Case Study – Informing Healthier Choices Programme for the
Department of Health

The IHC Steering Group

Dr. Judy Jones, Senior Responsible Officer, Department of Health
Professor Mike Catchpole, Director of the Centre for Infections,
Health Protection Agency
Dr. Steve George, President, Faculty of Public Health
Mrs Janine Dellar, Public Health Analyst, NHS Leicestershire County
and Rutland
Dr. Parul Desai, Consultant in Public Health and Ophthalmology at
Moorfields Eye Hospital
Professor Brian Ferguson, Chair, Association of Public Health
Observatories
Ms. Tricia Dodd, Deputy Director responsible for Health Analysis and
Life Events, Office for National Statistics
Dr. Judith Hooper, Executive Director of Public Health, Kirklees PCT
Ms. Angela McNab, Chief Executive, NHS Luton
Mr. Andy Mobbs, Policy & Customer Manager, The NHS Information
Centre
Professor John Newton, Regional Director of Public Health, NHS
South Central
Dr. Jammi Rao, Department of Health, Representing Strategic Health
Authority
Directors of Public Health
Dr. Jean Robinson, Public Health Analyst, Nottingham City PCT

IHC Programme Team

Sir Muir Gray, Programme Director
Mr. Mike Deacon, PHAST, Programme Manager
Dr. Catherine Brogan, PHAST, Clinical Lead
Mrs. Katie Enock, Aim 1 Lead
Dr. Richard Gibbs, Aim 2 Lead
Professor Sue Atkinson, Aim 3 Lead
Dr. Ben Toth, Aim 4 lead
Ms. Natalie Hutson, Business Manager
Mr. Christian Fenn, Project Co-Ordinator
Ms. Marie Grigson, Project Support Officer




December 2010                       1                    Mike Deacon
Case Study – Informing Healthier Choices Programme for the
Department of Health

Supporting local health and wellbeing - Background to
Informing Healthier Choices

Major health problems in many communities were highlighted in the Wanless Report
Securing good health for the whole population (February 2004) and acting on Wanless‟
recommendations, the Choosing Health (November 2004) initiative was launched.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuid
ance/DH_075488

At the same time, it had become clear that local authorities, health authorities, GPs and
community groups, were not being provided with the kind of useful, local evidence they
needed to plan their actions. And yet these are the groups whose work is key to
improving health and wellbeing, and preventing illness and disease. Their plans and
spending need to be based on actual evidence about what is going on in health in their
area, and it is the responsibility of public health Information and Intelligence to meet
these needs. A consultation on how to deliver better health knowledge, and new data
and 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 across
England and to increase its use to support population health improvement, health
protection and work on care standards and quality.”

What IHC set out to do

Six key health areas were targeted and IHC set out to deliver basic information and
tools 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 drinking

New data and tools were not enough, however. Standards for the public health
information 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 have
been achieved with great success. There is also a summary of how products were


December 2010                                   2                         Mike Deacon
Case Study – Informing Healthier Choices Programme for the
Department of Health

disseminated 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 training
for all

The Aim 1 team established three key objectives for their work:

1. To ensure that specialist health information and intelligence staff have access to
training and a coherent career development framework.
2. To support those who commission or provide NHS services to do so on the basis of
robust information and evidence.
3. To provide accessible training on the Internet to anyone who needs to understand
information and intelligence, to challenge it and to use it successfully.

Training outcomes

The website www.healthknowledge.org.uk was enhanced to provide a comprehensive
public health training resource.

Career Framework

A coherent, flexible public health career framework has been developed for use across
the 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 intended
end points. It can be accessed at www.phru.org.uk

IHC worked with a range of partners to develop model Job Descriptions (JD‟s) and
Person Specifications (PS‟s) for public health information and intelligence staff that
connect to the PHCF. The JD‟s and PS‟s can be accessed on www.pho.org.uk and
www.fph.org.uk

Aim 2 Improved data and the tools to use it - Meeting the need for local
data

The Aim 2 team carried out an extensive consultation with PCT public health and
commissioning teams, and local authorities, about the kinds of data and information they
need. Not surprisingly they specified accessible and useful local data that would help
address issues of health and wellbeing of their communities.

A focused drive was initiated to produce this kind of more localised data. The
Association of Public Health Observatories rose to the challenge as the main delivery
partner.

There are two highlights of this workstream:

Health Profiles - Health Profiles provide a snapshot of health for each local authority
area in England using key health indicators that enable comparison locally, regionally and
over time. They are designed to help local councils and the NHS decides where to
target resources and tackle health inequalities in their local area. Tools on the website


December 2010                                   3                          Mike Deacon
Case Study – Informing Healthier Choices Programme for the
Department of Health

help people compare their area‟s performance with other areas of the country and this
encourages sharing of best practice. www.healthprofiles.org.uk

Disease Prevalence Models - These provide prevalence estimates at PCT and local
authority area level, for some major long term diseases that absorb significant resources
in the NHS. They are already being widely used in local planning, case finding and early
detection. Early detection means early treatment and care. It is good for the patient and
good for the budget.

They can be accessed either through NHS Comparators (accessible to anyone with an
NHS email address) or at www.apho.org.uk/diseaseprevalencemodels

Aim 3 Stronger organisations using knowledge appropriately - Getting
the news out to every audience

As part of this workstream, IHC acted as an advocate for effective use of Public Health
Intelligence, particularly in PCTs and as part of the commissioning process.

IHC hosted a seminar on Health Impact Assessment for government departments; a
national 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 gave
presentations, as well as hearing from the leading figures in public health, including Sir
Michael Marmot. Workshops introduced all the IHC tools and products.

IHC has been working to make Health Impact Assessment (HIA) and Strategic
Environmental Assessment (SEA) easier, and to raise their profile. The IHC team wrote
a simple HIA tool which policymakers can use to quickly screen and then consider how
any new policy will impact on health and wellbeing. To encourage the use of health
evidence in HIA, IHC has provided a database of evidence sources, which policymakers
can access online. IHC also invested in the best practice HIA Gateway.
www.hiagateway.org.uk

Aim 4 Development of web-based support for health intelligence -
Intelligence on the web

This workstream set out to improve web based information for the public health
community, and beyond to anyone who needs access to high-quality evidence, tools and
knowledge about population health.

National Library for Public Health

A significant investment was made in the National Library for Public Health, now part of
NHS Evidence.

The Public Health Portal

An initial project to develop a stand-alone Public Health Desktop was closed when it
became clear that the route initially scoped would not deliver what was required, or win
partners‟ support.




December 2010                                   4                          Mike Deacon
Case Study – Informing Healthier Choices Programme for the
Department of Health

IHC began work with the NHS Information Centre to provide a browser based portal
for 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 default
set of resources to their personalised home page. Further content can be added from a
library of resources, including datasets, documents, tools, websites, and news feeds.

Managing the programme - How IHC delivered

Public Health Action Support Team CIC (PHAST), a public health consultancy and not-
for-profit social enterprise organisation, was appointed by the Department of Health to
manage delivery of the IHC Programme.

The programme worked with key leaders and influencers, and with key stakeholders and
users. The aim throughout has been to deliver “subsidiarity” at the right levels in terms
of collaborative working, and to align all outcomes with the way the health system
works at local and national level.

A Steering Group was established, chaired by the Department of Health‟s senior officer
responsible for the programme. There were representatives of PCTs and clinical end
users.

The Steering Group also included representatives from the Association of Public Health
Observatories, the Faculty of Public Health, the NHS Information Centre, the Health
Protection Agency, Directors of Public Health and the Office for National Statistics. This
ensured that outcomes were designed to be useful to a wide range of end users – from
local authorities to commissioning bodies, GPs to acute trusts. They are designed to be
sustainable and scaleable, and to have a long shelf life.

PHAST recruited first class leads for the four work-streams who led working groups and
took responsibility for commissioning and quality assurance and reviews.

Performance and Budget

IHC ran to time and well within the original budget, albeit with some reductions in
originally scoped deliverables, and with a need to adapt to change taking account of new
public health policy directions. A £4 million saving has arisen from the original IHC
Programme Budget of £12 million. £3 million was from the decision not to proceed with
the Public Health Desktop, as explained above, and the balance from efficiency savings
made in the other work streams.




December 2010                                   5                          Mike Deacon
Case Study – Informing Healthier Choices Programme for the
Department of Health

IHC Legacy Benefits

Where to find outcomes and products delivered by the Informing Healthier
Choices Programme:

Aim 1 Training for public health www.healthknowledge.org.uk
Public Health Skills and Careers Framework www.phru.org.uk
Model Job Descriptions and Person Specifications for I&I staff grade 4-8c
www.apho.org.uk/resource/item.aspx?RID=61407

Aim 2 Health Profiles for England www.healthprofiles.org.uk
Disease Prevalence Models www.apho.org.uk/diseaseprevalencemodels
National Child Measurement Programme
www.dh.gov.uk/en/publichealth/healthimprovement/healthyliving/DH_091956
Joint Strategic Needs Analysis Core Dataset
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAnd
Guidance/DH_086676
Nutrition and diet data www.empho.org.uk/viewresource.aspx?id=11024
Local lifestyle behaviour and wellbeing surveys
www.nwph.net/nwpho/Publications/Forms/DispForm.aspx?ID=158

Aim 3 Tools and support for Health Impact Assessment www.hiagateway.org.uk

Aim 4 Public Health Portal at MyIC – to use the portal register at www.ic.nhs.uk/myic
Public Health Futures website for trainees www.phfutures.org
National Library of Public Health www.library.nhs.uk/publichealth




December 2010                                  6                            Mike Deacon

Informing Healthier Choices Case Study

  • 1.
    Case Study –Informing Healthier Choices Programme for the Department of Health The IHC Steering Group Dr. Judy Jones, Senior Responsible Officer, Department of Health Professor Mike Catchpole, Director of the Centre for Infections, Health Protection Agency Dr. Steve George, President, Faculty of Public Health Mrs Janine Dellar, Public Health Analyst, NHS Leicestershire County and Rutland Dr. Parul Desai, Consultant in Public Health and Ophthalmology at Moorfields Eye Hospital Professor Brian Ferguson, Chair, Association of Public Health Observatories Ms. Tricia Dodd, Deputy Director responsible for Health Analysis and Life Events, Office for National Statistics Dr. Judith Hooper, Executive Director of Public Health, Kirklees PCT Ms. Angela McNab, Chief Executive, NHS Luton Mr. Andy Mobbs, Policy & Customer Manager, The NHS Information Centre Professor John Newton, Regional Director of Public Health, NHS South Central Dr. Jammi Rao, Department of Health, Representing Strategic Health Authority Directors of Public Health Dr. Jean Robinson, Public Health Analyst, Nottingham City PCT IHC Programme Team Sir Muir Gray, Programme Director Mr. Mike Deacon, PHAST, Programme Manager Dr. Catherine Brogan, PHAST, Clinical Lead Mrs. Katie Enock, Aim 1 Lead Dr. Richard Gibbs, Aim 2 Lead Professor Sue Atkinson, Aim 3 Lead Dr. Ben Toth, Aim 4 lead Ms. Natalie Hutson, Business Manager Mr. Christian Fenn, Project Co-Ordinator Ms. Marie Grigson, Project Support Officer December 2010 1 Mike Deacon
  • 2.
    Case Study –Informing Healthier Choices Programme for the Department of Health Supporting local health and wellbeing - Background to Informing Healthier Choices Major health problems in many communities were highlighted in the Wanless Report Securing good health for the whole population (February 2004) and acting on Wanless‟ recommendations, the Choosing Health (November 2004) initiative was launched. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuid ance/DH_075488 At the same time, it had become clear that local authorities, health authorities, GPs and community groups, were not being provided with the kind of useful, local evidence they needed to plan their actions. And yet these are the groups whose work is key to improving health and wellbeing, and preventing illness and disease. Their plans and spending need to be based on actual evidence about what is going on in health in their area, and it is the responsibility of public health Information and Intelligence to meet these needs. A consultation on how to deliver better health knowledge, and new data and 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 across England and to increase its use to support population health improvement, health protection and work on care standards and quality.” What IHC set out to do Six key health areas were targeted and IHC set out to deliver basic information and tools 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 drinking New data and tools were not enough, however. Standards for the public health information 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 have been achieved with great success. There is also a summary of how products were December 2010 2 Mike Deacon
  • 3.
    Case Study –Informing Healthier Choices Programme for the Department of Health disseminated 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 training for all The Aim 1 team established three key objectives for their work: 1. To ensure that specialist health information and intelligence staff have access to training and a coherent career development framework. 2. To support those who commission or provide NHS services to do so on the basis of robust information and evidence. 3. To provide accessible training on the Internet to anyone who needs to understand information and intelligence, to challenge it and to use it successfully. Training outcomes The website www.healthknowledge.org.uk was enhanced to provide a comprehensive public health training resource. Career Framework A coherent, flexible public health career framework has been developed for use across the 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 intended end points. It can be accessed at www.phru.org.uk IHC worked with a range of partners to develop model Job Descriptions (JD‟s) and Person Specifications (PS‟s) for public health information and intelligence staff that connect to the PHCF. The JD‟s and PS‟s can be accessed on www.pho.org.uk and www.fph.org.uk Aim 2 Improved data and the tools to use it - Meeting the need for local data The Aim 2 team carried out an extensive consultation with PCT public health and commissioning teams, and local authorities, about the kinds of data and information they need. Not surprisingly they specified accessible and useful local data that would help address issues of health and wellbeing of their communities. A focused drive was initiated to produce this kind of more localised data. The Association of Public Health Observatories rose to the challenge as the main delivery partner. There are two highlights of this workstream: Health Profiles - Health Profiles provide a snapshot of health for each local authority area in England using key health indicators that enable comparison locally, regionally and over time. They are designed to help local councils and the NHS decides where to target resources and tackle health inequalities in their local area. Tools on the website December 2010 3 Mike Deacon
  • 4.
    Case Study –Informing Healthier Choices Programme for the Department of Health help people compare their area‟s performance with other areas of the country and this encourages sharing of best practice. www.healthprofiles.org.uk Disease Prevalence Models - These provide prevalence estimates at PCT and local authority area level, for some major long term diseases that absorb significant resources in the NHS. They are already being widely used in local planning, case finding and early detection. Early detection means early treatment and care. It is good for the patient and good for the budget. They can be accessed either through NHS Comparators (accessible to anyone with an NHS email address) or at www.apho.org.uk/diseaseprevalencemodels Aim 3 Stronger organisations using knowledge appropriately - Getting the news out to every audience As part of this workstream, IHC acted as an advocate for effective use of Public Health Intelligence, particularly in PCTs and as part of the commissioning process. IHC hosted a seminar on Health Impact Assessment for government departments; a national 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 gave presentations, as well as hearing from the leading figures in public health, including Sir Michael Marmot. Workshops introduced all the IHC tools and products. IHC has been working to make Health Impact Assessment (HIA) and Strategic Environmental Assessment (SEA) easier, and to raise their profile. The IHC team wrote a simple HIA tool which policymakers can use to quickly screen and then consider how any new policy will impact on health and wellbeing. To encourage the use of health evidence in HIA, IHC has provided a database of evidence sources, which policymakers can access online. IHC also invested in the best practice HIA Gateway. www.hiagateway.org.uk Aim 4 Development of web-based support for health intelligence - Intelligence on the web This workstream set out to improve web based information for the public health community, and beyond to anyone who needs access to high-quality evidence, tools and knowledge about population health. National Library for Public Health A significant investment was made in the National Library for Public Health, now part of NHS Evidence. The Public Health Portal An initial project to develop a stand-alone Public Health Desktop was closed when it became clear that the route initially scoped would not deliver what was required, or win partners‟ support. December 2010 4 Mike Deacon
  • 5.
    Case Study –Informing Healthier Choices Programme for the Department of Health IHC began work with the NHS Information Centre to provide a browser based portal for 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 default set of resources to their personalised home page. Further content can be added from a library of resources, including datasets, documents, tools, websites, and news feeds. Managing the programme - How IHC delivered Public Health Action Support Team CIC (PHAST), a public health consultancy and not- for-profit social enterprise organisation, was appointed by the Department of Health to manage delivery of the IHC Programme. The programme worked with key leaders and influencers, and with key stakeholders and users. The aim throughout has been to deliver “subsidiarity” at the right levels in terms of collaborative working, and to align all outcomes with the way the health system works at local and national level. A Steering Group was established, chaired by the Department of Health‟s senior officer responsible for the programme. There were representatives of PCTs and clinical end users. The Steering Group also included representatives from the Association of Public Health Observatories, the Faculty of Public Health, the NHS Information Centre, the Health Protection Agency, Directors of Public Health and the Office for National Statistics. This ensured that outcomes were designed to be useful to a wide range of end users – from local authorities to commissioning bodies, GPs to acute trusts. They are designed to be sustainable and scaleable, and to have a long shelf life. PHAST recruited first class leads for the four work-streams who led working groups and took responsibility for commissioning and quality assurance and reviews. Performance and Budget IHC ran to time and well within the original budget, albeit with some reductions in originally scoped deliverables, and with a need to adapt to change taking account of new public health policy directions. A £4 million saving has arisen from the original IHC Programme Budget of £12 million. £3 million was from the decision not to proceed with the Public Health Desktop, as explained above, and the balance from efficiency savings made in the other work streams. December 2010 5 Mike Deacon
  • 6.
    Case Study –Informing Healthier Choices Programme for the Department of Health IHC Legacy Benefits Where to find outcomes and products delivered by the Informing Healthier Choices Programme: Aim 1 Training for public health www.healthknowledge.org.uk Public Health Skills and Careers Framework www.phru.org.uk Model Job Descriptions and Person Specifications for I&I staff grade 4-8c www.apho.org.uk/resource/item.aspx?RID=61407 Aim 2 Health Profiles for England www.healthprofiles.org.uk Disease Prevalence Models www.apho.org.uk/diseaseprevalencemodels National Child Measurement Programme www.dh.gov.uk/en/publichealth/healthimprovement/healthyliving/DH_091956 Joint Strategic Needs Analysis Core Dataset www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAnd Guidance/DH_086676 Nutrition and diet data www.empho.org.uk/viewresource.aspx?id=11024 Local lifestyle behaviour and wellbeing surveys www.nwph.net/nwpho/Publications/Forms/DispForm.aspx?ID=158 Aim 3 Tools and support for Health Impact Assessment www.hiagateway.org.uk Aim 4 Public Health Portal at MyIC – to use the portal register at www.ic.nhs.uk/myic Public Health Futures website for trainees www.phfutures.org National Library of Public Health www.library.nhs.uk/publichealth December 2010 6 Mike Deacon