Public health reform stakeholder event, Aberdeen

Transcript

1. Public health reform Angela Scott Chief Executive, Aberdeen City Council
2. #phpscot
3. Public health reform Eibhlin McHugh Co- Director Executive Delivery, Public Health Reform
4. Why are we here… The Health and Social Care Delivery Plan describes three related national reform actions: - Establish national public health priorities - Create a new national public health body - Enable a joined-up approach to public health at a local level
5. Life expectancy compared with other European countries. Population Health Challenge…. Scotland
6. Population Health Challenge….
7. What Creates Health Gain? Health care is not the main determinant of our health. Estimates of impact show that social and economic conditions determine more.
8. Enabling the whole system • Create a powerful coalition to promote health and challenge inequalities • Shift from focus on clinical activity to health of the whole population • Put Place at the heart of health and well being • Empowerment and asset based approach to working within communities • Collaborative Leadership at all levels
9. Building Blocks • Community Planning Partnerships • Community Empowerment • Locality Planning • Integrated Joint Boards • Participatory Budgeting • Inclusive Economic Growth
10. Public health reform Marion Bain Co- Director Executive Delivery, Public Health Reform
11. ‘Will require a positive, holistic, eclectic, and collaborative effort, involving a broad range of stakeholders’ (Davies et al 2014)
12. What has public health achieved …. …..truly transformational changes in health and wellbeing
13. Public health…evolving Davies et al 2014
14. What would modern ‘public health’ look like in Scotland….? Retain and maintain what's worked in improving the public’s health A whole system approach to improving the public’s health: • Environments that support, encourage, drive and enable health • Where healthy behaviours are the norm • Individuals take, and are able to take, responsibility for their own health Creating a “a culture for health’’ in Scotland
15. What is the vision for public health reform….? Will include the concepts of: Scotland being a world leader in improving the public’s health. Using knowledge, data and intelligence to create a culture of health in Scotland which drives, enables and sustains healthy behaviours, and where individuals take ownership of their health. Scotland responds to the complex 21st century challenges and is recognised across the world for delivering transformational change in the publics health. Our aspiration…
16. Progress to date Reform programme oversight, governance and delivery support established Programme team from different partners established The new national public health body –detailed planning work now underway Progress on how best to achieve a ‘whole system’ and the ‘joined-up’ approach to public health at a local level Process to agree national public health priorities
17. April 2017 March 2018 Public Health Priorities Principles • cover full spectrum of public health • based on partnership working • informed by evidence • focused on achieving the most health gain Initial workshop Modelling workshop Evidence-based evaluation criteria Engagement & gathering views Analysis of LOIPs Consideration of other sources Stakeholder events across Scotland Agreed priorities for Scotland Agreeing Public Health Priorities for Scotland
18. Prioritising Public Health Challenges Taking an evidence based approach
19. Today in context April 2017 February 2018 Public Health Priorities Principles • cover full spectrum of public health • based on partnership working • informed by evidence • focused on achieving the most health gain Initial workshop Modelling workshop Evidence-based evaluation criteria Engagement & gathering views Analysis of LOIPs Consideration of other sources Stakeholder events across Scotland
21. Source: Institute for Health Metrics and Evaluation Risk factors for ill health in Scotland
22. Comparing between countries Scotland Western Europe
23. Source: Long-term Monitoring of Health Inequalities, Scottish Government, Dec 2017 Or prioritise inequalities?
24. Development of the Criteria for Priorities
25. Method • Panel convened, chaired by Prof. Frank • Representatives from public health and local government • Evidence review, discussions and debate • Developed draft criteria and evidence matrix • Reference Group review and amendments • Final Report
26. Examples could include: • Alcohol • Smoking • Physical Activity • Physical Environment • Housing and Homelessness • Climate Change • Early years • Communicable disease control • Community Health Services What is a Priority? “Public health priorities for Scotland should be current problems that are important, amenable to change, with broad stakeholder agreement that they should be tackled now”
27. What makes a good priority? Is it of big concern for public health? Can we do something about it? Do we want to do something about it? 1.1 What is the current ‘size’ of the problem? 1.2 How has the problem changed and how might it change in the future? 1.3 What would happen if we disinvested in this area? 1.4 What are the wider impacts? 2.1 Is this issue amenable to prevention by known effective measures? 2.2 Are the measures cost efficient? 2.3 Does this priority impact health inequalities, or risk worsening them? 2.4 When might we expect to see results? 2.5 Is there scope for innovation on this priority? 2.6 How can communities be empowered through this priority? 3.1 Do the public prioritise this? 3.2 Do local government prioritise this? 3.3 Do the professions who will likely work on this prioritise this? 3.4 Does the Scottish Government share the aims? 3.5 Is this best addressed by a joined-up approach rather than by one agency?
28. Principles of Prioritisation • Tough decisions • Whole system • Qualitative process • Expert opinion • Weighting • Across the criteria Set of priorities: • Synergy Priority A Priority B
29. Public health reform
30. Workshop One Activities: • Are these the right criteria? • Which are most important to you? • What priorities do you want to consider? Outputs: • Agreed criteria and approach for your table • Long-list of potential priorities
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32. Workshop Two Activities: • How does each priority score on your criteria? • What does the whole set of priorities need to look like? Number, mix, connections. • Which should we pursue, and why? Outputs: • Ranked order list of priorities • Rationale for your top five
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34. What happens next March 2018 May 2018 Engagement Events Analysis of Engagement Findings Event Report Oversight Board Review (April) Draft Priorities Priorities Published Email: publichealthreform@gov.scot Further Engagement Making it happen….