1. Sandwell Public Health Paul Southon Health and Wellbeing Strategy and Delivery Manager Paul_southon@sandwell.gov.uk

2. Current context Health –Clinical Commissioning Groups –NHS England –Public Health England –Commissioning Support Units Local government –Health and Wellbeing Boards –Public health in local government –Personalised care –Localism

3. Current context Budget cuts (and more to come) Ageing population Economic downturn & welfare reform Better Care Fund –National programme – local plans –Driving integration across health, social care and public health across Sandwell and West Birmingham –No new money – better use of existing resources Increased focus on mental health & wellbeing

4. The Barnet graph of doom

5. Health and Wellbeing Board Improve the health of the population and reduce health inequalities Ensure commissioning is aligned across health, social care and public health Duty to publish; –Joint Strategic Needs Assessment (JSNA) –Joint Health and Wellbeing Strategy (JHWS) Ensure partner commissioning plans “pay due regard” to the JHWS 5

6. What we know Poverty and deprivation are associated with poor health and disability People living in areas of deprivation do not live as long People living in areas of deprivation spend more of their lives ill and/or disabled Inequality is associated with worse outcomes for everyone This brings significant costs –Social, economic, personal, cultural 6

7. 7 Life expectancy & disability free life expectancy at birth, by neighbourhood income level, England and Sandwell 1999-2003 Neighbourhoods by income deprivation (population percentiles) Age

8. Public Health “The science and art of promoting and protecting health and well-being, preventing ill- health and prolonging life through the organised efforts of society.” 8

9. 9 What determines health and wellbeing?

10. 10 The Marmot Review The best evidence for what we need to do The biggest influences on health & wellbeing are the ‘social determinants’ of health The social, environmental and economic conditions into which people are born, grow, live, work and age.

11. The 3 domains of Public Health Healthcare public health Health protection Health improvement 11

12. Sandwell Public Health Moved into the council in April 2013 Restructured to be fit for purpose Working to embed public health across the whole council Increasing life expectancy Increasing disability free life expectancy Health protection Information and intelligence

13. Mandated public health services - councils Health protection and emergency planning Children’s weight measuring Sexual health services NHS health checks Commission lifestyle services and other healthy public policy initiatives Public mental health improvement Health service policy and healthcare related public health Public health ‘core offer’ to clinical commissioning groups for healthcare public health 13

14. Success in Sandwell Male life expectancy increasing faster than national rate Teenage pregnancy reducing faster than national rate Healthcare acquired infections significantly reduced –MRSA close to zero –C diff down by over 30% All childhood immunisations now over 90% Tuberculosis reduced by 20% since 2005 Brief interventions for alcohol doubled Deaths from fractured hips down by 20% in 5 years Breastfeeding rates increased by 10% from 2010-11 Drug related burglaries reduced by over 5000 since 2004 14

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