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Tackling the wider determinants of health: Health Improvement Domain

Tackling the wider determinants of health: Health Improvement Domain. Andrew Jones Regional Director/ Director of Health Improvement. National Policy and Direction in Wales. ‘Designed for Life’

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Tackling the wider determinants of health: Health Improvement Domain

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  1. Tackling the wider determinants of health:Health Improvement Domain Andrew Jones Regional Director/ Director of Health Improvement

  2. National Policy and Direction in Wales • ‘Designed for Life’ • Commitment to deliver world class healthcare services and a clear focus on tackling health inequalities. • Public Health Strategic Framework • Key Strategic themes/priorities

  3. Strategic Management by Domain • National Director • Directors with specified responsibilities • Health Improvement • Health Protection • Health and Social Care Quality • Health Intelligence • Public Health Management Group • Public Health Executive Team • Four Domain Strategic Management Groups

  4. NPHS Direction • Business Plan : 2005-2008 • Strategic Goals and Objectives • National and Local work plans • Key tasks for delivery • Agreed with partners/stakeholders

  5. Health Improvement Domain “to improve the health and well-being of the population and reduce inequalities.” • Focus on strategic priorities and actions relating to the wider social, economic and environmental determinants of health. • Social model of health • Support national policy and local delivery

  6. Health Improvement Domain • Specialist public health advice aimed at supporting partners/stakeholders to work together to: • Address the root causes of poor health, • Promote ‘Investment for Health’ and • Reduce health inequalities. • Link to other Domains as required

  7. Domain Management Group • Chaired by Director • Senior staff specialising within the domain • Representation from Local Public Health Directors • Cross representation from other domains • Wider engagement as appropriate

  8. Moving from this

  9. Environment Public economic strategies Education Agri- culture & food Traffic Leisure & culture Social-insurance Eatinghabits Social assistance Social network Employ- ment Alcohol Health-& medical care Age, sex, heredity Sleep habits Social support Contact children and adults Work environment Tobacco Sex & life together Physical activity Illicit drugs Housing …..to this Haglund, Svanström, KI, revision, Beth Hammarström

  10. Domain Structure • 3 Areas to address the broad range of determinants of health • Economic and Physical Environment • housing, transport, waste, economic development, corporate health standard • Influencing Behaviours • tobacco, alcohol, nutrition, physical activity, substance misuse, sexual health • Communities and Families • Focus on children e.g. child poverty, community development, schools, mental health promotion

  11. Service Delivery • Local Public Health Directors/Teams • Domain support • ‘Lead’ Consultant in Public health in each of 3 areas • Dedicated practitioner support in each of 3 areas • Defined services – smoking cessation/ workplace health • Use of ‘Advisory’ roles using expertise from LPHTs • Task and Finish Teams/ Networks • Key links to partners e.g. Wales Centre for Health, Local Government

  12. Specific Managed Programmes • All Wales Smoking Cessation Service • National public health programme • Community focus • Pre –operative service ( NHS performance target) • Targeted services (maternity, mental health, manual workers) • Corporate Health Standard

  13. Some challenges • Task and Finish groups to address: • Economic and Physical Environment • Welsh Backs project • Injury Prevention • Climate change/Sustainable Development Influencing Behaviours • Obesity • Tobacco • Alcohol misuse/Prevention Programmes • Communities and Families • Child Poverty • CEHAPE (Children’s Health Action Plan - European)

  14. Economic and Physical Environment Priorities • Health at Work • Economic inactivity • Economic and physical regeneration (spatial plans) • Sustainable Development - climate change, heat wave plan, KWTW • Housing and built environment • Injuries

  15. Influencing Behaviours Priorities • Prevention and early intervention – link to chronic disease care pathways • Tobacco • Cessation • Prevention – ASSIST ( and more e.g. social marketing) • Environment ( Tobacco ban in public places) • Obesity • nutrition and physical activity • Alcohol misuse – comprehensive public health programme

  16. Communities and Families • Child Poverty • Children and Young People partnerships • Healthy Schools • Settings – next year Prison health

  17. Working with Stakeholders • Welsh Assembly Government • Local Health Boards • Local Government • Wales Centre for Health • National partners e.g. Health Protection Agency, Environment Agency • Independent and voluntary sector

  18. Research and Development • Link to academic public health • Promote research and evaluation • Contribute to development of public health evidence base • Share best practice

  19. Wales and beyond • Work within UK ( other devolved administrations Scotland, Ireland etc) • Europe – Children’s Environmental Health Action Plan (CEHAPE) • International Public Health

  20. Added Value • How can we best work together across NPHS to deliver a world class specialist advice service to promote health improvement and address health inequality?

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