Slide 1 NATIONAL TREATMENT AGENCY Addiction to Medicines: Understanding Public Health Commissioning Beverley Oliver & Corinne Harvey Regional Managers,

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NATIONAL TREATMENT AGENCY

Addiction to Medicines:Understanding Public Health Commissioning

Beverley Oliver & Corinne HarveyRegional Managers ,NTA North East and Yorkshire and Humber and the East Middlands

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Workshop Programme 45mins:Workshop Programme 45mins:

5mins: Introductions from facilitators and from work shop participants.

10mins: A short presentation to describe the landscape including realistic opportunities and threats - Setting the scene .

30 mins: Small working groups to discuss and raise the poignant points for discussion - each group to feed back.

 5mins: Any further questions and close

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Contents:

Understanding Public Health Commissioning

Public Health England and the Health and Care System

Commissioning Process

Opportunities and Support

Discussion and Questions

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Public Health England

5

The new health and care system

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Local people and communities

Health and Well-being Board

Parliament

Secretary of State for Health

PHE NHS CB

HealthWatch

PHE Centres

Local Authorities

CCG/NHS CB

Responsible for

publishing data and

supporting delivery of

PHOF

PHOF NHSOF

Police and Crime Commissioners could have

a seat. Up to each LA

Undertake JSNA & develop HWB Strategies setting out

local priorities

Mandate – only means of holding the CB to

account

Commissioning OF – set by the NHS

CB for CCGs

ASCOF

Sets out the indicators that the PH system & DH

understand are the best mechanisms to

improve public health. Up to LAs to

prioritise.

Sets out the indicators that the NHS should seek to achieve through the

Mandate objective of continuous improvement

The evidence in this presentation can inform

the JSNA and HWB Strategies.

Accountability

Oversight

Links

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Commissioning Flowchart

PHE needs assessment dataPHE needs assessment data

Local needs assessmentLocal needs assessment

JSNA & HWBSJSNA & HWBS

HWBBsHWBBs DsPHDsPH

Operational CommissionersOperational Commissioners

Local Performance Management

Local Performance Management

Engagement Opportunitie

s

Engagement Opportunitie

s

Public Health Grant

Public Health Grant

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Commissioning Process and the role of voluntary and statutory providers

ATM services commissioned by local authorities, through Directors of Public Health - supported by and coordinated through Health & Wellbeing BoardsStronger together - describes how Health and Wellbeing Boards can work effectively with local providers is a framework for building health and wellbeing board and provider engagement• A strategic, whole system approach – setting out a clear, strategic vision of how and why providers will be actively engaged in both determining and delivering the board’s priorities..• Clarifying the new commissioning landscape – and the benefits of the new partnerships to local providers and others.• Involving providers in determining engagement approaches – this collaboration will foster better understanding, stronger cooperation and greater enthusiasm for more productive engagement.

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Opportunities and Support – Health and Wellbeing Boards

• Provider-led initiatives – providers themselves have and can devise effective ways of how they can jointly engage with their health and

wellbeing board for mutual benefit.• Providers as board members – this can be applicable where health

and wellbeing boards have been established as strategic bodies rather than direct commissioning structures.

• A new kind of board and provider leadership is needed for all parties to work above their own organisation’s interests for the benefit of the local health and wellbeing system.

• Different approaches and new skills may be required.

•

• Provider representation for groups, not single organisations – sitting on and engaging with health and wellbeing boards can reduce conflicts of interest, as representation is linked to a group not an individual provider, and be an effective way of feeding in provider knowledge and expertise.• Cooperative working with provider forums – health and wellbeing boards can engage with various provider forums but, to ensure proper engagement, partnership rather than consultation will be required to build collaborative working with providers.• Sub-groups of the health and wellbeing board – these groups, made up of commissioners and providers, can be effective at looking in more detail at a particular theme, care pathway or client group.

Opportunities and Support – Health and Wellbeing Boards (continued)

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Opportunities and Support - Relationships

• There is no statutory seat on the Health and Well-being Boards for voluntary and community sector representation, nor for specialist representation for the drug and alcohol sector.

• However, HWBs are being encouraged to involve the VCS in the development of local strategies. The draft guidance on JSNAs and JHWSs published by the Department of Health for consultation in July 2012 explained that the local VCS could be represented on the HWB, and highlighted the potential for additional members, such as the VCS, service providers, health and care professionals, and representatives of criminal justice agencies ‘to bring expert knowledge to enhance JSNAs and JHWSs’.

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Opportunities and Support - Finance

Funding for drug and alcohol misuse treatment: •Drug and alcohol misuse prevention and treatment important part of public health responsibilities

•34% of national spend on public health has been on substance misuse - recognised in the target formula for the public health grants - illustrates significance of the agenda •Budget is the ring-fenced - but may be other local investment in services and local authorities will want to explore opportunities to lever in investment from elsewhere. • Activity and performance on drug treatment has had an impact on how much money an area has received

•LAs required to report spending on an annual basis. There are categories for adult drugs, adult alcohol and YP drug and alcohol spending. Disinvestment will be very evident •Drug treatment continues to be a key priority for the government and this is unlikely to change

Identifying and presenting ‘Need’ to Commissioners

Where can PHE support? •NTA’s/PHE JSNA documents • Evidence base - growing• To work with local PHE Drug and Alcohol teams in how to inform and

influence planning (who, where, how?)• Have your input via JSNA (contributing local data/intelligence)• Support with case studies and local practice examples • Scope and be aware of what contracts/funding may become available

(ads/tenders primarily but could involve prime provider and subs, integrated services, etc.)

• Consider working with other providers to prepare joint tenders where appropriate

• Other solutions such as offering yourself as a sub-contractor• Keeping in mind other relevant sources of funding: mental health

(CCGs), voluntary sector (LA, charitable trusts, Lottery, companies, etc.)

Context: Suite of evidence-based clinical guidance 2007

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Thank you for your time and any questions?

Any Questions?