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ANNUAL REPORT

Getting in touchPublic Health Agency HeadquartersOrmeau Avenue Unit 18 Ormeau Avenue BELFAST BT2 8HS Tel: 028 9031 1611

Eastern Office12–22 Linenhall Street BELFAST BT2 8BS Tel: 028 9032 1313

Northern OfficeCounty Hall 182 Galgorm Road BALLYMENA BT42 1QB Tel: 028 2531 1000

Southern OfficeTower Hill ARMAGH BT61 9DR Tel: 028 3741 0041

Western OfficeGransha Park House 15 Gransha Park Clooney Road LONDONDERRY BT47 6FN Tel: 028 7186 0086

Media line:Tel: 028 9031 1514Media enquiries only

Normal business hours:8.45am–5.00pm Monday–Friday

Website:www.publichealth.hscni.net

BoardThe board of the Public Health Agency (PHA) meets frequently throughout the year and members of the public may attend these meetings. The dates, times and locations of these meetings are advertised in advance in the press and on our main corporate website www.publichealth.hscni.net

Using this reportThis report highlights the broad range of work carried out by the PHA and shows how this work has contributed to meeting our objectives detailed in our Corporate plan 2009–2010. The online Portable Document Format (PDF) file of this report also has live web access to the relevant website.

This report is intended to be an overview of the year’s main accomplishments.

For more detailed information on our work, please visit our corporate website at www.publichealth.hscni.net

Other formatsCopies of this Annual report may be produced in alternative formats on request. A PDF file of this document is also available to download from our corporate website at: www.publichealth.hscni.net

Public Health Agency Annualreport 2009-2010

Contents | 1

Contents

Chair’s statement 2

Management commentary 3

Directors’ report 4

The role of the Public Health Agency

– Publichealth 8

– NursingandAlliedHealthProfessions 15

– Operations 18

Operating and financial review 24

PHA board 36

Acronyms 38

2 | Chair’s statement

My first statement to you as Chair of the PHA follows an exceptionally exciting and challenging period for health and wellbeing in Northern Ireland. We have all come a long way since the Health Minister, Michael McGimpsey, announced

his plans for HSC reform under the RPA, which led to the creation of our organisation in April 2009.

Our businessTacklinghealthandsocialwellbeinginequalities,andpromotingashiftacrossthehealthservicetothepreventionofillness,layattheheartoftheHSCreforms.ThePHAwassetuptoprovidearenewedandenhancedfocusonpublichealthbybringingtogetherawiderangeofpublichealthfunctionsunderoneorganisation,withimprovedhealthandwellbeingasitscorebusiness.

Itwasalsotaskedwithcreatingbetterinter-sectoralworking,includingenhancedpartnershiparrangementswithlocalgovernmenttotackletheunderlyingcausesofpoorhealthandreducehealthinequalities.

Shaping and developing2009–2010wasfundamentallyaboutshapinganddevelopingourneworganisationandsettinglonger-termdirections.Itwasayearoftransitionandmanagingchange,ayearofharmonisinginheritedsystems,ayearofimplementingaframeworkfordesignoftheorganisationand,mostimportantly,ayearoflayingdownfoundationsforafundamentalshiftinwhatweaimtodoandhowwedoit.

Extensive portfolio of workWhileestablishingourselvesasthemajorregionalorganisationforhealthimprovementandhealthprotection,wehadabusyandeventfulfirstyear,deliveringanextensiveportfolioofworkacrossallkeyareasofpublichealthandsocialwellbeing.

TherewasconsiderablecoverageandexposureofthePHA’sworkthroughouttheyear,notleastindealingwiththefirstnewpandemicvirusofthe21stcentury–commonlyreferredtoasswineflu.ThePHAworkedextremelyhard,togetherwitharangeofotherbodiesthroughoutHSC,duringthevariousstagesofthepandemictoensureasuccessfulresponse.

Engaging and joint workingInotherareasofwork,weestablishedengagementapproachestoenableeffectiveinvolvementofcommunities,groupsandindividualsinshapingtheworkofthePHA.ClusterleveljointworkingarrangementsbetweenthePHAandsevendistrictcouncilswereputinplace.Ontheoperationsside,wedeliveredontheinformationgovernanceleafletforallstaff.

Vibrant community sectorAnagencysuchasourscannotfunctionwithoutavibrantcommunityandvoluntarysector.Workingcollaborativelyacrossdisciplinesanddepartments,maximisingandmakingbestuseofavailableresources,wecanmakeadifference.

MyfirstyearhasbeenbusyestablishinglinksacrossNorthernIrelandwithawiderangeofcommunityandvoluntaryorganisationsworkinginsomeofourdisadvantagedareas.Attendinguptofivemeetingsmonthly,Iwasconstantlyimpressedwiththeflexibility,energyandmotivationIencountered.

Change, integration and commitmentOurachievementsareallthemorenoteworthywhensetinthecontextofconsiderablepublicsectorchange.TheintegrationofstaffandworkfromlegacyorganisationsintothePHApresentedmanychallengesandwasaperiodofgreatanxietyanduncertainty.OnbehalfoftheboardIwouldliketocongratulatetheChiefExecutiveandstafffortheirdedicationtoquality,continuedhardworkandcommitment.

A personal wordIwouldalsoliketopersonallythankmembersofourboardfortheirvision,dedicationandsupport,andacknowledgeourcolleaguesinthewiderHSCfamilyandintheDHSSPSfortheirassistanceandadvice.IlookforwardtoworkingwithyoualltoachieveourcommonvisionforahealthierNorthernIreland.

Mary McMahon Chair

Chair’s statement


Contents | 3

I think it’s fair to say that we all expected the first year of the PHA to throw up many challenges for all our staff. While much groundwork was undertaken to ensure as smooth a transition as possible into the new health and social care system, it was

clear from the outset that considerable work would be necessary internally within each of the organisations to build capacity and develop strong relationships among the new bodies.

However,Idonotbelievethatanyofuscouldhaveanticipatedjusthowmuchwewouldaskofourstaffduringthisinauguralyear,orthelevelofcommitment,professionalismandteamworkthathasbeendemonstratedrightacrosstheAgency.

WehadbarelybeensetupforthreeweekswhentheswinefluissueemergedandIamimmenselyproudofthewaystaffpulledtogethertoensureasuccessfulresponsetothiswhilecarryingouttheirnormalday-to-dayduties.

Inadditiontothese‘new’pressures,staffhavehadtocopewithsubstantialorganisationalchangethathasbeenslowertoresolvethananyofuswouldhaveanticipatedorwished.Yeteachofourareashasseensignificantdevelopmentduringtheyear,settinginplacestrongfoundationsforthefutureofpublichealth.

Wehaveundertakenandsupportedawiderangeofprogrammesandinitiativesacrossallmajorhealthandsocialwellbeingareasinfulfilmentofourcommitmentsandcoreobjectivesdetailedwithinourcorporateplanfor2009/2010–supportingthetargetsdetailedbytheMinisterforHealthaswellasmeetingtheobjectivesidentifiedintheoriginalbusinesscasesforthePHA.

Wecannot,however,achieveouraimsinisolationandourcommitmenttoworkingcollaborativelycannotbeemphasisedenough.Workingwiththelocalcommunityandvoluntarysectors,andthestatutoryandprivatesectors,willcontinuetobecentraltoallourwork.

Withintheareaofhealthprotection,forexample,wesawsubstantialreorganisationandstaffplayingakeyrolewithHSCBcolleaguesinimplementingthestrategicregionalactionplanforthepreventionandcontrolofHCAIsinNorthernIreland.

Withinhealthimprovement,anewPHA-funded‘one-stopshop’drop-incentrewasopenedinBanbridge,providinginformation,supportandeducationtoyoungpeopleandtheirfamiliesaffectedorconcernedbyalcoholanddrugmisuse.

AnothernotableachievementhasbeenthedevelopmentofcloserjointworkingwithlocalgovernmentacrossNorthernIreland.ThefirstinitiativetolaunchunderthesenewarrangementswithlocalcouncilswastheBelfastHealthDevelopmentUnitinMarch,whichwillbefollowedbyotherlaunchesastheinitiativesrolloutacrossNorthernIreland.

Iapplaudthecommitmentofeveryoneinvolvedinsettinguptheunit,whoseworkwillnodoubthelptonarrowthehealthgapbetweendisadvantagedgroupsandcommunities,andimprovehealthoverallbyaddressinginequalities.

Withinnursingandalliedhealthprofessions,wemadesubstantialheadwayindevelopingtheareaofPersonalandPublicInvolvement,includingaformalconsultationscheme,toensureserviceusersandthepublicareinvolvedinthecommissioning,planninganddeliveryofourwork.

OurhighprofileworkthroughpublicinformationcampaignswasrecognisedwithamajormentalhealthmediaawardandtheNorthernIreland“MaternityandFamilyAward”fornormalisingbreastfeedinginthecommunity.Wecontinuetolookatwaysofprovidinginformationandresources,particularlyforhard-to-reachgroups,throughthemosteffectivemethodsandinparticularthroughemerginganddevelopingsocialmediachannels.

Whilewefacednumerouschallengesthisyear,everyoneinvolvedhasrespondedwithenergy,enthusiasmandcommitment,withaclearfocusonmakingthehealthandwellbeingofourcommunitybetter–thankyouforallyourhardwork.OurboardmembershelpedlaythenecessaryfoundationsandIacknowledgetheircommitment,directionandworkovertheentireperiod.

AsweenteranewfinancialyearwefocusonensuringtherightstructuresareinplacetocontinuedeliveringavisionofHSCoutcomesthatareamongthebestintheworld.

Dr Eddie RooneyChief Executive

Management commentary

4 | Directors’ report

ThePHAisanintegralpartoftheHSCsystem,workingwiththeHSCB,BSOandPCC.Itdrivesthepublichealthandsocialwellbeingagenda,bringingtogetherawiderangeoffunctionstogivearenewed,enhancedandsustainedfocusonhealthprotectionandimprovinghealthandwellbeingoutcomes.ThePHAisamulti-disciplinary,multi-professionalbodywithastrongregionalandlocalpresence.Ithasfourkeyfunctions:

• improvementofhealthandsocialwellbeing;

• healthprotection;

• publichealthsupporttocommissioningand policydevelopment;

• HSCresearchanddevelopment.

Thefollowingdiagramhighlightstheorganisationalstructuredowntotierthreeanddetailsthemainareasofactivitywiththoseresponsible.

Directors’ report

Chief ExecutiveDr Eddie Rooney

Director of Nursing and Allied Health

ProfessionsMary Hinds

Assistant Directors

Allied Health Professions and Public Involvement

Michelle Tennyson

Nursing, Safety, Quality and Patient/

Client ExperiencePat Cullen

Director of Public Health/Medical

DirectorDr Carolyn Harper

Assistant Directors

Health ProtectionDr Lorraine Doherty

Health and Social Wellbeing Improvement

Mary Black

Service Development and ScreeningDr Janet Little

HSC R&DDr Michael Neely

Directorof

OperationsEd McClean

Assistant Directors

Planning andCorporate Services

Rosemary Taylor

Communicationand Knowledge

ManagementStephen Wilson


Directors’ report | 5

Communication

Fromdayone,thePHAwascommittedtoensuringthataccessibleandeffectivecommunicationchannelsunderpinnedourwork.Wecommunicatedemergingandkeyissuestoallofourexternalstakeholdersthroughregularupdatesonournewcorporatewebsitewww.publichealth.hscni.net

Goodinternalcommunicationwaskeyinayearofuncertaintyandchange,andpublicationofamonthlye-bulletinaimedtokeepallemployeeswellinformedaboutdevelopmentsandachievements,particularlyduringroll-outofthenewera.

Inaddition,anewPHAstaffintranetsitewasdevelopedandregularnewsandinformationaddedtokeepeveryoneinformedofinternaldevelopments.Toreflecttheorganisationalchangeandintegrationofstafffromlegacybodies,astandardemailaddresswasalsointroducedandusageguidelinescommunicated.

PublicationofourCorporateplanensuredstaffwereclearaboutthemissionandstrategic

directionofthePHAandhowweintendtofulfilourcommitments.Managementbriefingswerealsoconductedtoensurestaffwerekeptuptodatewithprogressonstructures,andaconsultationpaperonrestructuringwasissuedinconsultationwithtradeunions.

Payroll

Foranumberofmonthsaftertheneworganisationcameintoeffect,payrollarrangementsreflectedthoseofthelegacyorganisationsuntilasinglenewsystembecameoperational.

Equality and human rights policies

ThePHAhaslookedtobuildonthesoundpoliciesandprogrammesputinplacebyeachofthelegacyorganisations.Weareaccountableforensuringthatwecomplyfullywithourlegalresponsibilities,includingSection75oftheNorthernIrelandAct1998andtheHumanRightsAct1998.

Duringtheyear,advice,support,guidanceandtrainingonequality,humanrightsanddiversitywereprovidedtothePHAviatheequalityunitoftheBSO.

Equality of opportunity

InaccordancewithSection75oftheNorthernIrelandAct1998,thePHArecogniseditsobligationstopromoteequalityofopportunitybetween:

• personsofdifferentreligiousbelief,political opinion,racialgroup,nationality,age,marital statusorsexualorientation;

• menandwomengenerally;

• personswithadisabilityandpersonswithout;

• personswithdependantsandpersonswithout.

Indevelopingourpolicies,wewererequiredtoexamineorscreenthemforequalitypurposestoidentifyanythatwerelikelytohaveasignificantimpactonequalityofopportunityand/orgoodrelations.ScreeningalsocoveredissuesinrelationtotheHumanRightsAct1998andtheDisabilityDiscriminationOrder2006.

Inlightofthislegislation,wedevelopedatemplateandguidanceforusebyallstafftoensureconsistencyinapproach.ThisalsoactsasthetoolfordocumentingtheoutcomesofthescreeningandprovidedapapertrailofevidenceforthePHA’sscreeningreport.

6 | Directors’ report

Records management

PHAstaffwereinitiallyusingexistingfileplanswhileanewstandardfilingplanwascreated.Thenewproposedsystemisbeingtrialledtoensurecontinuityandcohesionacrossalllocationsandfunctionsandwillberolledoutoncethetrialhasbeencompletedandrevisedaccordingly.

Business continuity

Communicationsdetailingbusinesscontinuityarrangementsweresenttoallstaff,ensuringeveryonewasclearonwhatwouldhappenfrom1Aprilonwards,whateveryone’srolewouldbeandwhotheyshouldreporttoinlightofanychangesinlinemanagement.

Sick absence data

Forthe2009–2010financialyear,thefollowingsickleavedayswererecorded:

Totalworkingdayslostduetoshort-termsickness=286(0.71%)

Totalworkingdayslostduetolong-termsickness=714.8(1.78%)

Totalworkingdayslostduetosickness=1,000.8(2.50%)

Freedom of Information

ThePHAfulfilleditsobligationsundertheFreedomofInformation(FoI)Act2000bydevelopingandcirculatinganinformation

governanceleafletentitledInformationgovernance:whatyouneedtoknowtoallstaff.ItoutlinedgoodpracticeandguidanceonissuessuchasFoI,confidentialityandinformationsecurity.

Data-related incidents

Therewerenomajordata-relatedincidentsreportedduringtheyear.

ThetheftofalaptopandBlackberryfromanofficeinTowerhill,Armagh,wasreportedtothePSNIandtreatedinternallyasanadverseincident.Bothdeviceswereencryptedandhencethepotentialfordatalosswasminimised.

Follow-upworkconsistedofanimmediateauditofallPHAoffices,theprovisionofsecurityequipmentandadvicewhererequired,andtheintroductionofregular,out-of-hoursofficeinspectionstoalllocalities.

DetailsoftheincidentweresharedacrossallPHA/HSCBofficestoaidorganisation-widelearning.

TwolaptopswerealsostolenfromtheOrmeauAvenueUnitpremises.ThePSNIwasinformedandinvestigationslaunched.

Bothlaptopswereencryptedandnosensitivedataaccessible.Additionalsecuritymeasureswereinstalledandcommunicatedtostaff.

TheInformationgovernanceleafletalsocoveredtheareaofdataprotection.

Comments and complaints

ThePublicHealthAgencyreceivedtwocomplaintsin2009–2010.

Theserelatedtoissuesofcommunicationandprovisionofservicetothepublicandageneralpractitioner.Inbothcasesthecomplaintswereresolved.

Anumberofformalpositivecommentsinrecognitionofourworkwerereceived.

Ifyouwishtomakeaformalcommentorcomplaint,pleasewriteto:

EdmondMcCleanDirectorofOperationsPublicHealthAgencyOrmeauAvenueUnit18OrmeauAvenueBelfastBT28HS.


Directors’ report | 7

Quality

ThePHAcampaign,‘Don’tcoverupyourproblems’,wonthe‘Raisingpublicawareness’categoryintheMindMentalHealthMediaAwardsduringtheyear.ThecampaignwastakenforwardaspartoftheimplementationoftheNorthernIrelandsuicidepreventionstrategyandincludedTV,radio,outdoorandwashroomadvertising.

ThePHAcampaigntargetedyoungmentoraiseawarenessofmentalhealthandencourageapositiveattitudetoseekinghelp.

AttheNCT(formerlytheNationalChildbirthTrust)NorthernIrelandMaternityandFamilyAwards,thePHAwontheawardfor‘Normalisingbreastfeedinginthecommunity’forthe‘Goodforbaby,goodformum’campaignandforthe‘Breastfeedingawarenessforschools’CD-ROMresource.

AspartofourworktoreduceandpreventHCAIs,ajointPHA/HSCBHCAIpreventionteamwasestablishedtoprogressworkinthisarea.Takingthisworkforward,thePHAisplayingakeyroleinimplementingthestrategicregionalactionplanforthepreventionandcontrolofHCAIsinNorthernIreland,Changingtheculture2010.

Preparation of accounts

ThePHAhaspreparedasetofaccountsfortheyearended31March2010inaccordancewiththerelevantlegislativerequirements.

Summaryfinancialstatementsareincludedinthe‘Operatingandfinancialreview’sectionofthisreportfrompage24.

Dr Eddie Rooney, Chief Executive, PHA, holding the award from the Mind Mental Health Media Awards, along with Health Minister, Michael McGimpsey and Liz Mayne, one of the awards judges.

At the awards, from left, Mary McMahon, Chair, PHA; Janet Calvert, Regional Breastfeeding Coordinator, PHA; Julie Neill, Health Development Officer, PHA; Margaret McCrory, Marketing Manager, PHA and Gail Werkmeister, NCT President.

8 | The role of the Public Health Agency

ThePHAwassetupwiththeexplicitagendato:

• protectpublichealthandimprovethehealthand socialwellbeingofpeopleinNorthernIreland;

• reduceinequalitiesinhealthandsocial wellbeingthroughtargeted,effectiveaction.

Broad range of activity

DuringthepastyearabroadrangeofactivitywasundertakentohelpimprovethehealthofthepopulationofNorthernIreland.Thiswasachievedthrough:

• prevention;

• earlydetection;

• highqualityservices;

• addressinginequalities;

• protectinghealth.

Pandemic response

Lookingbackon2009–2010,itwas,ofcourse,dominatedbytheswineflupandemic–declaredbyWHOon1Juneasthefirstflupandemicfor40years.ThecommitmentanddiligenceofmanypeoplethroughoutHSCoverthepandemicperiodresultedinahighlyeffectiveresponseandgreatlyenhancedpreparednessforthefuture.

IwishtotakethisopportunitytothankeverymemberofstaffinthePHAwhocontributedtothepandemicresponsedirectlyorindirectly.IalsowanttoacknowledgethecontributionofcolleaguesfromtheDHSSPSandotherHSCbodiessuchastheHSCB,BSO,primarycarepractitioners,thefiveHSCtrustsandNIAS.Inaddition,Iwouldliketothankcolleaguesinlocalgovernment,theUKborderagency,thetransportindustryandmanyotherindividualsandorganisationsfromallsectorswhohelpedustacklethismajorchallenge.

Reducing the impact

Togetherweworkedextremelyhardinmanyareastoreducetheimpactofpandemicfluonthepublic,aswellasworkingwithclinicalstaffonmanagementofcasesandtheircontacts.

Theseareasincluded:

• planningtomanagepredictedneedfor healthcareandsupportservices,fromcaring forlargenumbersofpeoplewith uncomplicatedflutoexpandingintensivecare capacity;

• planningforprotectionofHSCstaffwith comprehensiveinfectioncontrolmeasuresand personalprotectiveequipment;

• providinginformation,supportandadviceto theHSCandbeyond,suchastheeducation sector,councils,prisons,portsandairports;

• planningandimplementingthepandemic fluimmunisationprogramme,whichincluded immunisingpregnantwomen;

• communicatingwithstaffandthepublic throughmediainterviews,meetings,bulletins andleaflets;

• liaisingwithnationalgroupssuchasHPA(UK) andcolleaguesintheNHS;

• surveillanceandservicepressuremonitoring inclosecooperationwiththeDHSSPS,HSCB, HPA(UK),alltrustsandindependent providers.

Activity in Northern Ireland

InNorthernIrelandupto17February2010,approximately9%ofthepopulationwereestimatedtohavehadpandemicInfluenzaA(H1N1)2009.

Therewere1,367laboratoryconfirmedcases,577hospitalisedcases,and50intensivecareadmissions.TheGPconsultationrateduringthepeakweekofthepandemicwas281peopleper100,000population,greatlyexceedingtheNorthernIrelandthresholdforseasonalfluactivity.

The role of the Public Health AgencyPublic health - Dr Carolyn Harper


The role of the Public Health Agency | 9

Protecting health – a frontline service

ThehealthprotectionfunctionprovidedbythePHAisafrontlineacuteresponseserviceofdiseasepreventionandinfectioncontrol,includingoutbreakmanagement,emergencyplanningandenvironmentalhazards.

In2009–2010,thePHAestablishedasingleregion-widehealthprotectionservice,buildingontheachievementsofsixlegacyservicesincludingtheCDSC,formerlypartofHPA(UK).

We’remaintainingourlinkswithHPA(UK)andwithhealthprotectionservicesinScotland,WalesandtheRepublicofIreland,makingbestuseofspecialistskillsandintegratingfunctions.

WearealsolinkedintoEuropeanandUScentresasmanyhealthprotectionthreatsareglobalandrequireinternationalcooperation.

Duringtheyearwerespondedtootherspecificthreatstopublichealthquicklyandeffectively,includingmultipleoutbreaksofnorovirus,clustersofC.difficilecasesinnursinghomes,casesofE.coliinnurseryschoolchildren,andmeningococcaldisease.

InAprilweissuedaboilwaternoticetopeopleinthegreaterBelfastareaandpartsofcountiesAntrimandDown,andwerepartofamulti-agencyresponsetoafour-daytyrefireatCampsie.

Partnership working

AministerialpriorityforpublichealthprotectionisworkingwithtruststoensurePfAtargetsonHCAIssuchasMRSA,MSSAandC.difficilearemet.

Inpursuanceofthis,wesupportedtheHSCBandfromApril2010tookaleadroleinreducingHCAIsthroughpartnershipworkingwithtrusts,primarycareandcommunitycare.ExtensionoftheSSIsurveillanceprogrammesintrustswasalsosuccessfullyimplemented.

Improving user experience

WeworkedwiththeHSCB,trusts,primarycare,andcommunityandvoluntarysectorstoimplementthecardiovascularandrespiratoryframeworks.

Patients,clients,carersandtheirwiderfamilieswillbeabletousetheseserviceframeworkstounderstandthestandardofcaretheycanexpecttoreceive,therebyimprovingtheuserexperience.

Early intervention

Wealsofocusedoureffortsintheareaofearlyinterventionprogrammestochangethelifeexpectancyofchildrenandfamilies.Intensesupportduringearlychildhoodenableschildrentomaximisetheirpotential,bringingbetterhealthandsocialoutcomesforthem.

APHAseminarattendedbyrepresentativesfromacrosspublicsectororganisationspromoteddiscussionanddebateontheearlyinterventions/infantmentalhealthagenda.

Building on the early years intervention seminar looking at best practice and learning from others are, from left, Mary Gordon, founder of Roots of Empathy, Canada; Dr Carolyn Harper, Director of Public Health, PHA; Danny Broderick, Public Health and Clinical Coordination, South Australia; and Mary Black, Assistant Director, Health and Social Wellbeing Improvement, PHA.


Improving mental health and wellbeing

AkeypriorityforthePHAinworkingwiththeDHSSPS,HSCBandtrustsistoimprovementalhealthandwellbeingandensurehighqualityandeffectivecareforthosewhoneedit.ThroughtheBamfordtaskforce,inpartnershipwiththeHSCB,thePHAcontinuedtocontributetowardsimprovingmentalhealthandwellbeing.

Wealsore-ranouraward-winningcampaign“Don’tcoverupyourproblems”asdetailedunderthequalitysectionoftheDirectors’report.On-the-groundprojectsincludedthedeliveryofMHFAtrainingtoanother14instructors,andtheestablishmentofcommunityresponseplansatdistrictcouncillevelacrossthewesternarea,guidedbytheregionalsuicidepreventionstrategy,tohelppreventsuicideclusters.

Tackling inequalities through commissioning

Reducinginequalitiesthroughcommissioningeffective,accessibleprogrammesandinitiativesisalsoapriorityforthePHA.InpartnershipwiththeHSCBanditsLCGs,weadvisedonpublichealthchallengesandprioritiesandensuredformalinputsfromkeyvoluntaryandcommunitysectorstakeholders,includinglocalareapartnerships,toputhealthinequalitiesattheheartofcommissioning.

Tackling inequalities in health

Tacklinghealthinequalitiesinourmostvulnerablecommunitieshasbeenidentifiedasapriorityatministeriallevelandpartofourmandateistoallowtheviewsoflocalgovernmenttoinfluencehealthimprovementprogrammes.

Ourkeyroleinmeetingourtargetsinthisareasawjointworkingarrangementswithlocalgovernmentputinplacetoharnessthewiderangeofprogrammesandpartnershipsthatexisttoimprovehealthandwellbeing.

OneofthekeyobjectivesofHSCreform–andoneofthekeyprioritiesforthePHA–istostrengthenintersectoralworking,particularlybetweenHSCandlocalgovernment.

PublichealthimprovementstafffromthePHAhavebeenfullyinvolvedinshapingnewworkingarrangementswithlocalgovernmentanddevelopingsharedplansfortakingthisinitiativeforward.

New MHFA instructors receiving their certificates from Mary McMahon, Chair, PHA.

At a conference highlighting the challenging issue of health inequalities are, from left, Baroness May Blood; Health Minister, Michael McGimpsey; Mary Hinds, Director of Nursing and Allied Health Professions, PHA, and Barney McGahey, Chairman, Farset International.



TheestablishmentofaBelfasthealthdevelopmentunitwasthefirstoperationalmanifestationoftheobjectivetoallowtheviewsoflocalgovernmenttoinfluencehealthimprovementprogrammes.

Action on alcohol and drug misuse

TacklingalcoholanddrugmisuseisapriorityfortheDHSSPSanditcontinuestobeakeypartofourwork.Insupportofthis,thePHA:

• launchedaonestopshopinformationand supportcentreinBanbridgeforyoungpeople andtheirfamilies;

• hostedaNDACT“Drugsandalcohol,suicide andself-harm–causeoreffect?”seminar;

• conductedmediacampaignsfeaturing issuessuchaslinksbetweenbreastcancer

andalcohol,and highlightingthe importanceof talkingtoyour childabout alcohol;

• establisheda steeringgroup andcoordinator forthe implementationof theHiddenharm strategy;

• developeda factsheetonlegalhighsinresponseto requestsfromparentsandthoseworkingwith youngpeople.

Health Minister, Michael McGimpsey and Dr Eddie Rooney, Chief Executive, PHA, with speakers from the ‘Drugs alcohol, suicide and self-harm – cause or effect?’ seminar.


Action on smoking

Throughmulti-agencyactionwithkeypartners,wecontinuedimportantworkintheareaofsmokingreduction.WehostedaworkshopforthestatutoryandvoluntarysectorstohelpshapefuturePHApracticeontobaccoandtoprioritisegroupsforattention–suchasmanualworkers,pregnantwomenandyoungpeople.ArangeofspeakersfromacrossthePHA,DHSSPSandHSEtookpart.

A“Doyouwanttobreakfree?”campaignwasalsolaunchedtoencouragesmokerstoquitand,insupportof“NoSmokingDay”inMarch,wepromotedthehelpandsupportavailabletosmokersusingtelevision,posterandpressadvertising.

Sexual health, physical activity and nutrition

SexualhealthisidentifiedasanareatobeaddressedundertheNorthernIrelandpublichealthstrategy,Investingforhealth.Itisanimportantfactoringoodphysicalandmentalhealth,andtheincreasingproblemofsexuallytransmittedinfectionsremainsachallenge.

Wecontinuedtofocusoureffortsonobesityreductionandimprovednutritionwitharangeofprojects.Acampaign“Physicalactivity:italladdsup!”waslaunchedtoencourageparentsandcarerstopromoteactivityinchildren.

InapartnershipbetweenSafefoodandWesternIfH,anall-islandresourcefocusingon“Fieldtofork”wasdevelopedandregionaltrainingwasdeliveredtoHEteachersontheirroleinpromotingnutritionalstandardsforschoolfood.

Tackling fuel poverty

TheimportancethePHAputsoncombatingfuelpovertyandreducingitsimpactonthehealthandwellbeingofhouseholderswasreflectedinaninvestmentof£780,000in2009–2010forourfuelpovertyprogrammes.Thefundingenabledanumberofinitiativesincludingdistributionof“Keepwarm”packstovulnerablepeople,insulationmeasures,andimplementationoflocalactionplans.

Aseminarwehostedonlocalfuelpovertyinthenorthernareaincreasedawarenessamongfrontlinestaffacrossarangeofsectors,localrepresentativesandcommunitystakeholders.

Working in partnership

Webuiltonexistingprogrammesanddevelopednewinitiativesandpartnershipswithlocalgovernment,andcommunity,voluntaryandotherorganisationstoaddressthewiderdeterminantsofhealthandsocialwellbeing,andtargetspecificissues.Weactivelyengagedwithourstakeholdersininformingandshapingprogrammedevelopment.

Amongthemanyactivitiesin2009–2010were:

• supportfortheregionalHLCnetworkinits development;

• agreementwithDARDtoassisttheroll-outof itsregionalruralpovertyprogramme;

• leverageof£800KINTERREGfundingfora communityallotmentwellbeingprojectinthe west;



• workwiththeCOEonthephysicalactivity andrejuvenationofConnswater(PARC)studyto evaluatetheeffectsoftheConnswater communitygreenwayenvironmentalprojecton localpeople;

• workwithDSDonneighbourhoodregeneration;

• managingahealthimprovementfocusand programmeforTravellers;

• launchbyPHA’sBelfastHAZofaprogramme toimprovethelifechancesofchildrenand youngpeopleinnorthandwestBelfast;

• inputtoNorthernIfHPartnership’slocalhealth improvementplan.

Extending screening

InAugustweaddedanothertesttotherangeofnewbornbloodspotscreeningor“heelprick”tests.ThetestrecognisesMCADD–aninheritedmetabolicdisorderthatcanleadtoseriousillness,disabilityorevendeathinaffectedinfants.Already,newcaseshavebeendetectedandtreated.

Anewelectronicdatatransfersystembetweengeneralpracticesandthediabeticretinopathyscreeningcentrewasalsointroduced.

Information encouraging uptake

DuringtheyearthePHAprovidedinformationtobothhealthprofessionalsandthepublictoencouragetheuptakeofappropriateinterventionsthatwillprotectandmaintainhealth.ExtensiveworkwasundertakentoprepareforthelaunchofabowelscreeningprogrammeinNorthernIrelandfromApril2010inacollaborativeprojectinvolvingthePHA,theHSCBtrustsandtheBSO,withsupportfromNICaN.

Securing safety and quality

ImprovinghealththroughhighqualityservicesisakeyaimofourHealthMinister.

InpartnershipwiththeHSCB,wearedevelopingthefirstjointcommissioningplan.Thisaimstosecurehighquality,safeserviceswhilemeetingpatientandclientneeds.Wealsosoughttobringprofessionalleadership,evidence-basedadviceandexpertiseonthecommissioningofservicesandwiththeHSCsafetyforum.

R&D essential role

HSCR&Ddivisionfunded24newresearchstudiesin2009–2010,representingatotalcommitmentof£5.5million.ThestudiesspanthefullspectrumofHSCR&Dincludingpublichealth,withastrongemphasisonresearchthatsitsclosetotheserviceandtotheserviceuser.

At the funding announcement for PARC are, from left, Dr Michael McBride, Chief Medical Officer; Professor Frank Kee, Director of the Centre of Excellence for Public Health; Dr Carolyn Harper, Director of Public Health, PHA; and Dr Eddie Rooney, Chief Executive, PHA.

Analysing a bowel cancer screening kit.


Commissionedresearchstudieswerefundedintheareasofsuicideprevention,acutelunginjury,pharmacyprescribingandself-managementofdiabetes.Mostofthesearefundedinpartnershipwithotherlocalornationalstakeholders.FundingpartnershipsincludedasecondUS-IrelandR&Dpartnershipawardintheareaofcysticfibrosis.

TheseawardsareassessedinopencompetitionbytheprestigiousUSNationalInstitutesofHealthandrepresentcollaborationbetweenresearchersinIreland,NorthernIrelandandtheUS.WecontinuedourcommitmenttobuildingHSCR&Dcapacity,awardingsixdoctoralfellowships,withprojectsrangingfromdietaryantioxidantsandcardiovascularhealthtoexaminingtheuptakeofdomesticviolencesupportservicesbyviolentmen.

Animportantareaofcapacitydeficitwasaddressedbytheawardofthefirsthealtheconomicsfellowshipin2009–2010.ThisschemeoperatesIreland-wideinpartnershipwiththeHRBinDublinandtheNCIinWashington.

Thetransferofknowledge,generatedbyHSCR&D,intopractice,policyorenterpriseisgainingmoreemphasis.Thisyear,HSCR&Devaluatedthefirstsetofapplicationsunderanewknowledgetransferscheme,makingtwoawardsintheareasofvisualassessmentforchildrenwithneurologicaldisordersande-learningforchildrenwithlearninganddevelopmentaldisabilities.

ThroughouttheyearweworkedtoimproveallaspectsofHSCresearchinfrastructure.TheNICRNgrewsignificantly,withover6,000patientsrecruitedinto93clinicaltrialsincancer,cardiovascular,criticalcare,dementia,diabetes,respiratory,strokeandvision.

TheHSCR&DDivisionalsofinalisedastrategyforPPIinR&D,andhasrecruitedanumberofPPIrepresentativesforinvolvementinHSCR&Ddivisionactivities.

First steps

InthisreportIhavepresentedjustasnapshotofhowthePHAhasworkedinitsfirstyearofoperationtoachieveitsaimofimprovinghealthandwellbeingforeveryoneinNorthernIreland.

Ourremitandresultsaretoowidespreadtodetailmorefullyhere,butareoutlinedinmoredetailinmyfirstDirectorofPublicHealthAnnualreport,availableonthePHAwebsite.

Theexamplesoutlinedabovearejustaflavouroftheworkcompleted.Again,mayIexpresssinceregratitudetoallinvolved,inwhatevercapacity,insupportingthepublichealtharenaofworkandinprogressingourgoalsthispastyear.

Wemadeafirststepandagiantleapinestablishingaregionalunifiedpublichealthservice,buildingontheachievementsofthelegacyorganisations,makingbestuseofspecialistskills,integratingfunctions,andstrengtheningstrategicalliances.

Nextyearwillbringfurtherchallenges,butalsoopportunitiestobuildonthisyearandmakeatangibledifferencetopeople’slives.



Expectations

“Ihavehighambitionsandhighdemandsforimprovementsintheserviceswedeliver–becausethepeopleweservedeserveandexpectnoless.”ThisexpectationforserviceimprovementbyourHealthMinisterunderpinsourworkintheareasofnursing,patientsafetyandquality,AHPandPPI.

Professionals transforming lives

Thetermnursingincorporatesnursing,midwifery,healthvisiting,healthcareassistantsandothersupportstaff,whileAHPsrepresentdietetics,occupationaltherapy,orthoptics,physiotherapy,podiatry,radiography,andspeechandlanguagetherapy.Allarekeymembersofhealthcare,providinginterventionsthathelpimprovepeople’slives.

Theseprofessionalsworkwithallagegroups,acrossallprogrammesofcareandinarangeofsurroundingsincludinghospitals,people’shomes,clinics,surgeriesandschools.TheyworkinpartnershipwithHSCcolleaguesacrossprimary,secondaryandsocialcare,theindependentandvoluntarysectors,andwithotheragenciessuchasDEandNIHE.

Making quality services safer

OurmandatehereatthePHAistoleadinmakingtheservicesprovidedbyhealthandsocialcaresafer,wheretheexperienceofapatientandthequalityofthatserviceisjustasimportantasthespeedofaccess,andwherecitizensfeeltheyhaveasayinthedesignanddeliveryoftheservicestheyreceive.

Patient/client experience standards

ThenursingandAHPdirectorateisleadingontheimplementationoftheDHSSPSpatient/clientexperiencestandardsthroughoutthetrusts.ThePHA,inpartnershipwiththetrusts,hasdevelopedarangeofmethodologiesformonitoringcomplianceagainstthesestandardsandhasbeguntestingtheseindesignatedareaswithineachtrust.

Thestandardsarebeingtestedinacutemedicalwards,andacuteinpatientandmentalinpatientunits.Plansareinplacetoincludeservicesprovidedforindividualswithalearningdisability.

ThefirstcompositemonitoringreporthasbeensubmittedbythePHAtotheDHSSPS.

ThePHAandHSCBhavejointlyrevisedtheprocessformanagementandreviewofSAIs.ThePHAwiththeDHSSPShascommencedarrangementsforestablishingasystem.ThiswillenabletruststotakenecessaryactionsandlearnfromSAIsacrosstheregion.

Building capacity

Buildingontheworkofourlegacyorganisations,wefurthersupportedanddevelopedcapacityinthisareathroughout2009–2010.Intheareaofelectivecarereform,weachievedthe26weekand13weekwaitingtimetargetsfortreatmentbyAHPsfor2009setbytheHealthMinister,andweareworkingtowardshisnineweekmaximumwaitingtimetarget.

Leading the way for AHPs

ThePHAisalsoleadingaregionalAHPreformprogrammethataimstosecureregionalagreementsonareassuchasAHPtreatmentpathwaysandmodelsofgoodpractice.Oneofthekeyareasoffocusismaximisingtheuseofprofessionalstaffthroughamoreeffectivecombinationofskills,usingassistantsandadministrativestaff.

H1N1 preparations

WeestablishedaregionalAHPgrouptodeveloparegionalguidetohelpHSCtrustsrespondtoapotentialH1N1pandemic.Eachofthesevenprofessionsagreedclinicalpriorities.

Nursing and Allied Health Professions - Mary Hinds


Inotherareasofclinicalpractice,wecontinuedtoleadindevelopinginnovativeandnewservices,andfacilitatechangesandmodernisation.Theseincluded:

• implementationofthereviewofhealthvisiting andcommunitynursing;

• implementationoftheBamfordactionplanfor mentalhealthandlearningdisability;

• nursing/AHPrepresentationonallLCGs;

• nursing/AHPinvolvementandsupportfor serviceframeworks;

• AHPchairoftheNorthernIreland lymphoedemanetwork;

• servicedevelopmentstoenhancepublichealth practitioners’skillsinworkingwithvulnerable childrenandfamilies;

• autismtrainingforallhealthvisitors;

• introductionofauniversalhomevisitforall childrenagedtwoyears;

• developmentofaregionalsafeguardingnursing project;

• developmentoftheDHSSPS10yearquality strategy.

Engaging and developing

DuringAugust2009aseriesofworkshopswereheldacrossNorthernIrelandtoengagewithmembersofthenursingandmidwiferycommunityandotherstakeholdersinthedevelopmentofaregionalstrategyfornursingandmidwifery.

Throughthefiveworkshops,150participantswereaffordedtheopportunitytocontributeandshapethisdocumentunderthefourstrategicthemesof:

• developingpersoncentredcultures;

• supportinglearninganddevelopment;

• promotingsafeandeffectivecare;

• maximisingresourcesforsuccess.

Thiswork,ledbyseniornurses,midwivesandpatientrepresentatives,willbuildonthestrategiesdevelopedbyeachofthetrustsandisanopportunitytorecognisethecontributionmadebythecommunityofnursingandmidwiferytothehealthandwellbeingofourpopulation.

Professional development

TheHealthMinisterlaunchedareviewintothecontributionofhealthvisitorsandschoolnursesinNorthernIrelandandhasaskedthePHAtotakeforwardtheimplementationofthereview.

Inaddition,workgotunderwaytoestablishaprofessionalforumforthosenursesandmidwiveswhoareemployedbythePHAandHSCB,bothwithinandoutsidemydirectorate.Thecorepurposeistomakesureeveryoneisuptodateonprofessional/regulatoryissues,fromapolicy,practiceandprofessionalregulationperspective.

Innovation for the future

ThesmoothhandoverfromtheDHSSPStothePHAoftheECCHsawthecontinuationofacomplexandchallengingservicedesign,procurementandimplementationprocessinpartnershipwiththefiveHSCtrusts.TheprimarypurposeoftheECCHistoimprovethepatientandclientexperience,providingbetterqualityandmoreeffectivecare.

AmongitsfunctionsistopromoteimprovementsinpatientcarethroughtheuseofhealthcaretechnologyandtofasttracknewproductsandinnovationinHSCservices.Thispastyearsawthecontinuationoftheremotetelemonitoringpilotsforpeoplewithseverechronicdiseasesuchascongestiveheartfailure,diabetesandCOPD.



Meeting priorities

ThePHAcontinuedtoworktomeetPfAprioritiesinrespectofcompliancewithpatientsafetyandquality,andclinicalandsocialcaregovernancerequirements,throughfullimplementationofapprovedqualityimprovementplans,workinginpartnershipwithHSCBandtrusts.

Effective public engagement

TheDHSSPSiscommittedtoastakeholder-ledservicethatiscentredontheneedsofpatients,clients,carersandthewiderpopulation.

ThisisapolicyreflectedinAhealthierfutureandreinforcedbyourHealthMinisterinhisPrioritiesforaction.EffectivePPIiscentraltothedeliveryofsafe,highqualityservicesandisakeyelementofclinicalandsocialcaregovernance.

AkeyactivityofthePHAistobuildeffectivepublicengagementintoourwork–toestablishcoherentapproachestoenableinvolvementofindividuals,communitiesandotherkeystakeholdersinshapingourwork.

Personal and Public Involvement

PPIisaboutpeopleandcommunitiesinfluencingtheplanning,commissioninganddeliveryofhealthandsocialcareservices.Itmeansactivelyengagingwithserviceusersandthepublictodiscuss:

• theirideas,ourplans;

• theirexperiences,ourexperiences;

• whyservicesneedtochange;

• whatpeoplewantfromservices;

• howtomakethebestuseofresources;

• howtoimprovethequalityandsafetyof services.

WhiletheconceptofPPIisnotnew,wehavemadeconsiderableeffortsduring2009–2010tofurtherembedPPIintooureverydaywork.

PPI consultation

TheHSC(Reform)Act2009requiredthePHA,theHSCB,theDHSSPS,HSCtrustsandspecialagenciestoprepareaPPIconsultationschemeforsubmissiontotheDHSSPSbytheendof2009.OurschemewasheavilyinfluencedbytheviewsofavarietyofstakeholdersobtainedthroughajointworkshopwiththeHSCBandaseriesofone-to-onemeetings.ThisisnowwiththeDHSSPSforconsiderationinpartnershipwiththePCC.

Wecontinuedtomakeprogressonanumberofissuesidentifiedbystakeholdersasrequiringaction.ThePHAhostedaworkshopinJanuaryinpartnershipwiththeHSCB.ThisallowedthePHAtoworkwithHSCcolleaguesonclarifyingrolesandresponsibilitiesinrelationtoPPI,toestablisharegionalforumthathelpsorganisationsworkinamorecoordinatedway,andtodeveloparegionalPPIactionplan.

Wealsopilotedaseriesoftwo-daytrainingeventsforsenior,frontlinehealthandsocialcareandvoluntary/communitysectorstaffinengagingwithserviceusersandthepublic.

Measuring the impact

Inpursuanceofactioninourcorporateplan,wecommencedthedevelopmentofarobustapproachtoassistthemeasurementoftheimpactofPPI,inparticularensuringfullengagementandsensitivitytopeopleandcommunitiesexperiencinghealthandwellbeinginequalities.EnsuringPPIinvolvementintheR&DfunctionofthePHAisalsounderway.

Thestakeholderinvolvemente-networkwww.engage.hscni.netcontinuestobeakeycommunicationtoolforinformationsharingandsupportamongstakeholders.


TheoperationsdirectorateofthePHAconcernsprocesses,peopleandresources–allessentialelementsindevelopingafit-for-purposeorganisationthatappliesitsskillsandcapabilitiessuccessfully,inpartnershipwithothers,toplayaleadingroleinthenewhealthstructures.

Corporate plan

Ourfirstcorporateplanfor2009–2010laiddownafirmfoundationonwhichtobuildanddevelopastrongorganisationandinfrastructurethatmanagesresourceseffectively,efficientlyandeconomically–intandemwithrobustaccountablegovernance.Itsetusontherightcourseandgaveusarealsenseofdirectionasweshapedourworkpracticesandfulfilledourcommitments.

Strategic development and governance

Weinheritedmuchgoodworkandpracticefromthelegacyorganisationsandthisstoodusingoodsteadaswebeganourjourneyofrollingoutourorganisation’sdevelopmentstrategy.Developmentofaninterimgovernanceframework–whichconcernsaccountabilitiesandresponsibilitiesandhowwearedirectedandcontrolled–wasacorestepinourworkingin2009–2010.

ThiswillformthebasisofaholisticnewgovernanceframeworkandstrategyforthePHA.AlliedtothiswasinitialworkonthedevelopmentofinternalperformancemonitoringandreportingsystemssupportingthePHAacrossallitsfunctions.

Asuiteofinteriminformationgovernancepoliciesweredevelopedandaninformationgovernanceleafletproducedandcirculatedtoallstaffoutlininggoodpracticeandguidanceonissuessuchasdataprotectionandfreedomofinformation.

ArrangementswereputinplacetoestablishtheChiefExecutiveandChair’soffices,andtoorganiseandprovidesupporttothePHAboardanditscommittees.

Commissioning

AnimportantmechanismforthePHAinconnectingregionalpoliciesandstrategiestolocalactionwasthedevelopmentofajointcommissioningplancoveringthefullPHAbudget.

InpartnershipwiththeHSCB,weagreedaplanthatfocusedonhighquality,safeservicesconsistentwithmeetingpatientandclientneeds,haddueregardtoministerialprioritiesandresourcesavailable,andstrovetoreduceinequalities.

Workbeganduringtheyeartoinitiateajointcommissioningplanfor2010–2011,takingintoaccountprioritiessuchastheNorthernIrelandExecutive’sPFG2008–2011andassociatedpublicserviceagreements,theministerialPfA2009–2010aswellasearlyguidanceonPfA2010–2011,andprevailingfinancialcircumstances.

Riskmanagementprocesseswereestablishedthroughthedevelopmentofaninterimcorporateriskregisteranddirectorateriskregisters.Thesewillbereviewedregularly.

Performance monitoring

TosupportimplementationofourcorporateplanandtimelyreportingonDHSSPSperformancetargets,aweb-basedperformancemonitoringsystemwasdeveloped.Thiswillbefurtherrefinedandrolledoutduring2010–2011.

Financial management

Infulfilmentofourresponsibilitytoachievefinancialbalanceandlivewithinourallocatedresourcesthrougheffectivestewardship,weimplementedfinancialmanagementarrangementswiththeHSCBandBSOandwillcontinuetoexamineanddevelopthesetoensurethatourstrategicfinancialmanagementrequirementsaremetfully.

AmajorpartofthiswasworkingcloselywithPHAprogrammemanagers,HSCBfinancecolleaguesandDHSSPSpolicyandfinancialcolleaguestoprovideaclearanddetailedpictureofcommitmentsandexpenditureagainstalltheprogrammebudgets,enablingtheprovisionoftimelyinformationtosupportAMTdecisionmaking.

Operations - Edmond McClean



ThePHAalsoledworkincollaborationwiththeHSCBtoreviewtherangeofprocessesusedbythelegacyorganisationstofundvoluntaryandcommunityorganisations,resultinginasingleregionalprocesssupportedbystandarddocumentation.

Interim controls assurance framework

Aninterimassuranceframework,whichoperatestomaintainandhelpprovidereasonableassuranceoftheeffectivenessofinternalcontrolacrossallareasofthePHA’sactivity,wasapprovedbytheboardinOctober.Thisframeworkcoverscorporatecontrol,safetyandquality,finance,operationalperformanceandserviceimprovement.During2010,itwillbereplacedbyanoverarchinggovernanceframeworkcoveringalldomainsofgovernanceandrelatedrequirementsplaceduponitbytheDHSSPS.

ThefollowingtabledetailscontrolsassurancestandardscompliancebythePHAduring2009–2010.

Figure 1: PHA controls assurance compliance 2009–2010

Governance and audit committee

TheinterimframeworkwillcontinuetobereviewedbytheGACandtheboarduntilafullyfunctioningsystemformonitoringthePHA’sinternalcontrolsystemisimplemented.TheGAChelditsfirstmeetinginJune.AsubsequentmeetingwasheldinOctobertoapprovethemid-yearassurancestatementandotherrelevantdocumentsthatsupporttheinternalcontrolsystem.

Accommodation

ThePHAwasaskedatitsoutsettoconsideroptionsforanewheadquartersfortheorganisation.AprojectteamwasestablishedinvolvingstafffromthePHA,healthestatesandHSCBfinancetodevelopabusinesscase.ThefirststageofthisworkhasbeencompletedandconsideredbythePHAboardandisnowawaitingcommentandguidancefromDHSSPS.

AtthesametimetheuseofworkspaceacrossthePHAlocationsinBelfastcitycentrewasreviewed,andsomeadditionalspaceleasedtoaccommodatetheneworganisationandbettersupportourfunctionalneeds.

Standard Progress expected by DHSSPS in 2009–2010

Position recorded by PHA in 2009–2010

Buildings,land,plant,andnon-medicalequipment

Substantive Substantive

Emergencyplanning Substantive Substantive

Environmentalmanagement Substantive Substantive

Financialmanagement Substantive Substantive

Firesafety Substantive Substantive

Governance Substantive Substantive

Healthandsafety Substantive Substantive

Humanresources Substantive Substantive

ICT Substantive Substantive

Purchasingandsupply Substantive Substantive

Recordsmanagement Substantive Moderate

Researchgovernance Substantive Substantive

Riskmanagement Substantive Substantive

Securitymanagement Substantive Substantive

Wastemanagement Substantive Substantive


A competent workforce

Wecontinuedtheworkstartedbyourlegacybodiesingrowingacompetent,confidentworkforcethroughplannedtrainingandsupport.TraininginoperationalproceduresandgovernanceissueswasorganisedforallPHAstaffinpartnershipwiththeHSCB.

WorkshopsfocusingongovernanceissuesorganisedthroughtheBeechesmanagementcentrefacilitatedthedevelopmentofnon-executivemembersoftheboard.Dedicatedcommissionerdevelopmenttrainingalsotookplace.

Toensureclosecollaborationwithallourhealthpartners,regularmeetingstookplacethroughouttheyearataseniorlevelwithallHSCorganisations,includingthechairsofthefiveLCGs,theassistantdirectorsofcommissioningand,insupportofthepartnershipworkingwithlocalgovernment,thechiefexecutivesofalllocalcouncilareas.

Staffing

Staffingstructuresareinplacetotier3level,whiletier4levelandbelowstillremaintobeputinplace.Anumberofstaffhaveavailedoftheopportunitytotakevoluntaryearlyretirementorvoluntaryredundancypackages.

Health intelligence

Responsibilityforhealthintelligencealsolieswithinthisdirectorate.Thisfunction,encompassingknowledgemanagement,facilitatesthecaptureanduseofknowledgeforhealthandwellbeingimprovementandprotection,andtheaddressingofinequalities.Demandsareincreasing–reshapinganddevelopinginlightofourneworganisation’sneeds.

Specialist support

Weprovidespecialistsupportoninformationcollation,analysisandappraisal,researchandevaluationstudies,andinformatics.Inaddition,wearecommittedtotestinganddevelopingnewandinnovativepracticesandseekinggreaterunderstandingaboutthenatureofhealthinequalitiesandtheimpactofaction.

Healthintelligenceisacross-cuttingfunctionacrossalldivisionswithinthePHA.Ourchallengethispastyearhasbeenrealigningthisfunctiontomaximisetheimpactofhighquality,relevantdatabyimprovingaccesstohealthinformationandintelligenceacrossallHSCorganisationsinNorthernIreland.

ApriorityhasalsobeentodevelopconstructiveandeffectivearrangementswiththeHSCdatawarehousetoaccessandshapeservices.

Building capacity

Muchofourtimein2009–2010hasfocusedonservicingthedemandsofprojectscarriedoverfromthelegacyorganisations.Inpursuingouraimtofurtherdevelopourknowledgeandresearchcapacity,workcommencedonthedevelopmentofaknowledgemanagementframeworkinconjunctionwiththenewCOEforpublichealth.

Building relationships

WehaveworkedtobuildcloserworkingrelationshipswithkeyHSC,departmental,academicandlocalgovernmentpartnerstooptimisetheuseofexistingdatasourcesandthecommissioningofnewresearch.Wecontinuedworkonthedevelopmentofaneffectiveandefficientknowledgebasethatenablesflexible,sharedaccesstopublichealthknowledgeandhelpsinfluencethestrategicagendaofotherorganisationsandinterests.

Important work

Keyachievementsthispastyearincludedtheall-Irelandevaluationofappliedsuicideinterventionskillstraining,evaluationofourregionalsuicidehelplineLifeline,andFoodinSchoolsresearch.



Joint working with local government

Thecommitmenttostrengtheninginter-sectoralworkingsawsubstantialprogressmadeinjointworkingarrangementswithlocalgovernment.Almostallofthe26localcouncilshaveindicatedaninterestinformingjointworkingarrangementswiththePHA.

TheworkindevelopingthejointpilotsisbeingledbyaSteeringGroupcomprisingseniorrepresentativesfromallcommittedgeographicareas.Taskgroupshavealsobeensetuptodevelopaseriesofproductstosupporttheworkofthejointteamsineachlocality.Attimeofwriting,twojointworkinginitiativeshavebeenlaunchedwithmoreplannedoverthecomingmonths.

Communications

ThePHA’scommunicationsfunction–forbothexternalandinternalcommunications–alsofallswithintheoperationsdirectorate.Accurateandrelevanthealthinformationisessentialifindividualsaretomakeimprovementstotheirhealthandwearecommittedtoachievinghighqualitystandardsinallaspectsofourcommunicationspractice.

Fit-for-purpose systems

Fromthestartitbecameapparentthattherealisationofthisnewerareliedinnosmallpartontheneedforfit-for-purposecommunicationsystemstobecomeacornerstoneinthestrategicoperationoftheorganisation.Ourfocustodatehasincludedconsolidationoflegacysystemstogetherwithplanningforthedevelopmentofnewbespokesystems.

A multi-disciplinary team

ThecommunicationsdemandsfacingthePHAtodatehavebeenbothvariedandchallenging,requiringthefullsupportofamulti-disciplinaryteamworkingacrossandsupportingallareasoftheorganisation,andspanningtheareasofpublicationsdevelopment,design,websitedevelopment,marketing,eventmanagement,publicandmediarelations,andcorporatecommunications.

Marketing and PR

Throughouttheyearourmarketingandpublicrelationsfunctionrananumberofmajorpublicinformationcampaignsacrossarangeofmediatoraiseawarenessandchangeattitudes,andhelppromotehealthchoicesanddecisionmaking,intheareasofsmoking,alcohol,physicalactivity,sexualhealthandmentalhealth.

Thecampaign“Reduceyourdrinking,reduceyourriskofbreastcancer”includedtelevision,radio,onlineandpressadvertising,andpostersandleaflets.WashroomandphonekioskpostersandFacebookadvertisingwerealsousedtopromotethe“Sex:don’tjustdoit–thinkitthrough”campaignforyoungpeople.Alongsideourusualpromotiontools,wedevelopedanactivitylogbookforprimaryschoolchildrenandaNewyoumagazineforparentsinsupportofour‘Physicalactivity:italladdsup!’campaign.

Campaign success

OursuccessinourcampaignworkwasreflectedinseveralawardsthataredetailedunderthequalitysectionoftheDirectors’report.

Publications support

Onthepublicationsanddesignside,wedeveloped,producedanddistributedover160resourcesforboththepublicandprofessionalsinsupportofourworkareas.Thisincludedtheproductionofswinefluinformationforthegeneralpublic,parentsofyoungchildren,pregnantwomen,andhealthandsocialcareworkers.

Anothermajorpieceofworkwasthedevelopmentandtestingofinformationforthepublic,andforhealthprofessionals,tosupportthenewbowelscreeningprogramme.Thefourleafletsforthepublicweretranslatedinto10regionalandethniclanguages.


Electronic communications

Developmentofacorporatewebsitewww.publichealth.hscni.nettocommunicatemessagestoourexternalstakeholdersandintegratecontentfromourlegacysystemswasapriorityfortheneworganisation.Anintranetsitewasalsorolledoutasacommunicationschannelforourstaff.

Threenewsiteswww.enjoyhealthyeating.info,www.hphlibrary.comandwww.lifelinehelpline.infowereintroducedinsupportofnutrition,hospitals/healthserviceandmentalhealthwork.

Thewww.breastfedbabies.org,www.getalifegetactive.comandwww.mindingyourhead.infositeswerealsoredeveloped.



Event management

Anumberofconferences,seminarsandtrainingcourseswereorganisedbythePHAthroughouttheyearontopicssuchasorgandonation,healthcareassociatedinfections,andhealthyworkplaces.

CommunicationssupportwasalsoprovidedatpartnershipeventssuchastheFarsethealthinequalitiesconferenceandatlaunchesoftheintegratedservicesforchildrenandyoungpeopleprogramme,theStJoseph’sprimaryschoolparentsupportprogrammeevaluationreport,andtheBelfastHealthDevelopmentUnit.Wefacilitatedstakeholderengagementforissuessuchassuicideprevention,fuelpovertyandcommunitydevelopmentwork.

Shaping our future

Alongsidetheeverydaycommunicationsactivities,goodprogresshasalsobeenmade,throughvarioustaskandworkinggroups,indevelopingtheprotocolsthatwillshapefuturecommunicationsstrategies.ImportantlinkshavealsobeenmadetoaidcoordinationwithcommunicationspersonnelacrosstheHSCfamilyintheDHSSPS,HSCB,andtrusts.

At the organ donor seminar held during the year are, from left, Dr Eddie Rooney, Chief Executive, Public Health Agency; Mr Chris Rudge, National Clinical Director for Transplantation, Department of Health, London; and Health Minister, Michael McGimpsey.

The staff involved in setting up the Belfast Health Development Unit, back row, from left, Suzanne Wylie, Beverley Smith, Caroline Bloomfield, Tom Crossan, Adele Keys, Margery Magee and Dr Leslie Boydell. Front row, from left, Mary Black, Elaine McCarthy, Valerie Brown, Elma Greer and Martina Smyth.

24 | Operating and financial review

Operating and financial review

Report from the Governance and Audit Committee (GAC)

TheGACwasestablishedtogiveassurancetothePHAboard,basedonanindependentandobjectivereview,thateffectiveriskmanagementandinternalcontrolarrangementsareinplaceforfinance,corporategovernanceandrelatedareas.

TheGACcomprisesfournon-executivedirectorsofthePHA:MrsJErskine(Chair);MrROrr;MrTMahaffy;andCllrSNicholl.Thecommitteeissupportedby:MrEMcClean,DirectorofOperations,PHA;MrPCummings,DirectorofFinance,HSCB;MrsCMcKeown,HeadofInternalAudit,BSO;andtheirrespectivestaff.

RepresentativesoftheNorthernIrelandAuditOfficeandPricewaterhouseCoopersattendasrequired.

TheGACdecidedatanearlystage(inconjunctionwiththeHSCBGAC)torecruituptotwoindependentlayadvisorswithexpertiseinfinanceandgovernance.Interviewshavetakenplaceandanannouncementwillbemadeshortly.

Meetings

TheGACmetonthefollowingdatesduring2009–2010:29June2009,6October2009,14January2010and4March2010.

GAC activities during 2009–2010

During2009/10theGAC:

• Notedthestatementofassuranceprovided bytheauditcommitteeofthelegacyHealth PromotionAgency(HPA)andrecommended theaccountsanddraftannualreportofthe legacyHPAtothePHAboardforapproval.

• Endorsedtheprocessfordevelopinganinterim corporateriskregister,directoraterisk register,andanewcorporateriskregister. Approvedanewriskassessmenttooland subsequentlyapprovedtheinterimcorporate riskregisterandnewdirectorateriskregisters.

• Approvedtheinterimassuranceframework.

• Hadoversightoftheprocessfor self-assessmentofcompliancewithcontrols assurancestandards.

• Agreedthemid-yearassurancestatementand recommendeditsapprovaltotheboard.

• Self-assessedtheGACagainsttheNAO auditcommitteeselfassessmentchecklist forsubmissiontotheDHSSPS,andapproved anactionplanarisingfromthis.

• Approvedasuiteofinteriminformation governancepolicies.

• Approvedtheinternalauditworkplanfor2010–2011 andconsideredthereportsoneachpieceofwork.

• Providedassurancetotheboardthattheannual accountswouldbepreparedinaccordancewith therelevantstatutoryregulations.

• Reviewedthestandingorders.

TheGAClooksforwardtocontinuingitsworkin2010–2011,buildingonrelationshipswithexecutivedirectors,PHAofficers,andinternalandexternalauditorstoensurerobustgovernanceacrossthePHA.

Julie Erskine Chair of Governance and Audit Committee

Overview

TheseaccountshavebeenpreparedinaformdeterminedbytheDHSSPSbasedonguidancefromtheDepartmentofFinanceandPersonnel’sFinancialReportingManual(FReM)andinaccordancewiththerequirementsoftheHealthandSocialCare(Reform)Act(NorthernIreland)2009.

ThissummaryfinancialstatementdoesnotcontainsufficientinformationforafullunderstandingoftheactivitiesandperformanceofthePHA.Forfurtherinformation,thefullaccounts(includingthestatementofinternalcontrol),AnnualReportandAuditor’sReportfortheyearended31March2010shouldbeconsulted.

Copiesofthefullaccountsareavailablefrom:

DirectorofFinanceHealthandSocialCareBoard12–22LinenhallStreetBelfastBT28BS


Operating and financial review | 25

NET EXPENDITURE ACCOUNT FOR YEAR ENDED 31ST MARCH 2010

Restated 2010 2009 £000s £000s Expenditure Staffcosts (12,988) (13,026) Depreciation (52) (68) Otherexpenditure (29,865) (44,266)

(42,905) (57,360)

Income Incomefromactivities - 419 Otherincome 392 874

392 1,293

Net expenditure (42,513) (56,067)

Credit reversal of notional costs Costofcapital (329) (86) Notionalcosts(auditfees) 26 24

Net expenditure for the financial year (42,816) (56,129)

Summary of Revenue Resource outturn Netexpenditure (42,513) (56,067)

RRLs issued (to) BelfastHSCTrust (9,795) SouthEasternHSCTrust (1,448) SouthernHSCTrust (6,824) NorthernHSCTrust (3,923) WesternHSCTrust (3,669)

Total RRL issued (25,659) -*

Total commissioner resources utilised (68,172) (56,067)

RRLs received from

DHSSPS(cashandnoncash) 68,350 56,067

Surplus/deficit against RRL 178 -

*TheequivalentofRRL’sissuedtoTrustsinthefinancialyearended31March2009areincludedwithinOtherExpenditure.


Revenue Resource Limit

ResultingfromtheintroductionoftheNonDepartmentalPublicBody(NDPB)formatofaccounts,theRevenueResourceLimit(RRL)hasbeenintroducedasameansofsettingacashlimittotheamountoffundingtobedrawndirectlyfromtheDHSSPSbythetrustinrelationtothecostsofprovidingservicestoAgencyresidents.ThisRRLmechanismreplacedtheServiceandBudgetAgreementpreviouslyinplace,whichallowedforcashtobepaiddirectlytothetrustsbythelegacyboardsforthecostsofservicesprovidedtothelegacyAgencyresidents.

ThememorandumbelowexpressesthePHA‘NetExpenditureAccount’inatraditionalincomeandexpenditureformat.

SUMMARY FINANCIAL INFORMATION FOR YEAR ENDED 31ST MARCH 2010

Restated 2010 2009 £000s £000s Income RRLreceivedfromDHSSPS 68,350 56,067 Otherincome 392 1,293

68,742 57,360

Expenditure (including RRLs issued to Trusts) Staffcosts (12,988) (13,026) Depreciation (52) (68) Expenditure (55,524) (44,266)

(68,564) (57,360)

Surplus/(deficit) 178 -



STATEMENT OF FINANCIAL POSITION AS AT 31 MARCH 2010

Restated 2010 2009 £000s £000s NON-CURRENT ASSETS Property,plantandequipment 199 108 Intangibleassets 3 6

TOTAL NON-CURRENT ASSETS 202 114

CURRENT ASSETS Inventories - 2 Tradeandotherreceivables 710 485 Othercurrentassets 24 58 Cashandcashequivalents 111 8,155

TOTAL CURRENT ASSETS 845 8,700

TOTAL ASSETS 1,047 8,814

CURRENT LIABILITIES Tradeandotherpayables (16,754) (11,931)

TOTAL CURRENT LIABILITIES (16,754) (11,931)

NON-CURRENT ASSETS PLUS/LESS NET CURRENT ASSETS/ LIABILITIES (15,707) (3,117)

ASSETS LESS LIABILITIES (15,707) (3,117)

RESERVES Revaluationreserve 23 21 Generalreserve (15,730) (3,138)

(15,707) (3,117)

IcertifythattheattachedFinancialStatementsandAnnualReportwereapprovedbytheboardofDirectorson:

Signed: Date:1June2010


STATEMENT OF CASHFLOWS FOR THE YEAR ENDED 31 MARCH 2010

Restated 2010 2009 £000s £000s Cashflows from operating activities

Netexpenditureaftercostofcapital andinterest (42,513) (56,067)

Adjustmentsfornoncashcosts (248) 21

(Increase)/decreaseintrade& otherreceivables (191) 20

(Increase)/decreaseininventories 2 2

Increase/(decrease)intradepayables 4,823 790

Lessmovementinpayablesrelatingtocapital - (4)

Net cash outflow from operating activities (38,127) (55,238)

Cashflows from investing activities

Purchaseofproperty,plantandequipment (144) (9)

Purchaseofintangibleassets - -

Proceedsofdisposalofproperty, plantandequipment 3 -

Proceedsondisposalofintangibles - -

Interestreceived - -

Net cash inflow/(Outflow) from investing activities (141) (9)

Cash flows from financing activities Grantinaid 30,224 54,806

Net financing 30,224 54,806

Net increase (decrease) in cash and cash equivalents in the period (8,044) (441)

Cash and cash equivalents at the beginning of the period 8,155 8,596

Cash and cash equivalents at the end of the period 111 8,155



Management board

TheManagementboardresponsibleforsettingthedirectionofthePHAismadeupofthefollowingindividuals:

Executive members:DrEddieRooney(ChiefExecutive)DrCarolynHarperEdmondMcCleanMaryHinds

Non-executive members:MaryMcMahon(Chairperson)JulieErskineDrJeremyHarbisonMiriamKarpThomasMahaffyCllrCathalMullaghanCllrStephenNichollRonnieOrr

Equal opportunities

ThePHAhasinplaceanequalopportunitiespolicytopromoteandprovideequalitybetweenpersonsofdifferentgenders,maritalorfamilystatus,religiousbelieforpoliticalopinion,age,disability,raceorethnicorigin,nationalityorsexualorientation,betweenpersonswithadisabilityandpersonswithout,betweenpersonswithdependentsandpersonswithout,betweenmenandwomengenerally,andirrespectiveofstafforganisationmembership.Thispolicyappliestorecruitment,promotion,training,transferandotherbenefitsandfacilities.

Public sector payment policy – measure of compliance

TheDepartmentrequiresthatthePHApaysitsnon-HSCtradecreditorsinaccordancewiththeCBIpromptpaymentpolicyandgovernmentaccountingrules.ThePHA’spaymentpolicyisconsistentwiththeCBIpromptpaymentcodesandgovernmentaccountingrulesanditsmeasureofcomplianceis:

2010 2009 number number

Totalbillspaid 6,821 7,180

Totalbillspaidwithin30daytarget 6,371 6,866

% of bills paid within 30 day target 93.4% 95.6%


Related party transactions

Duringtheyear,noneoftheboardmembers,membersofkeymanagementstafforotherrelatedpartieshasundertakenanymaterialtransactionswiththePHA.

Directors’ interests

Detailsofcompanydirectorshipsorothersignificantinterestsheldbydirectors,wherethosedirectorsarelikelytodobusiness,orarepossiblyseekingtodobusinesswiththePHAwherethismayconflictwiththeirmanagerialresponsibilities,areheldonacentralregister.AcopyisavailablefromEdmondMcClean,PHADirectorofOperations.

Charitable donations

ThePHAdidnotmakeanycharitabledonationsduringthefinancialyear.

Post balance sheet events

Therearenopostbalancesheeteventsthathaveamaterialimpactontheaccounts.

Sickness absence information

Thepercentagefigureforsicknessabsenceforthe2009–2010yearis2.5%.FurtherinformationisdetailedwithintheDirectors’reportsection.

Personal data-related incidents

Therewerenomajorpersonaldatarelatedincidentsrequiringdisclosure.

Audit services

ThePHA’sstatutoryauditwasperformedbyPricewaterhouseCoopersonbehalfoftheNorthernIrelandAuditOffice.Theauditfeefor2009–2010was£26k.

Statement on disclosure of audit information

AlldirectorscanconfirmthattheyarenotawareofanyrelevantauditinformationofwhichthePHA’sauditorsareunaware.

Staff numbers

Theaveragenumberofwholetimeequivalentpersonsemployedduringtheyearwas:

2010 2009

Permanently employed Total no. staff no. Others no. Total no.

Healthcommissioningimprovementandprotection 247 221 26 235



Remuneration report for the year ended 31 March 2010 (audited)

Scope of the report

Article242Bandschedule7AoftheCompanies(NI)Order1986,asinterpretedforthepublicsector,requiresHSCbodiestopreparearemunerationreportcontaininginformationaboutdirectors’remuneration.TheremunerationreportsummarisestheremunerationpolicyofthePHAandparticularlyitsapplicationinconnectionwithseniorexecutives.ThereportalsodescribeshowthePHAappliestheprinciplesofgoodcorporategovernanceinrelationtoseniormanagers’remunerationinaccordancewithHSS(SM)3/2001issuedbytheDHSSPS.

Remuneration committee

TheboardofthePHA,assetoutinitsstandingorders,hasdelegatedcertainfunctionstotheremunerationcommittee.Themembershipofthiscommitteeisasfollows:

Members

MaryMcMahon(Chair)DrJeremyHarbisonMiriamKarpCllrCathalMullaghan

Duringthe2009–2010yearthecommitteemetononeoccasiontoagreeitstermsofreference.

Remuneration policy

1. ThemembershipoftheremunerationcommitteeforthePHAconsistsoftheChairandatleasttwoofitsnon-executives.

2. ThepolicyonremunerationofthePHAseniorexecutivesforcurrentandfuturefinancialyearsistheapplicationoftermsandconditionsofemploymentasprovidedanddeterminedbytheDHSSPS.

3. Performanceofseniorexecutivesisassessedusingaperformancemanagementsystemthatcomprisesindividualappraisalandreview.Theirperformanceisthenconsideredbytheremunerationcommitteeandjudgementsaremadetotheirbandinginlinewiththedepartmentalcontractagainsttheachievementofregionalorganisationandpersonalobjectives.

4. TherelevantimportanceoftheappropriateproportionofremunerationissetbytheDHSSPSundertheperformancemanagementarrangementsforseniorexecutives.

5. Inrelationtothepolicyondurationofcontracts,allcontractsofseniorexecutivesinthePHAarepermanentandcontainanoticeperiodofthreemonths.


Service contracts

Seniorexecutivesintheyear2009–2010wereonDHSSPSseniorexecutivecontracts,whicharedetailedandcontainedwithinthecircularHSS(SM)2/2001.

Directors

DrEddieRooney,ChiefExecutive,appointed01April2009.DrCarolynHarper,DirectorofPublicHealth/MedicalDirector,appointed01April2009.EdmondMcClean,DirectorofOperations,appointed01April2009.MaryHinds,DirectorofNursingandAlliedHealthProfessionals,appointed18May2009.

Non-executive directors

TheNon-executivedirectorswereappointedforaperiodoffouryears,witheffectfrom1April2009.

Chair Mary McMahon

Non-executive director Julie Erskine

Non-executive director Dr Jeremy Harbison

Non-executive director Miriam Karp

Non-executive director Thomas Mahaffy

Non-executive director Councillor Cathal Mullaghan

Non-executive director Councillor Stephen Nicholl

Non-executive director Ronnie Orr

Nootherpersonsservedatboarddirectorlevelduring2009–2010.

Anoticeperiodofthreemonthsisprovidedbyeitherpartyexceptintheeventofdismissal.Thereisnothingtopreventeitherpartywaivingtherighttonoticeorfromacceptingpaymentinlieuofnotice.

Retirement age

Currently,employeesarerequiredtoretireatage65althoughemployeescanasktoworkbeyondthisageinaccordancewithEquality(Age)Regulations(NI)2006.



Premature retirement costs

Section16oftheAgendaforChangetermsandconditionshandbook(issued14February2007undercoveroftheDepartment’sGuidanceCircularHSSAfC(4)2007,setsoutthearrangementsforearlyretirementonthegroundsofredundancyandintheinterestofthisservice.FurthercircularshavebeenissuedbytheDepartment–AfC(6)2007andHSSAfC(5)2008setoutchangestothetimescaleforoperationofthetransitionalprotectionunderthesearrangements.

Undersection16oftheAgendaforChangetermsandconditionshandbook,individualswhoweremembersoftheHPSSsuperannuationschemepriorto1October2006,areover50yearsofageandhaveatleastfiveyearsmembershipoftheHPSSsuperannuationscheme,qualifyfortransitionalprotection.Staffwhoqualifyfortransitionalprotectionareentitledtoreceivewhattheywouldhavereceivedbywayofpensionandredundancypaymenthadtheytakenredundancyretirementon30September2006.

Thisincludesenhancementofupto10yearsadditionalservice(reducedbythenumberofyearsbetweenSeptember2006andtheactualdateofretirement)andalumpsumredundancypaymentofupto30weekspay(reducedby30%foreachyearofadditionalserviceover62/3years).Alternatively,staffmaderedundantwhoaremembersoftheHSSpensionsscheme,haveatleasttwoyears’continuousserviceandtwoyears’qualifyingmembership,andhavereachedtheminimumage(currently50years)canopttoretireearlywithoutareductionintheirpensionasaalternativetoalumpsumredundancypaymentofupto24monthspay.

Inthiscase,thecostoftheearlypensionpaymentistakenfromthelumpsumredundancypayment;however,iftheredundancypaymentisnotsufficienttomeettheearlypensionpaymentcost,theemployerisrequiredtomeettheadditionalcosts.

Salary (Audited)

ThesalaryandthevalueofanytaxablebenefitsinkindofthemostseniormembersofthePHAwereasfollows:

2009–2010

Salary, including Benefits in kind performance pay (Rounded to Name £000s nearest £100)

Non-executive members MMcMahon 30-35 - JErskine 5-10 - JHarbison 5-10 - MKarp 5-10 - TMahaffy 5-10 - CMullaghan 5-10 - SNicholl 5-10 - ROrr 5-10 -

Executive members EPRooney 115-120 100 CHarper 130-135 100 EMcClean 75-80 - MHinds 85-90 -


Pensions (Audited)

ThepensionentitlementsofthemostseniormembersofthePHAwereasfollows: 2009–2010

Real Total increase in accrued pension and pension at age CETV CETV Real related lump 60 and related at at increase sum at age 60 lump sum 31/3/09 31/3/10 in CETV Name £’000 £’000 £’000

Non-executive members

MMcMahon - - - - - JErskine - - - - - JHarbison - - - - - MKarp - - - - - TMahaffy - - - - - CMullaghan - - - - - SNicholl - - - - - ROrr - - - - -

Executive members

EPRooney *Seenotebelow

CHarper 0-2.5pension 20-25pension 317 353 9 0-2.5lumpsum 60-65lumpsum

EMcClean 0-2.5pension 15-20pension 266 326 35 5-7.5lumpsum 45-50lumpsum

MHinds *Seenotebelow

* EPRooneyandMHindsjoinedtheschemeduringthe2009–2010financialyear.BSO’sSuperannuationBranchhasindicatedthat duetothefactthattheyhavenotcompletedafullyearinthescheme,itwasnotpossibletocalculatetheirpensionentitlements.

AsNon-Executivemembersdonotreceivepensionableremuneration,therewillbenoentriesinrespectofpensionsforNon-Executivemembers.

ACashEquivalentTransferValue(CETV)istheactuariallyassessedcapitalvalueofthepensionschemebenefitsaccruedbyamemberataparticularpointintime.Thebenefitsvaluedarethemember’saccruedbenefitsandanycontingentspouse’spensionpayablefromthescheme.ACETVisapaymentmadebyapensionscheme,orarrangementtosecurepensionbenefitsinanotherpensionschemeorarrangementwhenthememberleavesaschemeandchoosestotransferthebenefitsaccruedintheirformerscheme.Thepensionfiguresshownrelatetothebenefitsthattheindividualhasaccruedasaconsequenceoftheirtotalmembershipofthepensionscheme,notjusttheirserviceinaseniorcapacitytowhichthedisclosureapplies.TheCETVfiguresandtheotherpensiondetails,includethevalueofanypensionbenefitsinanotherschemeorarrangementwhichtheindividualhastransferredtotheHSCpensionscheme.Theyalsoincludeanyadditionalpensionbenefitaccruedtothememberasaresultoftheirpurchasingadditionalyearsofpensionserviceintheschemeattheirowncost.CETVsarecalculatedwithintheguidelinesprescribedbytheInstituteandFacultyofActuaries.

RealIncreaseinCETV-ThisreflectstheincreaseinCETVeffectivelyfundedbytheemployer.Ittakesaccountoftheincreaseinaccruedpensionduetoinflation,contributionspaidbytheemployee(Includingthevalueofanybenefitstransferredfromanotherpensionschemeorarrangement)andusescommonmarketvaluationfactorsforthestartandendoftheperiod.



Statement of the Comptroller and Auditor General to the Northern Ireland Assembly

Ihaveexaminedthesummaryfinancialstatementfortheyearended31March2010assetoutatpages26to28.

Respective responsibilities of the Public Health Agency, Chief Executive and AuditorThePublicHealthAgencyandChiefExecutiveareresponsibleforpreparingthesummaryfinancialstatement.

MyresponsibilityistoreporttoyoumyopinionontheconsistencyofthesummaryfinancialstatementwithintheAnnualReportwiththefullannualfinancialstatements,anditscompliancewiththerelevantrequirementsoftheHealthandSocialCare(Reform)Act(NorthernIreland)2009andDepartmentofHealth,SocialServicesandPublicSafetydirectionsmadethereunder.

IalsoreadtheotherinformationcontainedintheAnnualReport,andconsidertheimplicationsformycertificateifIbecomeawareofanyapparentmisstatementsormaterialinconsistencieswiththesummaryfinancialstatement.TheotherinformationcomprisestheOperatingandfinancialreview.

Basis of audit opinionsIconductedmyworkinaccordancewithBulletin2008/03‘Theauditors’statementonthesummaryfinancialstatementintheUnitedKingdom’issuedbytheAuditingPracticesBoard.MyreportonthePublicHealthAgencyfullannualfinancialstatementsdescribesthebasisofmyauditopinionsonthosefinancialstatementsandthepartoftheRemunerationReporttobeaudited.

OpinionInmyopinion,thesummaryfinancialstatementisconsistentwiththefullannualfinancialstatementsofthePublicHealthAgencyfortheyearended31March2010andcomplieswiththeapplicablerequirementsoftheHealthandSocialCare(Reform)Act(NorthernIreland)2009andDepartmentofHealth,SocialServicesandPublicSafetydirectionsmadethereunder.

KJ Donnelly ComptrollerandAuditorGeneralNorthernIrelandAuditOffice106UniversityStreetBelfastBT71EU

18June2010

36 | PHA board

PHA board

Mary McMahon

MaryisthePHA’sChairandisaself-employedSocialPolicyResearcher.ShewaspreviouslycoordinatorwiththeBelfastTravellerSupportGroupandisamemberofAmnestyInternational(Mid-Downbranch),theCommitteeontheAdministrationofJusticeandalsotheUnitedNationsChildren’sFund(UNICEF).SheisaBelfastHarbourCommissioner.

Dr Eddie Rooney

DrRooneyisChiefExecutiveofthePHAandwasformerlyDeputySecretaryintheDepartmentofEducationwherehisresponsibilitiesincludedleadingpolicyontheRPA.HetransferredtotheOfficeoftheFirstMinisterandDeputyFirstMinisterasEqualityDirectorin2008.

Dr Carolyn Harper

DrHarperisthePHA’sDirectorofPublicHealthandMedicalDirector.ShewaspreviouslyDeputyChiefMedicalOfficerintheDHSSPS.ShetrainedingeneralpracticebeforemovingintopublichealthandalsoworkedasDirectorofQualityImprovementfortheQualityImprovementOrganisationinCalifornia.

Mary Hinds

MaryHindsisthePHA’sDirectorofNursingandAlliedProfessions.ShewaspreviouslyDirectoroftheRoyalCollegeofNursing(RCN)inNorthernIreland.PriortojoiningtheRCN,shewasDirectorofNursingattheMaterHospitalinBelfast.

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PHA board | 37

Edmond McClean

EdmondMcCleanisthePHA’sDirectorofOperations.HewaspreviouslyleadDirectorsupportingtheinitialdevelopmentofBelfastandEastLCGs.From1997to2007hewasDirectorofStrategicPlanningandCommissioningwiththeNorthernHealthandSocialServicesBoard.Thisrolealsoinvolvedleadingequalityandhumanrightsfunctions,InvestingforHealthandNorthernNeighbourhoodsHealthActionZonesinitiatives.

Paul Cummings

PaulCummingsisDirectorofFinance,HSCB.Paul,oradeputy,willattendallAgencyboardmeetingsandhaveattendanceandspeakingrights.

Julie Erskine

JulieErskineisamemberoftheNorthernIrelandSocialCareCouncilandamemberoftheNorthernIrelandLocalGovernmentOfficers’SuperannuationCommittee.Shehasworkedinthehealthcareserviceindustryforover25yearsandheldthepositionofOperationsDirectorandSupportServicesDirectorwithinaBelfast-basedprivatehealthcarecompany.

Dr Jeremy Harbison

DrHarbisonisaretiredcivilservant.HeisaProChancelloroftheUniversityofUlsterandaTrusteeoftheCommunityFoundationforNorthernIreland.HeisChairoftheNorthernIrelandSocialCareCouncilandaCommissioneroftheNorthernIrelandLegalServicesCommission.

Miriam Karp

MiriamKarpisamemberoftheNorthernIrelandSocialCareCouncil,amemberoftheStatutoryCommittee(Conductcommittee)oftheNorthernIrelandPharmaceuticalSociety,aCouncilMemberoftheNorthernIrelandGeneralTeachingCouncil,amemberoftheSocialCareInstituteOfExcellence(SCIE)Partners’CouncilandaconsultantforArthritisCareUKandtheNationalCancerScreeningProgrammeinIreland.

Councillor Stephen Nicholl

StephenNichollisalocallyelectedrepresentativememberofAntrimBoroughCouncil.HeisemployedasaPolicyAdvisortoJimNicholsonMEPandwaspreviouslySecretaryandProjectManagerfortheNewLodgeDuncairnCommunityHealthPartnership.

Thomas Mahaffy

ThomasMahaffyisemployedbyUNISONasaPolicyOfficerwithresponsibilityforpartnerships,equality,humanrightsandsocialpolicyissueswithinNorthernIreland.HeisaboardmemberoftheNorthernIrelandAnti-PovertyNetworkandHumanRightsConsortium.

Ronnie Orr

RonnieOrrworkedasaSocialServicesOfficerwithDHSSPSuntil2009.HeiscurrentlyamemberoftheIndependentMonitoringBoardforHydebankWoodPrisonandYoungOffendersCentre.

Not pictured

Maeve Hully

MaeveHullyisChiefExecutiveofthePatientandClientCouncil(PCC).ArepresentativefromthePCCwillattendallPHAboardmeetings.

Fionnuala McAndrew

FionnualaMcAndrewisDirectorofSocialCareandChildren,HSCB.Fionnuala,oradeputy,willattendallAgencyboardmeetingsandhaveattendanceandspeakingrights.

Councillor Cathal Mullaghan

CathalMullaghanisalocally-electedrepresentativememberofBelfastCityCouncil.HeisaboardmemberofLibrariesNIfrom1August2009.HealsositsontheNorthernIrelandLocalGovernmentAssociation(NILGA).

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38 | Acronyms

Acronyms

AHPAlliedHealthProfessions

AMTAgencyManagementTeam

BSOBusinessServicesOrganisation

CDSCCommunicableDiseaseSurveillanceCentre

COECentreofExcellence

COPDChronicObstructivePulmonaryDisease

DARDDepartmentofAgricultureandRuralDevelopment

DEDepartmentofEducation

DHSSPSDepartmentofHealth,SocialServicesandPublicSafety

DSDDepartmentforSocialDevelopment

ECCHEuropeanCentreforConnectedHealth

FoIFreedomofInformation

GPGeneralPractitioner

HAZHealthActionZone

HCAIHealthcareAssociatedInfection

HEHomeEconomics

HLCHealthyLivingCentre

HPA (UK)HealthProtectionAgency

HRBHealthResearchBoard

HSCHealthandSocialCare

HSCBHealthandSocialCareBoard

HSEHealthServiceExecutive

IfHInvestingforHealth

INTERREGAcommunityinitiativethataimstostimulateinterregionalcooperationintheEuropeanUnion

LCGLocalCommissioningGroup

MCADDMediumchainacyldehydrogenasedeficiency

MHFAMentalHealthFirstAid

MRSAMethicillin-resistantstaphylococcusaureus

MSSAMethicillin-sensitivestaphylococcusaureus

NCINationalCancerInstitute

NCTNationalChildbirthTrust

NDACTNorthernDrugsandAlcoholCoordinationTeam

NHSNationalHealthService

NIASNorthernIrelandAmbulanceService

NICaNNorthernIrelandCancerNetwork

NICRNNorthernIrelandClinicalResearchNetwork

NIHENorthernIrelandHousingExecutive

NILGANorthernIrelandLocalGovernmentAssociation

PARCPhysicalActivityandRejuvenationofConnswater

PCCPatientandClientCouncil

PfAPrioritiesforAction

PFGProgrammeforGovernment

PHAPublicHealthAgency

PPIPersonalandPublicInvolvement

PSAPublicServiceAgreement

PSNIPoliceServiceofNorthernIreland

R&DResearchandDevelopment

RAILRegionalAdverseIncidentLearning

RPAReviewofPublicAdministration

SAISeriousAdverseIncident

SSISurgicalSiteInfection

USUnitedStates

WHOWorldHealthOrganization


| 39

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