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

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

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

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

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

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

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

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

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

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

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

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