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People & Communities (Public Health)

Service Action Plan

2013/14

This plan is an active document that will be reported against every six months via the Service Delivery Programme performance report. All staff that are part of the Service should have an opportunity to contribute to its creation and any new staff joining the Service should be made aware of this document as part of their induction.

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Introduction

Divisional Director Dr Bruce Laurence

Lead Portfolio Holder Councillor Simon Allen

Staffing Establishment (FTE) (2013/14 @ March 2013)

11.66WTE

Scope of Service (size, proportions and activities) – linked to current MTSRP proposals

Responsibility for Public Health transferred to the local authority on April 1st 2013 in accordance with the Health and Social Care Act 2012. The Public Health Commissioning team have now transferred to the Local Authority and therefore this is a new service plan area. This service plan covers the three main functions of public health which are: 1. Health improvement 2. Health protection 3. Providing public health information and advice to service commissioners This includes services commissioned directly by the public health division and also considers the broader opportunities created across the whole council for health improvement when the local authority takes on this new responsibility in April 2013. Within these broad functions, the key responsibilities are:

Health Improvement NHS Health Checks programme

National Child Measurement Programme (height and weight)

Reducing smoking prevalence (tobacco control work and commissioning NHS Stop smoking services)

Reducing alcohol and drug misuse ( including test purchasing and licencing )

Reducing Injury prevention ( including trading standards and domestic violence)

Improve healthy weight

Increasing physical activity (including links to wider determinants of transport, spatial planning and green spaces )

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Improving children‟s public health (5-19 years)across the range of health improvement issues, including HPV vaccination

Improving dental public health

Developing locally led nutrition initiatives including breastfeeding

Improving workplace health

Suicide prevention, self-harm and mental wellbeing.

Health protection and emergency preparedness

Statutory duty to ensure plans are in place, and training and exercises carried out, to protect the health of the population in B&NES

Deputy co-chair for the Avon and Somerset Health Resilience Partnership (with the NHS Commissioning Board)

Coordinate local response to outbreaks of infectious disease or environmental hazards, and liaise with Public Health England

Overview and scrutiny function of immunisations and screening programmes, and infection prevention and control

Support new receiver organisations in their screening and immunisation commissioning responsibilities as part of transition

Statutory duty to commission a range of sexual health services (including testing and treatment for sexually transmitted infections, contraception outside of GP contract and sexual health promotion and disease prevention). Includes chlamydia screening and teenage pregnancy.

Support and review local work to tackle environmental risks, including adaptation to climate change, air pollution and noise pollution.

Public health information and advice to commissioners Statutory duty to provide specialist public health advice to the CCG (strategic needs assessment, health impact assessment,

service review, evidence of effectiveness, prioritisation, planning, evaluation and public and patient views).

Provide specialist public health advice to wider commissioning team across the council (same tasks as above).

Lead production of Joint Strategic Needs Assessment (JSNA)

Co-develop Joint Health and Wellbeing Strategy, and Action Plan

Public health input to broad Strategic Partnerships, including: o Health and Wellbeing Board o Clinical Commissioning Committee o Children‟s Trust Board o Responsible Authorities Group o Environmental Sustainability Partnership Board o West of England Child Death Overview Panel o Children and Adults Safeguarding Board

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o Complex Families Panel

Develop collaborative commission arrangements with: o other council divisions and directorates o Clinical Commissioning Group, NHS Commissioning Board, Public Health England

Ensure commissioning across the council address inequalities and narrows the gap for groups with the worst health and social outcomes

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Current Management Structure of Service

Currently host 2 Public Health Specialty Registrars – Kate Burton (1.0) & Amy McCullough (0.6)

Dr Bruce Laurence (1.0)

Paul Scott (Interim Acting)

Director of Public Health

Paul Scott (1.0)

Jean Gladwin - Interim (0.8)

Consultant in Public Health

Lauren Tew (0.4)

Louise French (1.0)

Infection Prevention Control Nurse

Sophie Knight (0.4)

Resilience Manager

Daniel Messom (1.0)

Commissioning & Development Manager

Helen Tapson (1.0)

Public Health Intelligence Manager

Denice Burton (0.8)

Assistant Director - Health Improvement

Cathy McMahon (1.0)

Jo Lewitt (0.6)

Sarah Heathcote (0.6)

Commissioning & Development

Manager

Shelley Oake (0.8)

Personal Assistant

Angela White (0.6)

Directorate Secretary

Angela White - Interim (0.2)

Vacant - 0.6 Contract Monitoring

Support

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Commissioning Manager Functions

Name of Manager Name of Manager Name of Manager

Name of Manager

Name of Manager

Name of Manager

Name of Manager

Name of Manager

Name of Manager

Bruce Laurence

( Paul Scott interim )

Paul Scott (Jean Gladwin interim)

Denice Burton Helen Tapson Cathy McMahon

Sarah Heathcote

Jo Lewitt Daniel Messom

Sophie Knight

Responsible for leading and

delivering statutory public

health services to the local

population

Specialist advice to commissioners. (The „Core Offer‟)

Health Improvement lead

JSNA / intelligence

Alcohol Children and young people 5 -19

Breast-feeding

Sexual Health

Preparing for the public health effects of emergenc-ies

Strategic lead for public

health, and principle adviser

to the council on health

issues and tackling health

inequalities.

Intelligence and performance lead Affordable Warmth Lead

Commissioning and finance lead

Tobacco control

Dental public health

Childhood healthy weight

Health checks

Maximising opportunities to

promote public health within

the services of the council

and across other

organisations.

Suicide prevention, self-harm and mental wellbeing

Physical activity / food policy / adult healthy weight / workplace health

Injury prevention

NCMP Screening assurance

Statutory member of the

Health and Wellbeing Board

and other key strategic

partnerships.

Leading response to health protection incidents, with Public Health England. Emergency Planning and Resilience: Health

Vulnerable groups

Assurance and Scrutiny of

screening and immunisation

programmes, and infection

and control

Temporary support to CCG & NHS England Area Team on a number of public health areas. These organisations will take back once up to capacity (Oct 2013).

Workforce development Social marketing

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There is a vacant post in the process of recruitment, which will fulfill a number of key commissionign responsiblities that are currently being managed by the team but this is not an effective or sustainable way to continue.

There are a number of staff who are situated within other council directorates or the CCG, who lead on the commissioning functions for specific public health programme areas such as substance misuse, infection control, school nursing, child health, etc. A number of these posts are funded by the public health allocation. The commissioning of services for children aged 0-5 years has transferred to NHS England but will return to the responsibility of the Local Authority in 2015. In the interim period, there is a process of transition to NHS England, with a view to the Local Authority retaining an important role in influencing this work until it returns.

Customer Profile

Outline who your main customers are, e.g., service users, residents, other council services, officers, members, partners etc.

Service users, residents, other council officers and members, Clinical Commissioning Group (CCG) colleagues

Are there any specific customer needs that require your service to change?

Residents‟ needs The Public Health service is reorienting it‟s work to ensure it is meeting the priority issues for local residents, that have been set out in the Joint Strategic needs Assessment (JSNA) and the Health and Wellbeing Strategy. Partner‟s needs The public health service has a duty to provide public health information, evidence and advice to a range of partners. These include advice about strategic, commissioning and health protection decisions. For example, the development of the CCG has led to a statutory duty for the local authority to provide public health advice to the CCG. Similarly, the Director of Public Health is now the lead on behalf of the local authority in fulfilling the statutory duty to ensure plans are in place to protection the health of the local population. The People and Communities directorate are undergoing a change whereby there is a single integrated commissioning support function and this is leading us to change the way we function and allocate some of our commissioning resource.

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Two new national organisations, Public Health England and NHS England, have started from 1 April 2013. This is leading the local authority to have an assurance role for some key programmes such as screening and immunisation, requiring a slight shift in the current roles of the public health team. However, these new organisations are not yet at full capacity and so we are continuing to undertake interim support for these functions as part of a transition handover until October 2013, to ensure the safety of these programmes for local residents.

Service Delivery

Planned Changes to service delivery in 2013/14 (Service Impact Statements (SIS) to be attached in Appendix 2)

Public Health commissioning has transferred into the Local Authority from NHS B&NES from April 1st 2013. The following changes to implementation of the commissioning function are planned:

A number of services which were commissioned services will now become internal service level agreements.

Some services due to transfer to new organisations such as NHS England need to fully transfer

All contracts with providers external to the Council will need to transfer onto council terms and conditions during 2013/14

New arrangements for the delivery of emergency preparedness. Current arrangement for a shared service with RUH will cease and we will instead focus on building a collaborative arrangement for this work area within the council and the existing council emergency preparedness team.

A review of the clinical infection control function, to develop the health protection aspects of this work.

An internal service level agreement for commissioning support from a centralised team in People and Communities will be established

A shared work programme across West of England to be established where economies of scale can be identified.

Areas of the Service that are to be stopped or reduced in 2013/14 (due to budget pressures / change in focus etc.)

Some service areas such as screening, immunisations, 0-5 public health have transferred to NHS England therefore the LA now have an assurance role rather than a commissioning role.

There are no changes in service due to Public Health budget pressures; however budget cuts across wider council services impact on achievement of public health outcomes. These include changes across all three council directorates (including public protection, children‟s services, youth service provision, social aspects of housing services, etc.)

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External influences / pressures / legislative changes that could impact on service delivery during 2013/14 (excluding budget pressures)

Development of One Council approach across the council.

Restructuring and potential commissioner / provider separation in council.

Development of integrated commissioning

Impact of other partner‟s commissioning intentions on services in block contracts

Impacts of welfare changes on mental and physical health of vulnerable groups in our population

Capacity issues within the public health team, as a risk to delivering our statutory duties.

Changes within emerging organisations and how responsibilities are shared or led between each of us.

Potential introduction of tariff based system for sexual health services (based on payment for each appointment with a risk of performance beyond what was expected at the start of the year and subsequent cost pressures).

Introduction of new NICE or other health guidance (including new immunisations or other public health programmes)

Introduction of new health legislation (tobacco control, alcohol minimum pricing).

Service Budgets and Costs

Explanation of Service costs (including areas of high spend and growth / investment)

The Public Health grant for 2013/14 is £7,183,000. This is a ring-fenced grant, allocated directly to the local authority from Public Health England.

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Value for Money improvements - planned efficiencies / savings to be made during 2013/14

We are contributing to the shared commissioning function across the new People and Communities Directorate, which will provide greater efficiency across all the service areas. The public health allocation is fully committed for 13/14 and will remain within the ring-fenced budget.

£- £100,000 £200,000 £300,000 £400,000 £500,000 £600,000 £700,000 £800,000 £900,000

£1,000,000 £1,100,000 £1,200,000 £1,300,000 £1,400,000 £1,500,000 £1,600,000 £1,700,000 £1,800,000 £1,900,000 £2,000,000 £2,100,000 £2,200,000 £2,300,000 £2,400,000 £2,500,000

Annual Budget £7,183,000

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Summary from Medium Term Service & Resource Plan (add hyperlink to relevant web page for more detailed information)

MTS&RP Items Finance Staff to complete

2012/13 (for comparison) £’000

2013/14 £’000

2014/15 £’000

2015/16 £’000

Opening Budget N/A new budget for

LA 7183 7384 Not known

Removal of one-offs N/A

Service Proposed Base Reductions to Balance Budgets

N/A

Service Proposed Growth N/A

Proposed Base Budget 7183 7384

Target Budget 7183 7384

Deficit / (Surplus) N/A

Additional Stretch Reductions N/A

In Year Adjustments N/A

Proposed Overall Budget 7183 7384 Not known

Workforce Planning & Development

It is important that we develop a workforce of the right size and with the necessary skills and capabilities to deliver the service our citizens require both now and as the Council„s future role in the community develops. People are a key driver for transformation and improvement. Please set out below workforce planning and development actions already underway or planned to address your service needs. If your service has developed a specific workforce development plan, please attach in Appendix 4 of this Service Plan.

Questions Comments

Organisational Design & Development: Implementation of “future organisational model”

Review of portfolios within the staff structure

Develop working arrangement with commissioning support function.

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… designing & implementing new workforce structures and ways of working in support of new operating models

Reviewing the health protection role of the infection prevention and control functions

Clarifying arrangements between the public health and the overall council emergency preparedness functions.

Leadership and Management Development

…developing visionary and ambitious leadership, which make best

use of the political and managerial role, in a partnership context

Support the management team to undertake leadership opportunities as appropriate.

Host and supervise public health registrars who are training to become consultants, and eventually directors, of public health.

Skills …identifying & developing skills and knowledge requirements in an innovative, high performance, multi-agency context

Support staff towards defined registration status with the UK Public Health (UKPHR) Register and enable them to work towards the relevant competencies.

Support our administrative staff to develop additional technical skills in line with their role.

Ensure all staff have undertaken annual appraisals the development of a professional development plan.

Recruitment and Retention …work to address potential skill shortages, promoting careers,

developing talent and addressing diversity issues

See above about supporting competency development to promote careers and develop talent.

Plans to recruit to vacant public health manager post as well as additional public health specialist capacity to deliver key local priorities and statutory functions, in particular the core offer of public health advice to the CCG

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Equalities

We are committed to the Council's core value of ensuring there is equality of opportunity through employment and service delivery. We are committed to promoting equality and eliminating discrimination on the grounds of age, disability, faith/religion or belief, gender including transgender, marital / civil partnership status, race, colour, ethnic or national origin and sexual orientation. Equality Impact Assessments (EIA) are carried out on all service changes and actions to mitigate impacts.

Under the general equality duty (Equality Act 2010), B&NES Council must have „due regard to the need to eliminate unlawful discrimination, harassment and victimisation as well as advance equality of opportunity and foster good relations between people who share a protected characteristic and those who do not.‟

The law requires us to demonstrate this in our decision making processes and, as officers, we must assist decision-makers to make sure that:

the process followed to assess the impact on equality of financial proposals is robust; and the impact financial proposals could have on protected groups is thoroughly considered before any decisions are arrived at

Assessing the potential impact on equality of proposed changes to policies, procedures and practices – communicated through all the service planning processes - is a key way of demonstrating that we have had due regard to the aims of the equality duty, in other words – listing what we have done to promote equality – and what we have done to mitigate any negative impacts our decisions may have. The EHRC guidance can be found here: www.equalityhumanrights.com/advice-and-guidance/public-sector-equality-duty/using-the-equality-duty-to-make-fair-financial-decisions/ Contact Samantha Jones for further guidance and assistance on 6364 or 8643. Please add your EIA in Appendix 3.

http://www.equalityhumanrights.com/advice-and-guidance/public-sector-equality-duty/using-the-equality-duty-to-make-fair-financial-decisions/

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Key Service Priorities 2013/14

It is important to show how each service priority links to the new Corporate Plan, in particular the three strategic objectives and high level outcomes set out in the table below. At the end of each priority, services must indicate whether it will contribute to an objective and add the reference letter for each outcome it will help to deliver.

Objectives Outcomes Ref

1. Promoting independence and positive lives for everyone

The people most in need are supported to live full active lives A

Older people are supported to live independently B

Children and young people enjoy their childhood and are prepared for adult life C

Schools develop and extend their role in the local community D

There are activities and opportunities to help young people to make a positive difference to their lives and communities

E

People have developed their skills and used them to improve their community F

Everyone has the opportunity to participate in sports, leisure and cultural activities G

Everyone has the opportunity to enjoy a healthy lifestyle H

2. Creating neighbourhoods where people are proud to live

Where people feel safe A

There are decent affordable homes in private and social sector B

Clean streets and open spaces C

Where local people actively lead the delivery of improvements in their community D

Where decisions are made as locally as possible E

Where there is easy access to public services and local amenities F

Reduced inequality between communities across Bath & North East Somerset G

Communities that have adapted to changes in our climate and are not dependent on high carbon energy

H

Recycling and reduction in waste continues to be extended with residents increasing their responsibility to minimising waste

I

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3. Building a stronger economy

With a broad range of job and employment opportunities that recognises the different need of rural, town and local communities

A

Where people are able to travel easily with reduced traffic congestion and pollution B

With a strong local business sector, tourism, and local shopping C

The quality of the environment is maintained or enhanced D

Key development sites are delivered to increase the number of local businesses E

A diverse economy with growth in the low carbon, knowledge creative, and ICT industries F

4. Listening Council (values)

A Council which operates efficiently:

An open and engaging Council that empowers Communities

An enabling Council making things happen

A Council that is positive about working with others

In partnership with a range of public, private and voluntary organisations

A Council that makes decisions at the right time and level

A Council that makes services easy to reach

An organisation that encourages continuous learning and improvement

A

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Priority 1: to meet our mandatory service obligations

Details of Service Priority The local authority is required to provide the following services under the requirements of the Health and Social care act.

Impact on local community

The actions will ensure that there is continued access to sexual health services which are free at the point of contact. More members of the population will be able to access a free health check and follow up support Parents of children will have access to information about their child‟s weight and supportive interventions The public will be assured that systems are in pace to deal with emergencies and protect them from risk All commissioning decisions will be based on accurate intelligence

Groups of service users affected

Adults aged 40- 74 accessing a health check Families with young children receiving the NCMP Adults and young people seeking sexual health advice and support All members of the public in receipt of commissioned services Other commissioners

Key Activities (add more lines as appropriate) Timescales Performance Measures

Provide appropriate access to sexual health services:

Re commission CASH and enhanced sexual health services (out of schools) services and possibly GUM

Increase number of SAFE branded services

Establish new contractual arrangements for national Chlamydia screening programme and ensure programme is embedded in core services

Introduce new contract for primary care providers for the provision of enhanced sexual health services

April 2014

New CaSH contract in place by April 2014 New contract in place with community pharmacy and general practice by April 2014

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Deliver NHS Health Check assessment

Implement planned programme to increase numbers receiving health check

Pilot introduction of alcohol screening and provide training for providers.

Introduction of dementia awareness raising and signposting to memory clinics

March 2014

Increase uptake across B&NES to 55% on average, with greater increase in areas with low uptake Introduction of new elements of the programme by March 2014

Ensure implementation of the National Child Measurement Programme

Performance monitoring process the NCM Programme, including proactive follow

up of children

Ensure intelligence from the NCMP is shared appropriately

March 2014 Quarterly on-going March 2014

Achieved target coverage rate Performance monitoring process adhered to, Briefing paper on outcome of programme circulated

Coordinate local response to outbreaks of disease or environmental hazards

Lead response to outbreaks of disease or incidences re chemical, biological or radiological threats in conjunction with partners

Ensure that health/social care services commissioned by the local authority have included contribution to incident response in the specifications

March 2014

Coordinated response delivered Service specifications include contribution to incidence response

Ensure effective health resilience planning to protect the health of the population of B&NES

Contribute to health resilience planning and testing of health plans in B&NES council

Ensure that health/social services commissioned by the local authority have business continuity plans

March 2014

Updated plans and agreements in place Tested the plans by training and exercises

Ensure NHS commissioners receive the public health advice they need

Develop and deliver a 2013/14 Action plan for the core offer

April 2014

2013/14 Annual plan developed, agreed Public health advice delivered

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Ensure JSNA – (Joint Strategic Needs Assessment) is fit for purpose

Contribute to the annual work programme updating the JSNA

Commission new research and health needs assessment

Develop plans to ensure that the community voice is considered where possible

Contribute to making the JSNA more accessible

July 2013 March 2014 March 2014 March 2014

JSNA available in WIKI format Usage monitored Number of briefings delivered to users Completing the annual work programme

Contribution to Strategic Objectives – please indicate which of the Corporate Plan objectives and outcomes this priority will contribute to:

Strategic Objective Contributes – Y/N? Relevant Outcomes

1. Promoting independence and positive lives for everyone Y A,B,C,D,G,E,H

2. Creating neighbourhoods where people are proud to live Y F,G

3. Building a stronger economy N

4. Listening Council (values) Y A

Priority 2: to implement the priorities of the JSNA, Health and Wellbeing Strategies and Director of Public Health Report

Details of Service Priority

The Health and Wellbeing strategy has identified Alcohol, Mental wellbeing and Childhood Weight as three areas for particular action in 13/14. The DPH report and JSNA further identifies Physical activity and tobacco control as areas where significant public health gain can be made.

Impact on local community Services will be commissioned within a clear framework and strategy Services will be in place to support lifestyle behaviour change

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Access to and quality of services will improve

Groups of service users affected All adults and children Adults and Children accessing commissioned services

Key Activities Timescales Performance Measures

Implement Health and Wellbeing Strategy

Lead the public health aspects of the Health and Wellbeing Strategy Delivery Plan

March 2014 Delivery plan of H&W Strategy includes public health actions

Contribute to improvements in mental wellbeing and suicide prevention:

On-going monitoring and completion of tasks in the suicide prevention action plan, including: A) completion of suicide audit to cover time period 2009-11; B) support the setting up of deliberate self-harm register at RUH

Scope the feasibility of developing a mental well-being college service

July 2013 July 2013 Sept 2013

Suicide audit to cover time period 2009-11 reported. Register established and proving monthly and annual deliberate self-harm report from register. Report/business case developed

Improve healthy weight in childhood Continue to commission and monitor related healthy weight services, and review and re- or de-commission where necessary : Launch and disseminate the healthy weight pathways Re-establish the healthy weight strategy group and agree Healthy Weight Action plan for 13/14 Ensure healthy weight is embedded into other relevant strategic groups

Quarterly throughout 13/14 to end 14/15 By September 2013 Sept

All contracts for commissioned services updated and signed off. Outcomes delivered as per each contract Some relevant contracts recommissioned Healthy Weight pathway completed (links/pdfs on website) Group re-established / other strategic groups prioritising excess weight

Promote sensible drinking and reduce alcohol misuse

Refresh Alcohol Harm Reduction Strategy and Action Plan 13/14

September 2013

Updated Strategy; Action Plan agreed

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Introduce Alcohol Risk Assessment into the NHS Health Check

Pilot approach to systematic screening for alcohol misuse within Primary Care

Establish/embed the role/representation of Public Health/Health bodies in Licensing policy/process

September 2013 March 2014 February 2014

All GP practices offering alcohol risk assessment as part of the NHS Health Check by 2014 Evaluation Report of pilot and proposal for implementation 14/15 Guidelines to support decision making for licencing bodies

Increase physical activity Complete and disseminate results of Passport to Health research Continue to commission and monitor related physical activity services, and review and re- or de-commission where necessary : Review need for re-establishment of Get Active Partnership and the Get Active Strategy

Contribute to development and implementation of Leisure Strategy Promote cycling via Cycling Working Group – and small grants Contribute to Sustainable Transport Work stream

March 14 Quarterly Sept 13 March 14 March 14 March 14

Report produced Outcomes delivered as per each contract Monitoring completed as per monitoring schedule Partnership re-established if required Service specification for Leisure providers includes key public health requirements Small grants awarded and delivered Contributions made

Reduce smoking prevalence: Undertake Peer Assessment of Tobacco Control work Finalise Tobacco Control Strategy and Develop and implement an Action Plan 2013 – 2015

Peer assessment completed and recommendations included into Tobacco Control strategy Tobacco Control Strategy developed and Action Plan agreed

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Continue to commission and monitor related tobacco control services, and review and re- or de-commission where necessary :

Outcomes delivered as per each contract. Monitoring completed as per monitoring schedule

Improve health of children 0 to 19 years Refresh local action plan to improve dental health Transfer breast feeding service commissioning responsibilities to receiver organisations Finalise commissioning arrangements for Food in Education Settings service Develop the DPH Awards policies on budget allocation, evidence base and website Quality assure the DPH Award process Continue to extend the DPH Award to early years and FE settings

March 2014 Dec 2013 2013 Sept 2013 Regular meetings throughout year Dec 2013

Local plan agreed Safe transition completed Commissioning arrangements finalised Policies developed Meetings of Quality Assurance group

Plans and processes fully completed

Improve Workplace Health Expand the engagement with the workplace charter via commissioned services

March 2014 Commissioned service delivering outcomes as per contract

Develop locally led nutrition initiatives Recruit Food policy worker Establish food policy steering group and develop food policy and action plan

March 2014 Food policy developed Steering group in place

Reduce injury Continue to commission, transfer to council contracts, and monitor services :

March 2013 Services delivered to target

Reduce drug misuse Actions relating to drug treatment services are in the Adult Service Plan – not in Public Health service plan

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1. Promoting independence and positive lives for everyone Y A C D E G H

2. Creating neighbourhoods where people are proud to live Y A F G



Priority 3: to ensure that the new Public health system in B&NES is fit for purpose


Following the restructure of the NHS a number of new organisations have been established which have a role to play in Public Health and responsibility for Public Health outcomes has transferred into the Council. This now requires a range of actions to ensure the roles and responsibilities and relationships are strengthened to maximise the opportunities for Public Health

Impact on local community The public can be assured that the restructuring has not impacted negatively on the access to intelligence, health protection systems and provision of services.

Groups of service users affected All adults and children in B&NES Other commissioning organisations


Ensure all Public Health contracts are aligned to local authority commissioning processes:

Contribute to the establishment of a commissioning support function

July 2013

Agreed and monitored SLA on the commissioning support function Commissioning plan is signed off

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Develop and implement a commissioning plan

July 2013 March 2014

All eligible contracts have been transferred to council terms and conditions

Develop assurance and scrutiny function of immunisations and screening programmes, and infection prevention and control Develop scrutiny mechanisms including: a health protection sub-committee of the health and wellbeing board in conjunction with partners

August 2013

HP subcommittee set up; TOR and membership agreed Other scrutiny mechanisms agreed

Strengthen infection prevention control structures

Ensure safe system for delivery of a response to communicable disease incidences in conjunction with partners and ensure that relevant partners are aware of system

Develop plans to broaden the remit of the infection control nurses beyond a focus on health care associated infection – to include a broader health protection remit

Continuous i– there will be

different systems at different times – see end note March 2014

Description of system available and agreed MOU with partners Development of new JD for infection prevention control nurses Action plan for infection control nurse that include health protection

Strengthen effective response to chemical, biological and radiological incidences

Develop plans and agreements in conjunction with partners and ensure that relevant partners are aware of system

March 2014 Description of system and agreements in place

Strengthen effective response to non-communicable disease (chemical, biological and radiological)

Develop plans and agreements in conjunction with partners and ensure that relevant partners are aware of system

March 2014 Description of system available and partners aware

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Transfer screening and immunisation commissioning responsibilities to receiver organisations

Complete safe transition of immunisation programmes to NHS England and Public Health England

Complete safe transition of cancer and non-cancer screening programmes to NHS England and Public Health England

Develop overview and assurance system for immunisation and other health protection issues

March 2014

Agreed transfer of responsibilities Description of system available and partners aware

Develop link to NCB in relation to 0-5 agenda returning to local authority in 2015 Establish communication and assurance processes with the Public Health lead in NHS England

March 2014 Processes agreed and in place

Support and review local work to tackle environmental risks, including adaption to climate change, air pollution, and noise pollution

Review areas for Public Health input Deliver Public health input to priority areas

March 2014

Review conducted Input to specific areas delivered



1. Promoting independence and positive lives for everyone Y C

2. Creating neighbourhoods where people are proud to live Y A H

3. Building a stronger economy Y D

4. Listening Council (values) N

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Priority 4: to influence the wider work of B&NES Council to impact on the social and economic determinants of health and health inequalities


The transfer of public health responsibilities to the Local Authority provides an opportunity to provide public health advice into wider commissioning decisions and to engage in activities which improve the wider determinants of health. Developmental work is required to ensure all council staff are aware of the contribution they can make and to provide the knowledge and skills to maximise their role.

Impact on local community

Council staff will be making the most of every opportunity to improve public health either when providing or commissioning services Quality of services will improve and be targeted appropriately Decisions will consider the impact on health and inequalities

Groups of service users affected Council staff All adults and children in receipt of council services


Support council officers, elected members and wider workforce to understand and maximise their influence on public health and health inequalities

Provide series of briefings and updates to range of councillors and officers about role of public health and JSNA

PH team meet with officers to discuss their outcomes and impact on public health, and develop joint working.

Develop and implement Public Health Communication Plan - to include DPH report, website, Council Connect Welcome page, and develop a “Bruce‟s Blog”

Produce summary briefings on each Public Health Outcome – to include the evidence base

Deliver „Introduction to Public Health‟ as part of the Induction and Core Annual Training

Establish public health seminar programme

March 2014

Number of briefings delivered Records of meetings attended Communication plan developed Summary briefings developed Introduction to Public health developed PH Seminars delivered

Links established

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Establish links with training department to identify training needs and provision

Expand awareness and uptake of Public Health Practitioner programme

Number of people working towards practitioner registration

Ensure that key decisions of the cabinet have included an assessment of the evidence base, and impact on public health and health inequalities of the decision options (as per MARMOT review)

Work with decision-makers to agree HIA/HNA, and evidence base is part of key decisions

Develop policy and processes to establish use of HIA, HEA and evidence –base

Produce summary of the evidence base, including economic evaluation for each outcome

Trial this and agree draft processes and paperwork

March 2014

Policy and processes agreed Templates agreed Report of pilot of policy and processes written Summaries of evidence produced

Contribute to and influence wider commissioning decisions and ensure that the council addresses inequalities and narrows the gap for groups with the worst health and social outcomes

Participate in integrated commissioning programme in People and Communities directorate

Participate in commissioning decisions in several directorates and influence using JSNA, other data/evidence

Contribute to partnership working e.g. Environmental Sustainability Partnership agenda, Children‟s trust etc.

Map the contributions of the wider council to the public health outcomes

March 2014

Evidence of integrated commissioning Evidence of wider councils and strategies demonstrated public health content Commissioning decisions demonstrate public health influence – re JSNA, data, evidence etc.; Monitor health and social outcomes Evidence of partnership working Map completed

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1. Promoting independence and positive lives for everyone N

2. Creating neighbourhoods where people are proud to live Y G



Appendix 1 – Key Performance Measures and Targets 2013/14

Service Priority Key Measure(s) 2013/14 Target(s) Strategic Objective(s) Outcomes(s)


New CaSH contract in place by April 2014

New service starts April 14

th

Promoting independence and positive lives for everyone

Creating neighbourhoods where people are proud to live

Listening Council (values)

A F H

F

A


Increase uptake of health checks across B&NES, with greater increase in areas of low uptake

55% uptake




A F H

F G

A

Priority 2: to implement the priorities of the JSNA, Health and Wellbeing Strategies, and Director of Public Health Report

Tobacco control strategy and implementation

Tobacco control strategy and action plan agreed

and implementation underway, including

recommendations from the „Clear Assessment‟



A FG H

G


JSNA available in “wiki” format

All JSNA subjects in “wiki” format and on

council internet



A H

G

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Healthy weight pathways Healthy weight pathways

completed and utilised



Building a stronger economy

A H

F G

B


Set up and make use of self-harm register at RUH

emergency department Self-harm register utilised



A

G


Delivery plan of H&W Strategy and public health

actions

Delivery plan of H&W Strategy includes of public health actions





A B C D E F G H

F G

B

A

Priority 3: To ensure that the new Public Health system in B&NES is fit for purpose

Assurance and scrutiny function for immunisations,

screening, emergency planning and resilience

Assurance and scrutiny function for

immunisations, screening, emergency

planning and resilience in place




H

A F G

A

Priority 4: to influence the wider work of B&NES council to impact on the social and economic determinants of health and health inequalities

Contribution of all council directorates to Public Health

outcomes

Improved understanding and agreements in place

with each council directorate for their

contribution to each PH outcome





A B C D E G H

A F G

B

A

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Appendix 2 – Service Impact Statement

Please add your SIS to this Appendix.

Appendix 3 – Equality Impact Assessment

Please add your EIA to this Appendix.

We have focused our priories for 2013/14 on the key groups identified in the JSNA and Health and Wellbeing Strategy, which included an analysis of key issue for different vulnerable groups within our population, many of which are reflected in the protected characteristics of the equalities legislation.

Require commissioned services to produce an equality impact assessment of their provided service as part of our contract monitoring service.

We have undertaken an equalities impact assessment of the transition of public health responsibilities from NHS B&NES to the local authority from April 2013

Appendix 4 – Workforce Planning

Please see earlier section on Workforce Planning and Development. i Continuous – there will be different systems at different times during the coming year – depending upon when receiver organisations have the staff resource to contribute; in the meantime PS and JG provide a response

people & communities (public health) service action … · people & communities (public...

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