1. The New Public Health System
Dr Rashmi Shukla CBE, Director of Public Health Public Health England Transition Team 1

2. new roles and responsibilities
The new public health system
new roles and responsibilities
leadership role for local authorities and partners
supported by a new integrated public health service, Public Health England
working alongside the NHS, with its continuing role of promoting health through clinical services. And other agencies and sectors
clear priorities
stronger focus on health outcomes, supported by the Public Health Outcomes Framework
public health as a clear priority for Government, backed by ring fenced resources 2

3. Roles in the new public health system
Duty to improve health
Brings together holistic approach to health and wellbeing
Employ DPH and PH staff
Ring fenced PH budget
Mandated services
Local Authorities
CCGs/NHS Commissioning Board
Population health advice to the NHS, including advice on health services
Commissioning healthcare
Commissioning some public health services
Duty to reduce inequalities
Public Health England
Supporting local authorities and others by:
Delivering services
Leading for public health
Developing the workforce
Health and Wellbeing Board
Coordinates local strategy through:
Joint Strategic Needs Assessment
Joint Health and Wellbeing Strategy
review of commissioning plans 3

4. A pathway from causes of illness to
A stronger focus on outcomes....
The Public Health Outcomes Framework
sets the scope of public health
focuses on outcomes not targets
alignment & integration across public health, the NHS and social care
takes a life-course approach
designed to also address the causes of the causes of ill health
A pathway from causes of illness to
caring for people 4

5. Wellbeing Causes of illness to caring for people …. Germ theory
and modern
medicine
19th century urban improvement – sewers / housing
Wellbeing
Lifestyles

6. The role of the NHS …. NHS Commissioning Opportunities for prevention
New public health responsibilities
Opportunities for prevention
Build prevention of poor health into day-to-day business
Make every contact count
Use every contact to improve wellbeing, mental and physical health
NHS workforce
1.4 million staff as advocates for changes for better health and wellbeing

7. April 2013 DH – to set public health policy (and PHOF)
PHE* – to support delivery (through LG and the NHS, and other partners) and links to NHS CB
PHE functions: Health Protection: Health Improvement; Information, Intelligence and Evidence
Local Health and Wellbeing Boards (links to CCGs) – JSNAs and Health & Wellbeing Strategies
Local Government – local public health delivery
*Structure of PHE published on 26 July 2012

8. What is PHE?
Public Health England has been established to protect and improve the nation’s health and wellbeing, and to reduce health inequalities.
PHE will provide national leadership for the delivery of improved public health. Working with key delivery partners including local government, and the NHS, to secure improved health outcomes
PHE will:
provide the evidence, intelligence and professional leadership
work through partners and directly with the public to promote healthier
lifestyles
act as an advocate for the public’s health and transparent reporting through
publication of the PH Outcomes Framework
provide a nationwide service to protect the public from threats to health
deliver a programme of world class research in support of protecting and
improving health

9. Objectives for Public Health England and Models for Change
Public Health England’s remit spans full range of public’s health. The delivery chains differ and will require different relationships, levers and ways of working. The maturity and history of the different delivery chains mean PHE will face very different tasks in establishing itself as a credible full spectrum PH body.
Mission
Outcomes
Levers/Delivery Models
Key task
To improve and protect health and wellbeing, and reduce inequalities
Improvement
across the PHOF
wider determinants
health improvement
health protection
health care
Health Protection
end to end delivery chains
clear command structure to SoS
expertise in large scale response
Ensure credible and consistent local delivery
Retain international reputation
Health Improvement
supporting LA, intelligence, evidence into practice
advocacy and publication of outcomes
professional relationship
limited national interventions
Build new 21st century capability in support of LA in holistic response to health and wellbeing
Health Care
specific PH specialist contributions
section 7A management
supporting NHS, intelligence, evidence into practice
advocacy and publication of outcomes
Establish explicit PH support to NHS from current implicit practice

10. Taking Shape: Senior Leadership

11. Taking Shape: National Presence

12. PHE delivery structures: 4 Regions, 15 Centres
North East
Midlands and East of England
4 Regions:
Supporting transparency and accountability across the system – leading strategic discussions with partners e.g. NHS CB, LAs and others
Providing professional support and leadership to the public health system including joint appointment of DsPH, clinical and medical supervision and professional guidance and leadership
Overseeing PHE Centres – ensuring delivery of consistently high quality services
Ensuring delivery of the national Emergency Planning, Resilience and Response strategy across their region
15 centres:
Provision of Health Protection Services maintaining and building on the services offered by HPUs
Building PHE’s relationship with Local Authorities –professional support for health improvement including building on the NTA role to oversee drug and alcohol treatment services
Ensuring the local NHS has access to high quality PH advice, supporting the local DPH relating to the NHS
Employment and professional development of Immunisation and Screening teams who will be embedded with NHS CB LATs
Development of the specialist and wider public health workforce supporting LAs and managing PHE’s relationship with the LETBs
Provide PH specialists to support specialised commissioning and dental commissioning – for those NHS CB LATs with this responsibility
South of England
London

13. Northern and Yorkshire
Eight Network Team areas
Northern and Yorkshire
Knowledge and intelligence teams (drawing on capacity from the public health observatories and the cancer registries) providing analytical and knowledge management support and advice to PHE and partners
Cancer registration and NDTMS teams collecting and quality assuring data from service providers
Quality Assurance teams for cancer and non-cancer screening (based on QARCs, and a new function for PHE) assuring safe and effective screening for a range of diseases
Network teams: all the above, plus colleagues in Regions and Centres as appropriate, within a particular geographical area cooperating and collaborating on corporate aspects (e.g. estates, IT), resources (e.g. shared administrative support) and/or specific projects (e.g. children and maternity; liver disease etc.)
North West
East Midlands
East of England
West Midlands
NDTMS = National Drug (and alcohol) Treatment Monitoring System
QARCs = Quality Assurance Reference Centres
8 network teams
Knowledge and intelligence teams (drawing on capacity from the public health observatories and the cancer registries) providing analytical and knowledge management support and advice to PHE and partners
Cancer registration and NDTMS teams collecting and quality assuring data from service providers
Quality Assurance teams for cancer and non-cancer screening (based on QARCs, and a new function for PHE) assuring safe and effective screening for a range of diseases
Network teams: all the above, plus colleagues in Regions and Centres as appropriate, within a particular geographical area cooperating and collaborating on corporate aspects (e.g. estates, IT), resources (e.g. shared administrative support) and/or specific projects (e.g. children and maternity; liver disease etc.)
South West
London
South East 13

14. LOCAL – Health and Wellbeing Boards
Joint Strategic Needs Assessment (includes assets)
Joint Health and Wellbeing Strategies
Key Local Priorities – and links to Outcome Frameworks
Links to Clinical Commissioning Groups
Local Public Health Departments – links to LA functions and Primary Care and Communities

15. From transition to transformation ….
Public Health England Transition Team
_ _ _ Support for PCTs and Local Authorities during the transitional phase _ _ _
Communication and data sharing infrastructures
Web resources
Assuring local transition plans
Finalising policy