Informing Healthier Choices Case Study


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3 year Department of Health public health programme delivered as part of the findings of the Wanless Report in 2004.

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Informing Healthier Choices Case Study

  1. 1. Case Study – Informing Healthier Choices Programme for theDepartment of HealthThe IHC Steering GroupDr. Judy Jones, Senior Responsible Officer, Department of HealthProfessor Mike Catchpole, Director of the Centre for Infections,Health Protection AgencyDr. Steve George, President, Faculty of Public HealthMrs Janine Dellar, Public Health Analyst, NHS Leicestershire Countyand RutlandDr. Parul Desai, Consultant in Public Health and Ophthalmology atMoorfields Eye HospitalProfessor Brian Ferguson, Chair, Association of Public HealthObservatoriesMs. Tricia Dodd, Deputy Director responsible for Health Analysis andLife Events, Office for National StatisticsDr. Judith Hooper, Executive Director of Public Health, Kirklees PCTMs. Angela McNab, Chief Executive, NHS LutonMr. Andy Mobbs, Policy & Customer Manager, The NHS InformationCentreProfessor John Newton, Regional Director of Public Health, NHSSouth CentralDr. Jammi Rao, Department of Health, Representing Strategic HealthAuthorityDirectors of Public HealthDr. Jean Robinson, Public Health Analyst, Nottingham City PCTIHC Programme TeamSir Muir Gray, Programme DirectorMr. Mike Deacon, PHAST, Programme ManagerDr. Catherine Brogan, PHAST, Clinical LeadMrs. Katie Enock, Aim 1 LeadDr. Richard Gibbs, Aim 2 LeadProfessor Sue Atkinson, Aim 3 LeadDr. Ben Toth, Aim 4 leadMs. Natalie Hutson, Business ManagerMr. Christian Fenn, Project Co-OrdinatorMs. Marie Grigson, Project Support OfficerDecember 2010 1 Mike Deacon
  2. 2. Case Study – Informing Healthier Choices Programme for theDepartment of HealthSupporting local health and wellbeing - Background toInforming Healthier ChoicesMajor health problems in many communities were highlighted in the Wanless ReportSecuring good health for the whole population (February 2004) and acting on Wanless‟recommendations, the Choosing Health (November 2004) initiative was launched. the same time, it had become clear that local authorities, health authorities, GPs andcommunity groups, were not being provided with the kind of useful, local evidence theyneeded to plan their actions. And yet these are the groups whose work is key toimproving health and wellbeing, and preventing illness and disease. Their plans andspending need to be based on actual evidence about what is going on in health in theirarea, and it is the responsibility of public health Information and Intelligence to meetthese needs. A consultation on how to deliver better health knowledge, and new dataand the tools to use it, led to the establishment of Informing Healthier Choices (IHC).The programme‟s vision was:“To improve the availability and quality of health information and intelligence acrossEngland and to increase its use to support population health improvement, healthprotection and work on care standards and quality.”What IHC set out to doSix key health areas were targeted and IHC set out to deliver basic information andtools to provide both a qualitative and quantitative picture:• Tackling health inequalities• Reducing the numbers of people who smoke• Tackling obesity, including promoting exercise• Improving sexual health• Improving mental health and wellbeing• Reducing harm from alcohol and encouraging sensible drinkingNew data and tools were not enough, however. Standards for the public healthinformation and intelligence community needed to be raised.The four ‘boxes’To address these issues, four „boxes‟ or Aims were established for the IHC programme:1. Improved workforce capacity and capability.2. Improved data and the tools to use it.3. Creation of stronger organisations using intelligence appropriately.4. Development of web-based support for health intelligence.A programme of work was agreed under each heading. Overall the programmes havebeen achieved with great success. There is also a summary of how products wereDecember 2010 2 Mike Deacon
  3. 3. Case Study – Informing Healthier Choices Programme for theDepartment of Healthdisseminated and how the project was managed. A legacy strategy has been completed,with safe homes for the products and outcomes, where the work can continue.Aim 1 Improved workforce capacity and capability - Public health trainingfor allThe Aim 1 team established three key objectives for their work:1. To ensure that specialist health information and intelligence staff have access totraining and a coherent career development framework.2. To support those who commission or provide NHS services to do so on the basis ofrobust information and evidence.3. To provide accessible training on the Internet to anyone who needs to understandinformation and intelligence, to challenge it and to use it successfully.Training outcomesThe website was enhanced to provide a comprehensivepublic health training resource.Career FrameworkA coherent, flexible public health career framework has been developed for use acrossthe UK. The Public Health Career Framework (PHCF) brings together competencies,underpinning knowledge, training and qualification routes and registration requirements.It provides a route map for careers in public health regardless of starting and intendedend points. It can be accessed at worked with a range of partners to develop model Job Descriptions (JD‟s) andPerson Specifications (PS‟s) for public health information and intelligence staff thatconnect to the PHCF. The JD‟s and PS‟s can be accessed on 2 Improved data and the tools to use it - Meeting the need for localdataThe Aim 2 team carried out an extensive consultation with PCT public health andcommissioning teams, and local authorities, about the kinds of data and information theyneed. Not surprisingly they specified accessible and useful local data that would helpaddress issues of health and wellbeing of their communities.A focused drive was initiated to produce this kind of more localised data. TheAssociation of Public Health Observatories rose to the challenge as the main deliverypartner.There are two highlights of this workstream:Health Profiles - Health Profiles provide a snapshot of health for each local authorityarea in England using key health indicators that enable comparison locally, regionally andover time. They are designed to help local councils and the NHS decides where totarget resources and tackle health inequalities in their local area. Tools on the websiteDecember 2010 3 Mike Deacon
  4. 4. Case Study – Informing Healthier Choices Programme for theDepartment of Healthhelp people compare their area‟s performance with other areas of the country and thisencourages sharing of best practice. Prevalence Models - These provide prevalence estimates at PCT and localauthority area level, for some major long term diseases that absorb significant resourcesin the NHS. They are already being widely used in local planning, case finding and earlydetection. Early detection means early treatment and care. It is good for the patient andgood for the budget.They can be accessed either through NHS Comparators (accessible to anyone with anNHS email address) or at 3 Stronger organisations using knowledge appropriately - Gettingthe news out to every audienceAs part of this workstream, IHC acted as an advocate for effective use of Public HealthIntelligence, particularly in PCTs and as part of the commissioning process.IHC hosted a seminar on Health Impact Assessment for government departments; anational workshop looking at Population Health Modelling, and a national „colloquium‟for 200 public health trainees in Spring 2010. Trainees led in designing the day and gavepresentations, as well as hearing from the leading figures in public health, including SirMichael Marmot. Workshops introduced all the IHC tools and products.IHC has been working to make Health Impact Assessment (HIA) and StrategicEnvironmental Assessment (SEA) easier, and to raise their profile. The IHC team wrotea simple HIA tool which policymakers can use to quickly screen and then consider howany new policy will impact on health and wellbeing. To encourage the use of healthevidence in HIA, IHC has provided a database of evidence sources, which policymakerscan access online. IHC also invested in the best practice HIA 4 Development of web-based support for health intelligence -Intelligence on the webThis workstream set out to improve web based information for the public healthcommunity, and beyond to anyone who needs access to high-quality evidence, tools andknowledge about population health.National Library for Public HealthA significant investment was made in the National Library for Public Health, now part ofNHS Evidence.The Public Health PortalAn initial project to develop a stand-alone Public Health Desktop was closed when itbecame clear that the route initially scoped would not deliver what was required, or winpartners‟ support.December 2010 4 Mike Deacon
  5. 5. Case Study – Informing Healthier Choices Programme for theDepartment of HealthIHC began work with the NHS Information Centre to provide a browser based portalfor everyone working in public health, as part of the MyIC service. It delivers useful,trustworthy, current knowledge. Users can create their own profile, and add a defaultset of resources to their personalised home page. Further content can be added from alibrary of resources, including datasets, documents, tools, websites, and news feeds.Managing the programme - How IHC deliveredPublic Health Action Support Team CIC (PHAST), a public health consultancy and not-for-profit social enterprise organisation, was appointed by the Department of Health tomanage delivery of the IHC Programme.The programme worked with key leaders and influencers, and with key stakeholders andusers. The aim throughout has been to deliver “subsidiarity” at the right levels in termsof collaborative working, and to align all outcomes with the way the health systemworks at local and national level.A Steering Group was established, chaired by the Department of Health‟s senior officerresponsible for the programme. There were representatives of PCTs and clinical endusers.The Steering Group also included representatives from the Association of Public HealthObservatories, the Faculty of Public Health, the NHS Information Centre, the HealthProtection Agency, Directors of Public Health and the Office for National Statistics. Thisensured that outcomes were designed to be useful to a wide range of end users – fromlocal authorities to commissioning bodies, GPs to acute trusts. They are designed to besustainable and scaleable, and to have a long shelf life.PHAST recruited first class leads for the four work-streams who led working groups andtook responsibility for commissioning and quality assurance and reviews.Performance and BudgetIHC ran to time and well within the original budget, albeit with some reductions inoriginally scoped deliverables, and with a need to adapt to change taking account of newpublic health policy directions. A £4 million saving has arisen from the original IHCProgramme Budget of £12 million. £3 million was from the decision not to proceed withthe Public Health Desktop, as explained above, and the balance from efficiency savingsmade in the other work streams.December 2010 5 Mike Deacon
  6. 6. Case Study – Informing Healthier Choices Programme for theDepartment of HealthIHC Legacy BenefitsWhere to find outcomes and products delivered by the Informing HealthierChoices Programme:Aim 1 Training for public health Health Skills and Careers Framework Job Descriptions and Person Specifications for I&I staff grade 2 Health Profiles for England Prevalence Models Child Measurement Strategic Needs Analysis Core and diet data lifestyle behaviour and wellbeing 3 Tools and support for Health Impact Assessment 4 Public Health Portal at MyIC – to use the portal register at Health Futures website for trainees www.phfutures.orgNational Library of Public Health 2010 6 Mike Deacon