By Faculty of Public Health (2014)
The Faculty of Public Health have recently produced standards for local public health departments in England. Section 4 (beginning on page 8) talks about public health intelligence.
This is a draft document which will be reviewed in May 2014.
Comments can be sent to workforce@fph.org.uk
By NHS England (2014)
This toolkit uses high level health system modelling and allows CCGs to map how interventions could improve local health services and close the financial gap. It is an additional guide to help commissioners with their five-year strategic plans, showing how a typical CCG could achieve financial balance over the strategic period up to 2018/19. Using 2013/14 as a baseline, ‘Any town’ uses detailed data including population size and disease prevalence, to predict what a typical health system’s quality and financial baseline may look like in 2018/19.
By The Nuffield Trust (2014)
This report explores how acute trusts are responding to the Francis Inquiry report, one year on from Robert Francis QC’s original report into the failings in Mid Staffordshire hospitals.
By Royal Society for Public Health (2014)
This report is based on a survey of public health professionals working in local authorities and it found the majority believe health decisions are being made based on politics rather than evidence. It also found that the public health workforce perceives that budgets which are meant to be reserved for public health initiatives are not being ring fenced in practice. Nearly three quarters of respondents also suggested that financial restrictions are impacting upon their team’s ability to deliver health improvement initiatives. Respondants expressed mixed views regarding the role of health and wellbeing boards which have been set up as a forum to discuss local needs and influence commissioning decisions.
By NICE (2013)
Overview: In 2011, 6.8 million (29.8%) of the 22.8 million houses and flats in England did not meet housing standards (English housing survey 2011: homes report). One in ten (10.6%) were in substantial disrepair, 4.6% had damp, a quarter did not meet the ‘decent home’ standard (23.5%), and 15.3% had a serious health and safety hazard.
A large body of evidence suggests an association between poor housing and poor physical and mental health, but the nature of any causal links is complicated by the coexistence of poor housing with other determinants of poor health, such as unemployment and poverty. An analysis by the Health Development Agency (2005), now part of NICE, found review-level evidence that a number of housing interventions, such as housing subsidy programmes for low-income families and improving housing energy efficiency measures, improved health. However, the authors noted a number of methodological issues that might limit the validity of their findings.
Current advice: The Department for Communities and Local Government considers a house or flat ‘decent’ if it:
• poses no serious health and safety hazards, as measured by the Housing Health and Safety Rating System
• is in a reasonable state of repair
• has reasonably modern facilities and services, such as kitchens, bathrooms and boilers
• provides a reasonable degree of thermal comfort.
Social houses and flats that do not meet the Decent Homes Standard should undergo refurbishment to bring them up to or above the standard. Homes in the private rented sector do not have to meet the standard but are required to meet Housing Health and Safety Rating System standards. Private landlords whose properties contain hazards as assessed by the system, in particular landlords with tenants on means tested or disability benefits, can be compelled to improve their properties by local authorities.
New evidence: A Cochrane systematic review by Thomson et al. (2013) sought to establish whether physical improvements to housing affected health and socioeconomic outcomes. The authors searched for studies of the effects of rehousing and any physical change to housing – for example, heating installation and general refurbishment – on physical or mental health, wellbeing or quality of life. Thirty-nine quantitative and qualitative studies were identified, but meta-analysis of the data was not possible because of extreme heterogeneity among the studies.
Assessment of the studies by intervention type suggested that warmth and energy efficiency improvements to housing (19 studies) benefited respiratory health and had some positive effect on general and mental health. The studies of rehousing or retrofitting houses mostly looked at housing-led neighbourhood renewal (14 studies) and had mixed results, with only one small study reporting a significant improvement in general health. The limited evidence available on provision of basic housing in low or middle income countries (3 studies) reported unclear or small health improvements, as did the poor evidence on rehousing from slums (3 studies). Three studies reported lower levels of school absence in children after housing improvements, with 1 additionally reporting a link between housing improvements and a significantly lower number of days off work among adults.
The authors generated a model using the 9 studies with the best available data to analyse the overall effect on health of modern day improvements to housing. These studies suggested that warmth or energy efficiency improvements, which are often part of rehousing or retrofitting projects, can lead to improvements in health in high income countries. Analysis of the qualitative data identified in the search suggested that improvements in thermal comfort and affordable warmth allow residents to use more of their indoor space, which can promote improvements in diet, privacy, and household and family relationships.
Commentary: “This study strengthens the evidence of the link between improvements in housing – particularly in warmth and affordable warmth – and improved physical and mental health. It shows the key role of housing in the dynamic between poverty and poor health, and how improving housing can benefit school attendance and reduce absenteeism from work; for example, through improved respiratory health and improved relationships within the home.
“The significance of this evidence for practice is that primary care health professionals and others with a responsibility for improving health and wellbeing should focus not just on individual lifestyle factors but also on supporting improvements in the environment. Such improvements might include interventions to tackle fuel poverty and to improve the energy efficiency of homes.
“Local authorities becoming responsible for public health, improved integration of health and social care in the care of the elderly, and local authorities taking commissioning responsibility for the public health of children ages 0 to 5 years will potentially support health and social care practitioners in improving the health of their patients, clients and communities.” – Sabrina Fuller, Head of Health Improvement, NHS England
Study sponsorship: Chief Scientist Office, Health Department, Scottish Government; and Nordic Campbell Collaboration (NC2), Norway.
By New Local Government Network (2013)
This research finds that councillors are preparing to transform the way public health services are delivered, but many of them are likely to be frustrated by inflexible ring-fenced budgets and locked-in contracts with the private sector. It also found that the wider determinants of public health and increasingly being considered as priorities for public health but this is not reflected in spending decisions.
By Monitor (November 2013)
All providers of health care services for the NHS including independent providers, will require a Monitor licence from 1st April 2014, unless they are exempt. This document outlines the action commissioners now need to take to be ready for 1st April 2014.
By Sodexo (December 2013)
This report explores the case for partnership working, helps define partnership and highlights the things to consider when navigating the procurement process. It looks at three phases of the partnership process: getting started, procurement and delivery.
By NHS England
NHS England has today published 37 nationally consistent commissioning policies as part of its role as a direct commissioner for some non-specialised services. The policies, which are interim at this stage, are of particular benefit to the armed forces and health and justice populations as members of these communities are subject to changes in location which may disrupt the provision of their healthcare. All of the policies will be subject to further review by NHS England’s Clinical Reference Groups, and will be subject to full public consultation next year.
By International Longevity Centre (November 2013)
This report sets out an argument for adult immunisation in the UK as a preventative public health intervention within broader healthy ageing strategies as a cost-effective measure. It highlights a number of policy recommendations that include: JSNAs taking a life-course approach to immunisation; health and wellbeing boards ensuring that that life-course vaccination is adequately considered as part of health planning and commissioning; and that commissioning arrangements for immunisation should support the uptake of adult vaccination.