PPMA Annual Seminar 2014 - Public Health is everyone's business - better outcomes for Communities and Workforces

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PPMA Annual Seminar 2014 - Public Health is everyone's business - better outcomes for Communities and Workforces

  1. 1. www.hertsdirect.org Population Health is everyone’s business better outcomes for Communities and Workforces Jim McManus, CPsychol, CSci, AFBPsS, FFPH, FRSPH, MCIPD, FCIEH Director of Public Health, Hertfordshire County Council Representing the Association of Directors of Public Health
  2. 2. www.hertsdirect.org Coverage • Public health - one year on – From closing brothels to changing places • Shared ownership of community outcomes • Applying public health skills across local government • Common ground between public health and people managers for the future? • Workforce wellbeing - keeping people healthy and resilient
  3. 3. www.hertsdirect.org Public Health – one year on Opportunity •The Big epidemiological challenges ahead •PH Skillsets adding value •Mainstreaming public health work Challenge •workforce challenges – Leadership – Market – Person-Organisation Fit – Redesigning roles and jobs •Service challenges
  4. 4. www.hertsdirect.org Crucial Situational Factors • Leadership doesn’t happen in isolation • Multiple environment and collaborative (Getha- Taylor,2013) The factors determining which style you need for which Public Health challenge The Personality of the Leader The issue itself Pandemic or health improvement? Organizational Culture Strategic and Partnership Environments Team and Organization
  5. 5. www.hertsdirect.org Crucial Situational Factors • Leadership doesn’t happen in isolation • Multiple environment and collaborative (Getha- Taylor,2013) The factors determining which style you need for which Public Health challenge The Personality of the Leader The issue itself Pandemic or health improvement? Organizational Culture Strategic and Partnership Environments Team and Organization
  6. 6. www.hertsdirect.org Crucial Situational Factors • Leadership doesn’t happen in isolation • Multiple environment and collaborative (Getha- Taylor,2013) The factors determining which style you need for which Public Health challenge The Personality of the Leader The issue itself Pandemic or health improvement? Organizational Culture Strategic and Partnership Environments Team and Organization
  7. 7. www.hertsdirect.org What does that mean for Public Health? The variety of challenges 1. The Strategic Challenge across our agency and geography 2. The distributed Challenge across agencies and stakeholders 3. The Professional challenge across domains of PH practice 4. The practice challenge to remain competent and practice well 5. The protective challenge of planning and responding to health protection incidents 6. The managerial challenge of tasks and resources 7. The personal challenge of resilience during this Agile Leadership Styles! See for example Lutz Allan et al, 2013
  8. 8. www.hertsdirect.org Work still to do – finding the new sewage? What is high impact public health today? • Transformation not transition • Multi-Dimensional public health – Phasing across the lifecourse – Layering across the real world • Colonising local government • Using PH as a babel fish • New applications for public health
  9. 9. www.hertsdirect.org The Challenges • Misery and Pain due to avoidable disease and poor resilience/happiness • What kills most people early is diseases of lifestyle • Seeing the wood for the trees in the midst of clinical detail
  10. 10. www.hertsdirect.org The Challenges – Living in a System
  11. 11. www.hertsdirect.org The challenges - busting the economy
  12. 12. www.hertsdirect.org The Challenges - the Lifecourse • Phasing across the lifecourse and layering across time Working age Accumulation Of risk in Late working age Good early Years outcomes For lifetime Mental health
  13. 13. www.hertsdirect.org Core Public Health Skill Sets – ppma can help unlock this • The population mindset • Problem Definition • Needs Assessment • Evidence of What Works • Generation of Outcomes and Priorities • Generation of Interventions • Testing and refining
  14. 14. www.hertsdirect.org Health Improvement Health Protection Commissioning priorities, Evidence, acting when evidence is silent, making it work, supporting implementation Protecting people from threats and hazards Long term, medium term, short term impacts Take any example and use the three domains model Service Improvement & Quality
  15. 15. www.hertsdirect.org Applications • Housing • Leisure • Social Care • Workforce • Behaviour Change – from driving behaviour to council tax payments and channel shift
  16. 16. www.hertsdirect.org Health Improvement Health Protection Commissioning priorities, Evidence, acting when evidence is silent, making it work, supporting implementation Protecting the workforce from hazards and threats Long term, medium term, short term impacts Applications in H R Terms – Phasing and Layering Service Quality/ Improvem ent
  17. 17. www.hertsdirect.org Common ground – our workforce health • Increasing non-communicable disease – Smoking, obesity • Increasing mental ill health • Increasing sickness absence • Increasing loss to business productivity and performance from sick pay • Avoidable cost of managing and replacing sick and absent staff
  18. 18. www.hertsdirect.org
  19. 19. www.hertsdirect.org Early and avoidable deaths • Most of them preventable • Problems start in working age life with sickness absence • Common causes: inactivity, MSK problems, diet, alcohol, smoking • Significant avoidable stress and mental health costs • The human side of resource depreciation because it isn’t looked after • WE REALLY MUST DO SOMETHING! BUT WHAT?
  20. 20. www.hertsdirect.org Mental Health • Biggest single cause of sickness absence • Mostly avoidable or remediable at early stages • Significant cause of ET claims and workplace disputes • Area most employers feel least prepared for • 1 in 4 of population have in lifetime • 1 in 3 of workforce report sickness absence around it • Behavioural sciences relatively under-utilised
  21. 21. www.hertsdirect.org What is the root issue? • There is a flow from low risk to high risk to disease for the working age population • This leads to: • Diseases of lifestyle • More risk, more absence • Compound risk, compound absence • Low productivity
  22. 22. www.hertsdirect.org What does this mean for you as employers? • Chronic disease related deaths account for 56% of all deaths in the working-age population in the world (World Health Organization). • High prevalence of major modifiable health risks contributes to the epidemic of chronic disease. – Elevated BMI (BMI ≥25kg/m2 ) Obesity (BMI ≥ 30 kg/m2 ) – Inactivity Smoking – Stress Elevated blood pressure – Elevated cholesterol High blood sugar – Alcohol • Places an increasing burden on employers: decreased productivity, increased absenteeism, increased health and worker’s compensation claims.
  23. 23. www.hertsdirect.org Productivity Decreases with Number of Health Risks Excess Productivity Loss Productivity Loss (%) Base Cost Number of Health Risks (Journal of Occupational and Environmental Medicine 2005;47:769-77 (n = 28,375))
  24. 24. www.hertsdirect.org Absenteeism Increases with Number of Health Risks Number of Health Risks (Journal of Occupational and Environmental Medicine 2005;47:769-77 (n = 28,375)) Base work loss days/yr Excess Work Loss days/yr work loss days/yr
  25. 25. www.hertsdirect.org Root causes One of the root causes of unsustainable increases in costs is natural flow of individuals from low risk → high risk →disease →higher employer costs natural flow estimated at 2% - 4% per year. • (Edington et al, 2009).
  26. 26. www.hertsdirect.org What can be done • An effective Workplace Wellness strategy is to stop migration of people to higher risk and keep low risk people at low risk. • • Employers costs go up as people age, regardless of their health risk status and as health risk status gets worse, costs go up regardless of age.
  27. 27. www.hertsdirect.org Three Examples
  28. 28. www.hertsdirect.org Our Offer 1. Workplace health champions (North Herts College) 2. Mental Health First Aid (Bourne Leisure) 3. Health Checks and Mini-MOTs (HCC) 4. Physical Activity (ServiceLine) 5. Weight Management 6. Stop Smoking 7. Alcohol and Drugs 8. Active Travel
  29. 29. www.hertsdirect.org A common Agenda 1. A Healthy, resilient population is a workforce sustainability outcome and a public health outcome 2. The Psychological Contract and Happiness 3. Public Health skills embedding across our agencies can help us understand new challenges 4. Public Health being effective in new world is a key shared outcome for us
  30. 30. www.hertsdirect.org Thank you! Jim.McManus@hertfordshire.gov.uk www.adph.org.uk

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