Public Health in IslingtonVoluntary and Community Sector Dialogue event

Julie BillettJonathan O'Sullivan

3 June 2013

Islington men and women die younger in Islington when compared to the rest of England.

Whilst life expectancy in Islington is increasing. Islington men have the lowest life expectancy in London.

In Islington the difference in life expectancy between the best-off and worst-off is 6.7 years for men and 4.4 years for women

Life expectancy

England

82.6 years Islington

81.4 years Islington

76.0 years England

78.6 years

The contribution of lifestyle risk factors to long term conditions and early death in adults.

Source: WHO popi

3 key ‘pillars’ of public health• Health promotion & disease prevention programmes• Influencing lifestyles/behaviours & the wider determinants

of health • Empowering and supporting communities to promote

health & reduce inequalities

health improvement

• Surveillance, monitoring & analysis of the population’s health & wellbeing

• Investigating and managing infectious, environmental and other risks to health

• Emergency planning and preparedness

health protection

• Public health advice to support service planning & strategic commissioning – health needs assessment, effectiveness and efficiency of interventions and services, equity

• Service audits & evaluations

health services

New statutory responsibilities of LAs from 1st April 2013The Act places duties on local authorities spanning all 3 domains:-

To promote and improve the health of their population (health improvement)To ensure robust plans are in place to protect the local population (health protection)To provide health advice to NHS commissioners (healthcare public health)

Mandated services• Sexual health services (excluding HIV

treatment)• NHS Health Checks • Health protection - to ensure plans are in

place to protect the health of the population and to have a supporting role in infectious disease surveillance and control and in EPPR

• Public health advice to Clinical Commissioning Groups

• National Child Measurement Programme

Non-mandated servicesTo provide or commission a wide range of other services to improve and protect the health of the local population and reduce health inequalities. Includes:• alcohol and drug misuse services• public health programmes for children aged 5-19• stop smoking services and tobacco control• interventions to prevent and manage obesity• Physical activity• Public mental health programmes• Health at work• Nutrition and healthy eating• Community safety, violence prevention & social

exclusion• Dental public health• Seasonal mortality interventions

Public Health England

• Executive agency of the DH

• Aims to support the public health system as a whole and do those things that would not be practicable to replicate in each local authority

• Provide services, expertise, information and advice in a way that is responsive to local needs

• Support PH capacity building and professional development

• Nationally 4 x Hubs (1 for London) and local units (1 for NC & NE London)

• Arms length non-departmental body

• Commissions specialist services and primary care

• Develops and holds CCGs to account

• Key leadership role in improving outcomes and driving up quality

• Oversees planning for emergency resilience and leading the NHS operational response to emergencies

• Public health services for children <5 (health visiting)

• Screening and immunisation programmes

National Commissioning Board

CCGs will be responsible for commissioning:- • Emergency and urgent

care• Community health

services• Maternity services• Elective hospital care• Rehabilitation services• Older people’s healthcare

services• Healthcare for children• Other services• Duties include duty to

participate in HWBBs and to have regard to health improvement and health inequalities

Clinical Commissioning Groups

Health and Wellbeing Boards

A statutory function of the local authority.

The means by which the local authorities will deliver their new duties to improve strategic coordination across local NHS, social care, children’s services, public health and other services that directly relate to health and wellbeing.

Key functions of the Health and Wellbeing Board

• Assess the needs of the population through the Joint Strategic Needs Assessment

• Agree and produce a Health and Wellbeing Strategy • Promote joint commissioning• Promote integrated provision joining up social care, public

health and NHS services with wider local authority services

• Ensure best use of resources• Consider the wider determinants of health

Who is on the board?

• Leader of the Council• Lead Member for Health and Adult Social Services• Lead Member for Children’s Services• Clinical Commissioning Group representation• Borough Director• Director of Housing, Adult and Social Services• Director of Children and Families Services• Director of Public Health• Local Healthwatch representation

What we want to achieve with the VCS

• bringing a wider perspective; reflective of different localities and communities.

• delivering messages to where they are needed most • crossing the health and social care boundaries • drawing together broad experience and expertise• providing a ‘live’ feed-back loop from experience to

policy • Greater engagement and involvement on Evidence

Hub/JSNA and JHWS• Outcomes focussed approach

Islington’s Health and Wellbeing priorities

Ensuring every child

has the best start in life

Preventing & managing

LTCs to extend

length and quality of life

& reduce health

inequalities

Improving mental

health and wellbeing

Delivering high quality, efficient services within available resources.

Key Achievements • Significant reduction in smoking rates

from 32% eight years ago to 22.5% now. 2nd highest quit rate in London.

• Teenage conception rate has reduced by 41% from baseline to 34.4 per 1,000.

• Over the past four years the rise in obesity levels has halted in reception pupils.

• 91.5% of children aged 2 years immunised against MMR, which is above target and the fifth highest rate in London.

• Breastfeeding rates are at the highest they have ever been at 77%.

• The NHS Health Checks programme goes from strength to strength with 10,167 Health checks offered and 7,142 delivered, which is above target.

• Continued increase in the number of people accessing iCope; 3,523 patients 2011/12, compared to 2,992 in 2010/11.

• Good alcohol licensing arrangements and policy

Key Challenges• Shisha Pipes, illegal tobacco sales and

Smoke Free Homes and reduce rates of smoking among BME communities

• Improve access to contraception advice and services in a range of settings.

• Improve pathways for prevention & management of obesity in childhood and adolescence

• Reduce the proliferation of fast food outlets near schools

• Tackling low rates of immunisation among BME communities and older children.

• Uptake of cancer screening programmes.• Increase the % of women booked with

maternity services by 12 weeks + 6 days• Increase levels of physical activity and

uptake of Exercise on Referral.• Reduce stigma and discrimination of mental

health problems and promote services to high-risk groups.

• Reduce alcohol consumption and negative impact on Islington

What’s on the Evidence Hub?• Summary factsheets• Datasets• Profiles• Strategies• Reports• Insight

• Adult care• Children, young people and families• Crime and anti-social behaviour• Demographics• Education and employment• Environment• Health and wellbeing• Housing and homelessness• Local economy

Who is it for?Residents, Council staff, Councillors, NHS, Community and Voluntary sector and other partners such as schools, police, pharmacies.