1. SEPHIG Health Inequalities

2. Introduction 1.Background – where have we come from 2.Where are we now? 3.The future – where are we going 4.Discussion 2SEPHIG 19th June

3. Where have we come from 3SEPHIG 19th June

4. Where have we come from ? NSTs on Health Inequalities Area Based Initiatives e.g. Sure Start, NRF, NDCs, Plenty has happened but was it enough and did it work? 4SEPHIG 19th June

5. Where are we now? 5SEPHIG 19th June

6. 6 Four regions, 15 centres Eight Knowledge and Intelligence Teams –London –South West –South East –West Midlands –East Midlands –North West –Northern and Yorkshire –East Other local presence –ten microbiology laboratories –field epidemiology teams Additional support –Local teams can also draw on national scientific expertise based at Colindale, Porton Down and Chilton Local presence SEPHIG 19th June6

7. Our priorities for 2013/14 7 –Reducing preventable deaths –Reducing the burden of disease –Protecting the country’s health –Giving children and young people the best possible start –Improving health in the workplace SEPHIG 19th June7

8. Health Equity – the team Consultant in PH Specialist in PH Health Equity Coordinator Lead Scientist in Health Equity Analyst/Policy Officer Programme manager Administrator 8SEPHIG 19th June

9. Where are we going? 9SEPHIG 19th June

10. Inequalities 10SEPHIG 19th June How do we reduce the gradient in health outcomes?

11. The New Context – the New Health System Marmot Review Economic Downturn Changes to benefits LAs in the lead Duty on SoS CCGs and NHSE Localism No targets – no performance monitoring 11SEPHIG 19th June

12. Public health outcomes framework 12 To improve and protect the nation’s health and wellbeing and improve the health of the poorest, fastest Outcome 1) Increased healthy life expectancy – taking into account health quality as well as length of life Outcome 2) Reduced differences in life expectancy between communities (through greater improvements in more disadvantaged communities) Improving the wider determinants of health 1 19 indicators, including: Children in poverty People with mental illness or disability in settled accommodation Sickness absence rate Statutory homelessness Fuel poverty Health improvement2 24 indicators, including: Excess weight Smoking prevalence Alcohol-related admissions to hospital Cancer screening coverage Recorded diabetes Self-reported wellbeing Health protection3 7 indicators, including: Air pollution Population vaccination coverage People presenting with HIV at a late stage of infection Treatment completion for tuberculosis Healthcare and public health preventing premature mortality 4 16 indicators, including: Infant mortality Mortality from causes considered preventable Mortality from cancer Suicide Preventable sight loss Excess winter deaths SEPHIG 19th June12

13. Inequalities Duty on SoS The Health and Social Care Act 2012 contains the first ever specific legal duties on health inequalities. The 2012 Act requires that the Secretary of State for Health has regard to reducing inequalities in health. This duty applies to NHSE, PHE and CCGs. The SofS is also under a duty to include in his annual reports an assessment of how effectively he has discharged his duties as to reducing inequalities; and to make an assessment of how well NHSE and PHE have discharged that duty as to reducing inequalities 13SEPHIG 19th June

14. In 5 Years We Envision: Marmot Review : From theory to action Significant translation of the policy areas of Marmot into practical action High Impact Priorities Progress levelling up gradient in High Impact priority areas Inequalities in all PHE programmes PHE is exemplar for reducing inequalities in the work place and addressing across all work programmes Inequalities and the NHS Measurement of outcomes for NHS demonstrate significant narrowing of gap 14SEPHIG 19th June

15. … and in the first year we will focus on 15SEPHIG 19th June Marmot Review : From theory to action Supporting action through ten top tips Place and Health Working with others Early intervention High Impact Priorities PHE priority areas – addressing equity in all of these areas Inequalities in all PHE programmes PHE is exemplar for reducing inequalities in the work place and addressing across all work programmes Inequalities and the NHS Working with the NHS in areas of complementary or mutual action

16. Opportunities and Risks Opportunities Working with LAs on wider determinants of health New narrative on inequalities PHE integrating all aspects of the public health knowledge and working with wider PH system Financial challenge creates opportunities for new and innovative action Risks Impact of changes and disruption of old networks Clarity on accountability New ways of cross directorate working 16SEPHIG 19th June

17. Time for discussion annmarie.connolly@phe.gov.uk