Public health reform A Scotland where everybody thrives

What is Public Health Why is Reform needed Reform Programme Public Health Priorities Public Health Scotland The Specialist Workforce

What is Public Health

What is Public Health What we as a society do, collectively, to assure the conditions in which people can be healthy. Institute of Medicine

What is Public Health Health protection Healthcare service improvement Individual Family Community Local Regional National Global Health protection Healthcare service improvement Health improvement Health intelligence and surveillance; leadership; partnership working; strategy, policy development and implementation; research

Why Reform is needed

Scotland’s Public Health Challenge

Scotland’s Public Health Challenge

Scotland’s Public Health Challenge 28 25

Scotland’s Public Health Challenge Unsustainable pressures on health and social care services

Scotland’s Public Health Challenge Scotland’s health is improving but not fast enough and not equally for everyone Scotland’s population is changing with more complex health and social care needs A focus on prevention is important to support public services better meet the needs of communities Health care is not the main determinant of our health – social. economic and environmental conditions are important

Public Health Reform Programme

Public Health Review - the need for change in the public health function simplify the public health landscape at the national level clear public health priorities clarifying and strengthening DsPH role a stronger voice for the public’s health stronger application of evidence, and technology to policy and practice specialist public health support for CPPs and IJBs public health workforce development – specialist and wider workforce

Agreed actions for public health reform Enable the whole system to work effectively together and support local public health activity Develop and establish shared public health priorities for Scotland  Establish a new national public health body – Public Health Scotland

Public Health Reform Programme Public health reform is an equal partnership between Scottish Government and COSLA The programme is being taken forward as a collaborative process involving the wider system in designing the future public health landscape Public Health Scotland, shared priorities and a focus on local partnerships are the foundations of the reform programme Scotland’s public health priorities provide catalyst for the whole system to focus on key public health challenges Public Health Scotland will provide strong leadership to improve healthy life expectancy and reduce health inequalities

Vision for public health reform The vision for public health reform is “a Scotland where everybody thrives”. Ambition… Scotland to be a world leader in improving the public’s health, using knowledge, data and intelligence in innovative ways, creating a culture for health in Scotland, with an economic, social and physical environment which drives, enables and sustains healthy behaviours, and where individuals take ownership of their health. PAUSE for questions/clarifications

Scotland's Public Health Priorities

Scotland's Public Health Priorities ‘ The most important things Scotland must focus on over the next decade if we are able to improve the health of the population’’

Scotland's Public Health Priorities A Scotland where we live in vibrant, healthy and safe places and communities. A Scotland where we flourish in our early years. A Scotland where we have good mental wellbeing. A Scotland where we reduce the use of and harm from alcohol, tobacco and other drugs. A Scotland where we have a sustainable, inclusive economy with equality of outcomes for all. A Scotland where we eat well, have a healthy weight and are physically active.

Questions and discussion What role do you/your organisations have in contributing to the Public Health Priorities?

Public Health Scotland

Health and Social care Public Health Public Health Scotland Health and Social care Public Health

Public Health Scotland – Bringing Together National Public Health NHS Health Scotland ISD Health Protection Scotland Public Health Scotland Depending on outcomes of work on the Specialist Public Health Workforce, this could include Public Health Departments in boards as part of the total Pubic Health Scotland delivery model. But to meet Scotland’s public health challenges, Public Health Scotland must be more than the sum of its parts.

Public Health Scotland The role of Public Health Scotland is to support and enable the wider public health system Public Health Scotland will provide more local support than the existing national organisations Public Health Scotland will be organised based on outcomes for how the organisation will help the whole public health system

Public Health Scotland – Legislative Consultation Describes our proposals for the new national body and how we expect it will interact with other organisations. Primarily asks for views on the expected functions, structure and wider role of Public Health Scotland. Some of the new arrangements will require legislative change and will be subject to parliamentary scrutiny.

Public Health Scotland – Legislative Consultation Key themes of the consultation are: Governance and accountability for the new model; Outcomes, performance and improvement; Functions of Public Health Scotland; Structure of Public Health Scotland; Composition of the Board. https://consult.gov.scot/public-health/public-health-scotland

Core and Specialist Public Health Workforce

Core and Specialist Public Health Workforce Core Public Health Workforce Wider Workforce that contributes to health & wellbeing Core Public Health Workforce - All staff engaged in public health activities that identify public health as being the primary part of their role Specialist Public Health Workforce – Specialist Public Health workforce registered with the General Medical Council (GMC), General Dental Council (GDC) UK Public Health Register (UKPHR) or the Royal Environmental Health Institute Scotland REHIS Wider Public Health Workforce – Workforce in wider public, private. voluntary and community sectors who contribute to improving health and wellbeing As part of the Reform process we are examing how we can best deploy the core and specialist PH workforce both locally and nationally to support the whole system to address the priorities. Currently this workforce are mainly distributed in national bodies, territorial health boards (public health units), HSCPs (Health improvement/promotion teams), and Local Government (Environmental health)

Core and Specialist Public Health Workforce – Options Option 1 - Move staff in public health departments to local authorities Option 2 - Move staff to health and social care partnerships (HSCPs) Option 3 – Enhanced current model: staff remain in NHS Boards (+ Public Health Scotland) Option 4 - All staff from Public Health Departments move to Public Health Scotland and deployed from there Option 5 - Regional public health hubs Option 6 – Hybrid model bringing together local, regional and national elements

Core and Specialist Public Health Workforce – some further reflections Recognition of the complexity of public health delivery Experience tell us that being located in an NHS setting does not always maximise impact, limits the focus on prevention and can make engaging communities challenging Overall there is an opportunity to strengthen elements of local delivery   Some elements of public health need local engagement and support but do not suit local delivery The relationship with the health system is vital for elements of public health

Questions for discussion Experience to date What links do you have with the local and national public health agencies and workforce? What works well? What doesn’t? Future state What more could be done at the local level to take a whole systems approach and strengthen the contribution of your organisations? What more could a national body - Public Health Scotland – do to support the local system and your work?

Email: publichealthreform@gov.scot Website: publichealthreform.scot Twitter: @phrscot

Public health reform A Scotland where everybody thrives