This presentation will cover…

1. The new public health systemour role in improving and protecting health and wellbeing; and the transition process

2. This presentation will cover… Context of the public health reforms Vision for a new public health system What the new locally-led system will look like Local system transition Workforce and HR issues Discussion

3. Health and wellbeing reforms: setting the context

4. Context Across the health and care system • Rising demand and treatment costs • Need for improved healthcare services – and reduced variation in health outcomes • Need for better value for money The modernisation programme will: • Put clinicians and local communities in the driving seat • Provide a greater voice for patients and the public • Increase accountability – locally and nationally • Support a greater focus on public health

5. Overview of health and social care structures from April 2013 Ministers and the Department of Health Public Health NHS Adult Social Care national Public Health England (part of DH) Monitor NHS CB NHS Trust Develop-ment Authority Care Quality Commission, including HealthWatch England National Institute for Health and Clinical Excellence Health and Care Information Centre local Local authorities CCGs Local authorities Health and Wellbeing Boards (part of local authorities) Local HealthWatch (formerly LINks) Public health providers • NHS providers, inc: • Foundation Trusts & NHS Trusts • Primary care providers • Independent / 3rd sector providers Social care providers Patients and the public

6. Modernisation timeline

7. Our vision for public health

8. A powerful case for change The white paper Healthy Lives, Healthy People set out a powerful case for reforming the public health system: • two out of three adults are overweight or obese • smoking costs the NHS £2.7 billion per year • rates of tuberculosis are rising • inequalities in health remain: people in the poorest areas live on average 7 years fewer than those in the richest • Major health threats, ranging from the risk of new pandemics to the potential impact of terrorist incidents. • We need a new approach to meet these and other public health challenges of the twenty-first century.

9. The new approach to public health Leadership role for local authorities – so services are shaped by local needs 1 Supported by a new integrated public health service, Public Health England 2 Stronger focus health outcomes supported by the public health Outcomes Framework 3 Public health as a clear priority across government 4 The commitment to reduce health inequalities as a priority across the system 5

10. An effective public health system… Accounts for the changing nature, assets and strengths of the population – is vigilant for new health threats Ensures economic development creates health and wellbeing Advocates wise use of environmental resources Promotes individual and community wellbeing Helps people limit behaviours damaging to their health. Secures equitable access to good quality health and social care, with prevention incorporated into all contacts. Systematically works to reduce health inequalities and embeds health and wellbeing in all policies.

11. the new locally-led public health system

12. Leadership role for local authorities – so services are shaped by local needs • Drive knowledge and analysis of population assets and needs. • Consider whole population outcomes and set goals. • Inform all health and social care commissioning using preventive approach. • Incorporate health and wellbeing across all local authority work – and across the locality. • Use evidence and return on investment to inform decisions. • Tackle health inequalities systematically focussed on People, Place and Power.

13. New delivery system requiring wide range of partners Government: DH lead but significant contributions from DCLG, Justice, Home Office, DWP, DfE PHE: Delivering health protection and supporting LAs and the NHS Local authorities: New public health functions build on existing wider role NHS: Delivering health care, every contact counts and specific public health interventions An effective public health system

14. Roles in the new Public Health System: Local Delivery • Duty to improve health • Brings together holistic approach to health and wellbeing • Employ DPH • Ringfenced PH budget • Mandated services Local Authorities • Core offer to the NHS, including PH advice on health services CCGs/NHS CB • Commissioning healthcare • Commissioning some public health services PHE (local units) • Local Health Protection Services (functions in development) Health and Wellbeing Board • Coordinates local strategy through • JSNA • JSHWS • Review of commissioning plans

15. Public Health System Updates: autumn 2011 Department of Health is completing the policy design phase • Public health Outcomes Framework • Operating model for PHE • Public health in local government: including grant conditions, mandatory services, and public health advice to the NHS. • Public health funding: including shadow allocations for local authorities. • Workforce strategy and other HR updates

16. Commitment to co-design We are working with stakeholders to co-design these five system reform updates • Regular discussions with local government • Regular discussions with the profession • Public Health Engagement Group, in autumn 2011, to provide advice and challenge • Alongside ongoing engagement forums – including with and via the Regional Directors of Public Health and DsPH group • NHS Future Forum review of the NHS’s role in the public’s health (due December)

17. Timeline End of 2010: White paper: Healthy Lives, Healthy People July 2011: White paper response, confirming new public health system structure By end 2011: complete the operational design of the new system, including the PHE Operating Model, how the local system will work, and their links into the NHS. Spring 2012: chief executive and senior team for Public Health England appointed. April 2012: start of transition year April 2013: Public Health England established April 2013: Local authorities take on their new public health responsibilities

18. Sept 2011 Oct 2011 April 2012 Nov 2011 Dec 2011 Baseline assessment Functions map Assessment HR concordat, Policy documents published March 2012 PCT cluster transition plan including delivery Key dates and activities

19. Workforce and HR issues

20. Scope of HR / workforce Work Local transfer: establish clarity on principles and terms and conditions of public health staff in LAs Directors of Public Health – devising an appropriate employment process PHE HR regime – exploring options for PHE terms and conditions Public Health workforce strategy – working group developing consultation document Regulationof non-medically qualified staff – seeking evidence to inform final decision

21. Aims of HR strategy An HR regime and wider workforce strategy which supports the public health reforms through: A secure transition of staff to PHE and LAs, retaining crucial capacity and expertise in the system Ensuring the supply of all expert staff, including medically qualified public health consultants, nationally and locally both in transition and in the future Supporting the future mobility of public health specialists across the whole of the public health system To create meaningful careers in all settings

22. Public health reforms: to stay in touch… Sign-up for the Transforming Public Health bulletin: www.dh.gov.uk/health/category/publications/bulletins/public-health-bulletin/ Contact details for workforce and HR issues: Andrew.Cooper@dh.gsi.gov.uk Oonagh.McIntosh@dh.gsi.gov.uk Contact for other transition issues: PublicHealthEngagement@dh.gsi.gov.uk Questions and discussion