MIDDLESBROUGH COUNCIL
EXECUTIVE REPORT
Report Title: Middlesbrough Public Health Transition plan
Brenda Thompson, Executive Member for Public Health and Sport
Mike Robinson, Director of Adult Social Care and Environment
Date: 31 January 2012
PURPOSE OF THE REPORT
To update the executive on the public health transition plan for managing the transferring public health statutory responsibilities from NHS Middlesbrough to Middlesbrough Borough Council.
SUMMARY OF RECOMMENDATIONS
The executive is requested to:
- Note the progress with developing the draft Middlesbrough public health transition plan
- Note that the draft consultation plan will be further developed, in consultation with a wide range of agencies, before a final transition plan is submitted to Executive in March 2012.
IF THIS IS A KEY DECISION WHICH KEY DECISION TEST APPLIES?
/ It is over the financial threshold (£150,000)It has a significant impact on 2 or more wards / X
Non Key
DECISION IMPLEMENTATION DEADLINE
- For the purposes of the scrutiny call in procedure this report is
Non-urgent
Urgent report / X
Draft transition plans to be submitted to the Regional Director of Public Health (RDPH) by 20 January 2012 and final plans signed off by the local authorities should be submitted by 31st March 2012
BACKGROUND AND EXTERNAL CONSULTATION
Public Health Policy update
- The NHS White Paper ‘Equity & Excellence’ proposed major changes in the arrangements for the delivery of public health functions in England as part of the Health and Social care Bill. . The key proposed changes, (subject to parliamentary approval) are:-
· For Primary Care trusts (PCTs) and strategic health authorities (SHAs) to be abolished by April 2013
· Responsibility for strategic planning and commissioning of NHS services is to transfer to the NHS Commissioning Board (NHSCB) and Clinical Commissioning Groups (CCGs).
· A national public health service is to be established, Public Health England to provide national leadership across public health
· Local Authorities (LAs) will assume statutory responsibilities for public health to include: health improvement, health protection and health service quality from April 2013.
· LAs will receive a ring-fenced public health grant. The Department of Health also propose to incentivise action to reduce health inequalities by introducing a new health premium
· LAs are to establish statutory Health & Well-being Boards (HWBs) responsible for the Joint Strategic Needs Assessment (JSNA) and the development of a health and wellbeing strategy.
- The Healthy Lives, Healthy People White Paper outlined a vision for new public health systems and subsequent documents have provided more detail about how plans must be taken forward. In December 2011, a series of fact sheets describing public health in local government and the operating model for Public Health England were published. The fact sheets covered the following:
Public Health in Local Government
The Role of the Director of Public Health
Local Government leading for Public Health
Local Government’s New Public Health Functions
Commissioning Responsibilities
Public Health Advice to NHS Commissioners
Professional appraisal and support, and capacity building
Public Health England’s Operating Model
Mission and values
Functions
Organisational design
Status and Accountability
Next Steps – establishing Public health England
- Further guidance on public health ring fenced budgets and the health premium, the public health outcomes framework, human resource toolkits and the workforce strategy is expected to be published in due course and will inform the local transition plan.
Middlesbrough Public Health Draft Transition Plan
8. In order to ensure the smooth transition of the responsibility from NHS Middlesbrough to Middlesbrough Borough Council, a local public health (PH) transition group has been established with membership from the PCT, council and clinical commissioning group.
9. The group meets every four weeks and reports to the Middlesbrough Health Transformation Programme, the Middlesbrough shadow health and wellbeing board and the NHS Tees PCT board.
10. The group will seek representation and advice as required from HR, workforce development, finance, IT, communications, Council Legal Services and other key colleagues as appropriate. The PH transition group will also work with the local Clinical Commissioning Groups, the emerging arrangements for Public Health England and the NHS Commissioning Board to ensure local activity is fully integrated and the transition plan is fully supported.
11. The strategic health authority has established a regional public health transition board and Middlesbrough is represented by the Chief Executive and the interim director of public health.
12. The draft Middlesbrough public health transition plan (Appendix 1) has the following themes:
· Vision and strategy for public health in Middlesbrough
· Designing the new local public health system
· Maintaining the public health services and programmes throughout the transition year
· Ensuring robust governance arrangements for the new local public health system:
· Corporate governance
· Clinical governance
· Performance and accountability
· Risk and resilience
· Enabling Infrastructure
· Workforce and human resource management – capacity and capability
· Finances, contracts and procurement
· Accommodation, IT and assets
· Communication and engagement.
Key milestones for the public health transition
13. A recent letter from Professor Paul Johnson, Regional Director of Public Health for the North of England highlighted the following timescales for implementing the plan.
· Draft transition plans to be submitted to the RDPH by 23 January 2012 and the final plans, signed off by the local authorities, should be submitted by 31st March 2012
· By the end of October 2012 it is expected the substantial majority of PCTs with local authority agreement will have transferred public health duties to local authorities with robust governance in place for the remainder of 2012/13
· By the end of December 2012 all remaining duties will be transferred
· By the end of March 2013 all PCTs must have completed the formal handover of public health responsibilities to Local Authorities.
IMPACT ASSESSMENT
14. An Impact Assessment (IA) of the proposed plan has been undertaken in line with Council requirements. The IA found that there were no concerns that the transition plan could have an adverse impact. The IA is attached to this report at Appendix 2.
RISK ASSESSMENT
15. A risk register for the transition plan is being developed by the transition group. The draft plan is RAG rated
· Red – actions where national guidance is yet to be published
· Amber – work in progress
· Green – actions that are progressing and on track or have been completed
FINANCIAL, LEGAL AND WARD IMPLICATIONS
16. Financial – The statutory public health responsibilities are transferring from the NHS to the local authority and these will be discharged through a ring fenced public health budget and the health premium. Further details on both the ring fenced budget and the health premium are expected later in January 2012.
17. Ward Implications – this report covers the entire population of Middlesbrough.
18. Legal Implications – Legal implications arising from the transfer of public health functions from NHS Middlesbrough to Middlesbrough Council will be identified and addressed through the Middlesbrough Public health Transition group.
SCRUTINY CONSULTATION
19. The draft transition plan will be presented to the Health Scrutiny on 26 January 2012.
RECOMMENDATIONS
The executive is requested to:
20. Note the progress with developing the draft Middlesbrough public health transition plan
21. Note that the draft consultation plan will be further developed, in consultation with a wide range of agencies, before a final transition plan is submitted to Executive in March 2012.
REASONS
22. The Department of Health expects local public health transition plans to be co-produced with and signed off by local authorities.
BACKGROUND PAPERS
The following Department of health policy and background papers were used in the preparation of this report:
· Public Health in Local Government Fact and Public Health England Operating Model fact sheets: Published December 2011
· Healthy lives, healthy people White Paper: Our strategy for public health in England, Published: 30 November 2010
· Healthy lives, healthy people White Paper: Update and way forward: July 2011
· Healthy lives, healthy people: our health and wellbeing Published: November 2010
· consultation on the funding and commissioning routes for public health
· transparency in outcomes - proposals for a public health outcomes framework
AUTHORS:
Edward Kunonga – Interim Director of Public health, Middlesbrough
Sue Perkin – Health Improvement Partnership manager, NHS Middlesbrough
4
1 - VISION AND STRATEGY FOR IMPROVING HEALTH AND TACKLING HEALTH INEQUALITIESAction / Lead / Support Officer / Progress / Comments / Timescale and RAG rating
1.1 / Develop and agree the vision and strategy for improving population health and reducing health inequalities in Middlesbrough / Acting Director Public Health / Ed Chicken / A paper describing the process for appointing a substantive DPH for Middlesbrough has been discussed at the council’s corporate management team / Mar 2012
The vision and strategy for public health in Middlesbrough that ensure public health is embedded across local government, NHS, VCS and other key partner agencies will be developed and shared in consultation with the different agencies / March 2012
Governance arrangements for the Middlesbrough shadow health and wellbeing board are being finalised and a paper will be discussed at the January 2012 meeting. / April 2012
1.2 / Ensure there is a plan for the development of the JSNA and the health and wellbeing strategy public health working across whole of local government. / Acting Director Public Health / Mark Reilly / JSNA refresh is currently under way and the draft JSNA will be presented to the shadow health and wellbeing board, Clinical commissioning board, PCT board / March 2012
A review of health and well being strategies is being carried out and recommendations for the Middlesbrough Health and wellbeing strategy framework will be presented to the health and wellbeing board in March 2012 / March 2012
Health and wellbeing strategy to be developed in consultation / Aug 2012
A health and wellbeing outcomes framework for Middlesbrough will be developed incorporating the JSNA, health and wellbeing strategy and the following national outcomes frameworks: NHS, Adult Social care, Children and Young people and public health outcomes framework. / September 2012
*awaiting further national guidance
The Middlesbrough Health and Wellbeing strategy once finalised will be used for developing commissioning intentions for 2013/14 / September 2012
1.3 / Develop a legacy handover document for all public health functions, programmes, schemes, services and activities commissioned with public health resources for 2011/12. / Acting DPH / Head of Health Improvement / A paper summarising the current arrangements paper covering the PH capacity, team structure, shared functions and services, finances, commissioning arrangements, and contracts / January 2012
Mapping of MBC’s existing public health arrangements i.e. services/functions, workforce, finances (budgets and spend) is currently underway and a paper will be presented at the January 2012 transition group meeting. / February 2012
Mapping of public health resource in the VCS using the community asset mapping approach is currently underway and is being led by the Middlesbrough voluntary Development Agency (MVDA) / February 2012
Legacy handover arrangements for all public health programmes will be developed (a combination of documents and electronic files). Migration of all public health work onto the shared drive is currently underway. / October 2012
2 - MAINTAINING THE SERVICES IN THE TRANSITION YEAR
Action / Lead / Support Officer / Progress / Comments / Timescale
2.1 / Ensure there is a robust business plan for the delivery and continuity of public health programmes during the transition year in line with local, regional and national priorities. / Acting DPH / Head of Health Improvement / Business plan for 2012/13 public health delivery in Middlesbrough being developed by health improvement, Safer Middlesbrough Partnership (drugs, alcohol and crime) , NHS Tees PH teams in line with local, regional and national priorities. / April 2012
The business plan will detail the governance arrangements for public health delivery and business continuity throughout the transition year / Ongoing
2.2 / Maintain NHS Emergency Planning arrangements and business continuity and ensure Public Health representation on the Local Resilience Forum. / Assistant Director of Health Improvement (Hartlepool) / Acting DPH / NHS Hartlepool will continue to host the emergency planning manager and prepare plans to comply with the Civil Contingency Act 2004 until national guidance is produced indicating how this duty is to be discharged post PCT. Assistant Director of Health Improvement (Hartlepool) to represent NHS Tees on LRF during 2012/13 for all emergency planning health issues / Ongoing
2.3 / Ensure strong relationships with the HPA, public health observatory, cancer registry, NHS Information Centre, National Treatment agency during the transition. / DPH / Dr Toks Sangowawa / Business continuity for public health programmes, services and support as well as regular updates on the transition and emerging structures from the HPA, public health observatory, cancer registry, NHS Information Centre, National Treatment agency during the transition will be achieved through existing arrangements. The NHS Tees Public health team and the Middlesbrough locality team will ensure the locality receives the support it requires to deliver local public health programmes. / Ongoing
2.4 / Ensure delivery of the public health performance indicators and achievement of health outcomes for local populations / DPH / Head of Health Improvement / The Middlesbrough locality public health business plan will detail how the how performance indicators and health outcomes for local populations will be achieved. / April 2012
3 - DESIGNING THE PUBLIC HEALTH SYSTEM
Developing the local public health system
Action / Lead / Support Officer / Progress / Comments / Timescale
3.1 / Develop an understood and agreed ‘operating model’ for the new local public health system. / Acting DPH / Ed Chicken / Develop an agreed, fit-for propose operating model for the local public health system that ensures:
· Clear and robust arrangements for delivery of the public health statutory functions
· Clear and robust arrangements for the support and relationship between locality teams and Public Health England and mechanisms for holding PHE to account for local delivery.
· Capacity and capability across the local government, NHS, VCS and other partner agencies to deliver local priorities