1. pct public health function and services to the local...
TRANSCRIPT
1
The Borough of Rochdale - Public Health Transition Plan March 2012 –March 2013
1. Introduction
This transition plan describes the current state of readiness, action required and identified risks associated with the transition of the Rochdale Borough PCT Public Health function and services to the Local Authority, Public Health
England, NHS Commissioning Board and Clinical Commissioning Group. This will be undertaken in line with national policy as it currently stands and as it
emerges. As such this is a dynamic document that is reviewed and amended on a regular basis.
This plan will serve the purpose of providing assurance to Rochdale Borough Council NHS Greater Manchester ( the clustered PCT), Shadow Health and
Wellbeing Board on the Rochdale Borough and relevant Greater Manchester elements of the Public Health Transition. The plan is overseen and managed by the established partnership Rochdale Borough Public Health Transition
Board.
The plan has already been signed off by NHS HMR Locality Board for initial submission to the Strategic Health Authority at the end of January 2012. The
assessment was AMBER and the enclosed plan address the previous weaknesses although we are still waiting for further clarity on the functions and resources transferring to Public Health England and the NHS
Commissioning Board
During this transition period the local Public Health team will prioritise agreed organisational objectives and programmes to ensure that they are delivered and will maintain our ability to tackle health inequalities in order to improve
outcomes for local people. The public health function at all levels will continue to
• Protect the Borough’s health from major emergencies, incidents, communicable diseases, threats and ensure an appropriate response
• Engage with partners including communities to identify and tackle the wider determinants of health and well-being
• Support local people to take responsibility to choose and maintain a healthy lifestyle
• Reduce the number of people living with preventable ill health
through prevention, early identification and screening programmes
• Prevent more people from dying prematurely and increase healthy life expectancy
2. The purpose of this transition plan
This transition plan aims to:
• Ensure the maintenance of the effective delivery of the local public health function throughout the transition period.
2
• Outline the key transition work streams to ensure the effective transition of public health functions, staff and
budgets to RMBC, Greater Manchester infrastructures, NHS Commissioning Board, Public Health England and the Clinical
Commissioning Group. • Identify and manage all risks and take action to mitigate
risks during and after the transition
• Outline and ensure robust governance arrangements during and after the transition including financial, clinical and
information governance • Outline plans for the development of the Health and
Wellbeing Board including the JSNA and the Strategic Health
and Wellbeing Framework for 2012/13 and 2014/15 • Ensure that the staff, commissioning and programme
budgets are affordable within the PHE allocation and are transferred within timescales to receiver organisations
• Describe and agree the PH offer from the Local Authority to
the Clinical Commissioning Group. • Develop and implement an integration model for the DPH and
Public Health Team within the Council • Agree the vision for public health and the leadership role of
RMBC. • Prepare RMBC for mandated service commissioning and
delivery functions.
• Prepare and support staff throughout the transition • Agree and implement the Greater Manchester Public health
and Commissioning support work streams as appropriate to deliver the local public health functions and responsibilities including the role of AGMA.
• Test out arrangements prior to and after transfer . • Ensure the new duties on health protection are in place and
tested. • Provide assurance to RMBC, NHS GM and NHS North.
3. The key changes that this plan will address
The proposed changes that form the basis of this plan are:
• The transfer of public health leadership, functions, commissioning,
staff and budgets to Local Authorities via a ring fenced budget to the chief executive of the Council.
• The transfer of public health functions to PHE. • The transfer of Public Health functions to the NHS Commissioning
board.
• Public health support and offer to the Clinical Commissioning Group from the Local Authority.
• The creation of the statutory Health and Wellbeing Board. Support RMBCs in it’s new role as the local lead for improving the health and well being of all people in the Rochdale Borough.
Ensure financial, governance and HR issues are effectively managed so
they are safe, legal and affordable.
3
Skills required by organisations and staff to deliver new responsibilities
and functions are retained and that staff are effectively supported through the change.
Where staff are transferred to new parts of the system and this is open and transparent
4. Local Authority Vision for Public Health
During 2011/12 the DPH has worked with the Executive Leadership Team of the Council to establish an initial vision and set of principles on the
integration of public health functions and team. This is set against a background of change within the Council in both service provision and
organisational structures and will be subject to review. Guiding principles have been agreed as follows:
• Public health will be a golden thread through all Council
activities • The Health and Wellbeing Board will work collaboratively to
improve people’s health and wellbeing • There will be an asset and people focus to building resilience
and wellbeing with citizens, communities and places to protect and improve health and wellbeing
• Public health will align and integrate with the Council
Blueprints. • Public health will be an outward facing function leading for
public health across the Borough of Rochdale
Currently the DPH is managed by the Chief Executive of RMBC and is an
active member of the Council Executive Leadership Team. The public health staff and budgets will transfer across under the leadership and
management of the DPH unless alternative models are agreed during 2012/13.
A joint local Transition Board is in place and the plan will be jointly delivered by the DPH and the Council Director for Performance and
Transformation. The Rochdale Borough Shadow Health and Wellbeing Board is established.
The Board is chaired by the Leader of the Council and has membership and attendance including; elected members, CCG, RMBC Directors of
Adult and Children’s Services, PCT Non executives and the Director of Public Health. A Board development and work programme is in place.
The Joint Strategic Needs Assessment is currently part way through a consultation phase and will inform the Board Health and Wellbeing
Strategic Framework/Strategy and other council actvities.
5. Greater Manchester Collaborative working
The ten GM Directors of Public Health commission and manage the existing GM Public health network. The GM DsPH are be working together
to manage the transition of GM functions. There is a strong track record of
4
pooled and joint service delivery at GM level. A GM plan is in place and links with AGMA have been established. GM work programmes are
underway in the following areas: • Health protection Infection control and prevention
• Immunisation co-ordination • Screening • Public health intelligence and information
• Review and development of Public health functions best delivered locally and which could be delivered more efficiently
or effectively at a sector or GM level building on existing good practice
GM has a well established work plan for delivering the national screening programmes. The lead DPH for this work is also linking with the DPH in
Cheshire and Merseyside and Lancashire and Cumbria and they have agreed a set of principles to manage the transition and mitigate any risks. The screening self assessment has been completed. Work is underway to
explore how screening work will be delivered by the National Commissioning Board and locally.
Collaborative work on the public health intelligence function is well
underway which includes a strong presence within Local Authorities. Discussion is focusing on which functions are best delivered locally and which may be better delivered at a GM level. Links with the NHS
intelligence functions and commissioning support services are also being discussed. This includes appraising options for collaboration in delivering
programmes and services where appropriate in terms of efficiency, effectiveness and sustainability.
6. Governance
NHS Greater Manchester retains overall responsibility for the effective discharge of public health functions until March 31st 2013 unless prior to
this date responsibilities are formally delegated during the transition period. The Joint Director of Public Health for the Borough of Rochdale is
the executive lead for this transition process and is accountable for this to the GM Cluster CEO and RMBC Chief Executive. It is expected that governance arrangements will develop through 2012 with the transition of
agreed duties by October 2012 and further duties by December 2012 with a completed formal handover by March 31st 2013.
A joint Rochdale Borough Public Health Transition Board has been established which reports to RMBC and the Locality/CCG Board and
provides updates to the Health and Wellbeing Board. Assurance for the transition process is being monitored and reports have been provided to
the RMBC Executive Leadership Team, Locality/CCG Board, Clinical Commissioning Committee, NHS GM ,NHS North and the local Health and Wellbeing Board. The Regional Director of Public Health for the North is
responsible for providing assurance to the DoH and the shadow Public Health England.
5
The Directors of Public Health across Greater Manchester have developed a transition plan with key work streams to identify the future direction of
work across a GM or sector footprint where appropriate. This work has also been reported through to AGMA in addition to the local transition
board. In addition the SHA will be offering localities an opportunity join in some
sector lead improvement by facilitating the open sharing of locality transition plans. Locally we plan to participate in this peer lead challenge
process. Locally we will also look at testing the emergency planning system for
health protection during 2012/13 and will be working with the NHS emergency planning service (which is now clustered into NHS GM) and the
emergency planning team in the council.
7. Work streams and Deliverables Our local transition plan has a number of work streams that are detailed
in the project plan in Appendix 1. These work streams encompass the transition of functions in three domains of public health:
• Health Protection • Health Improvement • NHS and care service development
7.1Deliverables
7.2Agreed integration model for the local PH team, activities and the
DPHto support the implementation of the Council Blueprints and the
NHS Operating Framework for 2012/13 and 2013 onwards.
7.3Transfer of the existing public health staff, budgets, contracts and overheads to receiver organisations including RMBC.
7.4Public Health staff development and Local Authority organisational and staff development to embed PH into the core business and
prepare PH staff for new ways of working
7.5Support the of the Health Overview and Scrutiny function to
effective scrutinise the Health and Wellbeing-Board.
7.6Formalise the contracts to be novated to come to RMBC and completed the transfer by March 31st 2013 .
7.7Commissioning infrastructure in place and transfer of all contracts, systems and responsibilities to RMBC by 31st t March 2013 with the
first phase complete by December 2012.
7.8A PH offer to support to Clinical Commissioning Group and the NHS
by April 2012 (mandated service).
6
7.9Agreed governance structures and assurance process during and after the transition.
7.10 Communication and engagement plan delivered across the
borough and to all staff.
7.11 Review and develop the GM level public health work
programme within the financial envelope from PHE/DoH .
7.12 Develop and embed a PH performance framework into the council, the HWBB and linked partnerships.
7.13 Active identification, assessment and management of risks (monthly).
7.14 Compliance with the SHA and NHS GM transition template
and reporting schedules
7.15 Development of the Rochdale Borough Shadow Health and
Wellbeing Board, Joint Strategic Needs Assessment and Health and Wellbeing Strategy.
7.16 A fully functioning public health system though out and after
the transition period
6. Transition Risks
A number of actual and potential risks have been identified to the delivery of public health functions, outcomes and for staff during and after the
transition period. These are listed in Appendix 2. The key risks are in the following areas:
• Funding allocations and infrastructure to each part of the system being insufficient to discharge given public health functions and outcomes
• A delay in a clear funding and budget allocation to the Public Health system
• Lack of clarity in the operating models and the interface between parts of the system e.g. effective public health to support screening
• Delay in detailed HR guidance and the affect on staff consultation
and transfer processes and timelines • NHS QIPP programmes prior to transfer may reduce the financial
envelope available to Local authority • Ensuring that functions split across the Public health system and
receiver organisations work together to achieve outcomes
• How staff and functions that are moved to a supra local level effectively discharge their responsibilities locally including being
accountable for local action and performance • Retention and distribution of specialist staff across the system and
in particular fears for individuals related to loss of NHS terms and
conditions, professional support etc • Funding allocations given for new programmes of work are not
increased in line with future needs e.g. health checks
7
• Ensuring sufficient capacity is retained to provide public health support to the NHS locally and within the NCB infrastructures
• Agreements across GM for collaborative work are not agreed by all Local Authorities
• Health protection and resilience functions if operating models are not clear and robust across the system for action at a local level
• Child and adult protection systems if they are not transferred to the
NHS effectively. •
7. Headline National timeline Autumn 2011 Public health guidance received including; HR
concordat, PH offer to CCGs, DPH role, PH commissioning
Dec 2011 Operating frameworks issued Jan 2012 Shadow budget formula allocations expected Public health outcome framework expected
Further HR guidance received and further guidance expected
Draft PH transition plan submitted to NHS North and NHS GM on 20th January 2012
End of March 2012 12/13 budgets confirmed by PCT PH transition plan agreed for 2012/13 and signed off by NHS GM and RMBC cabinet.
April 2012 Shadow year commences Oct 2012 Agreed duties transferred to RMBC
Dec 2012 Agreed duties transferred to RMBC Allocation formula announced.
1st April 2013 Formal handover to RMBC, PHE, CCG and NCB
1st April 2013 Statutory Health and Wellbeing Board commences
8
Appendix 1 Rochdale Borough Transition – Project Plan September 2011 to March 31st 2013 Work stream Actions lead Support
required
Timescale Progress/notes
5.1 Health and
Wellbeing Board,
JSNA and
Strategy
Establish th Rochdale
HWBB
J Rossini/Cllr C
Lambert
D O’Rourke, D
Armstrong
April 2011 Board established in
development April 2011 on
track for Shadow status by
April 2012
Programme of monthly
meetings set up for the
Board
D O’Rourke D Armstrong April 2012 Monthly meetings been held
throughout 2011/12.
Discussions in place with
Council legal and committee
services to agree schedule
for 2012/13 within
committee calendar
Development plan and
action to ensure Board
readiness for April 2013
J Rossini D O’Rourke. D
Armstrong
December
2012
Development plan has
included development
sessions, visioning,
agreeing priority areas,
JSNA development, joint
commissioning, agreeing a
forward plan for Board
development. Further work
identified re understanding
9
the public engagement work
stream required. Joined
national learning set
Development and
agreement of governance
arrangements including
terms of reference,
membership,
accountability and
relationships with HOSC
J Rossini D O’Rourke March 2013 Shadow membership, TOR
agreed. Governance work
stream underway with legal
services, Discussions held
with Chair of HOSC around
plans to develop the
scrutiny function.
Complete a review of the
infrastructure to support
the delivery of Board
priorities
D O’Rourke D Armstrong June 2012 Discussion taken place on
joint commissioning,
committee structures,
performance and links with
other Partnership
infrastructures
Establish a stakeholder
network/assembly to
engage and involve a
wider group
M Loughlin D O’Rourke June 2012 Board has agreed to
establish an assembly.
JSNA consultation and
engagement phase
completed
M Loughlin R Pinkney, L
Townson
D Armstrong
March 2012 The core data set has been
collated and completed.
Analysis across 5 mosaic
groups has been completed.
Consultation phase has
commenced to identify gaps
in data and identify the top
strategic priorities
Board agreement on
priorities and completion
of the Borough Health and
Wellbeing Strategy
M Loughlin L Townsen, R
Pinkney, D
O’Rourke
April/May
2012
Framework and plan
Process to gather views on
priorities from the JSNA
underway. Timescale and
process agreed by Board
10
Refresh of the Joint HWBS
for 2014/15 completed
M Loughlin R Pinkney, D
O’Rourke
December
2012
Timetable agreed
5.2 Local Public
health team
Consult, implement and
complete a local PH team
restructure
J Rossini W Meston, J
Cohen
September
2011
Restructure complete.
Implementation complete
Share public health
structure, functions and
objectives
W Meston October
2011
Shared within team, PCT
and ELT
Relocate public health
team to Telegraph House,
Rochdale
W Meston C Hartle
Admin team
IT
Oct 2011 Completed with access to
PCT and RMBC systems
Relocate public health staff
with Council staff to new
municipal offices
D Hunt P Jones Jan 2013 PH staff are in within sight
of project leads and will
relocate with all staff when
new Council offices are
ready
Develop a shared model
for the public health
function for 2012/13 and
2013/14 including vision,
values and core functions
J Rossini W Meston
GM PH network
SHA workforce
group
March 2012 Local discussions held to
date with ELT, HWBB
members, Clinical
commissioners and PCT
execs. ELT have agreed
vision and initial integration
plan.
GM work includes
development shared
services for infection
control, immunisation and
screening
Develop a business plan
for PH for 2012/13 jointly
J Rossini W Meston
L Townsen
Feb 2012 Team objectives for
2012/13 being developed in
11
with RMBC to include PH
outcomes, objectives and
performance frameworks
P Jones
All PH staff
line with operating
framework and Council
Blueprint. Discussion held
to align with service
planning process in RMBC
Integration of the Public
health outcomes
framework and amend
performance frameworks
as required
P Jones L Townsen May 2012 PHOF agreed ELT February
and being built in JHWBSF
and mapped across
partnerships, and in
performance manager
HR Concordat – review
and assess implications
J Rossini HR staff side November
2011
Concordat received,
circulated and considered at
Transition board and ELT
HR updates for staff and
briefings completed on the
HR concordat and further
expected DoH/PHE
papers/guidance
J Cohen
N Jolly
March 2013
Bi monthly
review
Session on TUPE held for
staff . HR concordat
discussed.Further HR
guidance just received and
being considered and
further detail expected
Engagement with staff
representatives
J Cohen
N Jolly
February
2012
Further
dates tbc
Initial briefing to be taken
to RMBC.
Submit assurance reports
on changes to PH staffing
to NHS North
W Meston A Hill Monthly Submitted to date
Participation in the GM and
NW work on options and
plans for screening and
immunisation staff
J Rossini C Khiroya
B O’Sullivan
H Lewis Parmar
Update at
TSB Bi
monthly
Work plan agreed in GM
transition plan for
immunisation
NCB and screening work
Participation in work to
identify future direction of
J Rossini Bernadine
O’Sullivan
Update at
TSB Bi
Work plan agreed in GM
transition plan and
12
infection control staff S Walton
J Mannion
monthly facilitated project underway
Participation in GM work to
identify future models for
local teams and PH
network staff
J Rossini
GM DPHs
W Meston
W Blandamer
Monthly Work plan is underway and
initial areas agreed as;
intelligence, screening and
health protection
Agreement on legacy
organisation for
safeguarding function and
PCT post
J Rossini H Chamberlain April 2013 Initial discussions held.
Awaiting further guidance
RMBC organisational
arrangements for the
location and management
of the PH team agreed
RMBC CEO
J Rossini February
2012
The current RMBC reporting
arrangements are that the
DPH reports to the CEO and
is a member of ELT and the
team will align to the DPH
Publication of LA DPH role
assess implications and
opportunities locally
ELT, EMT Jane Rossini February
2012
National guidance issued in
Dec 2011.
Agree a Job description,
process and appoint a DPH
CEOs, PHE Joanne Cohen
Nadine Jolly
tbc Job description awaited
from DoH. Process for
appointment awaited
PDRs and aspirational
interviews held with all
staff
Managers Liz Townson Oct 2011
April 2012
PCT processes being utilised
with all staff. Specific
section being completed on
learning needs related to
transition and LA working.
Process to be repeated in
March 2012.
Agree all destinations and
migration of affected PCT
staff
Jane Rossini Joanne Cohen
Nadine Jolly
March 2012 Initial scoping discussions
held.
Manage in conjunction J Cohen Staff Side Oct 2012 HR concordat received
13
with staff side and
management the HR
processes. This could
include, for example,
briefing sessions,
consultation, and TUPE
process.
N Jolly LA
Management
GM Cluster
Communications
Further HR guidelines
awaited Further work to
agree timescales with PCT
HR shared services re
engagement and
negotiations. TUPE
negotiations timescales to
be agreed
Transfer of legacy and
handover documents
relating to the team
W Meston
HR
D Armstrong
N Jolly
Draft Oct
2012
Final Jan
2013
Staffing documents being
reviewed and restructuring
has been completed. All
staff JDs were re written in
2011. completed
Initial scoping of local
contracts, budgets and
commissioning plans
undertaken
5.3
Organisational
development
RMBC induction day for
Public health team
B Bennett RMBC Oct 2011 Event completed with input
from Councillor Lambert,
Councillor Hornby, Roger
Ellis, Mark Widdup, finance
team and human resources
Further plans underway for
further induction into RMBC
policies and processes
PH team development L Townson B Jackson, Maria
Murphy, Lea
Fothergill
Oct 2011
Feb 2012
Team day completed
Day organised
Publication of PH
workforce strategy
J Rossini
Wendy Meston
Joanne Cohen
Jane Silvestor
Nov 2011 Participation in NW
workforce project
14
completed
Awaiting further HR
guidance
Local Authority have a
broad understanding of PH
and the new roles and
functions
Bernadine O’Sullivan
Jane Silvestor
Shakeela Bano
Diana O’Rourke
March 2013 Considered links with
Council Blueprint and input
to setting objectives and
plans for 2012/13. OD plan
in place
All council services clear
about their responsibility
for delivery of PH
outcomes
Peter Jones
Bernadine O’Sullivan
Liz Townson
Shakeela Bano
March 2013 Plans to enhance existing
links and plans. Links made
to service planning process.
Consultants aligned to key
work steams
Elected members
understand PH roles and
functions an councils role
Bernadine O’Sullivan Shakeela Bano
PH staff
Oct 2012 Presentation developed for
workshops with elected
members, one session
delivered Nov 2011, DH
attended all townships
meetings, PH staff attended
new member induction
Development of Health
Overview and Scrutiny
members
Jane Rossini
Peter Jones
Michelle Loughlin
Diana O’Rourke
Oct 2012 Meetings held with HOSC
chair, working group agreed
to work on JSNA,
presentation to HOSC
competed and further input
planned
5.4
Finance/Budgets
Publication of PH funding
and regime and shadow
allocations to assess local
implications
J Rossini
Pam Smith
Wendy Meston
Adrian Clarkson
Stuart Smith
Tim Riley
February
2012
Paper to be completed for
HWBB, PCT and RMBC in
Feb 2012 following the
shadow allocation.
15
Preparatory work completed
to jointly understand
budgets and responsibilities
for 2011/12
Complete and share with
RMBC budgets and
expenditure plans for
2012/13
W Meston L Lowe, T Riley March 2012 Agreement on finance leads
in PCT and RMBC
completed. Initial briefing
session on prevention
audits and public health
returns completed. RMBC
lead agreed to join the PCT
Improving Health
Commissioning Team
Review PH core team
following the shadow
budget allocation
J Rossini W Meston
Finance
January
2012
Financial mapping exercises
completed and current
staffing and budgets are
identified following the
restructure
Review all commissioning
budgets following the
shadow allocation against
required functions
W Meston
L Lowe
T Riley
Commissioning
leads
February
2012
Current position has been
identified.
Complete work on
overheads in line with
overall PCT work
A Clarkson PCT leadership
team
tbc Work has commenced
across the organisation in
line with TCS and GM
processes
RMBC transition finance
lead to join the PCT
Improving health
commissioning team
W Meston
T Riley
February
2012
Agreed by RMBC to
strengthen links with
commissioning functions
and budgets. Additonal
mebres will be considered
after Feb paper.
DoH Financial audits A Clarkson W Meston As requested NW Audits submitted in
16
completed on time L Lowe
S Evans
2009/10 and 2010/11
DoH audit submitted in
September 2011
Financial risks to be
identified and mitigated
A Clarkson
T
W Meston
Monthly Initial review identified
areas of potential risk.
Risk identified from
uncertainty over future
funding for programmes
with predicted growth such
as health checks. Full
review agreed following
shadow budgets for
2012/13
Support identified from
NHS GM
J Hutchinson
NHS GM
GMDsPH Feb 2012 Issue raised by lead DPH
within NHS GM
5.4
Commissioning
and contracting
2012/13 commissioning
arrangements agreed
W Meston
K Hurley
L Mort
IH CT
Drugs and
Alcohol JCG
Sept 2011
Initial Report completed and
submitted to HWBB, PCT
commissioners and CCC.
Follow up paper agreed for
Feb 2012 following shadow
budget paper. Refresh
completed following papers
received in Dec 2011. Joint
commissioning proposal for
drugs and alcohol submitted
for approval
Discussion planned for
January 2011 re shaping
17
current commissioning
teams in PCT to better fit
the transition year.
Discussion held at
Transition Board.
Arrangements for sexual
health, child health and
drugs and alcohol services
underway
Updated paper on
commissioning functions
and budgets for 2012/13
completed for HWBB, PCT
and RMBC
W Meston A Clarkson
L Lowe
March 2012 Initial scoping completed.
Discussions held with
current commissioners of all
future PH areas transferring
to LA
Contracts identified and
ready for transfer to
receiver orgs
Adrian
Clarkson/contracting
teams
Wendy Meston
A Dutton
Denise
Armstrong
T Riley
Dec 2012
Contracts baseline
underway to be established
in Jan 2012.
Work programme for
updating specifications has
been agreed
GM led work stream is also
in place for contracting
Update commissioning
report
W Meston A Clarkson Sept 2012
Legal agreements
completed
tbc
March 2013 Issue has been raised at GM
level and with RMBC legal
lead. Discussions have been
held with RMBC
5.5 Public health
support to
Clinical
18
Commissioning
Groups and NCB
CCG understanding of PH
transition and offer
J Rossini W Meston
H Lewis Parmar
B O’Sullivan
March 2012 Initial session completed
with clinical commissioners
to discuss transition and
JSNA
Regular DPH participation in
transition group
PH offer to CCG drafted.
Full transition plan going to
Board in January 2012
Link PH Consultants
aligned to CCG and
localities
W Meston
B O’Sullivan
H Lewis Parmar
September
2011
February
2012
Links agreed and process
underway to identify
priorities. Links to be
reviewed with newly
appointed CCG clinical leads
PH link to Clinical
Commissioning Committee
J Rossini W Meston July 2011 Membership confirmed and
attendance regular. DPH to
sit on CCG Board in 12/13
Local CCGS are engaged
on developing the PH offer
J Rossini/Clinical
leads
Wendy Meston
Feb 2012 Paper to CCG Chair. Paper
drafted
Operating model, staffing
and plans in place for NCB
PH transition for screening
and immunisation services
and services for under 5s
J Rossini GM PH Network
leads
April 2012 Papers received in Dec 2011
were considered. Awaiting
further guidance on
operating model for NCB
and interface with local
teams for screening, Imms
and under 5 services. GM
work underway re all of
these areas. DPH leads
screening work at GM.
Input given to GM core
19
Health Visitor spec to tailor
to local needs
GM Public health network
paper on PH offer to NHS
commissioning completed
GM DPH and network W Meston March 2012 Initial meeting held and
initial briefing paper
produced
5.1 Governance
Financial governance
transferred to RMBC
C Yarwood
S North
A Clarkson
T Riley
March 2013 Awaiting NHS GM process
for sign off. Initial work
been undertaken with RMBC
finance leads and joint
finance group is established
Clinical and Information
governance and required
transfer of functions and
information plan
completed
Paul Byrne
NHS GM
Debbie Hunter
Wendy Meston
R Pinkney
Oct 2012 Some governance issues it
is hoped will be resolved at
a national level such as
sharing mortality file data
and transfer of NHS
contracts. TBC. Raised at
NHS GM for collaborative
work. Governance review
underway locally. Indemnity
issue has been logged
Governance for the
transition year reviewed
and agreed
J Rossini Debbie Hunter
A Clarkson
W Meston
P Jones
March 2012 Interim governance agreed.
Update underway for
2012/13
Schemes of delegation
agreed at each stage of
the transition
J Rossini
NHS GM
W Meston
L Mort
At each
stage of
change
Work well underway in GM
to agree delegated
authority and accountability
arrangements from April
2012
Assurance reports NHS J Rossini monthly All completed to date and
20
North and GM completed
and returned as requested
W Meston recent assessment of this
plan against Annex 6
(attached) has been
completed
Final transition plan
submitted
J Rossini W Meston
D Armstrong
March 2012 Transition Board discussed
process for RMBC sign off
5.7
Communications
Comms plan in place D Morton March 2012 Initial plan completed. Due
for refresh in Feb 2012
Public Health England
Newsletters disseminated
A Hill As received Two received and circulated
Local public health
newsletter completed and
disseminated to staff
Danielle Morton August 2011
|Nov 2011
Jan 2012
Two completed and
distributed
HWBB newsletter
established and
disseminated
D O’Rourke quarterly Two completed and
distributed
Public Health transition
plan completed
J Rossini W Meston
L Townson
D Armstrong
Draft 20th
Jan 2012
Final March
2012
Draft completed and to be
refreshed following issuing
of template. Current plan
checked against annex 6
5.8 Review and
development of
the GM level
Public Health
functions and
structures
GM Leadership team
established to support DPH
W Meston monthly Group established and 4
meetings held
21
group
GM work stream on
developing a GM infection
control and Immunisation
function
Jane Rossini Sue Walton
Christine Khiroya
April 2012 GM work programme well
underway to develop a
resilient infection control
and immunisation workforce
through 2012/13 and t test
out future operational
models.
GM work to agree a
operating model for
screening programmes
Jane Rossini
Helen Lewis
Parmar
Elizabeth Wilson
Elaine Whitby
Oct 2012 NHS North screening
assessment completed for
NHS North and risk and
action agreed with
additional collaboration
across NW.
Work programme agreed
across GM and locally
Ensure clear public health/
DPH on call arrangements
J Rossini
DPH group
April 2012 Work underway to consider
and agree options to ensure
resilience during transition
via GM DsPH
Emergency
planning/resilience test of
arrangements
Anne Whitehead GM support
service
Oct 2012
Signed off by
GM Nov
2012
Agreement of requirement.
GM service to lead
Agree safeguarding
arrangements for
transition and post 2013
Jane Rossini Hazel
Chamberlain
Oct 2012 Agreed to move director
lead for safeguarding back
to Executive nurse in PCT.
GM work to agree plans for
safeguarding underway
Sexual health Neil Jenkinson
Eleanor Roaf
Andrea Dutton Oct 2012 Work being scoped to
identify areas of sexual
health work bets done on a
sector or GM footprint
22
including commissioning of
tariff based services
Intelligence Neil Bendell June 2012 Paper completed outlining
initial options for PH
intelligence.
GM JSNA work agreed
5.9 Risk
Identification
and mitigation
Risk log completed W Meston
J Rossini
October
2011
Initial log completed
Risk log updated and
organisational risks
included on risk register
and communicated to GM,
SHA and PHE as required
W Meston
J Rossini
D Armstrong monthly Log updated Jan 2012
Indemnity position
requires clarifications
Jane Rossini
GM DPH group
NHS GM Oct 2012 GM support been requested
by DPHs. Nationally this
issue has been identified
and raised
Appendix 2 Public Health transition – Risk Log
23
Ref Classification Title Description Consequence Likelihood
Status Review Date
Owner and Lead
Further Improvement Action
Residual Status
ACTIVE
PHT 5.1 Health and well being board
A statutory Board is not in place by April 2013
4 2 8
•
Monthly Jane Rossini Ensure the robust implementation of the plan and maintain stakeholder engagement
4
•
PHT 5.2 Public health staff and function
system The fragmentation of PH functions does not work as a system from 1st April 2013
5 4 20
Monthly Jane Rossini - Wendy Meston
Work across PHE, NW, GM and local areas are working to ensure this does not happen but assurance is not in place at this time. If this work is successful then the risk should be mitigated
12
5.2 Public health staff and function
function Screening and immunisation functions at a local level are lost and NCB do not cover
the work
5 4 20 Monthly Jane Rossini Work across the SHA and GM are working to mitigate this risk. A GM work programme is in place to develop a
shared service. Immunisation and NCB/LA interface less clear at present
12
5.2 Public
health staff and
function
function Health
protection
systems to do
not work and
local staffing
resource is lost
to respond
5 4 20 Monthly B
O’Sullivan
This is the focus of the work of PHE and locally we need to review the output of their work when received both at GM level and locally. Also need to monitor
roles through the
next 18 months to
ensure a response
is made when
required
12
24
5.2 Public
health staff and
function
Staff Ensuring
sufficient
support is
retained locally
to support the
NHS
4 3 12 Monthly J Rossini Work with CCGs
and NCB to define
public health
function required
12
5.2 Public
health staff and
function
staff Retention of
skilled staff
4 3 12
Monthly Jane
Rossini
This risk rating is
dependent upon
national
negotiations and
decisions that
affect staff terms
and conditions and
future development
of the PH workforce
going forward.
Work need to be
undertaken to
explain the need
for PH skills within
the LA. The risk
could be greater in
the medium to long
term
12
PHT 5.3 staff and
org
development
Org dev Staff and
organizations
are not ready
for the relevant
functions
4 4 16
Monthly Jane
Rossini
B
O’Sullivan
B Bennett
OD plan is
implemented
8
•
PHT 5.4 Finance budgets Funding
allocated
insufficient to
5 4 20
Monthly Jane
Rossini
Financial audits
have been
completed and
20
25
fulfill functions submitted. The
current budgets are
being aligned to
likely destinations
and risk areas have
been identified
5.4 Finance budgets NHS QIPP
programmes
reduce PH
budgets prior to
transfer
5 4
20
Monthly W Meston
S Smith
Review budgets via
the IH
Commissioning
team monthly and
update the HWBB
12
•
PHT 5.4 finance budgets New
programmes are
not funded in
future years
after transfer
5 4 20
monthly finance This depends on
how the agreement
to fund according
to functions and
working jointly on
future efficiency
programmes
20
PHT 5.5
Commissioning
Contracts Transfer of NHS
contracts to
RMBC not
completed
4 3 12
•
monthly Contracting Identify all
contracts affected
following shadow
allocation. Wait
national guidance
and agree plan
including legal
requirements
16
PHT 5.6 PH and NHS Operating
model
Clarity of
functions
between PHE,
NCB and LA
functions
5 5
25
monthly J Rossini Participate in GM
and RDPH
discussions and
resolution of any
identified gaps in
16
26
assurance
PHT 5.7 Governance Child
protections
NHS functions
are not
transferred
effectively
5 4 20
monthly J Rossini This is a GM
priority as well as a
local priority
12
PHT 5.8
Communications
comms Communication
with staff and
organizations
and external
partners
4
4
16
quarterly tbc Comms plan to be
revised and
implemented
12
PHT 5.9 GM work
stream
collaboration PCT and LAs
and AGMA do
not agree on
models for
delivery
5 3 15
monthly J Rossini GM DPHs are
working
collaboratively to
an agreed work
programme
12
Appendix 3 Public Health Guidance Annex 6 - PUBLIC HEALTH CHECKLIST FOR LOCAL USE
This checklist has been used to cross reference and inform the local plan.
Ensuring a
robust transfer of systems and services
Ø Is there an understood and agreed (PCT cluster/LA) set of arrangements as to how the local public
health system will operate during 2012/13 in readiness for the statutory transfer in 2013? Ø Is there a clear local plan which sets out the main elements of transfer including functions, staff and
commissioning contracts for 2013/14 and beyond?
Ø Are there locally agreed transition milestones for the transition year, 2012/13? Ø Is there a clear local plan for developing the JSNA in order to support the H&WB strategy?
27
Ø Is there a clearly developed plan for ensuring a smooth transfer of commissioning arrangements for the services described in Healthy Lives, Healthy People that Local Authorities will be responsible for
commissioning? Ø Is there a clearly developed plan for ensuring a smooth transfer of those PH functions and
commissioning arrangements migrating to NHS CB and PHE? Ø Is there local agreement on the delivery of a core offer providing LA based public health advice to
Clinical Commissioning Groups? Delivering public health
responsibilities during transition
and preparing for 2013/14
Ø Is it clear how future mandated services and steps are to be delivered during transition and in the new local public health services:
Ø Appropriate access to sexual health services, Ø Plans in place to protect the health of the population,
Ø Public health advice to NHS commissioners, Ø National Child Measurement Programme, Ø NHS Health check assessment?
Ø Is there clarity around the delivery of critical PH services/programmes locally, specifically: screening programmes; immunisation programmes; drugs & alcohol services and infection prevention and control?
Workforce Ø Has the workforce elements of the plan been developed in accordance with the principles encapsulated
within the Public Health Human Resources Concordat?
Governance Ø Does the PCT cluster with LA have in place robust internal accountability and performance monitoring
arrangements to cover the whole of the transition year, including schemes of delegation agreed as appropriate?
Ø Are there robust arrangements in place for key public health functions during transition and have they been tested e.g. new emergency planning response to include:
o Accountability and governance
o Details of how the DPH, on behalf of LA, assures themselves about the arrangements in place,
o Lead DPH arrangements for EPRR and how it works across the LRF area? Ø Are there robust plans for clinical governance arrangements during transition including for example,
arrangements for the reporting of SUIs/incident reporting and Patient Group Directions?
28
Ø Has the PCT cluster with the LA agreed a risk sharing based approach to transition? Ø Is there an agreed approach to sector led improvement?
Ø Is the local authority engaged with the planning and supportive of the PCT cluster approach to PH transition?
Enabling Ø Has the PCT cluster with LA identified sufficient capability and capacity to ensure delivery of their plan?
Infrastructure Ø Has the PCT cluster with LA identified and resolved significant financial issues?
Ø Has the PCT cluster with LA agreed novation/other arrangements for the handover of all agreed PH contracts?
Ø Are all clinical and non-clinical risk and indemnity issues identified for contracts? Ø Are there plans in place to ensure access to IT systems, sharing of data and access to health
intelligence in line with information governance and business requirements during transition and
beyond transfer? Ø Have all issues in relation to facilities, estates, asset registers been resolved?
Ø Is there a plan in place for the development of a legacy handover document during 2012/13?
Communication
and engagement
Ø Is there a robust communications plan? Does it consider relationships with the Health and Wellbeing
Board; clinical commissioning groups and NHSCB; Health Watch; local professional networks? Ø Is there a robust engagement plan involving stakeholders, patients, public, providers of PH services,
contractors and PHE?