Bob Hudson: Public health lessons from home: The view from Wales

About Public Health Wales

Lessons from home: the view from Wales

13 July 2011

Bob Hudson, Chief Executive, Public Health Wales

Presentation

• Health in Wales• NHS Wales restructuring in 2009• Public Health system in Wales• Reflections

Lessons from home: the view from Wales

Health in Wales

• Health of the population in Wales continues to improve

But• Health is worse in Wales than England, Scotland and Northern Ireland

• Health inequities remain stark and resistant to change

Lessons from home: the view from Wales

NHS Wales restructuring

• Replacement of 22 Local Health Boards and 10 NHS Trusts with seven health boards and three specialist NHS trusts

• Abolition of the internal market • Changes introduced in October 2009

Lessons from home: the view from Wales

Health system in Wales

• NHS Wales in Welsh Government• Seven health boards and three specialist trusts

• 22 unitary local authorities

Lessons from home: the view from Wales

Restructuring objectives

• Fit with ‘One Wales’ coalition government agreement

• Fit with Welsh culture and values: co-operation not competition

• Integration and simplification• Appropriate to scale in Wales

Lessons from home: the view from Wales

Public health in Wales• 2005: Establishment of National Public Health Service for Wales– Included most specialist public health services and Public Health Laboratory Service

– Reduced funding

• 2006: Review by Public Health Resource Unit

• 2009: Reorganisation in line with NHS Wales

Lessons from home: the view from Wales

Public health system in Wales• NHS Wales

– including Chief Medical Officer and Department of Public Health and Health Professionals

• Seven health boards – Population health responsibilities– Employ Directors of Public Health

• Public Health Wales– Specialist public health services

Lessons from home: the view from Wales

Public Health Wales

• Incorporates the functions and services previously provided by:– Congenital Anomaly Register and Information Service (CARIS)

– National Public Health Service for Wales– Screening Services Wales– Wales Centre for Health– Welsh Cancer Intelligence and Surveillance Unit (WCISU)

Lessons from home: the view from Wales

Public Health Wales

• Established in 2009 at the same time as the restructuring of NHS Wales

• 1,200 staff• £82 million budget• More than 40 locations• Staff working in local teams, all Wales programmes and networked services

Lessons from home: the view from Wales

Our ambition

• To achieve a healthier, happier and fairer Wales

• We can only achieve this by working together with our stakeholders

Lessons from home: the view from Wales

Directorate of Public Health Services• Accounts for approximately 70 per cent of Public Health Wales staff

• Responsible for the following divisions:– Health Protection– Screening– Safeguarding

Lessons from home: the view from Wales

Directorate of Public Health Development• Main link to the Directors of Public Health– Seven local teams

• Responsible for:– Health and Social Care Quality – Health Improvement– Health Intelligence including the Public Health Wales Observatory, Welsh Cancer Intelligence and Surveillance Unit

Lessons from home: the view from Wales

Reflections (1)

• NHS Wales system is simple• Public health system is complex

– Roles and relationships are complex and need time to develop

• Need to engage further with local government– But joint planning embedded in system: Health, Social Care and Wellbeing Strategies

Lessons from home: the view from Wales

Reflections (2)

• Public health is centre stage– Political support and consensus

• Integrated health system in Wales with public health at its core– From Government to grass roots

• Integrated public health system by organisation and by domain– Economies and efficiencies of scale

Lessons from home: the view from Wales

Reflections (3)

• Cross border issues need managing– Health protection issues– Population movement

• System in Wales is not self sufficient– Dependencies on HPA and FSA etc– Professional development– Research and development

Lessons from home: the view from Wales