1 The best possible health and well being for people in Lewisham Healthy Lives, Healthy People Strategy for Public Health in England November 2010 Jane Miller Deputy Director of Public Health NHS Lewisham

2 The best possible health and well being for people in Lewisham What is public health? ‘The science and art of promoting and protecting health and wellbeing, preventing ill health and prolonging life through the organised efforts of society’ (Faculty of Public Health definition) There are three domains to public health; Health improvement (including people’s lifestyles as well as inequalities in health and the wider social influences of health), Health protection (including infectious diseases, environmental hazards and emergency preparedness) Health services (including service planning, efficiency, audit and evaluation).

3 The best possible health and well being for people in Lewisham 02/10/2015 Health Background Poor mental health is estimated to be responsible for nearly a quarter of the overall burden of long-standing poor health Smoking claims over 80,000 lives a year 1.6 million people are dependent on alcohol Britain has amongst the worst levels of obesity in the world Over half a million new sexually transmitted infections were diagnosed last year, and one in ten people getting an infection will be re-infected within a year People in the poorest areas expect to live up to 7 years less than people in richer areas

4 The best possible health and well being for people in Lewisham A Radical New Approach representative – owned by communities and shaped by their needs resourced – with ring-fenced funding and incentives to improve rigorous – professionally-led, focused on evidence, efficient and effective resilient – strengthening protection against current and future threats to health.

5 The best possible health and well being for people in Lewisham Public Health Paper Commitment to public health Inequalities Recognition of relationship of mental health to physical health Recognition of role of local authorities in improving health and wellbeing National public health service – Public Health England Importance of health protection Intention to protect public health funding Public Health into GP Commissioning

6 The best possible health and well being for people in Lewisham A New Public Health System Public Health England – a national public health service A return to public health leadership to Local Government Professional leadership nationally and locally Dedicated resources for public health at national and local levels Focus on outcomes and evidence based practice Maintaining a strong relationship with the NHS, social care and civil society Set out in the Health and Social Care Bill

7 The best possible health and well being for people in Lewisham Working together locally Local authorities will lead local action on public health, playing an important new role in promoting people’s health and wellbeing, with new freedoms to make a major impact on health improvement and health inequalities Health and Wellbeing Boards - Local authorities will play a leading role in driving collaboration Directors of Public Health will be the strategic leaders for public health and health inequalities in local communities, working in partnership with the local NHS and across the public, private and voluntary sectors

8 The best possible health and well being for people in Lewisham Public Health England New public health service directly accountable to the Secretary of State for Health with a clear mission to: Achieve measurable improvements in public health outcomes; and Provide effective protection from public health threats

9 The best possible health and well being for people in Lewisham Director of Public Health Will be the principal adviser on health to the local authority, elected members and officers, on the range of local authority functions and their impact on the health of the local population Will be play a key role in the proposed new functions of local authorities in promoting integrated working With Directors of Adult Social Services and Directors of Children’s Services and GP Consortia lead the development of the local Joint Strategic Needs Assessment (JSNA) and a Health and Wellbeing strategy Will continue to be an advocate for the public’s health within the community

10 The best possible health and well being for people in Lewisham Director of Public Health Will be jointly appointed by local authority and Public Health England and employed by the local authority with accountability to locally elected members and through them to the public. Will produce an independent annual report on the health of their local population Accountable to the Secretary of State for Health for responsibilities relating to health protection and professionally accountable to the Chief Medical Officer

11 The best possible health and well being for people in Lewisham Department of Health Public Health England (within the Department of Health) Local authorities NHS commissioning architecture (Commissioning Board and Consortia) Providers Commissioning GPs NHS budget Health and wellbeing boards JSNA & Joint Strategic Health and Wellbeing Plans Public health budget Ring- fenced public health grant Funding for commissioning specific public health services integration Public health funding and commissioning

12 The best possible health and well being for people in Lewisham Outcomes Framework

13 The best possible health and well being for people in Lewisham Domain 1: Health protection and resilience: protect the population’s health from major emergencies and remain resilient to harm. Life years lost from air pollution as measured by fine particulate matter. Public sector organisations with a board approved sustainable development management plan.

14 The best possible health and well being for people in Lewisham Domain 2 – Tackling the wider determinants of ill health: tackling factors which affect health and wellbeing. Children in poverty School readiness: foundation stage profile attainment for children starting Key Stage 1 Rates of adolescents not in education employment or training at 16 and 18 years of age Truancy rates First time entrants to the youth justice system Proportion of people in long-term unemployment Proportion of people with long- term conditions Housing overcrowding rates Proportion of people with mental illness and/or disability in settled accommodation Statutory homeless households Fuel poverty Access and utilisation of green space Killed and seriously injured casualties on England's roads Cycling participation

15 The best possible health and well being for people in Lewisham Summary timetable (subject to Parliamentary approval of legislation ) Consultation on: specific questions set out in this White Paper; the public health outcomes framework; and the funding and commissioning of public health. Dec 2010–March 2011 Set up a shadow-form Public Health England within the Department of Health Start to set up working arrangements with local authorities, including the matching of PCT Directors of Public Health to local authority areas During 2011 Develop the public health professional workforce strategyAutumn 2011 Public Health England will take on full responsibilities, including the functions of the HPA and the NTA Publish shadow public health ring-fenced allocations to local authorities April 2012 Grant ring-fenced allocations to local authoritiesApril 2013