National Public Health Service for Wales

National Public Health Service for Wales / Report for NPHS Mid Year Review 2009 - 20010

Version: v1 / Date: 14/09/09 / Status: Approved
Author: Nathan Jones / Page: 1 of 30 / Intended audience: WAG & NPHS (Intranet)
National Public Health Service for Wales / Report for NPHS Mid Year Review 2009 - 20010
Version: v1 / Date: 14/09/09 / Status: Approved
Author: Nathan Jones / Page: 1 of 30 / Intended audience: WAG & NPHS (Intranet)
National Public Health Service for Wales / Report for NPHS Mid Year Review 2009 - 20010

Report for

National Public Health Service for Wales

Mid Year Review 2009 - 2010

Author: Nathan Jones, Planning and Performance Manager

Date: 14 September 2009

Version: 1

Status: Approved

Intended Audience: WAG, NPHS (Intranet)

CONTENTS

Version: v1 / Date: 14/09/09 / Status: Approved
Author: Nathan Jones / Page: 1 of 30 / Intended audience: WAG & NPHS (Intranet)
National Public Health Service for Wales / Report for NPHS Mid Year Review 2009 - 20010
1 / INTRODUCTION / 3
2 / HIGHLIGHTS / 4
3 / Establishment of public health wales & NHS Wales REORGANISATION / 7
4 / ACTION TO ACHIEVE HEALTH IMPROVEMENT / 8
5 / ACTION TO ACHIEVE HEALTH PROTECTION / 11
6 / ACTION TO ACHIEVE HEALTH AND SOCIAL CARE QUALITY / 14
7 / ACTION TO IMPROVE HEALTH INTELLIGENCE / 16
8 / LOCAL ACTION TO SUPPORT HEALTH / 19
Version: v1 / Date: 14/09/09 / Status: Approved
Author: Nathan Jones / Page: 1 of 30 / Intended audience: WAG & NPHS (Intranet)
National Public Health Service for Wales / Report for NPHS Mid Year Review 2009 - 20010

1 INTRODUCTION

This report summarises the key work in progress and achievements of the National Public Health Service for Wales (NPHS) for the period 1 April 2009 – 30 September 2009.

The report will sit alongside the NPHS Legacy Statement, which will provide a high level position statement, as of 30th September, for each area of NPHS work. The legacy statement will also identify implications, stemming from this work, for Public Health Wales.

The NPHS delivers independent public health services in:

· Health Improvement – wide ranging action to improve health and wellbeing and reduce inequalities;

· Health Protection – action for clean air, water and food, infectious disease control, protection against environmental health hazards and emergency response;

· Health and Social Care Quality – action in service planning, commissioning and development, clinical effectiveness, clinical governance, efficiency, research, audit and evaluation.

All this work is underpinned by health intelligence services. This includes surveillance, monitoring and assessment of health and the determinants of health; and the development of the public health evidence base and knowledge.

The NPHS works with multiple stakeholders and depends on successful partnership working in order to achieve its strategic aims and objectives.

The NPHS Business Plan outlines a number of strategic goals. For each goal, the Business Plan identifies a number of strategic objectives, which are intended to encapsulate the NPHS contribution to the achievement of each goal.

The work in progress and national achievements are listed by domain, strategic goal and objective and are reported in sections four, five, six and seven.

A selection of the work undertaken by NPHS Local Public Health Teams, in the priority areas of tobacco control, nutrition and physical activity, is captured in section eight. A snapshot of additional activity is also provided.

2 HIGHLIGHTS

The following section captures some key achievements for each NPHS domain.

Health Improvement

i. Smoking Cessation – Accreditation and Implementation of Brief Intervention Training

Stop Smoking Wales (SSW) has recently developed a Brief Intervention Training Programmefor smoking cessation. The course achieved accreditation from the Royal College of Nursing (RCN) and Open College Network Cymru (OCN). An application is also in process for SSW to become an approved OCN centre. The main aim in gaining accreditation is to provide quality assurance and increase attendance at training by offering relevant professional development credits. Delivery of the training has already commenced across Wales with45 courses booked for the period July 2009 to March 2010.

ii. Health at Work – Small Workplace Award

The NPHS has supported the piloting and launch of the Small Workplace Award. This award aims to engage with small to medium employers in order to improve health and wellbeing in the workplace setting. 46% of the workplaces in Wales employ 50 or less employees with 32% of these employing less than 10 employees. The development of a Small Workplace Health Award (SWHA) based on the key principles within the Corporate Health Standard was initiated in 2007 and the Award was officially launched in 2009. The Corporate Health team are currently engaged with 16 organisations.

iii. Healthy Schools

The NPHS has developed and piloted the Wales Network of Healthy Schools National Quality Award in partnership with colleagues in WAG and education services.

Health Protection

i. Response to Major Infection Emergencies

Health Protection services activity during the first 6 months of this year has primarily been focused towards responding to a number of major infection emergencies, most notably swine flu pandemic, measles and mumps outbreaks across several regions in Wales.

These outbreaks provided the opportunity to fully test NPHS emergency response operational plans, including communications, collaboration and co-ordination with other NHS services, WAG, HPA and international agencies (WHO).

This has led to a number of key developments:

· Improved integration and resilience in outbreak management structures, including acute/emergency response through wider involvement and training of staff and refinement of service continuity plans.

· Enhancement of respiratory virus surveillance through expansion of GP sentinel practice testing /reporting and improved links with automated reporting/alert systems.

· Enhancement in molecular capability and capacity for the identification and characterisation of respiratory viruses in Wales and an overall improvement in our ability to diagnose novel viral diseases with acquisition and introduction of specialised equipment and development of specialised testing methodologies.

ii. Contribution to Wider Public Health Agenda

The Health Protection programmes have made notable contributions to the wider public health agenda in:

· Providing a lead role in 1000 lives campaign and introduction of community strategy for reduction of healthcare associated infection

· Supporting the successful introduction of HPV vaccine

· Development of recommendations for an all Wales Hepatitis C action plan for consultation

· Development of recommendations for improving sexual health services across Wales

Health and Social Care Quality

i. Health Service Quality & Commissioning Support Team

The Health Service Quality & Commissioning Support Team has continued to provide a range of services to the Welsh Assembly Government, Health Commission Wales, Networks, and LHBs. The greatest achievements have been in pieces of work where collaboration with partners (WCfH, NLIAH) has enabled an holistic programme of work (evidence base and epidemiology, implementation of change through clinical engagement, measurement of changed outcomes) to be fully delivered – for example the Stroke Services Improvement Programme and the 1,000 Lives Campaign.

ii. Vulnerable Groups Team

The Vulnerable Groups Team has completed a review of the CPA for mental health services in Wales with recommendations for change that have beenaccepted by the Welsh Assembly Government. The team have also producedevidence based guidance on handling alcohol misuse in the workplace that has formed the basis of a Welsh Assembly Government policy consultation document.

iii. Pharmaceutical Public Health Team

The Pharmaceutical Public Health Team has continued to support Welsh Assembly Government on pharmacy and medicine related issues. Recent work has included chairing the group established to take forward the recommendations of the Routledge report, advising an All Party Parliamentary Group on their Drug Misuse report and responding to media reports of high levels of antidepressant prescribing in Wales. Work to support LHBsto develop pharmacy services is ongoing andhas recently focused on the role of community pharmacy in Chlamydia testing, reducing obesity, vascular screening and reducing harm from alcohol.

Health Intelligence

i. Release of Demography Profile

Demography profiles have been published to assist the new Local Health Boards (nLHBs) in understanding their populations and to assist with planning activities. The work was undertaken by the Public Health Observatory and involved joint working between the WCfH and NPHS. The profiles are available as a short ‘glossy’ publication, written to be accessible by lay members of the Board and provide key points for each health community. Eight versions have been produced for demography: one for each nLHB and one covering all-Wales. A web-based resource giving a greater level of detail than provided by the glossy publication is also available, including local authority level information, further data analyses, descriptive text and information of a more technical nature including full methodological details. This also includes the use of web-specific tools and links to Health Maps Wales and interactive spreadsheets. Initial feedback has been very positive.

ii. Completion of Feasibility Study into the Measurement of Childhood Heights and Weights

The report of a feasibility study into the measuring of childhood heights and weights report has been submitted to the Assembly Government (June 2009). The work was requested by the Minister for Health and Social Services and is intended to inform decisions on the development of a standardised national measurement programme of children’s heights and weights in Wales. The study involved measuring heights and weights of over 16,000 children in schools in five pilot areas, assessing children’s and parental attitudes towards measurement, feedback of individual results and the impact of the programme on primary care and NHS Direct. It included a randomised controlled study into the effect of different approaches to parental consent. Costings involved were also included in the report. The findings will be published in due course, once they have been considered by the Minister.

iii. Chronic Heart Failure Toolkit for Primary Care

In July 2009, the Primary Care Quality Information Service (PCQIS) produced a Chronic Heart Failure Improvement Toolkit to complement the November 2008 Welsh Medicine Resource Centre (WeMeReC) and its associated education module. The PCQIS toolkit contained an audit designed to reinforce the main points of the WeMeRec bulletin and the criteria within the 1000 Lives Campaign on Improving Medical & Surgical Care for Chronic Heart Failure. GP practices in the Wrexham LHB area were invited to participate in the PCQS CHF audit, anonymised audit data was collated and PCQIS produced the report. Within the report practices were asked to reflect on the results of the audit and to consider lessons learnt, including changes the practice may implement and any support needed for the practice to enhance the CHF service it provides to patients. PCQIS is currently working with the WCfH 1000 lives campaign leads on inviting other practices in Wales to participate in the audit.

Version: v1 / Date: 14/09/09 / Status: Approved
Author: Nathan Jones / Page: 1 of 30 / Intended audience: WAG & NPHS (Intranet)
National Public Health Service for Wales / Report for NPHS Mid Year Review 2009 - 20010
Version: v1 / Date: 14/09/09 / Status: Approved
Author: Nathan Jones / Page: 1 of 30 / Intended audience: WAG & NPHS (Intranet)
National Public Health Service for Wales / Report for NPHS Mid Year Review 2009 - 20010

3 ESTABLISHMENT OF PUBLIC HEALTH WALES AND NHS REORGANISATION

Establishment of Public Health Wales

On 2 June 2009 the Minister for Health and Social Services confirmed her intention to proceed to establish a new unified public health organisation as an NHS Trust, to be known as Public Health Wales. The new Trust will be in shadow form from 1 August 2009 and fully operational from 1 October 2009.

Public Health Wales will incorporate the functions and services provided by:

· Congenital Anomaly Register and Information Service (CARIS)

· National Public Health Service (NPHS)

· Screening Services Wales

· Wales Centre for Health (WCfH)

· Welsh Cancer Intelligence and Surveillance Unit (WCISU)

Throughout 2009/10 the NPHS has continued working closely with the Welsh Assembly Government, Velindre NHS Trust and the constituent bodies, which will be forming Public Health Wales. This close working relationship, between public health organisations in Wales, will ensure a smooth transition towards Public Health Wales.

The NPHS have been active members of the Delivery and Change Management Board, which was established by the Chair, Public Health Wales, to take forward transitional arrangements leading to the establishment of the new Trust. The NPHS has also actively participated with the Velindre Reorganisation Preparation Project, which was established to prepare the transfer of assets and staff from the NPHS, Screening Services and WCISU to Public Health Wales.

NHS Restructuring

The NPHS has continued to develop interim arrangements for the delivery of specialist public health services to all stakeholders, following the NHS Wales restructuring. These arrangements will ensure that services currently provided by the NPHS are adapted to meet the needs of the new configuration of stakeholders.

Arrangements have also been put in place by the NPHS to provide public health support to the seven new LHB Transition Directors and the new Chief Executives.

4 ACTION TO ACHIEVE HEALTH IMPROVEMENT

The majority of NPHS action in this domain is undertaken at local level – see Section 8

Strategic goal: Address the impact of the wider determinants of health on health and wellbeing

Strategic objective / Work in Progress & Achievements
Reduce the impact of poverty on health and wellbeing / · Provision of public health support to fuel poverty agenda.
Improve the health and wellbeing of the most vulnerable in society / · Signed WAG joint agreement to eradicate child poverty.
· Contribution to MEND Programme.
· Support for Keep Well This Winter Campaign.
· Support for local healthy schools schemes.
· Support for delivery of Ageing Well
Improve the health and wellbeing of employees / · Delivery of Corporate Health Standard and Small Workplace Award.
· Engagement with other health professionals in rolling out the 'stay active' message.
· Delivery of GP engagement element of Welsh Backs Initiative.
Encourage and facilitate community development to improve health and wellbeing / · Support for Local Government in taking forward ‘Route to Health Improvement’ activities and well-being activity grants.
· Support for delivery of wellbeing element of Health, Social Care and Well-being Strategies

Strategic goal: Reduce risk factors associated with ill health