Public Health in North Wales: Priorities and Next Steps

1. Iechyd Cyhoeddus yng Ngogledd Cymru / Public Health in North Wales 14 Ebrill / April 2011 Cyflwynydd / Presenter: Andrew Jones Cyfarwyddwr Gweithredol Iechyd Cyhoeddus / Executive Director of Public Health Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board Insert name of presentation on Master Slide

2. Gogledd Cymru / Bwrdd Iechyd PBC Model Darparu Gwasanaeth – tîm Iechyd Cyhoeddus Gogledd Cymru Blaenoriaethau Iechyd Cyhoeddus/ Ein Dyfodol Iach Bwrdd Iechyd Lleol ALlau a phartneriaid eraill Cyraeddiadau Allweddol Camau Nesaf North Wales / BCU Health Board Service Delivery Model - North Wales Public Health team Public Health Priorities/Our Healthy Future LHB LAs and other partners Key Achievements Next Steps Trosolwg Overview

3. North Wales Profile All Cause Mortality : Upper Super Output Area North Wales Demographics Source: Public Health Wales

4. Largest in Wales - 18,000 staff, £2.1 billion budget, 3 District General Hospitals, 121 GP practices Clinically led : 11 Clinical Programme Groups, 14 primary and community ‘localities’ Key relationships with: Chiefs of Staff (senior team, ‘operations’ and nursing) Other corporate support (finance, planning and performance) Partnership with 6 local authorities, North Wales Police and North Wales Fire and Rescue BCU Health Board

5. Service Delivery Model • Single local Public Health team (consultants and practitioners) – based on agreed Public Health Wales principles • Full engagement – all local staff (including feedback from project board and consultation on local DPH proposals) • Support to HB and LAs – concept of primary purpose and special interest • Agreed priority areas within OHF for focus - linked to national programmes • Implemented 1 April 2011

6. Public Health – BCU Health Board (1) • Our Healthy Future embedded into 5 year plan and core business (Public Health Practising Organisation) • Triple Aim – (Population health, patient experience, cost) • Clinical leadership model – chiefs of staff (champions), lead CPGs • Actions embedded into annual operational plans - key priorities/ performance

7. Public Health – BCU Health Board (2) • Engagement with primary care and localities • Corporate governance – reports to Board and committees on key PH issues, health improvement, health protection, screening • DPH part of corporate business: finance, partnership, organisational and workforce development, scrutiny

8. Public Health System:Bringing it all together(1) • Health Protection: immunisation, communicable disease/environmental hazard, hospital associated infection • Screening: national programme delivery, transformation of services e.g. cytology, emergency surgery • Public Health Wales Observatory – Service reviews, population profiles

9. Public Health System:Bringing it all together (2) • WCISU – investigation, service transformation • Safeguarding • Academic collaboration • Communications – all of the above!

10. Local Government • DPH and specific team support to each LA • Individual and collective engagement e.g. • North Wales leadership group (chief executives) • Area Planning Board (substance misuse) • Health Social Care and Well-being, Children and Young People • Agreed key priorities for collective action (outcome focused) • Ongoing development

11. Key Achievements: Health Improvement • Local ‘Our Healthy Future’ (Local Public Health Strategic Framework) • Outcome focused approach linked to 5 year strategic plan and annual quality framework • Whole system approach • HB clinical leadership – strategic and operational • Agreed action plans for tobacco & alcohol • ‘Upstream’ embedded into service transformation

12. Preventing the Preventable

13. Key Achievements: Health Services Quality (1) • Major service reviews/transformation • DPH: Exec Chair of Emergency General Surgery Review • Needs assessment and literature review for Unscheduled care, Maternal and child health, Emergency surgery, Orthopaedics, Haematology (local and Observatory support) • Cytology (screening input) • Joint Review of Microbiology Services

14. Key Achievements: Health Services Quality (2) • Development of primary and community care • Localities • Primary care engagement • Support to policy development and review – Individual Patient Commissioning

15. Key Achievements: Health Protection • Response to swine flu and winter pressures • Hanson Cement Investigation – community concern • Support to consultation on development of new nuclear power station • Economic regeneration – ‘Energy Island’

16. Key Achievements: Health Intelligence • Population profile on general health • Variation in surgical procedures (local and national) • Interim DPH annual report – population need • Detailed needs assessments on maternity and child health

17. Key Achievements: Communications • Working relations with central team • Examples of best practice in individual and multi-agency response • Support to HB communications team • Development of a model for the future

18. Workforce Development • Staff learning from transition – CPGs etc • Local team development – who we are, what we have and what we don’t • Journal club – local learning and challenge • Leadership for transformation – learning alongside HB colleagues • Developing the ‘virtual’ Public Health team – Nursing, clinicians, LA staff • Learning from others – collaboration with Liverpool PCT (& North West England)

19. Next steps • Implementing the new Service Model • Major project on programme budgeting – population outcome and cost • Implementing NHS service transformation • Delivery of agreed OHF actions (outcome, evidence base) • Health Impact Assessment of Wylfa B and related developments • Public Health Wales – formalising local arrangements for DPH support ‘whole team’ • Reporting to Public Health Wales Board