1. Public Health, Thrive Plymouth and Evaluation
Robert Nelder, Consultant in Public Health, Plymouth City Council
Claire Turbutt, Advanced Public Health Practitioner, Plymouth City Council
February 2017

2. Outline Introductions
The Office of the Director of Public Health (ODPH) explained
Public health responsibilities and priorities
Thrive Plymouth: background
Thrive Plymouth: the story so far
Thrive Plymouth: year three focus and case studies
Evaluation work to-date
Potential opportunities…..

3. The ODPH explained
Plymouth’s Public Health Team used to be part of the Primary Care Trust (PCT)
PCT’s were abolished on 31 March 2013 (as part of the Health and Social Care Act 2012) with their work taken over by Clinical Commissioning Groups
Public Health became the responsibility of (unitary and top tier) Local Authorities on 1st April 2013
Plymouth’s Public Health Team ‘transitioned’ to Plymouth City Council
The Public Health Team became part of the Council’s ‘People’ Direcorate
ODPH was chosen as the Team’s name to give it an identity within the People Directorate

4. The ODPH explained
From April 2013 to March 2014, series of acting/interim DsPH
Stop/pause/reflect at same time as Fairness Commission
Executive Director of Public Health appointed April 2014
Brought together Public Health, Public Protection (formerly part of the Council’s ‘Place’ Directorate) and Civil Protection (formerly part of the Chief Executive’s Department)
ODPH became a Directorate within the Council (made up of three teams) instead of a single Team (Public Health) with a strange name
ODPH is made up of three professions and managed day-to-day under four consultant-led multi-disciplinary teams

5. Public health responsibilities and priorities
Mandated responsibilities:
Appropriate access to sexual health services
Ensuring there are plans in place to protect the health of the population, including immunisation and screening plans
Ensuring NHS commissioners receive the public health advice they need (‘core offer’)
The National Child Measurement Programme (NCMP)
NHS Health Check assessment

6. Public health responsibilities and priorities
Local authorities are responsible for:
Tobacco control and smoking cessation services
Alcohol and drug misuse services
Public health services for children and young people
The National Child Measurement Programme
Interventions to tackle obesity such as community lifestyle and weight management services
Locally-led nutrition initiatives
Increasing levels of physical activity in the local population
NHS Health Check assessments
Public mental health services
Dental public health services
Accidental injury prevention
Population level interventions to reduce and prevent birth defects

7. Public health responsibilities and priorities
Behavioural and lifestyle campaigns to prevent cancer and long-term conditions
Local initiatives on workplace health
Supporting, reviewing and challenging delivery of key public health funded and NHS delivered services such as immunisation and screening programmes
Comprehensive sexual health services
Local initiatives to reduce excess deaths as a result of seasonal mortality
The local authority role in dealing with health protection incidents, outbreaks and emergencies
Public health aspects of promotion of community safety, violence prevention and response
Public health aspects of local initiatives to tackle social exclusion
Local initiatives that reduce public health impacts of environmental risks.

8. Thrive Plymouth: background
In January 2014 at a Budget Scrutiny meeting, the following recommendation was agreed:
“An action plan addressing the revised approach to health inequalities across the city is brought to the Caring Scrutiny Panel within six months by the incoming Director of Public Health.”
There was an opportunity to define and agree a clear approach to addressing health inequalities in the city

9. Thrive Plymouth: background

10. Thrive Plymouth: background
The concept is based on the original work of the Oxford Health Alliance (OxHA) who developed 3four50
3four50 was implemented in San Diego
A Plymouth-specific version of this approach has been developed to address health inequalities in the city.
The framework for addressing health inequalities in Plymouth is known as

11. Thrive Plymouth: background
Poor diet, lack of exercise, tobacco use and excess alcohol consumption are risk factors for coronary heart disease, stroke, cancers and respiratory problems which together contribute to 54% of deaths in Plymouth
Changing these four behaviours would help prevent four diseases and reduce the number of deaths due to chronic diseases
It’s a conversation starter

12. Thrive Plymouth: background

13. Thrive Plymouth: the story so far
Thrive Plymouth was launched on 10 November 2014 at an event held in the Council House.
The focus of year one was on workforce wellbeing
The positive impact that employment can have on health is well documented - employee health is critical to company culture and output
Evidence that having a healthy workforce can reduce sickness absence, lower staff turnover and boost productivity
Opportunities for messages to be shared with families and friends
Introduced the concept of the ‘offer’ and the ‘ask’

14. Thrive Plymouth: the story so far
Thrive Plymouth was the focus of the Director of Public Health Annual Report
Entitled ‘Positive choices for better health in a growing city’, it was published in July 2015
The focus is on positive choices (eating a healthy diet, leading an active lifestyle, drinking sensibly and not smoking tobacco) and the contexts in which these choices are made and influenced
Included a dashboard that shows details of all the data included in the report and the key measures that will be used to monitor changes in health and wellbeing in the city over the next 10 years
An ‘Easy Read’ version of the report was also produced which allowed the creation of some extra health resources for the city’s people with learning difficulties

15. Thrive Plymouth: the story so far
Year two was launched in November 2015.
The focus for year two was schools and educational settings
Over 140 people attended the launch event, including colleagues from 41 of the city’s schools.
A series of locality events were held where Public Health Team members and colleagues from the Healthy Child Quality Mark met with schools
A network was developed to bring together schools, public health professionals and wider stakeholders, to deliver improved health outcomes in education settings, share best practice, and support development of the evidence base
There are now 50 schools who have achieved the HCQM bronze award, 15 with the silver and six with the gold

16. Year 3 so far
Good afternoon, I hope you enjoyed our new animation. We will be using this to spread the word about Thrive Plymouth.

17. One You - A genuine revolution in the way adult health is addressed

18. A focus on behaviour

20. Local engagement and participation in Plymouth

21. PHE is using Plymouth’s engagement with the One You launch as a national case study

23. Offer and Ask

24. Year 3 case studies
Good afternoon, I hope you enjoyed our new animation. We will be using this to spread the word about Thrive Plymouth.

25. Livewell SW rebranding as One You Plymouth

26. PCH case study

27. Plymouth Hospitals Trust Thrive Group
Opening the wellbeing centre
Back to Netball
Health checks for staff
Plymotion advice

28. Plymouth Argyle engagement with Thrive Plymouth

29. Thrive Plymouth Network ONE YOU Active10 action plan
Flash Report from:
What would you like to do?
What do you need?
Who can give it to you?
PLEDGE:
What are you going to do and when?

30. Thrive Plymouth: evaluation work to-date
The Public Health Team is working with Plymouth University on the evaluation of Thrive Plymouth (years one and two)
As well as this more formal evaluation, the Council’s Public Health Team holds and has access to comprehensive datasets that allow trends in inequalities and health and wellbeing status to be monitored over time
The overall aim of the year one evaluation work to-date* has been to investigate how Thrive Plymouth improves the health and wellbeing of the population of Plymouth using workplace wellbeing (the year one focus) as an exemplar
* Led by Katrina Bannigan and Clare Pettinger (School of Health Professions, Faculty of Health and Human Sciences)

31. Thrive Plymouth: evaluation work to-date
Four recommendations (of the Y1 evaluation):
Refine the logic model (particularly the bigger questions around delivering public health in a local authority context, mechanisms and outcomes) and translating this into an assessment framework
Develop an action plan to implement the assessment framework for evaluating Thrive Plymouth
Allow longer lead in times for assigning the theme for the ‘focus of the year’ to allow prospective evaluations to be planned, funding bids to be submitted and to capitalise on links with academic programmes
Set up a public health forum as a network to facilitate the sharing of public health expertise, knowledge and skills across the city to support the evaluation of Thrive Plymouth

32. Thrive Plymouth: evaluation work to-date
Year two evaluation**
A systems approach to promoting health in schools: A case study exploring perceptions of school representatives and public health specialists
The study aims to explore school representatives’ and Public Health staff perceptions of whether the Thrive Plymouth locality events helped promote a collective approach to health promotion.
This will be done through an evaluation of the perceptions about the locality events, where Public Health Plymouth conducted 20-minute one-on-one sessions with school representatives to discuss schools’ health promotion projects.
** led by Sandiso Moyo (MSc in Healthcare Management, Leadership and Innovation)

33. Potential opportunities…..
Related to Thrive Plymouth:
Linkages between Thrive Plymouth years one and two
Evaluation of year three (localising ‘One You’)
Evaluation of year four (mental health and wellbeing)
Effectiveness of the ‘offer and ask’ approach
Related to wider public health:
Dataset inventory