Agenda item

Presentation to be made by Hannah Chellaswamy, Acting Director of Public Health, NHS Sefton and Sefton Council.

The Committee received a presentation by Hannah Chellaswamy, Acting Director of Public Health, NHS Sefton and Sefton Council, on the White Paper “Healthy Lives, Healthy People”, the Government’s strategy for public health in England.

 

The presentation included the following:-

 

A New Public Health System – Key principles:

•         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;

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

•         Enshrined in Health and Social Care Bill 2011 (Published 19 January 2011).

 

Health and Wellbeing Throughout Life:-

1. Empowering local government and communities;
2. Tackling health inequalities;
3. Coherent approach to different stages of life;
4. Giving every child the best start in life;
5. Making it pay to work;
6. Designing communities for active ageing and sustainability; and
7. Working collaboratively with business and voluntary sector –’Public Health Responsibility Deals’.

 

Public Health (PH) England - Operational in 2012/13:-

•         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 threats to the public (will incorporate Health Protection Agency and National Treatment Agency).

•         It will do this by:

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

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

–        Inspiring, challenging and commissioning partners from all sectors to work together.

 

Key Functions for Local Government:-

•         New statutory duty for local authorities to promote and improve health of population;

•         Joint Strategic Needs Assessment (JSNA) and joint health and wellbeing strategy with DASS, DCS, GP consortia leads and Health Watch;

•         Health & Wellbeing Boards – how public money is spent and outcomes achieved and how health inequalities are being addressed, but scrutiny role taken out;

•         NHS Complaints advocacy; and

•         Local government will be accountable to PH England.

 

Health and Wellbeing Board:-

•         One per Local Authority and will be a committee of the LA (Local Authority) under Section 102 of the Local Government Act;

•         Proposed Membership:

–        At least one councillor;

–        Director of Adult Social Services;

–        Director of Children’s Services;

–        Director of Public Health;

–        Local Health Watch (LINKs with a wider remit);

–        A representative from each relevant GP commissioning consortium; and

–        Any others – to be determined by the LA.

–        Duty to encourage integrated working; and

–        No longer will have scrutiny function.

 

The Director of Public Health and Team within the LA:-

•         Director of Public Health will be the principal adviser on all health matters on the full range of local authority functions and their impact on the health of the local population to:

–        the local authority and its elected Members and officers;

•         Jointly appointed by LA and PH England and employed by the LA;

•         Accountable to locally elected members and through them to the public;

•         Accountable to the Secretary of State for Health for health protection and professionally to the Chief Medical Officer;

•         Jointly lead the development of the Health & Wellbeing Strategy;

•         Continue to be an advocate for local community;

•         Provide public health expertise to inform the commissioning of NHS-funded services, facilitating integrated pathways of care by working with GP consortia.

 

Public health Outcomes Framework – Transparency in Outcomes

The Vision:-

“To improve and protect the nation’s health and to improve the health of the poorest, fastest”.

 

Domain 1 - Health Protection and Resilience:

Protecting the population’s health from major emergencies and remain resilient to harm.

Domain 2 - Tackling the wider determinants of health:

Tackling factors which affect health and wellbeing and health inequalities.

Domain 3 - Health Improvement:

Helping people to live healthy lifestyles, make healthy choices and reduce health inequalities.

Domain 4 - Prevention of ill health:

Reducing the number of people living with preventable ill health and reduce health inequalities.

Domain 5 - Healthy life expectancy and preventable mortality:

Preventing people from dying prematurely and reduce health inequalities.

 

•         Focus on major causes and impacts of health inequalities (HI), disease and premature death;

•         Data collated and analysed nationally (to reduce the burden on Local authorities); and

•         Local democratic accountability for performance against these outcomes and will be easy to compare across the country and to track progress.

 

Public Health Funding & Commissioning

 

Allocations and the Health Premium

 

Allocations:-

•         From April 2013, Public Health England will allocate ring-fenced budgets, weighted for inequalities, to upper-tier and unitary authorities in local government. Shadow allocations will be issued in 2012/13;

•         Actual allocations will move from current spend towards the target allocations over a period of time.

 

Health Premium:-

•         Incentive payment, (‘health premium’), against progress made in improving the health of the local population and reducing HI; and

•         It will be simple and driven by a formula developed with key partners, representatives of local government, public health experts and academics.

 

Shared Priorities:-

• Commission or directly provide public health programmes – eg.

–        Sexual health;

–        Seasonal mortality;

–        Lifestyle programmes;

–        Health at Work;

–        NHS Health Checks etc.;

• Health inequalities;
• Mental health;
• Learning disabilities;
• Social Care;
• Re-ablement Fund;
• Dementia;
• Carers; and
• Quality inc delayed discharge.

 

Summary timetable on the Public Health White Paper, subject to Parliamentary approval of legislation.

 

Further to the findings of the former Dementia Working Group, established by this Committee, Members enquired whether there would be an opportunity to lobby the Government concerning the the demographics in Sefton and the high number of older people in the north of the Borough in particular.

 

RESOLVED: That

 

(1)       Hannah Chellaswamy be thanked for her presentation;

 

(2)       this Committee urges the Secretary of State for Health to consider the demographics in Sefton and the high number of older people in the north of the Borough in particular, in the allocation of resources to local authorities; and

 

(3)       NHS Sefton be requested to present update information on the NHS reforms to the next meeting of this Committee.