Presentation for the workshops on developing Hertfordshire's public health strategy
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This presentation, along with the workshop papers, is the tool used at sessions to develop and shape Hertfordshire's Public Health Strategy
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Presentation for the workshops on developing Hertfordshire's public health strategy
- 1. www.hertsdirect.org Jim McManus Director of Public Health Public Health Developing the Herts PH Strategy
- 2. www.hertsdirect.org Major Disease Shifts • 1st – Poverty, Living Conditions – Improvement in incomes, reduction in deaths • 2nd –Communicable Diseases – Now on average 6-11% of deaths in UK. Was 85% of deaths before 1900 • 3rd – Non-Communicable Diseases – Over 60% of deaths due to lifestyle and behaviour – Poorest fare worst (smoking, diabetes, heart disease)
- 3. www.hertsdirect.org Contributors to overall health outcomes and why elected councillors are important leaders Smoking 10% Diet/Exercise 10% Alcohol use 5% Poor sexual health 5% Health Behaviours 30% Education 10% Employment 10% Income 10% Family/Social Support 5% Community Safety 5% Socioeconomic Factors 40% Access to care 10% Quality of care 10% Clinical Care 20% Environmental Quality 5% Built Environment 5% Built Environment 10% Source: Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute. Used in US to rank counties by health status While this is from a US context it does have significant resonance with UK Evidence, though I would want to increase the contribution of housing to health outcomes from a UK perspective.
- 4. www.hertsdirect.org Three key points • Unique role of local authorities able to work on 70% of determinants of health • The importance of a lifecourse approach • The new strategic role of local government
- 5. www.hertsdirect.org The Domains of Public Health Health Improvement Health Protection Service Quality Then & Now Sanitation Housing Now Environment Then & Now Smoking Heart Disease Now Care which keeps People healthy and independent
- 6. www.hertsdirect.org The Big Strategic Challenges for Hertfordshire Health Improvement Health Protection Service Quality Imms Vaccs TB HCAI Environment •Non Communicable Disease •Public Mental Health •Development •Ageing Health Care Quality Public Service Outcomes
- 7. www.hertsdirect.org The Strategy Pyramid 1 HWBS Herts PHS Local Strategies
- 8. www.hertsdirect.org The Strategy Pyramid 2 Missio nVision: Where we want to get to Strategy: How we want to get to the vision Implementation Plans : What we need to do in each area of the business and for each topic Individual Plans: My personal objectives and must dos Mission: Why ? Where/What do we want to be? Why do we Exist ? How we want to get there? What we need to do! What I need to do! Values, what’s important to us ? {
- 9. www.hertsdirect.org Values - Ottawa Charter, 1986 • Underpins strategic role of local government • "The goal of a healthy public policy is health promotion, i.e., to enable people to increase control over and improve their health. • It is also essential to – create supportive environments, – strengthen community action, – develop personal skills and – reorient health services. All of these are areas for elected member leadership
- 10. www.hertsdirect.org Values - Lifecourse approach • Conception to death • Protective and vulnerability factors (e.g. obesogenic or energy balanced environment) • Healthy outcome in one age is cumulative impact of earlier ages • Poor outcome in one age may be risk factor for another (low birth weight and CVD) • Early investment, early prevention (lifetime mental ill health and under 13s) • Data, Evidence, Implementation key
- 11. www.hertsdirect.org Values – A Public Health Family 2013 Environmental Health & Regulatory Services NHS Police, Fire, Community Safety Third Sector and Community Bodies Public Health England Specialist Public Health Agencies with Major Public Health Roles HCC Public Health County Council District Councils
- 12. www.hertsdirect.org The Opportunity for Herts • The conditions for everyone to be healthy • The conditions for the poorest and worst off to be healthier • Public services which put this at the core of their business • People thriving and prosperous • Healthy workforce, prosperous County
- 13. www.hertsdirect.org Values - You cannot change health overnight Some things happen faster than others.....
- 14. www.hertsdirect.org Mission • Our mission is to work together to improve the health and wellbeing of the people of Hertfordshire, based on best practice and best evidence* • • *Best evidence means not just effectiveness but cost-effectiveness
- 15. www.hertsdirect.org Vision • Healthy, Happy Hertfordshire: Our vision is that everyone in Hertfordshire is born healthy, and lives full, healthy and happy lives. • ALTERNATIVE • Our vision is that by 2026 everyone in Hertfordshire starts and stays as healthy as possible across their whole life
- 16. www.hertsdirect.org Priorities 1. Longer Healthier Lives 2. Start Healthy, Stay Healthy 3. Closing the Gap 4. Understand what’s needed and do what works 5. Partnership: Making PH everybody’s business 6. Protecting our communities from harm
- 17. www.hertsdirect.org Timeframes of impact/yield Years 0 1 5 10 15 Planning Education Vitamin Supplements Air Pollution Decent Homes Jobs Primary Care 20 CVD Events Self Care Vitamin D and TB Rickets CVD Events Acute Bronchitis Admissions Respiratory Mental Health overcrowding educational attainment Life Expectancy Healthier space use Changing culture of activity Life ExpectancyMental Health
- 18. www.hertsdirect.org The public health mindset in local government means working across different dimensions of time and responsibility •Think through what we can do short term •Start work on the medium term •Set the policy framework for the long term •Build this understanding among partners •Get started and realise •County, District, Parish, NHS, Business and Community Sector working together
- 19. www.hertsdirect.org The Tasks Now 1. Understand the context set by our population and the differences between it and England 2. Understand the big ticket issues we need to work on 3. Use specialist public health to impact on the £4bn +, not commission the £55m – 4. Stronger role for behavioural sciences
- 20. www.hertsdirect.org Phased Approach to transition • Phase 1 – to Sept 2012. Focus on transactional issues, accommodation, co-location, scoping further work • Phase 2a – to March 2013 – moving into transformational. Wide engagement of team and staff etc • Phase 2b – to March 2013 – Transformational – the vision and strategy of what Public Health is offering Hertfordshire • Phase 3 – march 2013 to March 2014 – Embedding the transformation and new way of working • Phase 4 – 2014 onwards – the hard long term work of making Hertfordshire a public health county.