Director of Public Health Development Report
Author:Dr Peter Bradley
Date:26 March 2012 / Version:1
Purpose and Summary of Document:
Update to the Executive Team
Date of Executive Team Meeting:2April 2012
Please State if the Paper is for:
Discussion
Decision
Information / x
Publication / Distribution:
- Executive Team only
Date: 26 March 2012 / Version: 1 / Page: 1 of 18
Public Health Wales / Director of Public Health Development Report – April 2012
1Executive Director of Public Health Development Update
Progress has been made in the directorate in the last month as follows:
1.1The end of the re-alignment Board in March 2012 has led to intensive productive discussions with Welsh government about the future of health improvement in Wales. A draft proposal for a Health Improvement Board detailing terms of reference and potential membership has been drawn up for Welsh Government. In the proposal, the Board would become a sub-committee of Public Health Wales Board, including a wide range of stakeholders, map current activity and make a set of recommendations by autumn 2012. The proposal needs to be submitted to the Minister for Health for her consideration.
1.2The process of creating an “Institute function” has now commenced. A meeting of academics from across Wales is planned in the near future. Accommodation possibilities for the functions are also being closely followed-up. A review of possibilities to attract research funding has also started and a paper detailing the review will be available in the near future.
1.3Areas for future development are currently being identified and will include: research synthesis, links between Health Boards and the Observatory, cancer intelligence, smoking, work on the wider determinants of health and workplace health. There are also plans to strengthen communication between directorates in areas such as vulnerable people, public health nursing, surveillance and safeguarding.
1.3.1The work on INNU has proposed a way to horizon scan, communicate with stakeholders and produce evidence summaries much more efficiently at the national level whilst public health staff in Health Boards will ensure local policies are developed and implemented. Clinicians are linked into the proposed model to ensure the policies are clinically appropriate and to aid horizon scanning for each clinical area.
1.3.2The work on smoking is looking at how to feedback data to leads in Health Boards, innovation in delivery and smoking in pregnancy. The work is uncovering areas that need development and proposals on how to improve the service will be developed soon.
1.4The directorate continues to champion the early year’s pathfinder (including input to the work on child poverty) and work on vascular checks. For early years, a costed implementation plan for 2012/3 is being drafted and will be available soon.
1.5The directorate has given considerable input to the National Case for Change in terms of expert advice and data including attendance at the National Clinical Forum.
1.6A proposal for the use of consultant and principal sessions across the system has been circulated to staff for comment. The proposal aims to create an aligned, flexible resource across the public health system for key topics. The proposal currently excludes national health protection staff. The consultation on the proposal closed towards the end of the month. Feedback was generally positive and an implementation plan is now being established.
1.7Job plans have now been agreed with core consultant staff including academic staff, an important milestone in preparing for re-validation.
1.8There is active involvement from the directorate on the proposals for developing public health nursing currently led by the Directorate of Public Health Services.
1.9An audit and action plan has been completed to ensure the safety of lone workers e.g. in the Stop Smoking service.
2Director of Health and Healthcare Improvement Update
2.1Audit and Improvement in Healthcare Quality
2.1.1Initial dialogue has commenced with the Observatory about using routine primary care derived data as a basis for audit and improvement in healthcare quality.
2.2Business
2.2.1A draft interim administration structure (excluding Stop Smoking Wales) has been circulated to staff for consultation.
2.2.2Work is ongoing to ensure the requirements for Standards for Healthcare Services is met.
2.2.3The move of the Health Promotion Wales Library and staff to Public Health Wales commenced on 19March2012 and will be completed by 1April2012.
2.2.4A review of how finances are managed within the Division is being undertaken with a view to simplifying systems and processes.
2.3Alcohol
2.3.1Work on the alcohol brief intervention project has continued.
2.3.2A half day course training healthcare professionals to deliver a 510 minute intervention has now been finalised and is awaiting accreditation by Agored Cymru. A shorter version of the training course (1.5 hours) to deliver a 2-5 minute intervention is now under development. Piloting of the half day course will be take place by mid-April.
2.3.3In response to request from the Minister for Health and Social Services, a progress report on the alcohol brief intervention project has been provided to Welsh Government.
2.3.4A 5x5 group has been established to produce a proposal to systematically provide alcohol brief intervention training for health care professionals across Wales. A report to Directors of Public Health is being finalised.
2.3.5There has been continued engagement with the Knowledge Transfer Partnership and Cardiff University to identify key work they have undertaken to deliver alcohol brief intervention in secondary care in Wales.
2.4ASSIST
2.4.1It is planned during 2012/2013 for 48-50 schools to receive ASSIST with approximately 1500 young people benefiting from participating in the programme.
2.5Cardiovascular Disease
2.5.1The Division contributed to the 1000 Lives event on cardiovascular risk assessment in primary care.
2.5.2Public Health Wales attended two stakeholder groups of the Welsh Government Health Checks programme, the Trust is represented on the Steering Group and leading the cardiovascular disease work stream, a Project Initiation Document for the work stream is being developed.
2.6Child Poverty Strategy
2.6.1Public Health Wales Child Poverty Strategy and Delivery Plan has been developed and will be presented to the Public Health Wales Board in April.
2.7Critical Care
2.7.1A ‘real-time’ surveillance network across Wales capturing data on patients admitted with Severe Respiratory Infectious Disease is being discussed with critical care consultants at University Hospital of Wales and the Royal Glamorgan Hospital.
2.8Critical Care Minimum Dataset
2.8.1Discussions have taken place within Public Health Wales and the Welsh Intensive Care Network on the Critical Care minimum dataset, with a view to reviewing its current dataset to capture information on patients admitted to Intensive Therapy Unit with infectious respiratory disease.
2.9Dementia: Prevention and Early Prevention
2.9.1A report has been produced to support the North Wales Dementia Planning Group, outlining the current evidence relating to prevention of and early intervention in dementia amongst older people, and an overview of the resulting economic impact. The report is available on the document database.
2.10Dental Public Health
2.10.1Initial analysis for the dental care home survey 2010/2011 is underway.
2.11Evidence Based Medicine
2.11.1A lecture and contribution to the educational meeting was provided to members of Cardiff and Vale University Health Board Prioritisation Board.
2.12Health Inequalities
2.12.1Literature reviews have been completed and submitted for internal quality review on:
- The evidence base on health inequities and the provision of green space, identifying any further costs effective interventions which could be considered for future action;
- Assess the potential of equipping health and social services staff with the skills and competencies required to make every contact count in supporting and encouraging people to stay healthy;
- Assess the contribution that different approaches to the training of health and social services staff can make to reducing health inequities.
2.12.2The review of the evidence on health inequities and community cohesion and make recommendations for strengthening the health assets approach is ongoing.
2.13International Issues
2.13.1An exchange meeting was hosted with the French National School of Public Health and Baden-Württemberg from the 79February2012.
2.14Interventions Not Normally Undertaken (INNU)
2.14.1Work is continuing on the development of the web based INNU prototype utilising the 5x5 methodology in conjunction with Health Board Directors of Public Health and Directors of Planning.
2.15Literature Reviews
2.15.1Rapid reviews have been completed on:
- The use of incentives in health improvement programmes to achieve behaviour change;
- The use of social marketing to achieve behaviour change.
2.16Mortality Working Group
2.16.1Public Health Wales contributed to a meeting convened by the Welsh Government to look at the use of certain metrics to measure healthcare performance in Wales. Clinical and statistical insights into the value of such measures provided, and builds on work previously carried out on mortality.
2.17National Assembly for Wales Children and Young People Committee
2.17.1A response to the enquiry on ‘Sun Protection for Children and Young People at school, or in Childcare’ has been produced detailing current evidence.
2.18National Institute for Health and Clinical Excellence (NICE)
2.18.1Ongoing contribution is being made to the Technical Appraisal Committee at NICE.
2.19Orthopaedics
2.19.1Initial discussions have been held with Abertawe Bro Morgannwg University Health Board regarding developing outcome measures in Orthopaedics.
2.20Pharmaceutical Public Health
2.20.1Interviews have taken place for an additional Pharmaceutical Public Health post and a candidate selected. A formal job offer cannot be made until the Minister for Health and Social Services has approved the transfer of resources as part of the realignment programme;
2.20.2In response to a screening initiative in Glyncoch, Cwm Taf, a new way of enhancing treatment completion was sought. A paper has been prepared providing an overview of the background, implementation, and evaluation of the new treatment service model, ‘A Community Pharmacy Tuberculosis Medicines Compliance Scheme.’ The document is available on the document database.
2.21Predictive Risk Stratification Model (PRISM)
2.21.1Further work has been undertaken with NHS Wales Informatics Service (NWIS), looking at the performance of the predictive risk modelling tool PRISM during the first 12months of its implementation. A paper has been produced and refers to its key parameters of performance i.e. Sensitivity, Specificity, Positive Predictive Value and Net Present Value. Other work is ongoing looking into variations in daily hospital mortality both in terms of place and time for several specific conditions e.g. Ruptured Aortic Aneurisms, Myocardial Infarction, Stroke, etc.
2.22Public Health Genomics
2.22.1Support is being provided to the Screening Division for the Newborn Blood Spot Policy and Quality Assurance Committee.
2.22.2Preparation has begun on the re-launch of the Genomics and Population Health course as a collaborative project between Cardiff University, the Wales Gene Park and Public Health Wales. A draft programme for a two day course has been prepared and the course provisionally arranged for 9-10March2013.
2.22.3Dr Jader, President of the Society for Genomics Policy and Population Health (SGPPH) affiliated to the British Society for Human Genetics (BSHG), has organised a symposium at the BSHG conference in Warwick in September2012 entitled ‘Epigenetics’.
As the representative of the SGPPH, Dr Jader contributed to the BSHG reconstituting an increase in the number of societies and special genomics interest groups who are keen to join the society. A model was proposed and the group is considering its adoption.
2.22.4A presentation to Senior Management Forum is being prepared on public health genomics.
2.23Public Health Networks
2.23.1Appointments have been made to the Physical Activity Network for Wales, and the All Wales Mental Health Promotion Network.
2.23.2The All Wales Sexual Health conference ‘The Fairer Sex: Addressing Sexual Health Inequalities in Wales’,took place on 22February. The Minister for Health addressed the conference and presented the Public Health Wales Good Practice Award to Barnardos Taith Project.
2.23.3The second ‘Creating an Active Wales’ research seminar took place at Bangor University on 8March which focused on Physical Activity in the green environment. Thirty four researchers, practitioners and policy advisors attended the seminar exploring issues and evidence related to physical activity and the natural environment with presentations on three recent key pieces of national research from both Wales and the UK. A number of new research ideas were generated and new collaborations fostered. The evaluation was highly positive.
An evidence briefing on ‘Measuring Children & Young People’ from the first seminar held is now available.
2.23.4International Health Framework has been agreed and announced by Welsh Government with Public Health Wales identified as the host of the International Health Co-ordinating Centre.
2.23.5Advice offered to Wales for Africa health links on establishment of own bank account. Ongoing discussions regarding Tropical Health and Education Trust (THET) funding bids.
2.23.6Launch of the C-Card standards will be in April following work and consultation through the All Wales Sexual Health Network.
2.23.7Evaluations planned to commence in April of the Public Health Wales Good Practice Scheme (Student from University of Glamorgan) and PlanetHealthCymru (Student from Maastricht).
2.23.8Public Health Wales agreed to join the ‘Good Practice Wales’ initiative following success of Public Health Wales Good Practice Scheme.
2.24Realignment project and Programme Level Agreements (PLAs)
2.24.1The realignment of programme level agreements from the Welsh Government to Public Health Wales is scheduled to be completed by the 1April2012.
2.24.2Arrangements are progressing to recruit to the posts for the:
‘National Breastfeeding Programme for Wales’;
- ‘Public Health Nutrition’
2.24.3In accordance with procurement and tendering requirements of Welsh Government, MEND has been awarded the contract for the provision of the ‘National Children’s Obesity Referral Programme’.
2.24.4The British Association of Dermatologist (BAD) has agreed translation into Welsh of two of its skin cancer leaflets:
The Teenage Cancer Trust (TCT) has agreed to produce their cancer leaflets into Welsh, Adnod Cyf has undertaken the translation and it has been to TCT;
A skin cancer prevention website is to be developed by Public Health Wales;
A briefing on progress has been forwarded to the Welsh Government.
2.25Stop Smoking Wales (SSW)
2.25.1Stop Smoking Wales has supported local activities for No Smoking Day, 14March2012, disseminating promotional resources and participating in local events.
Radio adverts for Stop Smoking Wales were aired on local stations.
2.25.2The service is working with Golley Slater to develop videos focussing on real life personal experiences of quitting smoking.
2.25.3A ‘5x5’ short term working group has began discussions on data and improving tobacco services in Wales.
2.25.4A response is being prepared to the Smoke-Free Premises (Wales) (Amendment) Regulations 2012 consultation, on behalf of Public Health Wales.
2.26Stroke/Disability
2.26.1A visiting French trainee has undertaken a review of the legislation on disability in Wales and France. Continuing work on this may lead to submission of a bid for European research money for a more extensive study of the impact of legislation on enablement and disability.
2.27University of Glamorgan
2.27.1Advice on the evidence base for various aspects of healthcare, is being provided to University of Glamorgan.
2.28Welsh Health Impact Assessment Unit (WHIASU)
2.28.1The WHIASU contract has been developed and agreed between Public Health Wales and Cardiff University for the coming year.
2.29Vulnerable Groups
2.29.1Meetings with Welsh Government officials to examine proposals received within the tendering framework have been undertaken as part of the realignment project.
2.29.2The end of year report (2011/2012) has been completed on behalf of the Public Health Wales advisory group on suicide and self harm. Work is continuing on: the mid plan review of national suicide and self harm prevention action plan; improving access to help lines and websites; producing a Wales version of Help is at hand (a resource for people bereaved through suicide); and developing a suicide and self harm webpage.
2.29.3Meetings and written quarterly reports have been provided to Welsh Government officials to provide updates on workplan progress.
2.29.4A paper is being prepared to scope the options for developing routine data collection on health and wellbeing in gypsies and travellers for Welsh Government.
2.29.5Public Health Wales is undertaking a review of healthcare available to asylum seekers within Wales. Scoping work is underway with key stakeholders:
Awork plan is being developed for the Welsh Asylum Seeker and Refugee Health Advisory Group;
A Safeguarding Children Service Designated Nurse for Safeguarding Children has agreed to join the Welsh Asylum Seeker and Refugee Health Advisory Group.
2.29.6Ministerial agreement has been received to revise the Improving the health and well-being of homeless and specific vulnerable groups – Standards 2009-2014. Staff in the Health and Healthcare Improvement Division are leading the process.
2.29.7The second Cymorth Cymru conference was organised in partnership with Public Health Wales and took place on 8-9 March 2012. Over 180 delegates attended and feedback was excellent. Public Health Wales was well represented exhibiting and speaker/workshop input.
2.29.8A report on effective models for mental health and housing is being developed with stakeholders.
2.29.9A briefing requested by the Chief Medical Officer on Public Health Wales current role in public mental health has been produced.
2.29.10A consultation response has been prepared on the Draft Mental Health (Secondary Mental Health Services) (Wales) Order 2012.
2.29.11Input has been provided to the Public Health Wales poverty strategy.
2.29.12Discussion will be taking place with health protection to develop effective methods of communication of important health messages to housing support providers.
2.29.13The use of health and health promotion e-learning packages with housing providers is being considered. This is likely to include brief interventions for smoking cessation and blood borne viruses. A pilot housing service has been identified.
2.29.14Meetings to discuss the health needs of vulnerable populations have taken place with colleagues in local public health and supporting people teams.
2.29.15A meeting was held with Welsh Government to discuss how the work of the team could assist with the requirement for equality.
2.29.16A prison mental health needs assessment is being undertaken.