BELFAST HEALTHY CITIES 25th ANNIVERSARY LECTURE SERIES Dr Andrew McCormick Permanent Secretary Department of Health, Social Services & Public Safety

Health Status of Northern Ireland

Investing for Health 2002-2012 Investing for Health 2002 sought to shift the emphasis by taking action to tackle the factors which adversely affect health & perpetuate health inequalities Goals “to improve health status of all our people” “to reduce inequalities in health” Based on taking action to address the wider determinants of health A framework for action based on intersectoral partnership at government & local levels

Review Findings Clear need for cross-sectoral public health strategy based on IfH Take account of emerging evidence e.g. Marmot on Inequalities Needs better coordination to implement more robust monitoring and performance management Better linkages to IfH agenda from other Departments Linkages with local Government and C&V sector roles

Response to 2012 Consultation Welcome whole systems approach Needs more detail – learn from IfH review Clear lines of accountability needed between high level group and any regional board What about sub-regional/ local level? Linkage to other structures, e.g., CYPSP Local Government and C&V sector roles

Implementation Partnership working remains key: Government level [MGPH] Regional level [Delivery Board] Local level [Local Arrangements] Whole Systems Approach required link policy, research and practice Given the range of factors that influence health and wellbeing partnership working will remain key – the aim will be to promote a “whole systems approach”, whereby there is more coherence across the various levels at which work needs to be taken forward, with effective linkages and communication across the range of sectors and various levels of the system. Proposal is to retain the cross departmental group Ministerial Group on Public Health under the leadership of Minister for Health but review and update its terms for reference to ensure it links with other cross- government structures, such as those led by OFMDFM under Delivering Social Change. There will need to be co-ordination of regional and local level activity which will need to connect with and be informed by other structures such as the Children and Young People’s Strategic Partnership. This is a public health framework for the whole population and given the role of the PHA, and its regional and local level reach, it is proposed to look to the PHA to play the lead role in developing proposals for regional and local delivery – it is considered there would be benefit in having a regional delivery structure/board which could gather and disseminate best practice, monitor and report on action etc. All of the various partners – departments and public bodies, community and voluntary organisations, business sector etc bring their specific contribution – at government level, need policy coherence delivery level, need collaboration and maximisation of opportunities and resources at local level need support to identify and engage with those who are isolated, disengaged and vulnerable We obviously need to ensure that the direction provided by the framework is well founded in evidence and that we can monitor progress over time. We anticipate needing to roll it forward again in three years time. The framework identifies as a long term outcome that policy, research and practice are supported by robust data and evidence base – we therefore need to consider how to collaborate more closely on research and linking it in with policy development, and to support this two data and research groups have been established.

Next Steps Feedback from consultation Factor in Health Committee report on health inequalities Finalise and publish Spring 2013 Implementation……. Currently we are working to analyse responses to the consultation , to re-engage with others (eg across departments, and other stakeholders) to consider and make any adjustments and to update the framework. The aim is to publish the final framework in Spring this year subject to Executive approval processes. Work will be required with partners to establish the structures and processes to take forward implementation.

Leadership and Governance Whole System, Whole of Government, Whole of Society Requires an enormous culture change “For Health, not For Health Services” Change the conversation, change the incentives, change the business model