Applications of Public Health Intelligence,

Drivers and Partnership Working

Day 4 Session 1

Dave Jenner EMPHO

July 2009

Day 4 Session 1: contents

• The main applications of PHI:

• surveillance

• informing planning

• performance monitoring and evaluation

• Current drivers:

• JSNA

• LOPs

• LAAs

• performance management and standards and inspection regimes

• WCC

• Partnership working in PHI

• the wider determinants of health

• joint working across sectors - JSNA, LAAs

• making best use of scarce resources

Applications of PHI: Supporting Planning

Issues for the Executives ...

1. what should our priorities be?

2. what should our strategy be for ...?

3. what changes do we need to make to local services?

4. where and how should we target our resources?

Group exercise:

In a PCT or health partnership - how can we start to

address the first of these questions?

Applications of PHI: Supporting Planning

... translate to Qs for the Public Health Analysts

• what are the current and future health problems in our area?

• how do we compare with other areas?

• within our area where are the health problems worst?

• where is there unmet need?

• what services are currently available?

• what’s the quality of local services?

• what’s the likely impact of a proposed initiative?

Applications of PHI: Supporting Planning

... translate to Qs for the Public Health Analysts

• what are the current and future health problems in our area?

• how do we compare with other areas?

• within our area where are the health problems worst?

• where is there unmet need?

• what services are currently available?

• what’s the quality of local services?

• what’s the likely impact of a proposed initiative?

Comparing ... And Benchmarking

• NHS Comparators– http://nww.nhscomparators.nhs.uk

• World Health Organisation – Health for All database– http://www.euro.who.int/hfadb

http://www.nhsbenchmarking.nhs.uk/benchmarking.asp

Applications of PHI: Performance Monitoring and Evaluation

Issues for the Executives ...

• are we achieving our objectives?

• are we meeting our targets?

• are our initiatives and service changes having the intended

effect?

... translate to Qs for analysts

• same as above

Executives worth their salt will be asking ...

• what should our priorities be?

• what should our strategy be for ....?

• what changes do we need to make to local services?

• where and how should we target our resources?

• are we achieving our objectives?

• are we meeting our targets?

• are our initiatives and service changes having the intended

effect?

Drivers

But just in case they don’t there is legislation andperformance management ...

• PCTs and LAs have a statutory duty to undertake JSNA

• Each PCT needs to have a Commissioning Strategy Plan

• Each PCT needs to have a local Operating Plan

• Each local partnership needs to have a Local Area Agreement

• Each local organisation is subject to performance management

• Each local organisation is subject to a standards and inspection

regime

Where to find out more

JSNAhttp://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081097

LOPshttp://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_082542

LAAshttp://www.communities.gov.uk/localgovernment/performanceframeworkpartnerships/localareaagreements/

http://www.idea.gov.uk/idk/core/page.do?pageId=1174195

Performance management, standards and inspectionhttp://www.cqc.org.uk/http://www.communities.gov.uk/localgovernment/performanceframeworkpartnerships/http://www.audit-commission.gov.uk/localgov/audit/CAA/Pages/default.aspx

WCChttp://www.dh.gov.uk/en/Managingyourorganisation/Commissioning/Worldclasscommissioning/

index.htm

Partnership working for health

Dahlgren and Whitehead’s diagram showing the wider determinants of health illustrates why partnership working in public health is inevitable and necessary - many different organisations and agencies at national, regional and local level can have an impact on the health of a local population. The job of public health is to make this complex system work for health improvement. The job of public health intelligence is to inform that effort.

Partnership working for health

• Local authorities have a specific legal power to promote well-being (Local Government Act 2001)

– Direct provision of social care services for children, people with disabilities and older people

– Influence over key determinants of health (housing, education, leisure, local and built environment)

– Scrutiny of health services in local area

• Increasing moves towards greater integration of health, social care

and well-being – Local Strategic Partnerships (LSP)

– Joint commissioning & service provision (e.g. Children’s Services)

– Joint inspection & review (e.g. Comprehensive Area Assessment)

Brings together representatives of public services, local businesses,

community groups and residents

Responsible for developing the Sustainable Community Strategy and

Local Area Agreement (LAA)

Provides a single overarching local co-ordination framework within

which other partnerships can operate

Often made up of thematic partnerships responsible for delivering

particular aspects of the Community Strategy (e.g. Crime and Disorder

Reduction Partnerships).

Local Strategic Partnerships (LSPs)

• about what sort of place you want to live in

• about focusing on what will make your town, city or community a better place to be

• three-year agreements with priorities agreed between all the main public sector agencies working in the area and

with central Government

• not just decided between public sector agencies - everyone should have a say

• bottom-up - around 35 performance targets (from a list of around 200) + 18 statutory education and early years

targets

• a means for pooling or aligning funding

LAAs are ...

Partnership working in public health intelligence

• Previous slides outline the policy and partnership environment in which we work

• Does it translate into local partnership working in public health intelligence in your area?

• If so, what is the focus?• ?JSNA• ?LAAs• ?shared resources, e.g. local shared information systems

• If not, what do you think are the missed opportunities?

The case for partnership working in public health intelligence

• improving communication and coordination and making best use of scarce resources:– within your organisation - across departments

– between organisations in the local area

– between local areas

– cross-regional collaboration (the regional PHI network)

– with commercial partners

– with academic partners

– APHO

• encouragement and support from management helps• different types of skills required

Day 4 Session 1: contents

• The main applications of PHI:

• surveillance

• informing planning

• performance monitoring and evaluation

• Current drivers:

• JSNA

• LOPs

• LAAs

• performance management and standards and inspection regimes

• WCC

• Partnership working in PHI

• the wider determinants of health

• joint working across sectors - JSNA, LAAs

• making best use of scarce resources