Public health and the Responsibility Deal

31 March 2011

Graeme Henderson20 April 2011

1

What is our overall goal?

Healthy, engaged workforces

• A high-performing, resilient workforce

• Enhanced productivity

Contributing to:

• A well-functioning society

• Better economic performance

Well-managed organisations

Marmot Review: Health Inequalities

• Create fair employment and decent work for all

• Improve access to good jobs and reduce long-term

unemployment across the social gradient.• Make it easier for people who are disadvantaged in

the labour market to obtain and keep work.

• Improve quality of jobs across the social gradient

Getting people into work is of critical importance for reducing health inequalities. Clear link between unemployment, health inequalities and likelihood of return to work.

Policy objectives of Marmot :

‘Healthy Lives, Healthy People’Our strategy for public health in England

• Starting well: enabling good health in mothers before, during and after pregnancy and good parenting

• Developing well: encouraging healthy habits and avoiding harmful behaviours

• Growing up well: identifying, treating and preventing mental health problems and creating resilience and self-esteem

• Living and working well: choosing lifestyles and behaviours that influence health and productivity

• Ageing well: supporting resilience through social networks and activity and providing protection from preventable ill-health

Acts as the Government response for the Marmot review

A new public health system

• Public Health England – a national public health service

• A return of public health leadership to Local Government

• Professional leadership nationally and locally

• Dedicated resources for public health at national and local levels

• Focus on outcomes and evidence based practice supported by a strong information & intelligence system

• Maintaining a strong relationship with the NHS, social care and civil society

• Set out in the Health and Social Care Bill

A new public health service – Public Health England

• New public health service directly accountable to the Secretary of State for Health with a clear mission to;

1. Achieve measurable improvements in public health outcomes; and

2. Provide effective protection from public health threats

• It will do this by;

1. Protecting people from infectious disease and biological, chemical and radiological threats;

2. Helping people and families to be able to take care of their own health and wellbeing; and

3. Inspiring challenging and commissioning partners from all sectors.

The Department of Health’s role in public health

• Public Health England will be the delivery arm of public health, outwards facing and supporting the front line

• The core Department will continue to be responsible for national public health policy

The Director of Public Health

• Will be jointly appointed by the relevant local authority and Public Health England and employed by the local authority with accountability to locally elected members and through them to the public.

• Will be the principal adviser on all health matters to the local authority, its elected members and officers, on the full range of local authority functions and their impact on the health of the local population

• Will play a key role in the proposed new functions of local authorities in promoting integrated working

• Jointly lead the development of the local Joint Strategic Needs Assessment (JSNA) and the joint health and wellbeing strategy (with Directors of Adult Social Services and Directors of Children’s Services)

• Will continue to be an advocate for the public’s health within the community

• Will produce an authoritative independent annual report on the health of their local population

Health and Well-Being Boards Membership

• Statutory health and wellbeing boards in every upper-tier local authority – established in April 2013.

• Minimum membership of:– At least one elected representative (a local councillor)

nominated by the leader or elected mayor, – A representative of each of the relevant GP Consortia (those

within the local authority area)– Directors of public health, adult social services, children's

services– Local HealthWatch representative– A representative of the NHS Commissioning Board (in

relation to their local commissioning responsibilities on request from the health and wellbeing board)

• Other representatives can be appointed by the local authority and/or the health and wellbeing board

Health and Wellbeing Boards

• Clear duties on GP Consortia and local authorities to prepare the joint strategic needs assessment – but do so through the health and wellbeing board.

• A new joint health and wellbeing strategy, prepared by the health and wellbeing board and based on the needs identified in the JSNA , with a requirement to consider the use of health act flexibilities (such as pooled budgets) in developing the strategy.

• Commissioners will each be required to have regard to the joint strategic needs assessment and the joint health and wellbeing strategy when developing their own commissioning plans

• Health and wellbeing boards will have a duty to promote integrated working between health and social care commissioners, as well as promoting joint working with commissioners of services that impact on wider health determinants (for example, housing or education).

Outcomes Framework – links to health and work

NHS outcomes framework (confirmed):• Employment of people with long term conditions• Employment of people with mental illness

Public Health outcomes framework (consultation now closed)• Proportion of people with mental illness / disability in

employment (PH)• Proportion of people in long term unemployment (PH)• Employment of people with long-term conditions (PH)• Work sickness absence rate (PH)

Working Well

RETURN TO WORK SCHEMES• Fit for Work Service pilots• Fit note• Reformed Welfare to Work Programme

OTHER INITIATIVES• Public Health Responsibility Deal• New provisions in the Equality Act 2010• Accreditation Process for occupational health services• Regional Growth Fund• Evidence and data

Public Health Responsibility Deal

Launched on 15 March.

An initiative of the Secretary of State for Health, the business community, the voluntary sector and NGOs, working together to:

• recognise their vital role in improving people’s health

• encourage and enable people to adopt a healthier diet

• foster a culture of responsible drinking

• encourage and assist people to be more physically active

• actively support our workforce to lead healthier lives.

The Responsibility Deal is delivered through 5 networks:

• Food

• Alcohol

• Physical activity

• Behaviour change

• Health at work

Responsibility Deal:Health at Work network

The aim of the Health at Work Network is to find ways to help employers use the workplace to improve the health of their employees.

Current work includes:

Publication of employers/employee guides on managing chronic conditions in the workplace

Local Business Partnerships: Unilever, Mars UK, Novo Nordisk, mentoring SMEs

Finding ways to make occupational health services more proactive and preventative

Future work:

Improving workplace adjustments particularly for people with mental health conditions

Helping children and young people to understand health risks before entering job market

Any Questions?