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Improving outcomes and reducing inequalities through integrating public health

Improving outcomes and reducing inequalities through integrating public health. Dr Peter Marks Director of Pu b lic H ealth Leicestershire and Rutland. Presentation. Why public health in local government? Where are we in Leicestershire? A vision of integrated public health

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Improving outcomes and reducing inequalities through integrating public health

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  1. Improving outcomes and reducing inequalities through integrating public health Dr Peter Marks Director of Public Health Leicestershire and Rutland

  2. Presentation • Why public health in local government? • Where are we in Leicestershire? • A vision of integrated public health • Fit for Work – one example of partnership working in action • Opportunities and challenges for Health and Wellbeing boards

  3. The determinants of health

  4. What makes folk feel okay about life? Health and Wellbeing

  5. Influence on many of the determinants of health Democratic legitimacy and community leadership Contacts with people Why public health in councils?

  6. “Public health is coming back to local government”

  7. Transition in Leicestershire • Shadow Health and Wellbeing Board established • chaired by county and district councillor • two district councillors as members • interim strategic priorities agreed • JSNA refresh underway • Health Member Champions in each DC linked into H&WBB • Two shadow CCGs • DPH member of Corporate Management Team in LCC • Two consultants provide link to CCGs • Public health staff moved to County Hall, retaining desks with PCT • Senior PH staff co-located in districts • Virtual Public Health Team • H&WBB linked into wider partnership approaches to strategic commissioning and “community budgets”

  8. Devolved Public Health Team

  9. Shifting the balance

  10. Virtual PH team • Need for relationships at all levels • Strategic – HWBB • Tactical – Staying healthy partnership • Operational – co-located team • Ability to influence other organisations • Empowering, devolved working, increasing trust with organisations • Structures important but personal working relationships are also key

  11. Leicestershire Fit For Work • Original remit to ensure that people at risk of long-term sickness absence receive timely, co-ordinated back-to-work interventions focused on preventing them from losing their employment • Move management of sickness absence from the medical model into vocational rehabilitation. • Move vocational rehabilitation closer to mainstream primary care.

  12. Commissioning Partnership

  13. What FFW currently does • Employer liaison • Case co-ordination, to facilitate timely intervention • Employment advice • Wider social support such as debt or housing advice • Learning and skills advice • Conciliation to overcome escalated disputes between employees and employers

  14. OutcomesApril 2011-August 2011 Totals Specific

  15. ‘Main intervention’ that made a difference April 2011-August 2011 Questionnaire responses from 67 cases based on client questionnaire completed after case closed

  16. FFW-the future • Continuing to improve the management of sickness absence ……but now also through joint working with employers, local authority and NHS: -Increasing focus on improving the health and wellbeing of all working age people -Championing health promotion in the workplace

  17. Health and Wellbeing Boards Opportunities Challenges Only part of the picture – needs partnership at all levels Not all the relevant partners will be around the table – needs wider engagement Effective partnership is not just about structures Ensuring those with the greatest needs are heard How will HWBBs hold partners to account? • Strong partnership working at strategic level • Shared understanding of JSNA • Shared vision in Joint Health and Wellbeing Strategy • Bringing together political leaders, officers and HealthWatch • Democratic legitimacy

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