leading health and wellbeing: from transition to transformation professor kevin a. fenton national...
DESCRIPTION
Leading Health and Wellbeing: From transition to transformation Professor Kevin A. Fenton National Director, Health and Wellbeing. 26 June, 2013 . The new public health system: a recap. Healthy Lives, Healthy People white paper - PowerPoint PPT PresentationTRANSCRIPT
Leading Health and Wellbeing: From transition to transformation
Professor Kevin A. FentonNational Director, Health and Wellbeing
26 June, 2013
The new public health system: a recapHealthy Lives, Healthy People white paper– Published November 2010 to set out a new approach to public health– Responsibility for local health improvement returned to local authorities from
1 April 2013– Public Health England is the expert national public health agency which
fulfils the Secretary of State for Health’s statutory duty to protect health and address inequalities, and executes his power to promote the health and wellbeing of the nation.
Health and Social Care Act 2012– Set the legislative framework for the changes to the health and care system
that led to the creation of Public Health England as an operationally autonomous executive agency of the Department of Health
– Received Royal Assent 27 March 2012
2 Leading Health and Wellbeing: From transition to transformation
Public health outcomes framework
3
To improve and protect the nation’s health and wellbeing and improve the health of the poorest, fastest
Outcome 1)Increased healthy life expectancy – takinginto account health quality as well as length of life
Outcome 2)Reduced differences in life expectancy betweencommunities (through greater improvements in moredisadvantaged communities)
Improving the wider determinants of health1
19 indicators, including:
• Children in poverty• People with mental
illness or disability in settled accommodation
• Sickness absence rate• Statutory
homelessness• Fuel poverty
Health improvement2
24 indicators, including:
• Excess weight• Smoking prevalence• Alcohol-related
admissions to hospital• Cancer screening
coverage• Recorded diabetes• Self-reported wellbeing
Health protection3
7 indicators, including:
• Air pollution• Population vaccination
coverage• People presenting
with HIV at a late stage of infection
• Treatment completion for tuberculosis
Healthcare and publichealth preventingpremature mortality
4
16 indicators, including:
• Infant mortality• Mortality from causes
considered preventable• Mortality from cancer• Suicide• Preventable sight loss• Excess winter deaths
Leading Health and Wellbeing: From transition to transformation
What is Public Health England?
“Public Health England (PHE) is the expert national public health agency
which fulfils the Secretary of State for Health’s statutory duty to protect health and address inequalities, and executes
his power to promote the health and wellbeing of the nation.”
Leading Health and Wellbeing: From transition to transformation
Outcome-focused priorities
5 Leading Health and Wellbeing: From transition to transformation
1. Helping people to live longer and more healthy lives by reducing preventable deaths and the burden of ill health associated with smoking, high blood pressure, obesity, poor diet, poor mental health, insufficient exercise, and alcohol
2. Reducing the burden of disease and disability in life by focusing on preventing and recovering from the conditions with the greatest impact, including dementia, anxiety, depression and drug dependency
3. Protecting the country from infectious diseases and environmental hazards, including the growing problem of infections that resist treatment with antibiotics
4. Supporting families to give children and young people the best start in life, through working with health visiting and school nursing, family nurse partnerships and the Troubled Families programme
5. Improving health in the workplace by encouraging employers to support their staff, and those moving into and out of the workforce, to lead healthier lives
Supporting priorities
6 Leading Health and Wellbeing: From transition to transformation
6. Promoting the development of place-based public health systems
7. Developing our own capacity and capability to provide professional, scientific and delivery expertise to our partners
Structure – Public Health England
7 Leading Health and Wellbeing: From transition to transformation
Chief Executive
Director of HealthProtection and
Medical Director
Director of Healthand Wellbeing
Chief KnowledgeOfficer
Director ofNursing
Chief of Staff
PrivateOffice Secretariat
InternalAudit
CorporateGovernance
LegalService
Director ofStrategy
Chief OperatingOfficer
Director ofProgrammes
Finance andCommercial
Director
Director ofHuman
Resources
Director ofCommunications
RegionalDirectors
CentreDirectors
DevelopmentAdvisor
Advisory Board
Microbiology
8 Leading Health and Wellbeing: From transition to transformation
Four regions, 15 centresEight Knowledge and Intelligence Teams
– London– South West– South East– West Midlands– East Midlands– North West– Northern and Yorkshire– East
Other local presence– ten microbiology laboratories– field epidemiology teams
Additional support– Local teams can also draw on national
scientific expertise based at Colindale, Porton Down and Chilton
Local presence
Place-based approach to public health
9 Leading Health and Wellbeing: From transition to transformation
Public health advice
Health and wellbeing boards
Local government CCGsPHEcentre
NHSE area team
• EPPR• Screening and immunisation• Offender public health programmes• Specialised commissioning• Primary care public health programmes
and population healthcare
NHS providers
Non-statutory
providers*People and communities
*Including voluntary and community sector
10
PHE provides expert advice to local government
DsPH have influence across all local government spend
PHE provides expertise in local area teams
Embedding ‘making every contact count’
Influence on wider spending in
commercial and voluntary sectors
Clinical Commissioning
GroupsAnd
NHS England
Leading Health and Wellbeing: From transition to transformation
Leverage from the public health ring fence
Transforming health and wellbeing
11 Leading Health and Wellbeing: From transition to transformation
We will focus on the major drivers of disease, disability, disadvantage and death
and tackle health inequalities.
12 http://www.healthmetricsandevaluation.org; The Lancet, Early Online Publication, 5 March 2013doi:10.1016/S0140-6736(13)60355-4
Overall, the three risk factors that account for the most disease burden in the United Kingdom are dietary risks, tobacco smoking, andhigh blood pressure. The leading risk factor for both children under 5 and adults aged 15-49 years was tobacco smoking in 2010. Tobaccosmoking as a risk factor for children is due to second-hand smoke exposure.
Focusing our effort
Health Impact PrioritiesThe health and wellbeing contribution to our corporate priorities
Health and Wellbeing
DirectorateHealth Impact
Priorities
Well being and Mental
Health
Mental disorder accounts for largest burden (23%) of diseases in England and affects >1 in 4 of the population at any timeMental wellbeing assoc with improved outcomes in health, education, employment, reduced crime and antisocial behaviourPublic mental health: Better assessment; interventions; prioritization
Diet, Obesity, and
Physical Exercise
All major causes of CVD and cancer. Poor diet accounts for one third of deaths from cancer and CVD. Low levels of physical activity increases the risk CVD, colorectal and breast cancer by 20-35%. Obesity increases risk of type II diabetes (5-13 times), hypertension (2-3 times) and colorectal cancer (3 times) in men.
Tobacco Control and
Smoking Cessation
Accounts for 20% of new cases of cancer (23%M and16%F)Tobacco causes nearly 1 in 5 deaths in England annuallyFor each death, 20 more suffer tobacco-related illnessesComprehensive cessation programs; excise tax increases; 100% smoke-free policies; media campaigns; cessation access; advertising restrictions work.
Alcohol Moderation
and Drug Recovery
Much of the cost of drug and alcohol misuse occurs to the criminal justice system. The main costs to society from drug an alcohol is from related crime. This is different to other lifestyle health related areas and needs a different public health response.
HIV and Sexual health
By the end of 2012 likely more than 100,000 PLWHA in the UKLate diagnosis a major problem with 50% diagnosed with CD4<350Millions of STD diagnosed annually, esp. among youth, MSM, minoritiesHIV/STD screening, early treatment, partner notification, social marketing campaigns, condom access, and policy to address stigma and discrimination are key interventions
While supporting and ensuring progress against the PHOF, the Directorate
will provide enhanced focus on the major drivers
of mortality and morbidity in England
where further gains may be made by scaling known,
effective strategies
Life course perspective
14 Leading Health and Wellbeing: From transition to transformation
Expert advisors will assist PHE technical leads to develop, implement and monitor population health, and health and wellness across the lifespan in five domains. They will also assist PHE in promoting the value and impact of this approach to our partners and stakeholders.
Healthy Infants, Children, and Young Adults
Healthy Adults and Older
Adults
Healthcare Public Health
Healthy People in Healthy
Places
Health in All Policies
A focus on improving health and health outcomes for mothers and infants, children, teens and young adults.
All people, and especially those at greater risk of health disparities, will achieve their optimal lifespan with the best possible quality of health, including mental health, in every stage of life.
Support sound decision-making and policy change within the NHS to deliver, scale up, evaluate and improve effective clinical preventive services that drive population health.
Ensuring that the places where people live, work, learn, and play will protect and promote their health, especially those people at greater risk of health disparities.
Inform and support DH and other government partners in sound decision-making and policy change at all levels to deliver and evaluate programmes and address social determinants of health.
The challenges we will tackle togetherAn example: The national Child Measurement Programme
15 Leading Health and Wellbeing: From transition to transformation
Child overweight (including obesity)/ excess weight: BMI ≥ 85th centile of the UK90 growth reference
One in five children in Reception is overweight or obese (boys 23.5%, girls 21.6%)
One in three children in Year 6 is overweight or obese (boys 35.4%, girls 32.4%)
The challenges we will tackle togetherAn example: The national Child Measurement Programme
16 Leading Health and Wellbeing: From transition to transformation
Child obesity: BMI ≥ 95th centile of the UK90 growth reference
12.8%
14.4%15.5%
17.0%17.9%
19.7%21.0%
22.5%23.9% 24.2%
6.2%7.2%
7.8% 7.9%8.6%
9.5% 10.0%10.8%
11.7%12.4%
0%
5%
10%
15%
20%
25%
Least deprived
Most deprived
Obe
sity
prev
alen
ce
Index of Multiple Deprivation 2010 decile
Year 6
Reception
The challenges we will tackle togetherInforming personal choiceInforming individual choice
17 Leading Health and Wellbeing: From transition to transformation
Questions
Professor Kevin A. FentonNational Director, Health and Wellbeing
www.gov.uk/phe Follow Public Health England on Twitter at @PHE_uk