Archived decisions

Contact: Rea Mattocks ext: 7200

1. Summary and Purpose

1.1 The purpose of this report is to provide Members with an update following the report on the Health and Well-being Review on 31 January 2006. At that meeting, the committee recommended:

"that a) the report be shared with the Adult Services Restructuring Board Working Group that is taking forward joint working with the Public Health Network. This will include

· A more detailed mapping of public health plans and programmes across the county, including opportunities to share best practice and identify gaps in delivery

· The development of LSPs and LAAs

· Identification of the health improvements to be delivered by local people

b) Lead officers from Adult Services and the Public Health Network will report back to the Committee on progress with this work on 28 November 2006 detailing the outcomes of the review".

2. Progress since January 2006

2.1 The implementation of "Commissioning a Patient-led NHS" has had a significant impact upon the development of an integrated public health and well-being agenda across the NHS and Adult Services. This has meant that it has been difficult to maintain engagement with the NHS as it reorganises on a local level. Therefore, it has not been possible to produce a detailed mapping exercise of public health programmes as envisaged in January of this year.

2.2 However, Adult Services has continued to work with the Director of Public Health at the Strategic Health Authority in order to identify opportunities for further integration and collaboration. A report was taken to Corporate Management Team in June 2006 recommending a model for developing leadership across the NHS and local government in public health. The model recognised the specific responsibilities and areas of common interest between the two organisations:

2.3 The CMT paper also recognised the opportunities which will now arise as a result of the decision of the Secretary of State for Health to create a Hampshire-wide Primary Care Trust (PCT). Therefore, it was recommended that Adult Services and Hampshire PCT should work to align the functions and teams responsible for Health and Well-being, and should seek to appoint a Joint Director of Public Health across the two agencies. CMT also recommended that the Director of Adult Services should establish a corporate public health and well-being in order to pursue this agenda.

2.4 Adult Services has also taken the opportunity within its restructuring to establish an Assistant Director post with responsibility for Well-being. In addition, the PCT and Adult Services have agreed to align their structures on a locality basis to improve opportunities for joint planning, commissioning and integration of services. The agencies have agreed their localities for this purpose, based on weighed capitation in order to recognise levels of deprivation. These localities will have explicit links with District and Borough Councils, who are key partners in Well-being and Public Health. These localities are also co-terminus with those identified for Practice-based Commissioning.

2.5 Unfortunately, it was not possible to recruit for either the Director of Public Health or the Assistant Director for Well-being during the first round of recruitment. Both posts have been re-advertised and it is hoped that post-holders will be identified by the new year.

3. Local Area Agreement

3.1 Adult Services has continued to work alongside the NHS to pursue the Local Area Agreement targets in Priority F (Promote and improve the Health and well-being of people in Hampshire). These targets include the achievement of national health inequality targets relating to areas such as smoking and obesity, together with pursuing the Flagship Initiative project to develop effective schemes to provide care at home and in the community and prevent admission to hospital, residential and nursing home care.

4. Future plans

4.1 The recent White Paper "Strong and Prosperous Communities" has again reinforced the need to develop robust partnerships across local authority and the NHS to pursue the Health and Well-being agenda (see Annex B of the White Paper). Four key areas have been highlighted as the priorities for this agenda:

i) patients are able to voice their concerns on health and well-being issues in their area

ii) more visible local leadership (lead Member for Adult Services to influence commissioning decisions of Health and Social care bodies and drive action to reduce health inequalities)

iii) Build on reforms by engendering systematic partnership working to tackle wider causes of social exclusion, worklessness and vulnerability

iv) Join up priorities, reporting systems and performance management arrangements for public health and social care.

4.2 Over the next few months, Adult Services will begin preparatory work with the local NHS to establish a statutory partnership for Health and Well-being. This will be informed by the results of the Department of Health's consultation on the implementation of partnership and will consider areas such as joint planning & commissioning, developing shared outcomes, establishing joined-up assessment processes, integrating services, and improving patient and public involvement.

5. Recommendations

As arrangements for the restructuring of the local NHS and Adult Services are now becoming clearer and are beginning to provide opportunities for further collaboration, it is recommended that:

· Lead officers from Adult Services and Hampshire Public Health Network report back to the Committee in July 2007 with a clear action plan for developing a joint strategy for Public Health and Well-being across the county.