1. Healthy Lives, Healthy People
The Public Health White Paper
Dr Richard Harling, Director of Public Health

2. Context and key messages
Coalition values: Freedom, Fairness and Responsibility
Localism and ‘Big Society’
NHS reforms:
NHS Commissioning Board
GP Commissioning Consortia
All healthcare providers will be independent
SHAs and PCTs to be abolished
Health & Well-being Boards
Healthwatch
Public Health is a priority for this government
Familiar challenges – new delivery system
Return of public health leadership to local government
Responsibility across society with everyone, including citizens, playing a part

3. Challenges
“…we cannot sit back while so many people are suffering lifestyle-driven ill health and health inequalities…”
Smoking claims 80,000 lives - costs NHS £2.7bn /yr
Among highest levels obesity in world – costs NHS £4.2bn /yr
1.6mn people dependent on alcohol
Mental ill-health contributes ¼ total burden of ill health
Life expectancy 7 years less in poorest than richest areas
Health & economy mutually dependent
Prevention essential to NHS sustainability - QIPP
Range of social, economic, environmental and behavioural influences on health
Ongoing significant threats to health - CBRN

4. Key features of approach
Responsive
Resourced
Rigorous
Resilient
Coherent life course approach:
Giving every child the best start in life
Making it pay to work
Designing communities for active ageing and sustainability
Collaboration through the Public Health Responsibility Deal

5. Public Health England
New body to improve health outcomes and protect against health threats - part of DH & accountable to SoS
National & sub-national infrastructure for health protection – including emergency preparedness, resilience and response
Commission health improvement interventions
Help citizens take care of their own health
Intelligence function
Develop the evidence base
Uphold excellence in PH practice and develop PH workforce

6. NHS and the role of GPs NHS : GPs as commissioners and providers:
Public health embedded in the mandate SoS sets for NHSCB
From ‘diagnose and treat’ to ‘predict and prevent’
Prevention integral to QIPP programme
GPs as commissioners and providers:
GPCC expected to maximise opportunities for prevention
Performance management by NHSCB
Individual general practices incentivised and assessed through the contract
Supported by DPH

7. The local Public Health system
Local authorities:
Duty to improve population health
Ring-fenced grant
Bring to bear wider social, economic & environmental influences
Facilitate & empower voluntary sector, businesses and individuals
Health protection functions
DPH:
Requirement for local authorities - jointly appointed with PHE
Strategic leadership
Collaborative, evidence-based approach
Principal adviser on health matters
Advocate for health
Lead JSNA & JHWS
Preparedness & response to health threats
HWB:
Principal forum for improving health & well-being
Core membership local authorities and GPCC
Additional partners
JSNA & JHWS - then ensure commissioning consistent with these
Integrate commissioning: NHS, public health, social care & others

8. Commissioning and funding
Accountability
Commissioning and funding
Healthwatch
Local communities
HWB
Partners
Housing
Transport
Environmental services
Education
Children’ services
Environmental health
GPCC
Providers
Local authorities
Smoking cessation
Drug & alcohol
Sexual health
Obesity
School nursing
QOF
Immunisations Screening
NHSCB
PHE
Social care
Health services
CQC
Monitor DH
DCLG &other

9. Outcomes Transparency and accountability across PH system
For Local Authorities a subset linked to Health Premium

10. Opportunities for Worcestershire
Builds on a solid foundation:
Political ownership and history of partnership working
In the vanguard of devolved decision making and personalised services
Strong local professional team
Strengthen political leadership:
Raises profile and priority for Members
Basis for further engagement with communities
Re-energise partnerships:
Health & Well-being Board and the Joint Health & Well-being strategy
Re-define respective roles and responsibilities
Developing a cadre of community leaders and mobilising citizens

11. Next steps Consultation until 31 March 2011:
The role of GPs in public health
Developing and using public health evidence
Regulation of public health professionals
Outcomes framework
Commissioning and funding of public health
Raising awareness among partners and the public
National transition process

12. Healthy Lives, Healthy People
The Public Health White Paper
Dr Richard Harling, Director of Public Health