1. Public Health Caryn Cox Director of Public Health, Cheshire West & Chester Council

2. Champs - who we are Cheshire & Merseyside public health collaborative service launched April 2013 Led by nine Cheshire & Merseyside local authority Directors of Public Health Key areas of work delivered by local public health teams and facilitated by small support team hosted by Wirral Council Builds on success of previous award-winning public health network which collaborated for 10 years within the NHS

3. What we do Improve the quality of services Offer value for money Achieve better health outcomes Reduce health inequalities We do this by sharing goals, resources and expertise

4. Our key areas of work Supporting a safe and resilient health protection system that protects local people’s health through expert leadership and co-ordination Enabling a unified, dynamic and effective public health system through expert public health leadership and input into strategic partnerships Improving quality, efficiency and cost-effectiveness by reviewing locally commissioned public health services Ensuring fair and better quality health care services for local populations by providing expert advice and intelligence to Clinical Commissioning Groups and other NHS organisations

5. Part of the local authority from April 2013 – part of wider NHS changes Overall responsibility for the health and wellbeing of populations and communities Identifying health risks – preparing a Joint Strategic Needs Assessment (JSNA) Developing plans and commissioning programmes to improve the health of the population as a whole, based on evidence of what works Who and what is public health?

6. Three domains of public health

7. Key essential areas Longer healthier lives Start healthy and stay healthy Narrow the gap between the most and least healthy Protect communities from harm Use evidence base Embed public health everywhere (make every contact count) Use ‘Lifecourse Approach’ (Marmot)

8. What do Public Health Commission? Drug and alcohol services Children’s public health >5 yrs (school nursing) Sexual health services NHS Health Checks National Child Measurement Programme Dental public health, oral health promotion Initiatives to reduce excess deaths Physical activity Accidental injury prevention, falls prevention Mental health promotion Stop smoking services Behaviour campaigns Community infection control

9. Health and Wellbeing Boards Boards established in each local authority area (top tier) Pharmacy Needs Assessment Health and Wellbeing Strategy Joint Strategic Needs Assessment (JSNA) Be strategic Look beyond needs (assets based approaches) Understand inequalities Jointly prioritise Examine all factors of ill-health Provide impartial evidence Public Health Outcomes Framework

10. Picture of Health? Good or bad?

11. Picture of Health? Obesity

12. Picture of Health? Alcohol

13. Picture of Health?

15. Picture of Health? We know the answers

16. Housing and health Source: Barton and Grant (2006)

17. How important? 40% - Socioeconomic factors education, employment, income, family/social support, community safety 30% - Health behaviours alcohol, tobacco, sexual health, diet/exercise 20% - Clinical care quality and access to healthcare 10% - Built environment built environment, environmental quality

18. Factors vary through life

19. What makes a difference to health? EMPLOYMENT (MEANINGFUL ACTIVITY) DECENT HOUSING STOP SMOKING

20. Key drivers – a few examples Fiscal challenge Welfare reform Increasing community capacity/resilience Integration Transformation Fund (ITF) Pioneer Status – Pan Cheshire Care Bill - April 2015 Ageing demographic

21. Housing & health – what is happening already? Warrington Developing a housing and health strategy Using RSLs to identify vulnerable individuals Mapping health improvement activities of RSLs Mapping homes where more energy improvement needed Cheshire Snow Angels Altogether Better programme eg early support, working well

22. Housing and health – opportunities? Employment/meaningful activity Energy efficient homes/affordable warmth – tackling fuel poverty Personal resilience Early identification of vulnerable individuals to provide early support Good mental health and wellbeing – all ages Building social cohesion/communities Housing data into the Joint Strategic Needs Assessment (JSNA) Health and Wellbeing Strategy - contributing Annual public health report Capturing voice of communities Making Every Contact Count

23. Contacts caryn.cox@cheshirewestandchester.gov.uk @DPHcheshirewest Champs @CMPHN

24. Thank you – any questions?