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Introduction to Public Health
England
Andy McParland
CIEH East Midlands Seminar, 5 December 2013
Origins of Public Health England
–Healthy 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
Sender bodies
The organisations and functions that contributed some or all of their staff to
Public Health England include:
–Health Protection Agency
–National Treatment Agency
–Department of Health
–Strategic Health Authorities
–Primary Care Trusts
–Public Health Observatories
–Cancer Registries
–National Cancer Intelligence Network
– Quality Assurance Reference
Centres (QARCS)
– Specialist dental commissioners
– Specialist commissioners
– NHS Cancer Screening
Programme
– UK national screening
programmes (non-cancer)
PHE priorities for
2013/14
– Sets out Public Health England’s
priorities and actions for the first
year of our existence
– Five outcome-focused priorities –
what we want to achieve
– Two supporting priorities –
how we will achieve it
– 27 key actions
Mission
“To protect and improve the nation’s
health and to address inequalities, working with national and local
government, the NHS, industry, academia, the public and the voluntary
and community sector.”
What we do
Public Health England:
–works transparently, proactively providing government, local government, the
NHS, MPs, industry, public health professionals and the public with evidence-
based professional, scientific and delivery expertise and advice
–ensures there are effective arrangements in place nationally and locally for
preparing, planning and responding to health protection concerns and
emergencies, including the future impact of climate change
–supports local authorities, and through them clinical commissioning groups, by
providing evidence and knowledge on local health needs, alongside practical
and professional advice on what to do to improve health, and by taking action
nationally where it makes sense to do so
Outcome-focused priorities
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. 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
PHE in the East Midlands
Local focus
15 CENTRES
• Deliver services and advice across three domains of public health
• Support local government and local NHS action to improve and protect health and reduce inequalities with intelligence and evidence
• Deliver the local Public Health England input to emergency preparedness, resilience and response
• Front door to PHE
• Centre Director – ‘Account Manager’
The Prospectus
• Developed and informed by consultation with
local partners
• Incorporates PHE’s statutory functions
• Commits to a local focus
• Delivers an integrated offer across the domains
of public health practice
• Reviewed and updated:
https://www.gov.uk/government/publications/eas
t-midlands-prospectus
Services and functions
• Nurturing a place-based approach
• Providing expert input
• Managing and planning for incidents and
outbreaks
• Assuring and improving service quality
• Facilitating networks
• Monitoring and reporting on the public’s health
• Supporting training and development
• Supporting and collaborating on research
Nurturing a place-based approach
• Ensure delivery against
local priorities, defined in
collaboration with partners
• Maximise utility of local
assets
• Actively contribute to the
local public health system
Providing expert input
• Provide independent public health advice and
support
• Based on best-available evidence– Scientific literature
– Local best practice
– Disease surveillance
– Assessment of health needs and impact
– Expert opinion
– User views
• Add value to commissioning
Managing and planning for
incidents and outbreaks
• Statutory role to protect the public from disease
and other dangers to health
• Category 1 responder under Civil Contingencies
Act 2004
• Facilitated by disease surveillance and early
detection of exceedance
• Collaborate with others to respond
15
Facilitating networks
• Contribute to, lead and co-ordinate local and
national networks on priority topics and themes
• Actively support the sharing of local innovation
and best practice
• Access to national expertise
16
Monitoring and reporting on the
public’s health
• Collect, collate, analyse and disseminate data
for public health action
• Produce benchmarking of outcomes
• Provide bespoke analysis as agreed
17
Supporting and contributing to
research
• Support production of evidence
• Focus on research that leads to public health
action to protection and improve health and
reduce inequalities
• Foster strong links with academic partners
18
Why do we need public health
information?• Surveillance
• Forecasting/predicting
• Setting and monitoring health improvement targets
• Benchmarking - seeing how we compare with elsewhere
• “Needs assessments”
– what are the health problems in our area?
– where are these health problems worst?
– what services are available and how good are they (quality)?
– where is there unmet need or overcapacity?
• Planning interventions
– where shall we concentrate our resources?
– what capacity will be required?
• Evaluating interventions
– did we make a difference?
Operations DirectoratePHE East Midlands Centre
Health Protection
Health Improvement
Population Healthcare
HP DirectorateCentre for Radiation,
Chemical and
Environmental
Hazards
HP DirectorateField
Epidemiology
ServiceHWB DirectorateScreening QA
HP DirectorateMicrobiology
(FWE)
CKO Directorate
Knowledge and
Intelligence Team
Public Health Intelligence
Cancer Intelligence
OPs Directorate
PHE Midlands
and East RegionEmergency Planning
OPs Directorate
PHE West Midlands Centre
Drugs and Alcohol
Team
Miscellaneous
Support ServicesHR, IT, Comms
PHE East Midlands
Health and
Work
Andy McParland, Environmental Public Health Scientist
Dr Justin Varney
Adults and Older People’s Health and Wellbeing
Programme Lead: Corporate Priority Programme Board on Health and
Work
Why is health at work a public
health issue?
71.1% of adults aged 16-64yrs in the UK are in employment.
The average working adult spends 36.3hrs a week in work, although higher in
some sectors like manufacturing and construction (41.2hrs).
People in work are healthier and use health and social care services less than
the unemployed.
Workplace injuries and ill health (excluding cancer) cost society an estimated
£13.4 billion in 2010/11. Stress is now the largest cause of workplace absence.
Health at Work initiatives are an opportunity to engage adults in a structured
way and promote healthier lifestyles and health promoting environments,
supported by the fact healthier staff are more productive, more present and it
makes good business sense.
Work and Health and the Public Health Outcomes Framework
Domain 1: Improving the wider determinants of health
•Employment for those with long-term health condition, including those with a
learning difficulty/disability or mental illness (NHS OF 2.2 & 2.5)
•Sickness absence rate
Indirect Indicators of success
Domain 2: Health Improvement
•Excess weight in adults
•Proportion of physically active and inactive adults
•Smoking prevalence – adult (over 18yrs)
•Self-reported wellbeing
Domain 3: Health Protection
•Population vaccination coverage
Domain 4: Healthcare Public Health and Preventing Premature Mortality
•Mortality
•Preventable sight loss
Health and Work: Employment
The vast majority of businesses in the UK are small to medium enterprises
(SME: 0-249 employees).
Across the UK small business (0-49 employees) accounts for 99.2% of the total
private sector, employing just under 46.9% of the total private sector workforce
and 34.4% of the annual turnover.
Companies with higher levels of staff engagement have 13% lower staff
turnover, less than half the UK average sickness absence and consistently
outperform on the FTSE 100 Ref Sunday times ‘Best companies to work for in the UK
Workplace wellbeing initiatives are demonstrating a return on investment in
sickness absence, productivity, and presenteeism, as well as reputational
benefits and recruitment and retention.
WIDER DETERMINANTS1.09i Sickness absence - the percentage of employees who had a least one day off in the previous week
The percent of employees who had a least one day off due to sickness absence in the previous working week
ranged from 6.7% in Boston to 2.2% in Sedgemoor.
0
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Pe
rce
nt
of
em
plo
ye
es
(%)
325 Local Authorities - chart excludes city of London
LA Value England
WIDER DETERMINANTS1.09ii Sickness absence - the percentage of working days lost due to sickness absence
The percentage of working days lost due to sickness absence in the previous week ranged from 6.7% in Boston
to 1.51% in Sedgemoor.
0
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Pe
rce
nt
da
ys
lost
du
e t
o s
ick
ne
ss a
bse
nce
(%
)
325 Local Authorities - chart excludes city of London
LA Value England
Health and Work: Older people - Median age of
population
Figure 4.12 Average age of withdrawal from the labour market using the static indicator:
by sex, 1984 to 2012
United Kingdom, age
Source: Labour Force Survey: Office for National Statistics
60
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651
98
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Ag
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Men Women
Public Health England H&W Prioritie
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
• Support employers large and small – public, private and voluntary – to
establish the business case for supporting a healthy workforce, securing
adoption of practical evidence-based interventions.
• Encourage more widespread adoption of the Responsibility Deal commitment
on mental health adjustments in the workplace, and develop a greater
understanding of the workplace’s potential for improving and sustaining good
mental health, resilience and wellbeing.
• Lead where we expect others to follow by developing the employment
practices of PHE to become a key exemplar of the aspirations embodied in the
Responsibility Deal to support a healthy and productive PHE workforce.
Conclusions• Work is generally good for physical and mental health and well being
• Unemployment is associated with poorer physical and mental health and
well being
• Work can reverse the adverse effects of unemployment
• The quality of work matters
• Good work is characterised by a living wage, having control over work, in-
work development, flexibility, protection from adverse working conditions, ill
health prevention and stress management strategies, support for sick and
disabled people that facilitates return to work
“Being in good employment is
protective of health. Conversely,
unemployment contributes to poor
health.”
Marmot Review
East Midlands Platform
Andy McParland, Environmental Public Health Scientist
Ann Goodwin, Consultant in Health Improvement
What is the East Midlands Platform
• A multi-partner forum launched in 2009 by the DH Regional
Public Health team
• Originally developed in response to the increase in obesity
• More broadly focussed on health and wellbeing since 2012
• Partners join by making a ‘commitment’ to take action and
share knowledge about concrete efforts to improve health and
wellbeing
The members and their commitmen
• There are now 62 members
• Around 53 commitments have been made since 2009
• Members are from private sector, 3rd sector, academia
and the public sector
• The commitments must be action over and above the
day to day business of an organisation, must be
measurable and completed within a given timeframe
Regional Members
Boston Borough Council
British Gas
Community Sports Trust
Derby County Football Club
Derby County in the Community
Derby Hospital NHS Foundation Trust
Derby University
Derbyshire Community Health Services NHS Trust
E.M NHS Sustainable Development Network
E.ON
East Midlands Ambulance Service
Ecoworks Nottinghamo
Food & Activity Buddies (FAB Leicester)
Garden Organic
GEM Vending
Greencore
Groundworks East Midlands
Institution of Occupational Safety and Health
JRDM Dental Care
Kettering General Hospital NHS Foundation Trust
Leicester City Council Transport Strategy Section
Leicester-Shire and Rutland Sport
Leicestershire County Council
Leicestershire Fit For Work Service
Let's Get Cooking
Lincolnshire Sports Partnership
Loughborough College
Natural England
NHS Derby City (PCT)
NHS Leicestershire & Rutland (PCT]
NHS Lincolnshire
Northampton Library Services (Northants CC)
Nottingham City Council
Nottingham City Public Health
Nottingham Forest Charitable Trust
Nottingham Trent University
Nottingham University Hospitals Trust
Nottinghamshire Food Initiatives Group (Greater Nottingham Groundwork)
Notts County FC in the Community
Nuffield Health
Shoezone
Slimming World
Soil Association
Sports Nottinghamshire
Sustrans
Thomson Reuters
Unionlearn
University of Lincoln
University of Nottingham
Walkers Charnwood Bakery
Walkers Snacks / Pepsico
Wilkinson
The benefits of membership
• Platform members identified various benefits to
membership,
• they were clear that the positive impact on health was important, but identified an intrinsic benefit to
membership itself in terms of the networking opportunities at Platform meetings
• This networking is probably the key unique selling point for the Platform’s continued success
The business benefits
• Sharing best practise
• the development of reciprocal relationships between
Platform members
• Offering services to others and the opportunities to grow
businesses
• Sharing across the public, private and 3rd sectors in a safe
environment
• Belonging to something unique and pioneering
• Making a difference
