Since 1842 things have progressed in our understanding of what determines Health.
Health Watch: The aim of Local Health Watch will be to give citizens and communities a stronger voice to influence and challenge how health and social care services are provided within their localityHealth & Wellbeing Board –Joint Health & Wellbeing Strategy: Local priorities for joint action.
Quote from Nye Bevan accepted as the Father of the NHS. This was his vision before economics took the organisation down another path. Effectively the NHS was in debt in 1950 due to the strain put on its finances by the offer of free dental care and free spectacles, services that people previously had to pay for.
The New Public Health Agenda continues John Snow’s approach by gathering data on the wider determinants of health in one place the JSNA.
Public health are we nearly there yet health and safety group with sound
Public HealthAre We Nearly There Yet? Pete Hill & Sarah James
Public Health Are We Nearly There Yet?• A Quick Recap•Draft Health & Wellbeing Strategy•DPH and the Life Course•JSNA Update•Lies Damned Lies and Statistics!•Something To Think About.
Health and its determinants “Health is a state of complete physical mental & social wellbeing and not merely the absence of disease or infirmity.” World Health Organisation (1948) Health is the science & art of promoting & protecting health & wellbeing, preventing ill health & prolonging life through the organised efforts of society.” UK Faculty of Public Health 2010Health Improvement Health Protection Health Services
The health and well-being of individuals and populations acrossall age groups is influenced by a range of factors both withinand outside the individuals control.
Draft Health & Wellbeing StrategyChildren and Working Age Older PeopleYoung People Adults Healthy Weight Reducing smoking Managing long term conditions Supporting family carers Promoting good mental health Helping families to Thrive Reduce the harm caused by drugs and alcohol Fulfilling lives for people with learning difficulties Physical Activity
Health & Wellbeing Boards JSNAHealth Health & PublicWatch Wellbeing Board Health Outcomes Framework Joint Health & Wellbeing Strategy LA NHS CCG Commissioning Decisions
Director of Public Health• Jim McManus• Appointed July 2012• Employed by Hertfordshire County Council• Principal Advisor to Health & Wellbeing Board Responsible for: Health Improvement Health Protection Health Services
Health Influences Over the Life CourseHealth Influences Over The Life Course 8 From Neal Halfon
“District Councils in particular have functions crucial to health inhealth protection and environmental health, planning, housing andleisure/culture to name but a few. I think this gives us an opportunityto develop arrangements which work locally for us”.“In particular, I think we will be able to re-emphasis that thespecialist public health family is larger than we think.”Jim McManusDirector of Public Health Hertfordshire County Council
The Future of Public Health In April 2013, the Health and Social Care Act 2012 will beimplemented, which means that Hertfordshire County Council will take on the duty to improve the health of people in its areaand with it, acquire many of the public health services currently the responsibility of the NHS. The landscape for both public health and the NHS will be very different.’’ Jim McManus DPH
Jim’s vision…..this gives Hertfordshire a significant opportunity to develop a robust public health function which works across the various partners in the County, and a significant opportunity to realise the shared ambitions for a healthier population.
Six domains of specialist public health activity are emerging1. Commission and account for Mandated Services (e.g. smoking, Chlamydia, health checks, sexual health etc)2. Healthcare public health support to CCGs3. Health Protection and resilience role (still being defined) DPH will co- chair local Health Resilience Fora and have system duties for infectious disease and other health protection issues4. Applying public health skills to local authorities and the public sector (Link consultant in public health to each Directorate of HCC,Links to Districts)5. Joining things up between and across agencies (e.g. Obesity)6. Delivering health and wellbeing Board priorities
Specialist Public Health links to these through lead officers and also by a modest amount of financial support.
How JSNAs, JHWS’s and Commissioning plans fit together So what have we achieved? – what difference have we made to people’s lives? (outcomes) What services do we need to commission, or de-commission / provide and shape both separately and jointly? (our commissioning plans) So what are our priorities for collective action, and how will we achieve them together? (our JHWS) What are we doing now, how well is it working and how efficient is it? (an analysis on our progress) So what does that mean they need, now and in the future and what assets do we have? (a narrative on the evidence – our JSNAs)What does our population & place look like? –evidence andcollective insight
The JSNA process will be easily used and understood by everyone including: Health & Care Commissioners Representatives General Public & Healthwatch Schools & Providers Education JSNA Criminal Economy & Justice Employment Housing Environment Community Transport Organisations Leisure
JSNA 3. OUR 1. WELCOME 2. OVERVIEWS 4. YOUR 6. RESEARCH PRIORITIES 5. OUR HEALTH, COMMUNITY AND 7. YOUR VIEWS CARE AND RESOURCES WELLBEING 2.1 Needs 3.1 Healthy Summary Weight1.1 What is JSNA 4.1 Community Profiles 6.1 Funding / 2.2 Performance 3.2 Smoking Finances Snapshots 7.1 Discussion 5.1 Health and Comment 1.2 How to use JSNA 4.2 Clinical Conditions and 2.3 Priorities 3.3 Long Term Commissioning Disabilities Progress Conditions Group Areas 6.3 Current Data 1.3 How wecommission and 3.4 Carers 4.3 District Areas monitor 5.2 Health Improvement and 3.5 Mental Health Healthy Living 6.2 Assets and and Wellbeing Services 1.4 FAQ 3.6 Thriving Families 5.3 Life Stages and Social Groups 3.7 Alcohol 3.8 Learning Disabilities 3.9 Dementia
5. OUR HEALTH, CARE AND WELLBEING 5.2 Health Improvement and Healthy Living 5.2.4 Health 5.2.6 Sexual 5.2.8 Mental 5.2.2 Drug Misuse Improvement Health Wellbeing 5.2.3 Healthy 5.2.5 Physical 5.2.1 Alcohol 5.2.7 Smoking Eating Activity 5.3 Life Stages and Social Groups 5.1 Health Conditions and 5.3.6 Particular 5.3.2 Carers 5.3.4 End of Life Disabilities Groups 5.1.6 Mental 5.1.4 Learning 5.1.8 Physical 5.1.2 Cancer Health and 5.3.3 Children and 5.3.5 Mother and Disabilities Disabilities 5.3.1 Ageing Dementia Young People Baby5.1.1 Acute Care 5.1.3 Infectious 5.1.5 Long Term 5.1.7 Other 5.1.9 Sensory and Trauma Diseases Conditions Disorders Disabilities
4. YOUR COMMUNITY 4.2 Clinical Commissioning Group Areas 4.2.1 East and 4.2.2 Herts Valleys North Herts 4.3 District Areas 4.3.10 Welwyn 4.3.2 Dacorum 4.3.4 Hertsmere 4.3.6 Three Rivers 4.3.8 Stevenage Hatfield 4.3.1 Broxbourne 4.3.3 East Herts 4.3.5 North Herts 4.3.7 St Albans 4.3.9 Watford 4.1 Community Profiles 4.1.2 Community 4.1.3 Community 4.1.5 Employment 4.1.7 Equality and Resources and 4.1.9 Other Safety and the Economy Deprivation Leisure 4.1.1 4.1.4 Education 4.1.8 Health andAccomodation and 4.1.10 Population 4.1.6 Environment and Learning Wellbeing Housing
Community Profiles• http://www.hertslis.org/keyresources/profiles/
UK Newspaper Circulation Figures Jan –Jun 20121. The Sun 2,622,1232. Daily Mirror 1,091,0943. Daily Star 612,56811. The Independent 100,139
So• How Do We Prove We Make a Difference?• Are We Concentrating on the Right Things? Are We……….
Cost Analysis Cost of poor health in the UK working age population in 2007 was between £103-129 billion^ The Total Cost of Workplace Injuries in 2009/10 was £5.4 billion* Cost to the NHS of Workplace Accidents & Ill Health in 2009/10 was £608 million* In 2009/10 700,000 people suffered a Workplace Injury* The HSE Cost Model Predicts each Workplace Fatality Costs £1.5 million* Annually 16,000 People Leave the Labour Market as a Result of a Workplace Injury or Illness*more than three-quarters of the population do not have disability-free life expectancy as far as the age of8. If society wishes to have a healthy population, working until 68 years, it is essential to take action to bothaise the general level of health and flatten the social gradient” – Sir Michael Marmot *Costs to Britain of Workplace Injuries & Work Related Ill Health 2009/10 – HSE Publications ^ Working for a Healthier Tomorrow – Dame Carol Black Review 2008
Where Do You Fit InThe Health Jigsaw?“I’m not like everybody else” – Ray Davies 1966