Developing our Integrated Medium Term Plan 2015/16 – 2017/18 Insert name of presentation on Master Slide

About Public Health Wales Now five years old, established in 2009 Budget of £102m in 2013/14, increase from £80m in 2010/11 Workforce of 1,248 whole time equivalents 1.4m microbiology laboratory tests processed each year Over 500,000 people are screened each year 6,929 smokers treated through Stop Smoking Wales service each year Delivery of health improvement programmes Developing our Plan 2015/16 – 2017/18

Budget allocation Developing our Plan 2015/16 – 2017/18

How we deploy our staff Developing our Plan 2015/16 – 2017/18 FTE Division % of Staff 333 Screening 27% 315 Microbiology 25% 73 Health Protection 6% 12 Safeguarding 1% 20 Public Health Development (central) 2% 166 Health and Healthcare Improvement 13% 57 Health Intelligence 5% 14 Policy, Research and Development 159 Local Public Health Teams 99 Enabling functions 8% 1248 Total 100% Developing our Plan 2015/16 – 2017/18

Policy / legislative context Public Health Bill White Paper Wellbeing of Future Generations (Wales) Bill Commission on Public Service Governance and Delivery Welsh Government response to Commission on Devolution in Wales (Silk Commission) Welsh Government commitment to reducing poverty and inequalities Minister’s commitment to Prudent Healthcare Assembly elections 2016 and manifesto development Developing our Plan 2015/16 – 2017/18

State of the nation (1) People are living longer – not necessarily healthier Health inequalities are widening – healthy life expectancy is 20 years shorter in some parts of Wales than in others Cancer mortality is over 50% higher in most deprived areas compared to least deprived Nearly three in ten children aged four to five are overweight and obese Alcohol consumption is increasing 23 per cent of the population still smokes Developing our Plan 2015/16 – 2017/18

Life expectancy related to socio-economic deprivation This information is based upon the Public Health Wales Observatory’s Measuring Inequalities Profiles Here the former Chief Medical Officer for Wales ask us to reproduce some of the information in a style first developed by the London Health Observatory who showed how life expectancy falls as you move from west to east along the Jubilee line We replicated the approach by showing the same thing moving west to east along the railway line between Dinas Powys in the Vale of Glamorgan towards Grangetown, a socio-economically deprived inner-city area of Cardiff *Life expectancy in years (confidence intervals) 1 Cardiff: Produced by Public Health Wales Observatory, using ADDE & MYE (ONS) (2001-2010) 2 Belfast: Data source: Project Support Analysis Branch, DHSSPS (2006-08), reproduced with permission 3 London: Data source: London Health Observatory (2004-08) , reproduced with permission 4 Glasgow: Data source: Glasgow Centre for Population Health (2001-05) , reproduced with permission Underground logo reproduced with permission of Transport for London Developing our Plan 2015/16 – 2017/18

Older population is growing A higher proportion of the Welsh population is 65+ compared to any other UK nation (8.7% vs 6.7 (NI), 7.9% (E), 7.9% (S)) Source: http://wales.gov.uk/docs/statistics/2013/131106-national-population-projections-2012-based-en.pdf Developing our Plan 2015/16 – 2017/18

Percentage of children aged 4-5 who are obese Developing our Plan 2015/16 – 2017/18

Challenging smoking targets Wales Oct-Dec 2013 5% of smokers make a quit attempt via smoking cessation services, 1.7% with at least a 40% CO validated quit rate at 4 weeks 36.6% Developing our Plan 2015/16 – 2017/18

Healthy life expectancy Gradual rise in healthy life expectancy. But 18 year gap in healthy life expectancy- little change over last decade Developing our Plan 2015/16 – 2017/18

State of the nation (2) Communicable diseases and globalisation continue to pose a threat to public health Inadequate vaccination rates Threat from antibiotic resistance Healthcare associated infections are far too high Existing screening programmes do not reach their full potential due to people choosing not to participate Economic and environmental factors threaten health gains that have already been made Developing our Plan 2015/16 – 2017/18

Challenges and opportunities NHS Wales financial context Relationships within the public health system – complex and evolving Welsh Government planning requirements Shifting the equilibrium to keeping people healthier for longer Preventing ill health and preventing the exacerbations of ill health Active and supportive leadership Focusing on what’s important Developing our Plan 2015/16 – 2017/18

Areas we could focus on? (1) Core areas of ongoing service delivery and service modernisation – the ‘Must Dos’ Screening, microbiology and health protection services Supporting vaccination Key health improvement programmes that continue following Transforming Health Improvement in Wales Public health priorities where greater impact is needed Smoking, obesity, cancer, healthcare associated infections? Developing our Plan 2015/16 – 2017/18

Areas we could focus on? (2) Recent priorities that are increasingly important Prudent healthcare Transforming Health Improvement in Wales Public Health Outcomes Framework / Future Generations Bill ‘wellbeing indicators’ Areas where more work is needed to define and develop the Public Health Wales contribution Poverty and health inequality Primary and community care Mental health Early years focus Developing our Plan 2015/16 – 2017/18

Areas we could focus on? (3) Influencing development of policy and strengthening our role Strengthening relationships with stakeholders and partners Leading for change Stronger focus on facilitate leadership Strengthening the organisation Organising ourselves to deliver what’s required Developing our Plan 2015/16 – 2017/18

Summary of board session Increase emphasis on tackling inequalities Increase emphasis on active facilitative leadership Increase role in influencing and policy development Continued improvements in our ‘must dos’ Become respected source of knowledge and learning on closing inequalities gap Link healthcare with communities and partners Use knowledge and targets to lead, mobilise and motivate others BE CLEAR ON OUR PRIORITIES Developing our Plan 2015/16 – 2017/18

Next steps Formulate output from Board session Wider senior leadership session with Divisional Directors and Directors of Public Health Agreeing core priorities Developing ‘what does success look like’ Identifying Public Health Wales’ role to deliver Session with health boards to agree 2-3 core public health priorities in all IMTPs Wider staff engagement External general and targeted consultation Developing our Plan 2015/16 – 2017/18

And finally... “If we are ever in doubt about what to do, it is a good rule to ask ourselves what we shall wish on the morrow that we had done.” John Lubbock Developing our Plan 2015/16 – 2017/18