1. Case Study – Informing Healthier Choices Programme for the
Department of Health
December 2010 1 Mike Deacon
The IHC Steering Group
Dr. Judy Jones, Senior Responsible Officer, Department of Health
Professor Mike Catchpole, Director of the Centre for Infections,
Health Protection Agency
Dr. Steve George, President, Faculty of Public Health
Mrs Janine Dellar, Public Health Analyst, NHS Leicestershire County
Dr. Parul Desai, Consultant in Public Health and Ophthalmology at
Moorfields Eye Hospital
Professor Brian Ferguson, Chair, Association of Public Health
Ms. Tricia Dodd, Deputy Director responsible for Health Analysis and
Life Events, Office for National Statistics
Dr. Judith Hooper, Executive Director of Public Health, Kirklees PCT
Ms. Angela McNab, Chief Executive, NHS Luton
Mr. Andy Mobbs, Policy & Customer Manager, The NHS Information
Professor John Newton, Regional Director of Public Health, NHS
Dr. Jammi Rao, Department of Health, Representing Strategic Health
Directors of Public Health
Dr. Jean Robinson, Public Health Analyst, Nottingham City PCT
IHC Programme Team
Sir Muir Gray, Programme Director
Mr. Mike Deacon, PHAST, Programme Manager
Dr. Catherine Brogan, PHAST, Clinical Lead
Mrs. Katie Enock, Aim 1 Lead
Dr. Richard Gibbs, Aim 2 Lead
Professor Sue Atkinson, Aim 3 Lead
Dr. Ben Toth, Aim 4 lead
Ms. Natalie Hutson, Business Manager
Mr. Christian Fenn, Project Co-Ordinator
Ms. Marie Grigson, Project Support Officer
2. Case Study – Informing Healthier Choices Programme for the
Department of Health
December 2010 2 Mike Deacon
Supporting local health and wellbeing - Background to
Informing Healthier Choices
Major health problems in many communities were highlighted in the Wanless Report
Securing good health for the whole population (February 2004) and acting on Wanless‟
recommendations, the Choosing Health (November 2004) initiative was launched.
At the same time, it had become clear that local authorities, health authorities, GPs and
community groups, were not being provided with the kind of useful, local evidence they
needed to plan their actions. And yet these are the groups whose work is key to
improving health and wellbeing, and preventing illness and disease. Their plans and
spending need to be based on actual evidence about what is going on in health in their
area, and it is the responsibility of public health Information and Intelligence to meet
these needs. A consultation on how to deliver better health knowledge, and new data
and the tools to use it, led to the establishment of Informing Healthier Choices (IHC).
The programme‟s vision was:
“To improve the availability and quality of health information and intelligence across
England and to increase its use to support population health improvement, health
protection and work on care standards and quality.”
What IHC set out to do
Six key health areas were targeted and IHC set out to deliver basic information and
tools to provide both a qualitative and quantitative picture:
• Tackling health inequalities
• Reducing the numbers of people who smoke
• Tackling obesity, including promoting exercise
• Improving sexual health
• Improving mental health and wellbeing
• Reducing harm from alcohol and encouraging sensible drinking
New data and tools were not enough, however. Standards for the public health
information and intelligence community needed to be raised.
The four ‘boxes’
To address these issues, four „boxes‟ or Aims were established for the IHC programme:
1. Improved workforce capacity and capability.
2. Improved data and the tools to use it.
3. Creation of stronger organisations using intelligence appropriately.
4. Development of web-based support for health intelligence.
A programme of work was agreed under each heading. Overall the programmes have
been achieved with great success. There is also a summary of how products were
3. Case Study – Informing Healthier Choices Programme for the
Department of Health
December 2010 3 Mike Deacon
disseminated and how the project was managed. A legacy strategy has been completed,
with safe homes for the products and outcomes, where the work can continue.
Aim 1 Improved workforce capacity and capability - Public health training
The Aim 1 team established three key objectives for their work:
1. To ensure that specialist health information and intelligence staff have access to
training and a coherent career development framework.
2. To support those who commission or provide NHS services to do so on the basis of
robust information and evidence.
3. To provide accessible training on the Internet to anyone who needs to understand
information and intelligence, to challenge it and to use it successfully.
The website www.healthknowledge.org.uk was enhanced to provide a comprehensive
public health training resource.
A coherent, flexible public health career framework has been developed for use across
the UK. The Public Health Career Framework (PHCF) brings together competencies,
underpinning knowledge, training and qualification routes and registration requirements.
It provides a route map for careers in public health regardless of starting and intended
end points. It can be accessed at www.phru.org.uk
IHC worked with a range of partners to develop model Job Descriptions (JD‟s) and
Person Specifications (PS‟s) for public health information and intelligence staff that
connect to the PHCF. The JD‟s and PS‟s can be accessed on www.pho.org.uk and
Aim 2 Improved data and the tools to use it - Meeting the need for local
The Aim 2 team carried out an extensive consultation with PCT public health and
commissioning teams, and local authorities, about the kinds of data and information they
need. Not surprisingly they specified accessible and useful local data that would help
address issues of health and wellbeing of their communities.
A focused drive was initiated to produce this kind of more localised data. The
Association of Public Health Observatories rose to the challenge as the main delivery
There are two highlights of this workstream:
Health Profiles - Health Profiles provide a snapshot of health for each local authority
area in England using key health indicators that enable comparison locally, regionally and
over time. They are designed to help local councils and the NHS decides where to
target resources and tackle health inequalities in their local area. Tools on the website
4. Case Study – Informing Healthier Choices Programme for the
Department of Health
December 2010 4 Mike Deacon
help people compare their area‟s performance with other areas of the country and this
encourages sharing of best practice. www.healthprofiles.org.uk
Disease Prevalence Models - These provide prevalence estimates at PCT and local
authority area level, for some major long term diseases that absorb significant resources
in the NHS. They are already being widely used in local planning, case finding and early
detection. Early detection means early treatment and care. It is good for the patient and
good for the budget.
They can be accessed either through NHS Comparators (accessible to anyone with an
NHS email address) or at www.apho.org.uk/diseaseprevalencemodels
Aim 3 Stronger organisations using knowledge appropriately - Getting
the news out to every audience
As part of this workstream, IHC acted as an advocate for effective use of Public Health
Intelligence, particularly in PCTs and as part of the commissioning process.
IHC hosted a seminar on Health Impact Assessment for government departments; a
national workshop looking at Population Health Modelling, and a national „colloquium‟
for 200 public health trainees in Spring 2010. Trainees led in designing the day and gave
presentations, as well as hearing from the leading figures in public health, including Sir
Michael Marmot. Workshops introduced all the IHC tools and products.
IHC has been working to make Health Impact Assessment (HIA) and Strategic
Environmental Assessment (SEA) easier, and to raise their profile. The IHC team wrote
a simple HIA tool which policymakers can use to quickly screen and then consider how
any new policy will impact on health and wellbeing. To encourage the use of health
evidence in HIA, IHC has provided a database of evidence sources, which policymakers
can access online. IHC also invested in the best practice HIA Gateway.
Aim 4 Development of web-based support for health intelligence -
Intelligence on the web
This workstream set out to improve web based information for the public health
community, and beyond to anyone who needs access to high-quality evidence, tools and
knowledge about population health.
National Library for Public Health
A significant investment was made in the National Library for Public Health, now part of
The Public Health Portal
An initial project to develop a stand-alone Public Health Desktop was closed when it
became clear that the route initially scoped would not deliver what was required, or win
5. Case Study – Informing Healthier Choices Programme for the
Department of Health
December 2010 5 Mike Deacon
IHC began work with the NHS Information Centre to provide a browser based portal
for everyone working in public health, as part of the MyIC service. It delivers useful,
trustworthy, current knowledge. Users can create their own profile, and add a default
set of resources to their personalised home page. Further content can be added from a
library of resources, including datasets, documents, tools, websites, and news feeds.
Managing the programme - How IHC delivered
Public Health Action Support Team CIC (PHAST), a public health consultancy and not-
for-profit social enterprise organisation, was appointed by the Department of Health to
manage delivery of the IHC Programme.
The programme worked with key leaders and influencers, and with key stakeholders and
users. The aim throughout has been to deliver “subsidiarity” at the right levels in terms
of collaborative working, and to align all outcomes with the way the health system
works at local and national level.
A Steering Group was established, chaired by the Department of Health‟s senior officer
responsible for the programme. There were representatives of PCTs and clinical end
The Steering Group also included representatives from the Association of Public Health
Observatories, the Faculty of Public Health, the NHS Information Centre, the Health
Protection Agency, Directors of Public Health and the Office for National Statistics. This
ensured that outcomes were designed to be useful to a wide range of end users – from
local authorities to commissioning bodies, GPs to acute trusts. They are designed to be
sustainable and scaleable, and to have a long shelf life.
PHAST recruited first class leads for the four work-streams who led working groups and
took responsibility for commissioning and quality assurance and reviews.
Performance and Budget
IHC ran to time and well within the original budget, albeit with some reductions in
originally scoped deliverables, and with a need to adapt to change taking account of new
public health policy directions. A £4 million saving has arisen from the original IHC
Programme Budget of £12 million. £3 million was from the decision not to proceed with
the Public Health Desktop, as explained above, and the balance from efficiency savings
made in the other work streams.
6. Case Study – Informing Healthier Choices Programme for the
Department of Health
December 2010 6 Mike Deacon
IHC Legacy Benefits
Where to find outcomes and products delivered by the Informing Healthier
Aim 1 Training for public health www.healthknowledge.org.uk
Public Health Skills and Careers Framework www.phru.org.uk
Model Job Descriptions and Person Specifications for I&I staff grade 4-8c
Aim 2 Health Profiles for England www.healthprofiles.org.uk
Disease Prevalence Models www.apho.org.uk/diseaseprevalencemodels
National Child Measurement Programme
Joint Strategic Needs Analysis Core Dataset
Nutrition and diet data www.empho.org.uk/viewresource.aspx?id=11024
Local lifestyle behaviour and wellbeing surveys
Aim 3 Tools and support for Health Impact Assessment www.hiagateway.org.uk
Aim 4 Public Health Portal at MyIC – to use the portal register at www.ic.nhs.uk/myic
Public Health Futures website for trainees www.phfutures.org
National Library of Public Health www.library.nhs.uk/publichealth