Healthy Lives, Healthy People:  The Public Health White Paper  Jon Burke NAVCA Development Adviser  (Health and Social Car...
The White Paper <ul><li>Builds on  Equity and Excellence: Liberating the NHS   </li></ul><ul><li>Is a high-level vision fo...
Highlights of the White Paper <ul><li>Local authorities will have new statutory duties to improve the health of their popu...
Funding And Commissioning 1 – Issues for local voluntary sector organisations <ul><li>The DH expects that </li></ul><ul><l...
Funding And Commissioning 2 – Issues for local voluntary sector organisations <ul><li>The DH will work to ensure that the ...
Local authority  commissioning responsibilities <ul><li>The DH proposes that responsibility for commissioning or providing...
Local accountability <ul><li>Public Health England will publish national and local performance data. This will make it eas...
The Health Premium <ul><li>Local authorities will receive a premium if progress is made in improving the health of the loc...
Public health outcomes 1 <ul><li>The government propose a new outcomes framework for public health with three purposes: </...
Public health outcomes 2 <ul><li>The Outcomes Famework will include measures that allow assessment of health improvement a...
Outcomes Indicators <ul><li>Current thinking is that a small number of indicators will focus on health improvement.  </li>...
The importance of Partnerships 1 <ul><li>One of the most important aims of the Public Health Outcomes Framework will be to...
The importance of Partnerships 2 <ul><li>By sharing the same or complementary measures between sectors, there is a stronge...
Transition to a new public health system Timetable (subject to Parliamentary approval of legislation)   Date Consultation ...
Consultation questions  1 <ul><li>What are the best opportunities to develop public health information and intelligence?  ...
Consultation questions  2 <ul><li>How can the government ensure that the outcomes framework, the Local Authority Public He...
Further Information <ul><li>To share ideas and discuss health and social care issues, join the Social Care and Health disc...
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Healthy Lives, Healthy People: The Public Health White Paper

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  • Sir Michael Marmot’s report; Fair Society, Healthy Lives was a strategic review of health inequalities in England post-2010. The white paper adopts the aims of Sir Michael Marmot’s report; Fair Society, Healthy Lives, in tackling the wider social determinants of health and stronger support for early years. The vision for adult social care also intends to deliver the best social care outcomes for citizens and helps to build the Big Society.
  • Public Health England will strengthen the national response on emergency preparedness and health protection. For example it will be responsible for funding immunisation and all national screening programmes Directors of Public Health will be the strategic leaders for public health and health inequalities in local communities but they will have to work in partnership with the local NHS and across the public, private and voluntary sectors.
  • Local authorities will want to contract for services with a wide range of providers. Also those organisations will be incentivised and rewarded for improving health and wellbeing outcomes and tackling inequalities, to deliver best value for their population.
  • The Department of Health believes local authorities may use grant funding to build capable and confident communities and to support preventive community-focused activities, such as volunteering peer support, befriending and social networks.
  • Although the NHS Health Check Programme will be provided by GP Practices, it will include lifestyle interventions commissioned and funded by the local authority such as smoking cessation and weight management services. Also Local authorities will take responsibility for funding and commissioning mental wellbeing services but treatment of mental ill health will be funded and commissioned by the NHS. It will then be up to Health and wellbeing boards to ensure appropriate integration of these different perspectives.
  • The health and wellbeing board will provide a forum in which elected representatives, such as local mayors or councillors, DsPH, Children and Adult Services, GP consortia, the NHS Commissioning Board where necessary, HealthWatch and potentially local community and voluntary organisations
  • Disadvantaged areas will see a greater premium if they make progress, recognising that they face the greatest challenges, and with payments which reflect achievement, not the ability to negotiate a less stretching target. There would be a sliding scale depending on the size and extent of a local authority’s progress and relative to the authority’s position in terms of relative health outcomes
  • The government propose a new outcomes framework for public health. They say this will be based on what councils and voluntary organisations and communities have said. They believe a co-produced and nationally applicable Outcomes Framework is the best vehicle for combining requirements in one place and that this Outcomes Framework should have three purposes:
  • Healthy Lives, Healthy People: The Public Health White Paper

    1. 1. Healthy Lives, Healthy People: The Public Health White Paper Jon Burke NAVCA Development Adviser (Health and Social Care) Presented by Ben Smith VAL Development Officer
    2. 2. The White Paper <ul><li>Builds on Equity and Excellence: Liberating the NHS </li></ul><ul><li>Is a high-level vision for public health which “improves and protect the nation’s health and improves the health of the poorest, fastest” </li></ul><ul><li>Responds to Professor Sir Michael Marmot’s report on health inequalities </li></ul><ul><li>Complements the recent Vision for Adult Social Care in emphasising more personalised, preventive services. </li></ul>
    3. 3. Highlights of the White Paper <ul><li>Local authorities will have new statutory duties to improve the health of their population. This work will be funded by a new ring-fenced budget </li></ul><ul><li>A new health premium will be given to local authorities to reward them for progress in improving public health </li></ul><ul><li>Public Health England will be set up as part of the Department of Health (DH) </li></ul><ul><li>Directors of Public Health will be jointly appointed between local authorities and Public Health England </li></ul><ul><li>There will be stronger incentives for GPs so that they play an active role in public health </li></ul>
    4. 4. Funding And Commissioning 1 – Issues for local voluntary sector organisations <ul><li>The DH expects that </li></ul><ul><li>Local authorities will want to contract for services with a wide range of providers </li></ul><ul><li>Local communities will need to be engaged more widely in the provision of public health to deliver best value and best results </li></ul><ul><li>Local people will have access to information about commissioning decisions, how public health money has been spent and the outcomes that have been achieved </li></ul>
    5. 5. Funding And Commissioning 2 – Issues for local voluntary sector organisations <ul><li>The DH will work to ensure that the voluntary sector is supported to play a full part in providing health and wellbeing services </li></ul><ul><li>The DH believes local authorities may use grant funding to build capable and confident communities and to support preventive community-focused activities </li></ul><ul><li>The DH will encourage and expect that local authorities, where possible and appropriate, should be commissioning on an any willing provider basis </li></ul><ul><li>The DH would particularly welcome views about how this can best be achieved </li></ul>
    6. 6. Local authority commissioning responsibilities <ul><li>The DH proposes that responsibility for commissioning or providing the following services will pass to local authorities… </li></ul><ul><li>Stop smoking services and prevention activities </li></ul><ul><li>Sexual health services </li></ul><ul><li>Obesity and physical activity programmes </li></ul><ul><li>Workplace health at a local level </li></ul><ul><li>Treatment, harm reduction and prevention services </li></ul><ul><li>The NHS Health Check Programme </li></ul>
    7. 7. Local accountability <ul><li>Public Health England will publish national and local performance data. This will make it easy for local areas to </li></ul><ul><li>compare themselves with others across the country and </li></ul><ul><li>allow local people to assess the performance of their local authority </li></ul><ul><li>increase the incentives for local authorities to improve their performance </li></ul><ul><li>Each local authority will have a Health and Wellbeing Board which will: </li></ul><ul><li>co-ordinate commissioning of NHS, social care and public health services </li></ul><ul><li>undertake the Joint Strategic Needs Assessment </li></ul><ul><li>develop a high level joint health and wellbeing strategy aimed at addressing local needs </li></ul>
    8. 8. The Health Premium <ul><li>Local authorities will receive a premium if progress is made in improving the health of the local population and reducing health inequalities. </li></ul><ul><li>Disadvantaged areas will see a greater premium if they make progress but the premium will be designed to improve and reduce inequalities across all of a local authority’s population. </li></ul>
    9. 9. Public health outcomes 1 <ul><li>The government propose a new outcomes framework for public health with three purposes: </li></ul><ul><li>to set out the Government’s goals for improving and protecting the nation’s health, and for narrowing health inequalities through improving the health of the poorest, fastest </li></ul><ul><li>to provide a mechanism for transparency and accountability for health improvement and protection and inequality reduction </li></ul><ul><li>to provide the mechanism to incentivise local health improvement and inequality reduction against specific public health outcomes through the ‘health premium’ </li></ul>
    10. 10. Public health outcomes 2 <ul><li>The Outcomes Famework will include measures that allow assessment of health improvement across all years of life, and enable a focus on where there can be good opportunities to influence health outcomes. </li></ul><ul><li>In focusing on how to improve the public’s health, local authorities and their partners must also seek to advance equalities, eliminate the impact of discrimination and narrow inequalities in health between communities. </li></ul>
    11. 11. Outcomes Indicators <ul><li>Current thinking is that a small number of indicators will focus on health improvement. </li></ul><ul><li>The rest of the indicators will cover health protection and preventative services, and reflect the wider determinants of health, to link in the different local services that play a part in delivering health. </li></ul>
    12. 12. The importance of Partnerships 1 <ul><li>One of the most important aims of the Public Health Outcomes Framework will be to support local partners to work together where they share common outcome goals. It will be critical that alignment is built in with the partner health and social care frameworks. Figure 1 opposite shows how the relationship between public health, the NHS and adult social care might work in terms of shared outcomes </li></ul>
    13. 13. The importance of Partnerships 2 <ul><li>By sharing the same or complementary measures between sectors, there is a stronger incentive for local services to work together and measure their progress on the same basis </li></ul><ul><li>A core function of public health is tackling the wider determinants of health and wellbeing, whereas the NHS and adult social care frameworks cover those outcomes for people who are in need of health and social care services. </li></ul><ul><li>At the local level, partnerships across the local authority, the NHS and other public services will be essential to health improvement and protection and reducing inequalities.  </li></ul>
    14. 14. Transition to a new public health system Timetable (subject to Parliamentary approval of legislation) Date Consultation on The White Paper The public health outcomes framework The funding and commissioning of public health Dec 2010–March 2011 Set up a shadow-form Public Health England within the DH Start to set up working arrangements with local authorities Directors of Public Health appointed During 2011 Develop the public health professional workforce strategy Autumn 2011 Public Health England will take on full responsibilities Publish shadow public health ring-fenced allocations to local authorities April 2012
    15. 15. Consultation questions 1 <ul><li>What are the best opportunities to develop public health information and intelligence? </li></ul><ul><li>What can partners locally contribute to improving the use of evidence in public health? </li></ul><ul><li>What mechanisms would best enable local authorities to utilise voluntary and independent sector capacity to support health improvement plans? </li></ul><ul><li>What can be done to ensure the widest possible range of providers are supported to play a full part in providing health and wellbeing services? </li></ul><ul><li>Which services should be mandatory for local authorities to provide or commission? </li></ul>
    16. 16. Consultation questions 2 <ul><li>How can the government ensure that the outcomes framework, the Local Authority Public Health allocation and the health premium are designed to ensure they contribute fully to health inequality reduction and promoting equality? </li></ul><ul><li>How can the government ensure that the outcomes framework enables local partnerships to work together on health and wellbeing priorities, and does not act as a barrier? </li></ul><ul><li>Finally, the government would welcome views on the likely impact on different equality groups and in reducing health inequalities, of the policies outlined above </li></ul>
    17. 17. Further Information <ul><li>To share ideas and discuss health and social care issues, join the Social Care and Health discussion group on NAVCA's social networking site, navcaboodle www.navcaboodle.org.uk </li></ul><ul><li>To ask a question about a health or social care topic, or to find out what others are doing in other areas, sign up to HealthNet , our dedicated health and social care email group, by emailing: [email_address] </li></ul><ul><li>For the latest health and social care news visit http://www.navca.org.uk/teams/hsc/news </li></ul><ul><li>Or for any other health and social care related enquiry please contact </li></ul><ul><li>Jon Burke </li></ul><ul><li>Development Adviser (Health and Social Care) </li></ul><ul><li>Tel: 0114 289 3991 </li></ul><ul><li>jon.burke@navca.org.uk | http://www.navca.org.uk/teams/hsc </li></ul>

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