1 Shaping Health and Wellbeing in Yorkshire and Humber: National Policy context Martin Gibbs Health Inequalities Unit Department of Health 1 February 2012

2 Current focus in DH NHS reforms Public Health reforms Local Government Wider determinants of health/Marmot

3 Reform agenda - headlines NHS Commissioning Board Clinical commissioning groups Public Health England Public health role for local authorities New core role for Dept. Health Strengthened roles for Monitor, CQC and NICE And underpinning this: Greater democratic legitimacy and patient involvement And crucially: Reducing health inequalities will be a priority for the NHS, Public Health England and local authorities

4 Role of NHS Commissioning Board Work with clinical commissioning groups to use the commissioning budget to secure the best possible health outcomes for patients and communities. Bring together a number of functions into an organisation that will support commissioners to improve quality and outcomes. Directly commission a number of services. Support, develop and hold to account an effective and comprehensive system of clinical commissioning groups, in promoting the delivery of health services of the highest possible quality using available resources. Promote the NHS Constitution.

5 Role of the Public Health England Drive delivery of improved outcomes in health and well-being. Design and maintain systems to protect the population against existing and future threats to public health. It will do this through commissioning arrangements, its direct services, its evidence and intelligence functions and through its relationships with others in the public health system and the wider health and care system.

6 PHE’s relationship with local authorities Partnering and supporting local leaders by: providing specific services and support in particular on health protection; supply evidence and intelligence to support development and implementation of local approaches; provide professional support for local authority public health staff; and support transparency by publishing local authority outcomes.

7 Public health reform – new role for local authorities Local authorities taking the lead for: improving health; coordinating local efforts to protect the public’s health and wellbeing; and ensuring health service effectively promote population health. Local political leadership will be central to making this work.

8 Public health reform – new role for local authorities Health and Wellbeing Boards  Joint health and wellbeing strategies, drawing on Joint Strategic Needs Assessments  Directors of Public Health in local authorities  Ring-fenced public health grant - based on relative population health need and weighted for inequalities  Health premium - designed to incentivise action to reduce health inequalities

9 Why local government? “Giving this role to local government opens new opportunities for community engagement and to develop holistic solutions to health and wellbeing embracing the full range of local services (e.g. health, housing, leisure, planning, transport, employment and social care).”

10 Challenges But all this in a difficult environment: Reorganisation Transition timeline Loss of expertise and capacity Impact of financial pressures