Workforce in the New Public Health System Leaders ’ Networking Event 9 th May 2012 Yvonne Doyle

1. Workforce in the New Public Health System Leaders’ Networking Event 9th May 2012 Yvonne Doyle Director of Public Health, NHS South of England Chair, Workforce Strategy Group Public Health England Transition Team

2. Challenges and Opportunities • Unresolved health challenges from the good times • New health challenges for the most vulnerable from the bad times • Opportunities to act differently and to address neglected problems

3. An effective public health system Accounts for the changing nature, assets and strengths of the population – is vigilant for new health threats Ensures economic development creates health and well being Advocates wise use of environmental resources Promotes individual and community well being 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 well being in all policies.

4. The new approach - what will be different? Integrated service delivery Holistic high quality prevention services Public Health communications Health Protection/ Resilience Local people Economic and social return on investment Health in all policies Sustainable communities 4

5. Features of contemporary public health practice

6. Levels of workforce and intervention in Public Health

7. Examples of roles in levels 3&4 LEVEL 4 Consultant in PHDPH Specialist Registrar Consultants in health protection Professor of PH Consultant in dental PH Consultant PH microbiologist Infectious disease consultant Communicable disease consultant Medical toxicologists LEVEL 3 Environmental specialists Health promotion practitioners Health visitors School nurses Occupational nurses Drugs and alcohol liaison nurses Sexual health nurses Health intelligence and information analysts Radiation protection specialists

8. Specialist public health skills Knowledge- *Population *Evidence *Background professional Recruitment Able to take an overview Practice Analytical Leadership Advocacy Social Entrepreneurship Adaptive Leadership Transformation Outstanding leadership 20 October 2014

9. Levels of workforce and intervention in Public Health

10. How different is the new public health system?

11. The public health workforce operating with new relationships from 2013 This diagram shows elements of the new commissioning and policy systems

12. The NHS’s role in public health • The provision of health servicesand ensuring fair access to those serviceswill contribute to improving health andreducing inequalities. • The NHS will also continue to commission specific public health services and will seek to maximise the impact of the NHS, making every clinical contact count. • PHE will have a close working relationship with the NHS Commissioning Board.

13. National Institute for Health Research NIHR School for Public Health Research Aim To increase the evidence base for effective public health practice by: • conducting research to increase the volume and quality of applied public health research and evidence, including evaluations; and • creating an environment where first class applied public health research, focused on the needs of the public, can thrive

14. National Institute for Health Research NIHR School for Public Health Research Approach • Comprises leading academic centres of applied public health research • Designed to build closer relations between researchers and practitioners across Public Health England and Local Authorities • Will place an emphasis on what works practically and can be applied across the while of England • Funding up to £5m per annum • Launched on 18th April 2012

15. A Public Health Workforce Strategy • White Paper Healthy Lives Healthy People gave commitment to develop a PH workforce strategy for consultation • Working Group includes members from the FPH, BMA, LGA, DCLG, RCN, the Deaneries, HPA as well as officials from DH. • A consultation document has been published. Seeks views towards a definitive strategy which will be prepared later in 2012.

16. Purpose and vision • Public health is everyone’s business – we need to make further step change in order to solve major health challenges • How can the wide range of skills available – from specialist to community development enable this next phase of health improvement and protection? • What roles could be played by workforces that can improve health – some of whom are not in NHS? • How can people help their own communities and their own health?

17. Chpt 1: Purpose of the consultation • To set out proposals that will support and develop a highly qualified, motivated workforce that will be employed in a range of settings including LAs, the NHS, PHE; • To identify opportunities to develop and embed public health into the wider workforce from healthcare practitioners, clinicians, housing officers – making every contact count. • Not about HR issues, these are dealt with through HR Concordat, HR Frameworks and LA guidance

18. Chpt 2: The current public health workforce • Who are they and where are they located? • What are they called and do we agree what the terms mean? • Where will they be in future? • How much do we need to know about the PH workforces in future ? • How do we get that information?

19. Chpt 3: Workforce challenges and opportunities • Values of the public health workforces • International literature • Equity and equality • Future public health challenges • Achieving a good transition

20. Chpt 4: Wider workforces and local communities • How will we make every contact count? • What contribution will the wider local government and key NHS workforces* make to public health in future? *Such as health visitors and school nurses • Where are there current and new opportunities for developing communities? • What is the contribution of the PH practitioner workforces?

21. Chpt 5: Getting it right for the public health specialist workforce • Competencies for specialist public health • Recruitment to specialist training • Education and training, HEE, LETBs • Health protection • CPD • Leadership • Academic public health and PH information and intelligence

22. What issues has the work to date identified • The importance of a coherent approach to the public health workforce of the future – viewing public health as a whole system in which various components of the workforce contribute their ‘unique’ components • The difficulty of knowing who is in the public health workforce and where they are operating • The ambition of those who represent lay interests to be more involved in determining their ‘own’ public health – building on good work that is in hand • The importance of planning the education and training components in future and working in national and local partnerships towards this • The need of certain key workforces for career planning.

23. Further work is needed • Relationship between public health specialists, practitioners and the wider workforce; • Development of our leaders in public health for new environments • Can we support employers to plan workforces of central importance in the future public health system? • PHE – how will it provide professional leadership to those working in LAs, NHS and elsewhere? • Key relationships throughout the public health system

24. Taking forward work on the consultant/practitioner interface. Policy messages. • The practitioner workforce is important for building capacity in public health now and particularly in future • They comprise an important element of teams led by specialists and an essential component of pathways in public health • These pathways are not always well defined and therefore ‘the baton’ can fall before it is passed on from consultant to practitioner • Practitioner training programmes are worthy of further examination and extension

25. In conclusion:

26. Opportunities will present to: • -exploit relationships in new (local) settings to mobilise a wider workforce to tackle longstanding challenges • -build a robust evidence base to use in a number of practice locations • -make the most of co-location of skills in PHE to deliver excellence and high level professional support • -use the developments of the transition period to deliver more aligned national public health services

27. Next steps • Public Health England Transition Team will collate and analyse the responses received • Will continue to work with stakeholders until the strategy is published • The strategy will need to be regularly reviewed and updated to reflect developments and ensure that it remains fit for purpose

28. Public health system updates The new public health system factsheets are available at http://healthandcare.dh.gov.uk/publichealth Sign-up to our regular Transforming Public Health bulletin http://phbulletin.dh.gov.uk/ Contact the DH Public Health England transition team PublicHealthEngagement@dh.gsi.gov.uk Contact the DH Public Health Development Unit PublicHealthDevelopmentUnit@dh.gsi.gov.uk Workforce consultation (until July 2012) www.consultations.dh.gov.uk

29. ADDITIONAL SLIDES • WORKFORCE • DETAILS OF FUNCTIONS OF PHE

30. PHE’s organisational design National Office (incl. hubs and supported by national centres) Units Specialist distributed networks Factsheet: PHE’s organisational design

31. Local authority commissioning responsibilities (1) • Tobacco control & smoking cessation • Alcohol and drug misuse • Services for children 5-19 • National Child Measurement Programme* • Obesity and weight management • Local nutrition services • Increasing physical activity • NHS Health Checks* • Public mental health services • Dental public health services • Injury prevention • Birth defect prevention • Behavioural and lifestyle campaigns to prevent LTCs • Local initiatives on workplace health • Support and challenge of NHS services (imms and screening) • Public health advice to NHS* • Sexual health services* • Seasonal mortality initiatives • Local role in health protection incidents* • Community safety • Social exclusion * Indicates mandated services

32. PHE will work in partnership Local government PHE will support local authorities by providing services, expertise, information and advice to ensure action is taken on best available evidence NHS Commissioning Board PHE will provide advice and service to support commissioning, support delivery of service, and ensure prevention and health promotion are systematically addressed Devolved administrations PHE will coordinate nationwide action to tackle threats to health and enable effective UK-wide emergency, resilience and response arrangements Expert partners worldwide PHE will work with partners to identify, understand and develop approaches to tackle health threats, foster innovation and draw on behavioural sciences

33. Accountability and governance structure for Public Health England

34. How do current public health workforces operate?

35. Workforce in the New Public Health System Leaders’ Networking Event 9th May 2012 Yvonne Doyle Director of Public Health, NHS South of England Chair, Workforce Strategy Group Public Health England Transition Team