NHS TRAFFORD CLINICAL COMMISSIONING GROUP GOVERNING BODY 24 th June 2014

Transcription

1 Agenda Item No Part 1 x Part 2 NHS TRAFFORD CLINICAL COMMISSIONING GROUP GOVERNING BODY 24 th June 2014 Title of Report Purpose of the Report Update This short report provides an update to the CCG Governing Body on the following: Trafford Delivery Plan 2014/15 (attached); Joint Health and Well Being Strategy Action Plan (attached - as at 1 April 2014); England (PHE) Business plan (attached as at June 2014). Actions Requested Decision x Discussion Information x Strategic Objectives Supported by the Report Recommendations 1. Consistently achieving local and national quality standards. 2. Delivering an increasing proportion of services from primary care and community services from primary care and community services in an integrated way. 3. Reduce the gap in outcomes between the most and least deprived communities in Trafford. 4. To be a financial sustainable economy. The CCG Governing Body is asked to: Note and agree the Trafford Delivery Plan 2014/15; Note the current progress and ongoing work on the Joint Health and Well Being Strategy action plan for the eight identified priorities; Note the publication of the England (PHE) business plan. Discussion history prior to the Governing Body Business Delivery Group.

2 Trafford Clinical Commissioning Group Agenda Item No Financial Implications Risk Implications Impact Assessment - Communications Issues Public Engagement - Local Authority grant allocation. Current and future investment decisions. - Prepared by Responsible Director Mr Abdul Razzaq Director of Mr Abdul Razzaq Director of PUBLIC HEALTH UPDATE 1.0 INTRODUCTION AND BACKGROUND 1.1 This short report builds on the previous updates to the CCG Governing Body in March and May 2014 in relation to the Outcomes Framework (PHOF). 2.0 PUBLIC HEALTH DELIVERY PLAN 2014/ A Trafford delivery plan 2014/15 plan has been developed (attached) that describes the work programme of the function in the Local Authority and with the Clinical Commissioning Group. 2.2 The Joint Health and Well Being Strategy action plan has been presented to the Trafford Health and Well Being Board and the plan as at the 1 st April 2014 meeting is also attached that describes the work in relation to the eight identified priorities. 2.3 England (PHE) has published their business plan (attached) that complements local work and describes the added value in relation to the accountabilities and contribution of the respective organisation(s). 3.0 SUMMARY The above plans together with the CCG 5 year strategic plan describe how the respective organisations are working to address improving the and wellbeing outcomes of the local population and tackle preventable premature mortality. 3.1 RECOMMENDATIONS 3.2 The NHS Trafford Governing Body is asked to: Note and agree the Trafford Delivery Plan 2014/15; Note the current progress and ongoing work on the Joint Health and Well Being Strategy action plan for the eight identified priorities; Page 2

3 Trafford Clinical Commissioning Group Agenda Item No Note the publication of the England (PHE) business plan. Page 3

4 Appendix 3a - HEALTH AND WELLBEING ACTION PLAN (24 Mar 14) - Draft 5 Housing, Employment, Leisure, Environment, Education, Living and Working Conditions Targeted Vulnerable & Disadvantaged Groups Priority Priority Lead Officer Big Idea Governance / Partnership (Partners Involved) Monitoring Board. Actions Organisations linked to Action Reporting Lead for Actions Planned Completion date Intended Outcomes linked to actions Bid for, and develop, a Trafford wide cycle scheme Trafford Council / Pennine Care NHS Foundation Trust Jan Trainor Oct-14 Cycle Scheme in place Improve links between community sport and schools Sport and Physical Activity Partnership Louise Wright Mar-15 Greater - number of school children engaging with local sports clubs and number of links schools have with community clubs Develop a Healthy Weight Care Pathway involving key stakeholders. Clinical Commissioning Group Jill Colbert/Jan Trainor Mar-15 Healthy Weight Pathway for Children and Young People implemented Develop a Grandparent involvement programme in relation to family based y eating activities Age UK Trafford. Ann Marie Jones Sep-14 Family based approach to y eating activities completed 1. Reduce Childhood Obesity Lisa Davies We will maintain or increase the number of children who are a y weight, through the provision of a range of y weight interventions and the promotion of physical activity and y eating. Maternity and Child Health Advisory Forum Joint Commissioning Management Board (Children and Young People) Children's Trust Board Identify, train champions in relation to improving the general of offenders based on a family approach Raise awareness of Junior Active Trafford Probation Services Kevin Bulman Dec-14 Trafford Community Leisure Trust (TCLT). Kay Statham On-going Health champions identified, trained and awareness support underway Active Trafford Scheme refreshed Awareness of Junior Active Trafford proved Agree and implement a collaborative programme for childhood obesity Trafford Council / Trafford CCG Lisa Davies Dec-14 Programme agreed and in place Support new mothers to breastfeed using peer support scheme Trafford Council / Trafford CCG Lisa Davies on going Reduction in inequalities between areas in Trafford in relation to breastfeeding at 6-8 weeks Develop and implement a work programme in 3 food outlets to promote ier choice Trafford Council / Trafford CCG Helen Darlington Jul-14 Programme in place to work with planners in 3 food outlets Implement LARCO project to engage local families in the reduction of childhood obesity in areas with high levels Trafford Council / Trafford CCG Lisa Davies Jun-14 Project in place and evaluation to be completed Establish a "Lads and Dad s" football initiative bluesci / TCLT / Trafford Council Stuart Webster Jan-14 Initiative in Place Work as a partnership to develop a single point of access (SPA) for emotional services to provide a clear and easy to access system Trafford CCG and Council Jill Colbert Dec-14 Clear routes of access in place Self Help information available for early access by children, young people and families Engage schools in developing the SPA as key supporters of children with emotional issues Trafford Council and local schools Jill Colbert Dec-14 Engagement programme for schools implemented 2. Improve the emotional Health and wellbeing of children and young people Jill Colbert Trafford will support children and families with emotional issues to access the most appropriate services quickly and easily. Emotional Health and Wellbeing Advisory Forum Joint Commissioning Management Board (Children and Young People) Children's Trust Board Develop a communication strategy to ensure that all relevant services, as well as young people and families, understand how to access the SPA Deliver targeted (National Institute Health and Care Excellence) behaviour change evidence based interventions for parents of 0-5 year olds Work with schools to coordinate mental services and promote emotional for children and young people Clinical Commissioning Group Jill Colbert Mar-15 Trafford CCG and Council Jill Colbert Dec-14 Communication strategy and accessible publicity aimed at local services, children, young people and families Early intervention programme in place. Improvement in School Readiness and the delivery of the AGMA eight stage model Trafford Council and local schools Jill Colbert Dec-14 Schools engaged in promoting good emotional

5 Priority Priority Lead Officer Big Idea Governance / Partnership (Partners Involved) Monitoring Board. Actions Organisations linked to Action Reporting Lead for Actions Planned Completion date Intended Outcomes linked to actions A partnership task and finish group will work together to ensure that all services locally are evidence based (NICE) and of a high quality Trafford Council/CAMHS Jill Colbert Dec-14 Guidance on ensuring services are evidence based and a flexible outcomes framework accessible for local commissioners and providers Develop a parent and Family approach to support bluesci/trafford Council Stuart Webster Mar-15 Parent and Family approach to support in place To run a Learning Though Adventure Programme Trafford Community Leisure Centre Kay Statham Mar-15 Programme completed Work collaboratively with partners to ensure messages relating to drugs/alcohol are promoted across the borough at events such as the Warehouse project Trafford Council Kylie Thornton Mar-15 Reduction in serious incidents Monitor the implementation of the RAID model within Trafford to reduce the demand on A & E Clinical Commissioning Group Ric Taylor On-going Reduction in attendances at Accident and Emergency Ensure those with alcohol/drug misuse issues who are committing crime are subject to appropriate positive requirements GMP Paul Burton On-going Decrease in re-offending 3. Reduce alcohol and substance misuse and alcohol related harm Kylie Thornton We will reduce the and social harm alcohol and substance misuse causes in communities Safer Trafford Partnership: Joint work with police, linking with the police crime commissioner and joint working on alcohol related harm Revise the annual Alcohol Action Plan, ensuring objectives are SMART and involving all partners. Deliver a stakeholder programme of events in Trafford for Alcohol initiative including Alcohol Awareness week, Festive Campaigns and Dry January. Review and revise as necessary the care pathway for GPs around Shared Care to increase the involvement of Primary Care. Trafford Council Kylie Thornton April-June 2014 Alcohol action plan revised Trafford Council Dave England Feb-15 Stakeholder programme of events delivered Trafford Council Kylie Thornton June-July 2014 Increase in those accessing treatment at early stage Awareness raising regarding alcohol and substance misuse and Dementia Age UK Trafford Ann Marie Jones Mar-15 Awareness programme of alcohol related dementia developed. 2 training programmes completed Refresh and promote client pathways for substance misuse provision across Trafford Partners and Residents. Collaborative Jessica Taati Aug-14 Increase in numbers accessing treatment Raise awareness of substance misuse issues across the BME population of Trafford. Alchemey Arts Paul Burton / Dave England Mar-15 Increase awareness within BME community. Develop an Early Intervention and Wellbeing Hub Trafford Council Linda Harper Mar-17 Hub in place To commission a Patient Care Co-ordination Centre (PCCC) on which the Hub will be based Trafford Clinical Commissioning Group Jonathan Cross Apr-15 PCCC in place by April To reduce activity at Acute Providers and improve patient experience whilst reducing DNA's. As part of the Better Care Fund - Develop a Frail and Older People Programme to identify provision in service to support/reduce interventions into Acute Providers Trafford Clinical Commissioning Group Adam McClure Phase one September 2014 Programme in place Improve provision to over 75's to reduce interventions within Acute Providers Develop a hub and spoke model of information and advice services with partners, linked to locality working Trafford Council Linda Harper Mar-15 Hub in place 4. Support People with Long term & Disability Needs to live ier lives Julie Crossley/Linda Harper We will deliver a transformational universal model of integrated care and support with people who have a range of long term conditions and disabilities, based on coproduction. Commissioning and Operations Steering Group Increase the number of people in receipt of a personal budget to further promote choice and control by 10% by March 2014 Increase the number of people in receipt of Telecare, to promote independence and resilience linked to the Trafford Telecare Pledge. Trafford Council Diane Eaton Mar-15 Increased numbers of people with a personal budget Trafford Council Barry Glasspell Mar-15 Increase the number of people in receipt of Telecare Implement the Winterbourne View Response Actions Plans and deliver on the identified areas for improvement in the Winterbourne submission stocktake Trafford Council/Trafford Clinical Commissioning Group Jenny Holt/Sandy Bering Mar-15 Winterbourne View Response Actions Plans delivered Implement the Trafford Autism Strategy Delivery Plan Trafford Council/Trafford Clinical Commissioning Group Jenny Holt/Sandy Bering Mar-15 Autism strategy delivery plan implemented

6 Priority Priority Lead Officer Big Idea Governance / Partnership (Partners Involved) Monitoring Board. Actions Organisations linked to Action Reporting Lead for Actions Planned Completion date Intended Outcomes linked to actions Macmillan Gp's/Long Term Conditions/Cancer support for Carers bluesci Stuart Webster Mar-15 Improved support for people with, and carers of people with, cancer Establish an "in-reach" Community Hips and Hearts activity in 2 residential care homes TCLT/Trafford Council Kay Statham/Helen Darlington Jan-15 Programme established in 2 residential homes Ensure that strategic planning processes contribute to creating a local environment, including facilities for outdoor recreation, physical activity and play that supports an active lifestyle. TCLT, Sport and Physical Activity Partnership Kay Statham/ Louise Wright Sep-14 Audit of current provision to be completed, partnership approach to the promotion of the offer. Work in partnership to increase participation levels and offer GP Referral pathways to progression and develop social prescribing TCLT, Trafford Council, sport and Physical Activity Partnership Kay Statham Jan-15 Formalise an offer for GP referral that links to partners 5. Increase Physical Activity Helen Darlington/ Kay Statham More People, More Active, More Often. The Trafford Strategic Sport and Physical Activity Partnership Identify gaps in provision and target interventions where they are most needed, e.g. women and girls', ethnic minority communities and young people between the ages of TCLT, Trafford Council, sport and Physical Activity Partnership and Greater Sport Louise Wright/ Helen Darlington/ Kay Statham Jan-15 Current gaps in provision identified and funding stream located to kick-start activity (Sportivate) Develop and extend/promote the Active Trafford and Junior Active Trafford Scheme to communities in most need. TCLT Kay Statham Mar-15 Review of current offer and develop links through partner organisations Evaluate, then develop and expand / innovate the Healthy Hips and Hearts older peoples exercise programme throughout Trafford working with physiotherapists and Occupational Therapies and Housing. TCLT/ Trafford Council Kay Statham/ Helen Darlington Sep-14 Training package developed, engagement work taking place Support practices to improve uptake of their population for cervical and bowel cancer screening Trafford Council / Trafford CCG Lisa Davies Dec-14 Invitation letters being revised in practices with low cervical cytology uptake and letters of support from GPs being piloted in 4 practices 6. Reduce the number of early deaths from cardiovascular disease and cancer Abdul Razzaq/Julie Crossley Reduced differences in life expectancy and y life expectancy between communities (through greater improvements in more disadvantaged communities) Commissioning and Operations Steering Group Deliver NHS Health Checks programme through general practices in Trafford and consider extending the programme using local pharmacies as a pilot and possibly(e.g. out of hours, non clinical venues) targeting disadvantaged communities Design and implement a patient education programme for CVD and cancer awareness targeted at disadvantaged communities (subject to public proposed funding) Trafford Council / Trafford CCG Lisa Davies on-going Trafford Council / Trafford CCG Adele Coyne Mar-15 Design and implement a clinical education programme in Primary Care Trafford CCG Julie Crossley on-going Earlier identification of risk factors for stroke, heart disease etc. Patient education programme for CVD and cancer awareness implemented Clinical education programme in Primary Care implemented Develop and deliver primary care cancer strategy across whole population Trafford CCG Julie Crossley on-going Primary care cancer strategy delivered Review and refresh the council section 75 Partnership agreement with Greater Manchester West to further transform the model of support based on personalisation, choice and control. Trafford Council/GMW Linda Harper/Annette Rooney Mar-14 Renewed Partnership Agreement is in place To facilitate a review of Trafford's mental services to ensure that services are fit for purpose and meeting the challenges and priorities articulated within Closing the Gap: Priorities for essential change in mental (DH 2014) NHS Trafford CCG / TMBC / GMW / MMHSCT / CWP Ric Taylor/Mark Grimes Apr-15 Review completed. Proposed approach agreed Deliver the Improving Access to Psychological Therapies Service Improvement Programme Trafford CCG / GMW / Self Help Services Ric Taylor / Annette Rooney Apr-15 66% dementia diagnosis target achieved in Trafford (62% adjusted) Implement effective psychiatric Liaison 'RAID' services for Trafford's registered population NHS Trafford CCG / TMBC / GMW / CMFT / UHSM / MMHSCT Ric Taylor / Annette Rooney Apr-14 Service in place and reduction in excess bed day payments (core RAID KPI) achieved Review and retender of the component of Trafford's Community Learning Disability team NHS Trafford CCG Sandy Bering Apr-15 CLDT Health Team in place following re-tender Develop an Age UK Trafford Dementia awareness training programme tailored for Trafford Police and deliver to Officers and Probation Services. Age UK Trafford Ann Marie Jones Sep-14 Dementia awareness training programme developed and delivered

7 Priority Priority Lead Officer Big Idea Governance / Partnership (Partners Involved) Monitoring Board. Actions Organisations linked to Action Reporting Lead for Actions Planned Completion date Intended Outcomes linked to actions 7. Support people with enduring mental needs, including dementia to live ier lives. Ric Taylor We will commission streamlined services which are joined up and have the person at the heart of what we do. Trafford CCG Quality Finance & Performance / Dementia Strategy Group. Work in partnership to deliver Trafford's Dementia Strategy Action Plan Deliver the Trafford Dementia Kite mark for residential care and homecare services across the Borough. TMBC / NHS Trafford CCG / All organisations linked to Trafford's Dementia Strategy Group Linda Harper Mar-15 Action Plan signed off and review conducted Trafford Council Linda Harper Jun-14 Dementia Kite mark developed with partners. Pilot completed. Formal launch planned for June Deliver a Dementia Campaign TMBC / NHS Trafford CCG / All organisations linked to Trafford's Dementia Strategy Group Ric Taylor / Linda Harper Apr-14 66% dementia diagnosis target achieved in Trafford (62% adjusted) Review Dementia Friendly Community implementation work in Sale and Urmston to inform best practice for further community development work TMBC / NHS Trafford CCG / All organisations linked to Trafford's Dementia Strategy Group Linda Harper Oct-14 Review completed. Best practice identified for further development Identify 2 natural dementia communities in South and North of Trafford as initial development areas for dementia friendly initiatives TMBC / NHS Trafford CCG / All organisations linked to Trafford's Dementia Strategy Group Linda Harper Mar-14 2 communities identified Deliver the GP and Pharmacy dementia wellbeing project NHS Trafford CCG / National Association of Primary Care Ric Taylor Apr-15 Pharmacists and GPs trained in basic dementia awareness Develop particular initiatives to implement preventative agenda RE; vascular dementia TMBC / NHS Trafford CCG / All organisations linked to Trafford's Dementia Strategy Group Ric Taylor Apr-15 Initiatives developed relating to vascular dementia Ensure alignment of dementia initiatives with Frail Elderly workstream within Trafford CCG and across partner agencies and organisations. TMBC / NHS Trafford CCG / All organisations linked to Trafford's Dementia Strategy Group Ric Taylor Apr-14 Frail Elderly lead as member of Trafford Dementia Strategy Group We will develop mental in the workplace training for businesses and organisations including GMP and other support agencies. GMP / Trafford Council / Trafford CCG / Probation Helen Darlington Dec-14 Mental in the workplace training programme developed / delivered 8. Reduce the occurrence of common mental problems amongst adults Helen Darlington Developing workplace by supporting Trafford employers to prevent / intervene early and support those experiencing common mental problems. Joint Strategic Commissioning Group. Proposed: Wellbeing Partnership. We will implement targeted, mental and wellbeing programmes with 2 partner organisations We will develop and deliver a new 2014 Salford, Bolton and Trafford Suicide Prevention Strategy Targeted approach to men Trafford Council / Trafford CCG Helen Darlington Mar-15 Programme implemented with 2 partner organisations Trafford Council Helen Darlington Dec-14 Suicide prevention strategy developed and delivered We will pilot 'books on prescription' scheme with 2 GP practices as part of a programme to promote mental resilience Trafford Council / Trafford CCG / NHS England (local area team) Helen Darlington Mar-15 Books on prescription scheme piloted and evaluated

8 Who we are and what we do: business plan for 2014/15 May 2014

9 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources Contents Page Welcome from our chairman and chief executive... 3 England at a glance Supporting local leadership for y communities Some of our achievements in 2013/ A and wellbeing framework for England... 7 This year s work programme Protecting the public s Improving the public s and wellbeing Improving population through sustainable and care services Building the capacity and capability of the public system Develop PHE Developing England people resources

10 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources Welcome from our chair and chief executive primary duty is to protect the public from infectious diseases and other environmental hazards and on this we will remain at all times alert and ready. This plays to our unique strengths in world-class science, disease registration, screening and vaccination programmes and surveillance systems, and our experts in emergency preparedness and response. This is a global concern as diseases cross borders so our work is UK orientated but international too. second responsibility is to improve the of the people and reduce inequalities. Good is more than the absence of illness and disease and importantly it is not synonymous with the NHS, a common belief but in error. By itself the NHS cannot improve as important as it is in the diagnosis and treatment of illness, with socioeconomic, behavioural and environmental factors mattering much more. Essentially this means that the choices people make about their, whether to smoke and to drink, to exercise and about their diet are crucial to length and quality of life, but those who have fewer choices do less well than those with more. Local government reflects this understanding in its dual goal of driving local economic prosperity with an eye to how this is benefiting local people, known colloquially as wellbeing. Efforts to promote and wellbeing, and tackle ill, will have a better chance of success when they are framed in a way that aligns with how people think about the structure of their lives: their own choices and behaviours as individuals, and the importance of their environment, and of the communities around them. We believe that all three people, places and communities are key to improving and wellbeing. Children will remain a key focus for PHE, we know that a good start to life is the best investment in a long and y life. PHE will play its supporting role in improvement through communicating what matters to good and what can be practically done by people themselves and by those who exist to serve them in government, local government, the NHS, business and the community and voluntary sector. In August we will publish a Health and Wellbeing Framework setting all this out and a small number of Big Ambitions that we believe, from the evidence, will make the greatest difference over the coming three, five and ten years. The measures of our success will of course be through improved outcomes and a narrowing in inequalities, and meantime delivering whatever we promise, and this document sets these out for this coming year. The risks of any national agency are complacency and arrogance, dangers we are alive to so the other important judgement of our success will be the views of those we most closely work with and support and so we commit to regularly seek and publish these. We hope you find this an interesting read and that you agree it articulates a stretching role for PHE as we enter our second year. David and Duncan David Heymann PHE board chair Duncan Selbie PHE chief executive 3

11 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources England at a glance PHE exists to protect and improve the public s and wellbeing and reduce inequalities. We do this through advocacy, partnerships, world-class science, knowledge and intelligence, and the delivery of specialist public services. PHE is the expert national public agency that fulfils the Secretary of State s statutory duty to protect and address inequalities, and executes his power to promote the and wellbeing of the nation. The remit letter from the Minister for sets out her requirements of PHE. PHE has operational autonomy. freedoms are set out in the Framework Agreement, which makes clear that PHE must speak to the evidence and its professional judgement. PHE has a Board with a non-executive chair and non-executive members. We employ scientists, researchers, public professionals and essential support staff. PHE works transparently, proactively providing government, local government, the NHS, MPs, business, public professionals and the public with evidence-based professional, scientific and delivery expertise and advice. PHE has four core functions: protecting the public s from infectious diseases and other hazards to improving the public s and wellbeing and reducing inequalities improving population through sustainable and care services building the capability and capacity of the public system PHE provides specialist protection, epidemiology and microbiology services across England. We are the lead for the UK on the International Health Regulations, and this extends to playing our part in protecting the UK from international hazards, most obviously from communicable diseases. PHE will support local authorities in their duty to improve the public s, and through them CCGs, by providing evidence and knowledge of local needs, alongside practical and professional advice on what to do to improve and reduce inequalities, and by taking action nationally where it makes sense to do so. PHE in turn is the public adviser to NHS England. PHE will enable the system to be held to account for its performance, for example by publishing public outcomes data and exposing variation in performance. PHE will actively promote the public s, using the evidence as a challenge to local and national action and in providing the public with the information they need to take responsibility for their. We know our effectiveness depends on how we behave so we will: consistently spend our time on what we say we care about work together, not undermine each other speak well of each other, in public and in private behave well, especially when things go wrong keep our promises, small and large speak with candour and courage Ultimately, together, we will be judged on the improvements secured in the public s through the Outcomes Framework. We will work with the NHS to make our system the most transparent in the world. We can make early progress in some areas and in others it will take longer. The key is to build momentum and secure lasting change. 4

12 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources Supporting local leadership for y communities PHE exists to serve the public through the public system, led locally by elected members, who have responsibility for the public s alongside the responsibility for inward investment, creating jobs, decent housing and resilient communities. Unitary and county authorities have a duty to improve the of their local people; counties work in partnership with district councils that are responsible for housing, leisure, planning and environmental. In our first year we established our 15 local centres, aligned with a number of local authorities. Each works with our national and regional specialist teams to deliver an integrated and tailored response to work alongside and support the local system to deliver its priorities. Each of our centres, in agreement with local partners, has developed a prospectus that sets out how PHE will support the local system in making a positive difference to the and wellbeing of their people. PHE is the national spine for the public s, linking the local public system and national action. Across all parts of the system, we commit to: continue to develop the expertise of the specialist, national and local protection teams handling around 9,000 local protection issues a year provide tailored support to local authorities on evidence-based and cost-effective ways to address and wellbeing priorities and reduce inequalities, including supporting local authorities to come together to tackle key regional challenges, for example, Well North which aims to support the poorest individuals and communities to improve their support local authorities in addressing the issues that are important to them, from rural, to air pollution, to the differential impact of austerity ensure that the eight PHE knowledge teams and intelligence networks provide trusted intelligence and help local systems with interpretation and insight to translate knowledge into practice deepen the partnership with NHS England on local commissioning and quality assurance of national public services provide public advice to NHS England and the local system on primary and acute care, community pharmacy, dental care and specialist commissioning provide leadership and support for emergency planning and response work with local authorities to develop a resilient and skilled public workforce ensure a strong network of public microbiology through national reference laboratories, regional collaborations with NHS hospital consortia for clinical microbiology and the food, water and environmental testing network work with local systems to implement the Health and Wellbeing Framework 5

13 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources Some of our achievements in 2013/14 We successfully managed the transition to PHE and were fully operational in our new form, with all functions transferred safely, to ensure no dip in delivery. We handled around 9,000 local protection issues, including outbreaks of infection, chemical radiation and environmental incidents. We launched the world s largest single database of cancer. The cancer registry provides clinical information on the 350,000 cancers diagnosed each year in England and includes 11 million historical cancer records. Working with NHS England we introduced three new immunisation programmes to protect babies against rotavirus, children against influenza, and people aged over 70 from shingles. Thirteen partnerships between us and universities won 47.5 million in Department of Health funding to set up protection research units. Combining researchers from academia and PHE, the units will focus on public priority areas ranging from immunisation to radiation hazards. We published the first NHS Atlas of Variation in Diagnostic Services, showing significant differences in how conditions are identified and monitored. 50% more smokers tried to quit during our Stoptober campaign than during other months of the year, according to a study by University College London, which concluded that the campaign was very cost-effective, saving 10,000 years of life. Longer Lives website, which won first place in the disrupting category at the international 2014 Interaction Awards, allows local authorities to compare their mortality rates for the four most common causes of death. The NHS Abdominal Aortic Aneurysm Screening Programme for all 65-year-old men was rolled out nationally. Early detection through the screening programme will prevent around 2,000 deaths a year. Published ground breaking UK analysis of the Global Burden of Disease setting out the causes of ill and mortality in the UK and the underlying risk factors that drive them. The NHS Health Check programme, which seeks to reduce premature death and ill from heart disease, stroke, kidney disease and diabetes, and raise awareness about dementia, is now being delivered in every local authority across England. We generated over 180 million through commercial contracts for products and services, including the manufacture and clinical trials of life-saving medicines and vaccines, while supporting wider UK economic growth, exports and life sciences. We launched an emergency measles MMR catch-up campaign with NHS England to vaccinate unprotected children against measles, mumps and rubella. Seventy cases of measles were confirmed in the first three months (January to March) of 2014, compared to 673 in the same period of We provided expert protection advice and support alongside colleagues in local government, the Environment Agency and the emergency services, as well as assisting in the recovery process, during last winter s floods and storms. 6

14 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources A Health and Wellbeing Framework for England This business plan sets out the key steps and measures we will be taking this year. However, the challenges we face are complex and we need a sustained focus on the critical issues over a period of many years, and so we are doing two things. First, in August, we are publishing a Health and Wellbeing Framework for England to provide a compelling account of the challenges to, which will set out the interventions we believe would improve and reduce inequalities, and the impact of acting now on our in the future. Dementia TB Best start in life Big Ambitions for the public s Alcohol Tobacco Obesity Of course care matters. But the truth is that we have all focused more on treatment and illness than on prevention and resilience. This is not where we need to be. The promotion of wellness and resilience, prevention and early intervention should be our watchwords, helping people to stay as y as they can be for as long as possible, recognising that each stage of life is a foundation for the next. And crucially, intervening before conditions become unmanageable. This is not about spending more money, it is about making sure we get the best impact for the money we already spend being clear on what works and ensuring effective interventions are adopted at scale and pace The Health and Wellbeing Framework will provide a menu of evidence-based interventions that all engaged in improving can adopt as, together, we seek to transform the of the people of England. Second, we want to maximise our impact through focusing on a small number of Big Ambitions for the public s for the next three, five and 10 years. It is obviously important that these ambitions connect with real people living in real places who often live lives where y behaviours are not their first consideration. By focusing on a small number, each of them rooted in the evidence, we hope to galvanise all those involved in and care, including of course the public itself, and begin to reverse the gaps in life expectancy and years of y life. We will articulate these through the Health and Wellbeing Framework and these are most likely to include tobacco, obesity, alcohol, tuberculosis, dementia and every child having the best start in life. We are ambitious and confident because we have to be, and because many large-scale public challenges have already been tackled successfully. From reducing teenage pregnancy rates by 40%, making huge strides in reducing care-associated infections through to the collective efforts of local government to address poor school attainment in London, we know that together we can secure real gains for everyone s and wellbeing. 7

15 Welcome England at a glance Supporting local leadership The year ahead achievements Health and Wellbeing Framework Protecting next page Improving Sustainable and care services Capacity and capability Developing England people This section sets out what we plan to do against each of our four core functions but does not encompass all that we will undertake over the full year. We have presented this to show shared commitments, those that are principally for PHE, and our unique capabilities. resources Protecting the public s : this year s work programme primary duty is to protect the public s. We provide national and international leadership and scientific advice to reduce harm from infectious disease and environmental hazards. We ensure there are effective surveillance arrangements in place nationally and locally to identify threats and for preparing, planning and responding to protection concerns and emergencies. diverse and expert workforce applies unique knowledge and scientific skills and capabilities across epidemiology, microbiology and environmental hazards. Shared commitments work with NHS England to extend the childhood flu vaccination programme to all children aged 2-4 and pilot the delivery of flu vaccinations to primary school aged children and those in secondary school years 7 and 8 support the cost-effective procurement of the meningococcal B vaccine by March 2015 develop plans with Genomics England and NHS England as part of the 100,000 genomes project to apply whole genome sequencing to increase our understanding of severe sepsis, and to use disease registry data to support the cancer and rare disease aspects of the 100,000 genomes project reduce the range of variation in local levels of performance of immunisation and screening programmes, while improving or at least maintaining the national levels of performance work with the Department of Health to implement the Elliot Review on the future of the Public Analyst Food Laboratories by August 2014 Key PHE actions publish the collaborative TB strategy by September 2014 run a pilot programme of whole genome sequencing for TB from July 2014 to bring next generation sequencing into use for public and complete feasibility studies for pilot programmes for HIV and hepatitis C virus publish the first report of the English Surveillance Programme for Antimicrobial Utilisation and Resistance by October 2014 lead delivery of Exercise Cygnus (October 2014) to test the nation s ability to respond to a flu pandemic develop a programme in support of national and local government to reduce the 25,000 deaths each year in England attributable to air pollution by March 2015 deliver the data capture system for reporting care-associated infections by March

16 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources Protecting the public s capabilities key capabilities include: we maintain a robust system for the detection, assessment, management, control and reporting of new and emerging threats to public ranging from emerging infections to climate change we ensure effective public emergency preparedness, resilience and response in the UK, including providing support to local and national resilience partners and to international crises as part of our role in disaster risk reduction we protect and improve by controlling and reducing risks to from environmental hazards, ranging from weather related extreme events to radiation and chemical threats we are accelerating the application of genomics technologies to improve the treatment of individuals and support the wider control of disease we provide specialist investigation and control of communicable disease outbreaks, chemical incidents, radiation and other environmental hazards we develop and manufacture appropriate biopharmaceutical products we provide the evidence-based science and clinical practice in specialist microbiology in support of the wider public system and NHS hospitals we undertake leading-edge translational research in vaccine development and infectious disease control we deliver a unified, integrated surveillance system capable of detecting changes in patterns of disease and its determinants to help target interventions we ensure high coverage of safe, cost-effective vaccines to reduce the burden of vaccinepreventable diseases 9

17 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources Improving the public s and wellbeing: this year s work programme next page We will support local authorities, the NHS and central government to secure the greatest gains in and wellbeing and reductions in inequalities through evidence-based interventions. We will act nationally where we are uniquely placed to do so. We will promote actions to build y places, people and communities, making the case for prevention and early intervention. Shared commitments at least 20% of the eligible population offered a NHS Health Check and aim to reach 66% take up of these offers by 2015 work with NHS England to increase the number of eligible families receiving services from Family Nurse Partnerships to 16,000 by March 2015 and partner the expanded Troubled Families programme to support early intervention and improve and wellbeing for vulnerable families work with local authorities and NHS England to ensure readiness for the transfer of commissioning responsibilities for 0-5 child services improve recovery rates from drug dependency, recognising this as the core purpose of drug treatment, by supporting a shared ambition with local authorities for continuous improvement, through the provision of benchmarked data and bespoke support, particularly for commissioners and providers in the most challenged areas make significant progress towards reaching a chlamydia detection rate of 2,300 per 100,000 by March 2015 Key PHE actions recruit one million dementia friends, in partnership with the Alzheimer s Society, by March 2015 deliver 750,000 quit attempts through the Smokefree marketing campaigns by March 2015 deliver marketing campaign on smoking in cars with children in advance of the smoke-free legislation through our social marketing plan, deliver a series of national campaigns that increase early diagnosis of cancer and other conditions by March 2015 launch the National Mental Health Dementia and Neurology Intelligence Network by June 2014 sign up 500,000 more families to Change4Life through the 10 magic moves and y eating Smart Swaps campaign by January 2015 publish vision and action plan for improving blood pressure by December 2014 roll out the national standard for Workplace Wellbeing Charter by March 2015 and work to activate and engage employers of all sizes in all sectors to recognise the return on investment for supporting the and wellbeing of staff publish draft advice on next steps to reduce sugar consumption in light of the draft Scientific Advisory Committee on Nutrition report by Spring 2015 produce a report for government on the public impact of alcohol and possible evidence-based solutions by Spring 2015 review the emerging evidence on e-cigarettes to provide evidence-based recommendations to support smoking cessation, tobacco control and to inform the government s future thinking by spring 2015 to review the impact of obesity as a cofactor (with alcohol and hepatitis C) in other long-term liver disease and provide advice on evidence-based interventions and practice support the National Suicide Prevention Strategy, including the production of an atlas of variation on suicide prevention and developing an appropriate measure on mental to incorporate in the NHS Health Check programme produce a national implementation framework for physical activity by October

18 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources Improving the public s and wellbeing Improve PH capabilities key capabilities include: we apply and translate scientific knowledge, expertise and advice, including from epidemiology and from social, behavioural and implementation science we promote the public s, on the basis of the evidence and professional judgement we partner policymakers, researchers and practitioners to facilitate the implementation of evidence-based practice and policy we support local government, the voluntary sector and the NHS to apply evidence and policy we identify and champion cost-effective interventions that are good for, society and the environment we ensure that all have access to the best possible evidence on what works we present information and intelligence that is tailored and targeted to specific audiences we deliver, manage, monitor and evaluate programmes and projects we engage with and empower individuals, communities and populations to change their behaviour 11

19 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services next page Capacity and capability Developing England Improving population through sustainable and care services: this year s work programme people resources We are the public adviser to NHS England, and we will support NHS commissioners and providers as they seek to improve population and tackle inequalities, and to develop more personalised, proactive care that can help each of us maintain the best possible and wellbeing. specialist staff will provide the evidence and analysis to help the NHS and local authorities allocate their resources most effectively, with a greater shift towards prevention and early intervention. stainable HC serv Shared commitments achieve at least 60% of centres providing bowel scope screening by March 2015 pilot 40,000 kits of the faecal immunochemical test for faecal occult blood bowel cancer screening and publish results by March 2015 extend newborn blood spot screening to test for four additional disorders pilot and evaluate the addition of pulse oximetry to newborn screening and link screening for cardiological defects from the antenatal to the newborn period aim for 75% uptake for winter flu vaccine in people aged 65+ and support NHS England and local government to reduce winter emergency admissions Key PHE actions publish the interim evaluation of the pilots of human papillomavirus primary screening as an alternative to primary screening by cytology by March 2015 conduct a review of specialised services by November 2014 to identify key areas for action to optimise value and population outcomes in support of NHS England s urgent and longer term work support the local NHS to integrate public by building the evidence base and sharing examples of people-focused, integrated preventative approaches support local authorities to make the best use of resource through the rollout of the return on investment tools developed by the National Institute for Health and Care Excellence review quality assurance functions for cancer and non-cancer screening programmes to deliver a more harmonised service where appropriate 12

20 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources Improving population through sustainable and care services capabilities Sustainable HC serv key capabilities include: we act as NHS England s public adviser, and we support them through the professional staff in PHE and through teams permanently embedded in NHS England we use our expertise in economics, intelligence and evaluation and system approaches to support NHS England to develop population-based effective systems of care, including commissioning of specialised and primary care services we work with the NHS to deliver gold standard screening programmes in order to reduce the burden of disease and disabilities across the life course, tackling variations in performance and access across the country we work with partners to encourage staff to make every contact count as an holistic opportunity to promote and wellbeing more broadly we lead, plan and implement immunisation programmes (including the procurement of vaccines and immunoglobulins) and provide specialist advice and information to reduce regional variations in performance we present the evidence on the return on investment of public interventions for local authorities and the wider and care system we provide surveillance and evidence-based support to the NHS in reducing harm from care-associated infections and particularly in tackling the emerging problem of carbapenem-resistant Enterobacteriaceae we maintain and deliver the collection and reporting processes for the Systemic Anti- Cancer Therapy Dataset (SACT), working towards full integration into the National Cancer Registry Service Develop PHE 13

21 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability next page Developing England Building the capacity and capability of the public system: this year s work programme people resources We will support the development of the public system as a whole ensuring access to the best evidence and intelligence, to ensure the current and future excellence of the public workforce and by publishing outcomes to ensure transparency and promote improvement. We will work closely with local authorities, the Association of Directors of, the Faculty of, the Chartered Institute of Environmental Health, the voluntary and community sector, and the NHS as we build the capacity and capability of the public system, as a whole. Shared commitments work with the Local Government Association, Association of Directors of, Department of Health and Society of Local Authority Chief Executives to agree the model of sector-led improvement for public by August 2014 support the Association of Directors of s regional networks in their work on sector-led improvement by March 2015 with key partners, co-design, develop, and pilot a single agreed approach to talent management across the public system by March 2015 work with national partners to improve career development and normalise staff movement across the public system, addressing issues raised in the recent national surveys carried out by Ipsos MORI, the British Medical Association, the Association of Directors of and the Centre for Workforce Intelligence work with partners in the NHS and local government to implement the Sustainable Development Strategy for Health and Care Key PHE actions publish a Health and Wellbeing Framework for England by August 2014 and a web-based guide to the evidence and emerging best practice support public career development through piloting a Skills Passport by March 2015 as part of a review of the public workforce strategy develop the Outcomes Framework web tool with disaggregated data by equality characteristic and inequalities by December 2014 on behalf of the Chief Nurses in the devolved administrations and the Republic of Ireland we will lead in developing a five nations framework for nursing and midwifery on population support the establishment of the What Works Centre for Wellbeing by December 2014 expand the Longer Lives web tool to include primary care indicators for diabetes (August 2014), checks (August 2014), cancer and hypertension (October 2014) and measures on drug and alcohol treatment and recovery (December 2014) 14

22 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources Building the capacity and capability of the public system capabilities Capacity & Capabil key capabilities include: we work with local government and the NHS, providing practical support, tools, evidence and information to realise effective public services and improved population outcomes we support the development of the public workforce, including within PHE, to ensure people have the right skills, and providing opportunities for talent, leadership and career development for specialists and generalists across all employers we accelerate the spread of effective and innovative practice at scale and pace we support the international development of effective public practice, providing expertise on public issues globally and develop best practice in global resilience and disaster risk reduction we translate data, research and experience into practical evidence and guidance through our public intelligence service, including publication of topic-based NHS Atlases of Variation we ensure professional governance is in place to support the professionalism of the expert public workforce, and is linked to high-quality performance management and professional appraisal processes we exercise system-wide professional leadership functions, directly for PHE clinical and professional staff, through supporting partners to develop the wider public workforce and working with the NHS to promote the population role of all care professionals we maintain high-quality research capability to generate new knowledge to improve and protect and drive the timely translation of research into public practice we enable the system to be held to account for its performance, for example, by publishing public outcomes data and exposing variation in performance and ensuring the Grant is used appropriately 15

23 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England next page Developing England: this year s work programme people resources As we enter our second year, we will continue to develop our capacity and capability. We want to be an organisation that is recognised as a great place to work and a great partner to work with. Outcomes for 2014/15 improve the Employee Engagement score from the PHE staff survey from 52% in 2013 to 55% in 2014 maintain the proportion of our stakeholders who speak highly or very highly of PHE, in the annual stakeholder survey by March 2015 Key PHE actions implement staff survey action plans and act on staff feedback including ensuring leadership is more visible, communications are improved, and learning and development opportunities are highlighted, by November 2014 implement an integrated workforce planning framework by September 2014 carry out a comprehensive strategic review of our functions and purpose to ensure that we deliver our responsibilities in the most efficient and effective way, doing more and new for less by October 2014 to complete the PHE commercial strategy setting out how we will maximise our income generation and ensure alignment between our commercial, research and service delivery functions by October 2014 PHE will go digital first. We need to improve our digital activity so we meet our users needs. This year we are developing a digital strategy, starting to rationalise our websites and improve our digital services, and getting the specialist digital skills we need. We will transition 15 websites to GOV.UK and NHS Choices by July 2014 finalise options to create a science hub of national and international importance in protecting and improving the public s, based on the Science Hub Survey, and produce the outline business case by July

24 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources Developing England focus on our people and our teams We will accelerate our investment in our staff in a number of ways: grow our people through meaningful, open and objective appraisal based on equality and diversity principles, and identify and develop talent to ensure we have motivated staff with the right skills shape the workforce for now and for the future through the implementation of an integrated workforce planning framework, to ensure we have the right people, in the right place, at the right time provide a y and safe workplace, by implementing best practice to engage and support staff to achieve their potential, and work towards becoming an exemplar of and wellbeing in the workplace focus our efforts on creating high-performing teams, including through our leadership of staff from different professional groups within PHE, who feel valued, are supported to reach their individual and collective potential, and who live the civil service values of impartiality, integrity, objectivity and honesty continuously improve the quality of our work and maximise our impact by fully embedding the PHE quality programme implement our IT, estates, procurement and finance strategies to ensure we deliver best value for the tax payer provide occupational services whenever needed, so staff are supported to return to work, and are empowered to make y choices which enable us to live the values that we promote support the business by integrating HR support for our staff, underpinned by simple and effective systems and advice embed sustainability into all our policies and practices ensure our staff take full advantage of the resources of Civil Service Learning, and the talent and development programmes for the civil service 17

25 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources people four regions are coterminous with those of NHS England, and they also map onto the nine regional local government groupings. Each will nurture and support the local public system and maintain an overview of the whole system s progress in implementing the Public Health Outcomes Framework. They have a special responsibility for developing the wider public workforce. In addition to our local centre and regional staff, we also have other expert staff including those based at Colindale in north London, Chilton in Oxfordshire and Porton Down in Wiltshire, and in Function Microbiology: national centres, regional laboratory network, the capability to identify infectious disease and production of Erwinase and anthrax vaccine Health protection: providing the surveillance and management for outbreaks of infectious disease and chemical and radioactive hazards a network of regional microbiology laboratories throughout the country. Expertise in radiation and chemical protection is provided at Chilton and by teams around the country, and offices in Scotland and Wales. Staff (WTE) Local centres and regions: regional and local staff providing public advice to local authorities 950 Knowledge and intelligence: distributed across eight regionally located teams providing information on performance and variation 510 Screening (cancer and non-cancer): developing new programmes and quality assuring screening 275 Health and wellbeing: supporting local authorities, the NHS and central government to secure gains in and wellbeing through evidence-based interventions and supporting behaviour change through social marketing 195 Finance, commercial and procurement 140 IT and estates 100 Human resources 55 Corporate support 145 We have four regions and 15 centres We have 5,110 staff (WTE) We have scientific campuses at Colindale, Porton and Chilton staff work from over 100 locations 18

26 Welcome England at a glance Supporting local leadership achievements Health and Wellbeing Framework Protecting Improving Sustainable and care services Capacity and capability Developing England people resources resources We are funded primarily by the Department of Health although we also generate significant income from our portfolio of products and services, such as the manufacture of vaccines, provision of advisory and laboratory services, research and royalties. expenditure can be split into three main segments: Breakdown of our government funding Local authority grants 2,793.8m Ringfenced public grants to local authorities Much of the funding we receive from the Department of Health is passed on directly to upper tier local authorities in England as ringfenced public grants ( 2.79bn) to enable them to discharge their public responsibilities m 366.5m Vaccines and counter measures We receive specific funding from the Department of Health to procure vaccines and other counter measures ( 366.5m) Net operating expenditure Vaccines and counter measures Breakdown of our external income Operating expenditure This reflects the costs both to run the organisation and deliver specific public programmes (eg screening programmes, social marketing etc). net operating expenditure funding of 397.9m from the Department of Health is supplemented by 181m of commercial income that we generate. This funds the specific programmes of public activity ( 451.3m) and our administrative running costs ( 127.6m). Royalties Others 39m 32m 18m 41m 51m NHS Laboratory testing Research Sale of products 19

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28 PUBLIC HEALTH DELIVERY PLAN: 2014/15 Improving Outcomes, Tackling Preventable Premature Mortality June 2014, V4 0