The New Public Health System Federation of Sports & Play Associations

Chris Wright Project Manager - Health

Youth Sport Trust

The session will cover...

• Create an understanding of the public health context.

• Your understanding of the new Public Health system.

• What elements of Public Health relate to your organisation(s)

• Identify the implications and opportunities for Sport and Play.

• Share examples of YST interventions.

• Provoke some thinking and action.

Understanding Public Health and

its significance.

First ‘wave’ of public health

Second ‘wave’ of public health

Third ‘wave’ of public health

Fourth ‘wave’ of public health

Fifth ‘wave’ of public health

“ physical inactivity should be appropriately described as a

pandemic, with far-reaching health, economic, environmental,

and social consequences

inactivity causes 9% of premature mortality which is equal to

the same number of deaths as tobacco

The Lancet (July 2012)

“

The cost of physical inactivity

The cost of physical inactivity

The cost of physical inactivity • The 2011/12 evaluation by The National Obesity Observatory shows:

One in five children in Reception is overweight or obese (boys 23.5%, girls 21.6%)

One in three children in Year 6 is overweight or obese (boys 35.4%, girls 32.4%)

• Impacts on self-esteem and emotional wellbeing (mental health of young people)

• Reduces risk of over 20 health conditions including cardiovascular disease and

some cancers

• Increases Confidence and competence to be physically active as adults

• Positive links between movement, activity and educational attainment

The physical inactivity cycle Early

Childhood Adolescence Adulthood

Physically inactive

children

19.2% Year 6

Obese

£21bn cost to

NHS

2 extra days a

year missed

from school

£1750 a

year extra

health

costs

Children with

inactive parents

are far less likely

to be active and

twice as likely to

be obese

Lower

attainment

A New Public Health System

A New Public Health System

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• Public Health England – a national public health service

• A return of public health leadership to Local Government

• Dedicated resources for Public Health Nationally and Locally

• Health & Wellbeing Boards in operation from April 2013

• Strong relationship between Public Health, NHS and Social

Care ( Health prevention, clinical commissioning and social

care commissioning)

• Focus on outcomes and evidence based practice supported

by co-ordinated information and intelligence system.

Health & Wellbeing Boards

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• Health & Wellbeing Boards in every upper tier local authority (150).

• Prepare a Joint Strategic Needs Assessment (JSNA) working with GP

Consortia and local authorities.

• Develop a Health and Wellbeing Strategy based on needs identified

through the JSNA.

• Commission services to deliver the strategy through individual

commissioning plans.

“H&WB’s will have a duty to promote integrated working between

health and social care commissioners that will impact on wider

determinants i.e. Housing and education” (DH 2012)

The role of the Local Authority

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• Local authorities will have a duty to take steps to improve the health of the people in their area

• Regulations will prescribe certain steps local authorities must take (mandatory functions) – NHS Health Checks

– National Child Measurement Programme

– Sexual health – testing and treatment of STIs and provision of contraception

– Ensuring health protection plans are in place

– Providing healthcare public health advice to CCGs.

• The commissioning of other services will be discretionary including (non-exhaustive) – Interventions to tackle obesity, physical activity

– Tobacco control

– Drugs and alcohol misuse

– Children’s public health services for 5-19 year olds

Public health funding and commissioning

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Department of Health

Public Health

England (within the

Department of Health)

Local

Authorities

NHS

commissioning

architecture

(Commissioning

Board and

Consortia)

Providers

(inc schools

and GPs)

NHS

budget

Health and

wellbeing boards JSNA & Joint Strategic

Health and Wellbeing

Plans

Public

health

budget

Ring-

fenced

public

health

grant

Funding for commissioning

specific public health

services

integration integration

Evidence & Commissioning

• All Health & Wellbeing Boards will be advising the commissioning of

public health services on the basis of outcomes and evidence.

• Local partners (statutory and non-statutory) will have to evidence

their work in a more detailed and prescriptive way i.e. RCTs.

• Partnership will be central to effective and cost efficient delivery as

opposed to lobbying and ‘shouting the loudest’.

• Some services and programmes will be predetermined and funded

straight ‘from source’.

• All of the funding provided to support the delivery of health prevention

work locally will come through Local Authorities and their new public

health teams.

Connecting Sport, Physical

Activity and Play with Public

Health

Implications for Sport & Play

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• Sport and Play Industry are not statutory partners on Health and

Wellbeing Boards and these remain discretionary.

• Public Health commissioning through credible ‘local’ partners with no

centralised funding.

• Children & Young People health outcome priorities determined locally.

• You will need to be credible partners at a local level with evidence.

• Repositioning national programmes and services to fit locally

determined priorities.

Consider the following 3 areas...

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Advocate and influence •How are you going to communicate your role and contribution? •How do you get that contribution recognised? •What are the local health networks you need to work through?

Creating new partnerships

•What good partnerships do you have currently? •Are you involved in any forums currently that link to this agenda? •What are the key groups and agencies you need to work with on this agenda? (Is schools one of them?)

Programme delivery and demonstrating impact

•Do you know which health outcomes your product/services relate to? •How will you go about positioning these as an intervention? •How does this fit with your organisational outcomes as well as local health outcomes?

What has the YST done?

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Advocate and influence •Developed a national model for sport and physical activity in schools. •Created membership offers and health related products and programmes. •Created a network of schools to work directly with Local Authorities.

Creating new partnerships

•Created new partnerships and strengthened others i.e. YMCA and PHT •Revisited our Local Authority engagement and health related work. •Developed a stronger working relationship with Change4Life/Dept. Health

Programme delivery and demonstrating impact

•Repositioned programmes against health outcomes. •Developing a knowledge bank and evidence around the health agenda. •Positioned whole school and health outcomes together.

PHYSICAL EDUCATION

DELIVERED During curriculum time

LITERACY LEARNING LEADERSHIP

HEALTHY ACTIVE LIFESTYLES

DELIVERED Outside curriculum time ENJOYMENT ENGAGEMENT EXERCISE

COMPETITIVE SCHOOL SPORT

DELIVERED Outside curriculum time COACHING COMPETITION CLUBS

COMMUNITY PROVISION

Pay and play

Leisure and recreation activities

CLUB SPORT (NGBs)

Clubs and teams

Coaching

Talent development

Bupa Start 2 Move

(KS1)

Matalan TOPs

(KS2)

C4L Sports Clubs & HLCs

Sainsbury’s School Games School Sport Clubs & Coaching

What the evidence says……

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• More physically fit children have been found to have improved brain

function, higher academic achievement scores and superior cognitive

performance than less fit children - Chaddock et al (2012) Journal of

Sports Science

• Female adolescents who participated in sports were less likely than their

non-athletic peers to engage in sexual activity and / or report a pregnancy

– Sabo D et al (1999) Journal of Adolescent Health

•Academic reviews are in agreement that physical activity improves self

esteem but opinion varies on which types of activity give the greatest

benefit most show that fitness focused activity and programmes that

encourage skill development i.e. rock climbing rather than competition! –

Biddle, Fox and Boutcher (2000), Physical Activity and Psychological

Well-Being

Local Example of this working...

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• Hull City Council local Obesity strategy.

• Additional funding secured through YST Lead Partner Health &

Wellbeing Schools.

• Change4Life Sports Club in every primary school.

• Partner funding through YST for clubs using Dept. Health

investment.

• Programme evaluation around physical activity and wellbeing

through SPEAR.

• Independently evaluated through Local Authority directive and

NCMP.

• Sustainability through internal workforce and pupil premium

spend.

What Next?? :-

www.dh.gov.uk/health/tag/public-health-england

www.youthsporttrust.org - We’re keen to here from you…

Chris.wright@youthsporttrust.org