Technical Advice and assistance/liasion • Health Protection Arrangements
  • 22. www.hertsdirect.org Primary Prevention Secondary Prevention Tertiary Prevention The shift to prevention
  • 23. www.hertsdirect.org Thank you! Jim.mcmanus@hertfordshire.gov.uk Public Health page http://www.hertsdirect.org/your-council/hcc/publichealth/ Free learning resources for public health www.hertsdirect.org.uk/phelearn