Public HealthEast Surrey CCG Clinical Executive Team

Thursday 11th December 2014

Kate Lees – Consultant in Public HealthKate.lees@surreycc.gov.uk

Session Objectives

• To provide an overview of the role of Public Health in Local Authorities

• To summarise the mandatory Public Health functions delivered in Surrey

• To summarise the non-mandatory Public Health functions delivered in Surrey

Role of Public Health in Local Authorities

• Work with partners (CCGs, Community Safety Partnerships) to undertake Joint Strategic Needs Assessments (JSNAs)

• Develop Joint Health and Wellbeing Strategies• JSNAs and JHWSs must inform local authority

commissioning plans

Public Health Grant

• From Secretary of State to upper tier LA.s• Ring-fenced until 2015/16 and can be used to:– Significantly improve health and wellbeing of local populations– carry out health protection and health improvement functions

delegated from the Secretary of State – reduce health inequalities across the life course, including

within hard to reach groups – ensure the provision of population healthcare advice

Role of Public Health in the Local Authority - Mandatory services

• Ensure there are plans in place to protect the health of the population

• Ensuring NHS commissioners receive the public health advice they need

• National Child Measurement Programme • NHS Health Check assessment • Appropriate access to sexual health services

Role of Public Health in the Local Authority – action on

• tobacco control • alcohol and drug misuse services • obesity and community nutrition

initiatives • increasing levels of physical activity in

the local population • dental public health services • public mental health services • accidental injury prevention • population level interventions to

reduce and prevent birth defects • behavioural and lifestyle campaigns to

prevent cancer and long term conditions

• local initiatives on workplace health

• local initiatives to reduce excess deaths as a result of seasonal mortality

• promotion of community safety, violence prevention and response

• local initiatives to tackle social exclusion

• supporting, reviewing and challenging delivery of key public health funded and NHS delivered services such as immunisation programmes

Public Health Outcomes Framework

Surrey CC Public Health Service Plan Priorities

• Lead Health & Wellbeing Prevention Strategy• Support CCGs to develop prevention plans• Deliver Public Health Offer to CCGs• Lead metrics for Better Care • Re-commission integrated sexual health service• Strategic review of JSNA• Collaborate with CCGs & others to prioritise

health care pathways, programmes & systems

Public Health advice to NHS

• Memorandum of Understanding agrees responsibilities of CCG and PH and includes e.g.:

– Lead health improvement partnership working between CCGs, county and district councils, other partners and residents

– Ensure that plans are in place to protect the health of the population from the full range of threats and emergencies

– Provide health protection advice to each CCG and support the management and review of infection control incidents.

– Support understanding of needs of its local population and the actions required to address the main priorities.

– Public health advice on the development of care pathways, service specifications and quality indicators.

– Support the prioritisation work (TNRF / IFR)

Examples of PH advice given to ES CCG

•Health Profiles

•Evidence reviews – eg social prescribing

•Priorities committee

Our core purpose is to improve patient outcomes by working collaboratively with all of our stakeholders to deliver health services differently. We will be bold in our plans and celebrate our achievements. We will commission safe efficient care for our population.

Context Strategy Priorities/ Change Programme Outcomes Change Enablers Key Stakeholders

Everyone Counts:

Planning for Patients

2014/15 to 2018/19

NHS Outcomes Framework

NHS Constitution

and Mandate Quality Focus

Aging population

with multiple Long Term Conditions

1. Increase efficiency and productivity with all of our providers through robust contract management

Urgent Care Pathway - Increased access to primary care for urgent care- Paediatric urgent care- Improved hospital discharge

Increase the number of people having a positive experience of hospital care, care outside of hospital, in general practice and in the community

Contract ManagementVariations to existing contractsIM&T StrategyBetter Care FundCommunications

Patients

Public

Surrey County Council

NHS England

Surrey and Sussex

Healthcare NHS Trust

Surrey and Borders

Partnership NHS

Foundation Trust

First Community

Health and Care

South East Coast

Ambulance Service NHS Foundation

Trust

East Surrey CCG Governing Body

and Practices Commissioning

Committee

Third Sector including Dorking

Healthcare

2. Deliver recognised best practice to ensure a consistently high quality National Health Service

Health Hubs managing integrated care:- Prevention Programme- Alcohol- Stroke- Cardiovascular Disease- Neurology- Gastro-intestinal - MSK/ T&O- Respiratory- Genito- urinary- Diabetes

Reduce the number of potential years of life lost due to conditions amenable to healthcareReduce the amount of time people spend avoidably in hospitalIncrease the proportion of older people living independently at home following discharge from hospitalIncrease the number of people having a positive experience of hospital care, care outside of hospital, in general practice and in the community

Clinical Care Pathway RedesignContract Management and VariationsOutcome Based CommissioningIM&T StrategyBetter Care FundCustomer Care ProgrammeWorkforce ReviewEstates ReviewCommunications

3. Transform local services so that we become one integrated health service

Mental Health and Learning Disabilities- IAPT- Dementia- Children's services- Review contract and service specification

Increase IAPT referrals to 15%Achieve IAPT recovery rate of 50% by March 2015Increase dementia diagnosis rate to 66% by March 2015Reduce the number of potential years of life lost due to conditions amenable to healthcareIncrease the number of people on CPA in settled independent accommodation and in employmentIncrease provision of urgent services for children with mental health conditions

Clinical Care Pathway RedesignContract Management and VariationsOutcome Based CommissioningIM&T StrategyBetter Care FundCustomer Care ProgrammeCommunications

4. Drive the use of innovative technology to improve commissioning, quality of care and patient experience

Improve Patient experience:- Accessible care- Improved resource and information for self care and self-management- Customer Service approach- Patient input and feedback

Increase accessibility of care in primary careIncrease the number of patients able to self care and self manage Long Term Conditions

IM&T StrategyCustomer Care ProgrammePrimary Care StrategyCommunications

5. Improve patient experience

6. Develop a culture based upon ambition and delivery that all staff are proud to be a part of

Organisation Development- OD programme for all- Shared Vision- Opportunity optimisation

Develop mechansims to monitor staff satisfaction OD ProgrammeCommunications

Public Health Commissioned Services

• Substance misuse (including Alcohol)• Sexual Health • Tobacco Control (Stop Smoking) • Health Checks • School Nursing• Obesity, nutrition and physical activity• Mental Health Promotion

ES CCG Team around the place (approx 20% of work)

• Kate Lees – PH Consultant – CCG lead• Helen Harrison - PH Principal – Community Safety

Partnership lead• Maya Twardzicki– PH Lead – Tandridge lead• Tinashe Jonga – PH Lead – Reigate & Banstead lead• Marcus Butlin & Brendan Donaghy – PH Analysts• Jane Semo – PH Dev. Worker

Review of objectives

• To provide an overview of the role of Public Health in Local Authorities

• To summarise the mandatory Public Health functions delivered in Surrey

• To summarise the non-mandatory Public Health functions delivered in Surrey