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The new public health system our role in improving and protecting health and wellbeing; and the transition process. This presentation will cover…. Context of the public health reforms Vision for a new public health system What the new locally-led system will look like Local system transition

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The new public health systemour role in improving and protecting health and wellbeing; and the transition process

This presentation will cover
This presentation will cover…

Context of the public health reforms

Vision for a new public health system

What the new locally-led system will look like

Local system transition

Workforce and HR issues


Health and wellbeing reforms:

setting the context


Across the health and care system

  • Rising demand and treatment costs

  • Need for improved healthcare services – and reduced variation in health outcomes

  • Need for better value for money

    The modernisation programme will:

  • Put clinicians and local communities in the driving seat

  • Provide a greater voice for patients and the public

  • Increase accountability – locally and nationally

  • Support a greater focus on public health

Overview of health and social care structures from April 2013

Ministers and the Department of Health

Public Health


Adult Social Care


Public Health England (part of DH)



NHS Trust Develop-ment Authority

Care Quality Commission, including HealthWatch England

National Institute for Health and Clinical Excellence

Health and Care Information Centre







Health and Wellbeing Boards (part of local authorities)

Local HealthWatch (formerly LINks)

Public health providers

  • NHS providers, inc:

  • Foundation Trusts & NHS Trusts

  • Primary care providers

  • Independent / 3rd sector providers

Social care providers

Patients and the public

A powerful case for change 2013

The white paper Healthy Lives, Healthy People set out a powerful case for reforming the public health system:

  • two out of three adults are overweight or obese

  • smoking costs the NHS £2.7 billion per year

  • rates of tuberculosis are rising

  • inequalities in health remain: people in the poorest areas live on average 7 years fewer than those in the richest

  • Major health threats, ranging from the risk of new pandemics to the potential impact of terrorist incidents.

  • We need a new approach to meet these and other public health challenges of the twenty-first century.

  • The new approach to public health 2013

    Leadership role for local authorities – so services are shaped by local needs


    Supported by a new integrated public health service, Public Health England


    Stronger focus health outcomes supported by the public health Outcomes Framework


    Public health as a clear priority across government


    The commitment to reduce health inequalities as a priority across the system


    An effective public health system
    An effective public health system… 2013

    Accounts for the changing nature, assets and strengths of the population – is vigilant for new health threats

    Ensures economic development creates health and wellbeing

    Advocates wise use of environmental resources

    Promotes individual and community wellbeing

    Helps people limit behaviours damaging to their health.

    Secures equitable access to good quality health and social care, with prevention incorporated into all contacts.

    Systematically works to reduce health inequalities and embeds health and wellbeing in all policies.

    Leadership role for local authorities so services are shaped by local needs
    Leadership role for local authorities 2013– so services are shaped by local needs

    • Drive knowledge and analysis of population assets and needs.

    • Consider whole population outcomes and set goals.

    • Inform all health and social care commissioning using preventive approach.

    • Incorporate health and wellbeing across all local authority work – and across the locality.

    • Use evidence and return on investment to inform decisions.

    • Tackle health inequalities systematically focussed on People, Place and Power.

    New delivery system requiring wide range of partners 2013

    Government: DH lead but significant contributions from DCLG, Justice, Home Office, DWP, DfE

    PHE: Delivering health protection and supporting LAs and the NHS

    Local authorities: New public health functions build on existing wider role

    NHS: Delivering health care, every contact counts and specific public health interventions

    An effective public health system

    Roles in the new public health system local delivery
    Roles in the new Public Health System: 2013Local Delivery

    • Duty to improve health

    • Brings together holistic approach to health and wellbeing

    • Employ DPH

    • Ringfenced PH budget

    • Mandated services

    Local Authorities

    • Core offer to the NHS, including PH advice on health services


    • Commissioning healthcare

    • Commissioning some public health services

    PHE (local units)

    • Local Health Protection Services (functions in development)

    Health and Wellbeing Board

    • Coordinates local strategy through

    • JSNA

    • JSHWS

    • Review of commissioning plans

    Public Health System Updates: autumn 2011 2013

    Department of Health is completing the policy design phase

    • Public health Outcomes Framework

    • Operating model for PHE

    • Public health in local government: including grant conditions, mandatory services, and public health advice to the NHS.

    • Public health funding: including shadow allocations for local authorities.

    • Workforce strategy and other HR updates

    Commitment to co-design 2013

    We are working with stakeholders to co-design these five system reform updates

    • Regular discussions with local government

    • Regular discussions with the profession

      • Public Health Engagement Group, in autumn 2011, to provide advice and challenge

      • Alongside ongoing engagement forums – including with and via the Regional Directors of Public Health and DsPH group

      • NHS Future Forum review of the NHS’s role in the public’s health (due December)

    Timeline 2013

    End of 2010: White paper: Healthy Lives, Healthy People

    July 2011: White paper response, confirming new public health system structure

    By end 2011: complete the operational design of the new system, including the PHE Operating Model, how the local system will work, and their links into the NHS.

    Spring 2012: chief executive and senior team for Public Health England appointed.

    April 2012: start of transition year

    April 2013: Public Health England established

    April 2013: Local authorities take on their new public health responsibilities

    Sept 2011 2013

    Oct 2011

    April 2012

    Nov 2011

    Dec 2011








    Policy documents published

    March 2012

    PCT cluster transition

    plan including delivery

    Key dates and activities

    Scope of HR / workforce Work 2013

    Local transfer: establish clarity on principles and terms and conditions of public health staff in LAs

    Directors of Public Health – devising an appropriate employment process

    PHE HR regime – exploring options for PHE terms and conditions

    Public Health workforce strategy – working group developing consultation document

    Regulationof non-medically qualified staff – seeking evidence to inform final decision

    Aims of hr strategy
    Aims of HR strategy 2013

    An HR regime and wider workforce strategy which supports

    the public health reforms through:

    A secure transition of staff to PHE and LAs, retaining crucial capacity and expertise in the system

    Ensuring the supply of all expert staff, including medically qualified public health consultants, nationally and locally both in transition and in the future

    Supporting the future mobility of public health specialists across the whole of the public health system

    To create meaningful careers in all settings

    Public health reforms to stay in touch
    Public health reforms: to stay in touch… 2013

    Sign-up for the Transforming Public Health bulletin:

    Contact details for workforce and HR issues:

    [email protected]

    [email protected]

    Contact for other transition issues:

    [email protected]

    Questions and discussion