1 Informing Healthier Choices ERPHO, SEPHO Dr Gillian Schiller 13 October 2008

2 11 June 2006  Information and intelligence for healthy populations  Aims  improve the availability, timeliness and quality of health information and intelligence across England  increase its use to support population health improvement, commissioning of services for health and well-being, and health protection.

3 Objectives  Support the work of professionals engaged in improving the health and well-being of the population  Enhance delivery of  Choosing Health  Our health, Our care, Our say by making information and knowledge available to local communities to inform their decisions  Meet the information and intelligence needs of other key DH and Government Departments policy objectives  commissioning for health and wellbeing  reducing inequalities in health  achieving health literacy  tracking relevant Public Service Agreement targets locally and nationally

4 Four boxes Box 1 Workforce capacity and capability Box 2 Improved data and information provision Box 3 Stronger organisations Box 4 Health information and intelligence portal and systems …with many cross links and connections

5  Improving public health information and intelligence skills and capacity across England for all levels of the public health workforce  PH Specialists  PH Practitioners  Wider PH workforce 3 objectives  Career pathways  Training strategy  Training resources Box 1 Workforce capacity and capability

6 PH Skills and Career Framework  “ A5_Employers%20%20Commissioners_copyri ghted.pdf”  Identified competencies and skills needed at all levels Regulated practitioner standards Library job descriptions and person specs graded against NHS pay bands Rotating training programme to build capacity & capability Box 1

7 Training strategy  Working together  Local experts  Teaching Public Health Networks  Other institutions  To support  Personal and professional development of PH I&I workforce  Information skills for the wider workforce  Information for undergraduates  Comprising  Training programmes based on PHSCF  Training the trainer programmes (from 2009)  Modules/materials for wider workforce, eg commissioners Box 1

8 Online resources  Further development of “ (on-line text book)  PowerPoint slides and teachers notes on all training developed within this strategy  Interactive e-learning modules  Teaching modules with video and podcasts Box 1

9 Box 2 Improved data and information provision Reliable data on key health challenges Centrally from provider data eg general practice smoking raised BP Special surveys eg well being dental health exercise levels Surveillance systems eg child health systems disease registers

10 Outputs to date  Prevalence modelling  Primary care data development  Health profiles Box 2

11 Prevalence modelling 1  Used to assess disease register completeness in primary care  Cancer  CHD  COPD  Chronic Kidney Disease  Dementia  Hypertension  Mental Illness needs  Severe Mental Illness  PBS Diabetes  All on APHO website Box 2

12 Model implementation Population by age-sex- ethnicity Smoking status Deprivation Relative Risks Prevalence estimates

13 Prevalence modelling 2  Assess completeness of case finding (main current use)  Compare complication rates or admission rates after adjustment for variation in expected prevalence  Compare service provision with population need  Undertake health equity audits  Allocate health service resources  Support to commissioning Box 2

14 Data development in primary care  GP Extraction System and IC  Seek information on risk factors for  Smoking  Obesity & nutrition  Hazardous drinking  Physical activity  Sexual health  Blood pressure  Lipids (lipid ratios)  CVD risk  Ethnicity  Available 2009 by PCT / LA Box 2

15 Health profiles  2008 profiles (Year 3)  Improved design and layout  New indicators  Filled gaps in existing indicators  Regional profiles  Facility to display indicators on maps or in charts  Interactive comparison facility Box 2

16  Structures, secure funding and governance for collecting, managing and analysing information  SHA and PCT levels integrated, clear I & I systems  Fits with WCC, FFP and similar  Build and maintain systems  Monitor and improve data quality  Support users esp commissioners  Support national screening programmes Box 3 Stronger organisations

17 Outputs to date  Health Impact Assessment  Government Impact Assessment (national)  Specific proposal impact (regional, local)  Training for HIA  Strategic Environmental Assessment  Regional workshops  Support activity towards intelligence integration  Use locally agreed priorities eg surveillance Box 3

18 HIA - National  Independent assessment of policy  One of 12 impact tests  Focus on costs and benefits  Signed off by Chief Economist  Mandatory for proposals  > £20M in NHS  > £5M in business, social care, third sector  All Depts screen proposals using bespoke tool  All HIAs published on Government websites with policies  IHC shaping tools and support system Box 3

19 HIA – regional and local  HIA gateway website  “  Contains resources, tools, case studies  WMPHO led  HIA UK and international conference  9/10 October 2008 Liverpool (  DH funds, contributes, on steering group  Competency based training programme proposal Box 3

20 Strategic Environmental Assessment 1  Directive 2001/42/EC (July 2004)  Applies to spatial/land use plans + some others inc  Energy  Transport  Water  Waste  Often within 3 to 5 year cycles  (Maybe) 400 SEA pa  5-stage process Box 3

21 Strategic environmental assessment 2  Responsible Authority produces plans and must consult on impacts, including health  DPH comments on health impact at Stage 1  Useful WDH influence  Right now consultation encouraged: maybe PCTs and SHAs to be consulted statutorily  DH presently considering Box 3

22 HIA and health inequalities  Arose from Tackling Health Inequalities  June Commitments  DH developing HIA Intervention tool  Scale up National Support Team for Health Inequalities  Support programmes of leadership development  Extend Communities for Health  Invest in appropriate third sector bodies Box 3

23 HIA and Health is Global  30 September 2008  Principles 1 and 2 (of 10)  “…evaluate the impact of domestic and foreign policies on global health…”  “…base our global health policies and practice on sound evidence, especially public health evidence,…”  Use HIA more systematically at all levels  Local Area Agreements  World Class Commissioning  Strengthen inequalities element in HIA Box 3

24  Better presentation and accessibility of data to professional public health people  Better use of systems and tools by use of existing networks of people, super users  Demos and communications to promote sound public health information use Box 4 Health information and intelligence portal and systems

25 Benefits  Improve Public Health practitioners’ use and sharing of both data and information  Promote collaborative ways of working and improve commissioning  Reduce duplication of effort and process  Improve co-ordination of effort on Public Health subjects  Facilitate sharing of expertise  Promote acting on data rather than searching for it Box 4

26 Key themes  Integration  Information Centre, PHOs  PH users  Management v technology  PH Intelligence Academy  User driven Box 4

27 Knowledge ExplicitTacit GeneralisableParticular Valid anywhereValid in particular circumstance eg location, population Evidence (from research) Use: diagnosis Data derived (stats, info) PHOs, IC, IHC Use: therapy for population Experiential evidence NLPH, IC/PHOs Use: assists implementation Box 4

28 Structure  National public health library  Web service  Desktop  Knowledge management service  Metadata management  Data management services  Data analytic tools  Compendium  SUS users  Project management projects  Training  Evaluation Box 4

29 Structure  National public health library  Knowledge management service  NEPHO led  Data management services  IHC, DH, PHAST, APHO, IC discussion  Web service  Interoperability between NLPH, IC, PHOs, APHO via Box 4 INFO

30 Public health casebook  Expedites shared learning  All public health practitioners must submit 1 (or more) report pa  Reports contain  Outline of problem  Why prioritised  Objective of PH investment  Project impact  Lessons learned  Signpost to full documentation  Contact details Box 4

31 Desktop  First outputs end Oct 2008  For comment by invited audience  Tools  Information and knowledge formats  Free standing website?  Discussion on process for future  Hosting?  Accountability?  Fit with other systems? Box 4

33 What now?  Policy drivers eg  Darzi  World Class Commissioning  Review currently underway  Boxes to merge?  Connect more overtly to other policies?  Key questions  Greatest benefits from..?  Timing?  Regional involvement?  Partner involvement?

34 Thoughts?     Thank you!

35 Reflections  Map what IHC does and tell everyone  Show links between IHC and WCC (esp JSNA) and agendas of partners eg wellbeing  Offer intelligence to meet “hot” policies  Demonstrate quality of data, maybe agree a scoring system  Focus on ownership of data (governance)  Invest in growing capacity and capability on non-PH people, and in non-commissioners  Support PH community, make IHC an attractive place to click  Agree a single front end for knowledge access

36 Ideas  Killer slide  Missing links – reports that make a difference  Casebook – connect to CPD and make it for all, not just front liners