Many thanks for your interest in the above project and for taking the time to discuss with Louise Holden.

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1 Appendix 1 Helen Walters Head of Health, Greater London Authority - by North Central and East London th 4 Floor Stewart House 32 Russell Square London WC1B 5DN 1 March 2016 Dear Helen, Re: An Academy of Public Health for London and the South East Many thanks for your interest in the above project and for taking the time to discuss with Louise Holden. As you can read in the attached document, Health Education England (HEE) is seeking to invest in the establishment of a multi-agency academy that will provide a coordinated offer of clearly signposted development opportunities for all those working in health improving organisations. This includes all those working in NHS, local authority, social care and the third sector. HEE has, in the first instance, committed to 1M years of 'setup' funding in the understanding that the Academy will in due course become (largely) selfsufficient. As Louise may have discussed with you, during this set up phase we are looking for an organisation to provide a home for the project, its funding and any associated support staff. I understand from Louise that the London Health Board may be able to provide this. Practically this would mean that HEE would place the total funding envelope with the Greater London Authority. This funding would cover salary, project costs and any other administration required. There would be option of integrating this activity with your existing team to mutual benefit, perhaps some form of joint appointment(s). If you are in agreement we would like to make arrangements for the supporting funds ( 1,000,000) inclusive any overhead costs (to be agreed) to be transferred to you, before the end of March under a memorandum of understanding which we will prepare. I hope that you will agree that this is an exciting development, and that it aligns with the strategic aims of the London Health Board. We would be very grateful if you would confirm whether you are in a position to support this as outlined above, and we will then liaise with final funding arrangements. I look forward to hearing from you.

2 With best wishes. Yours sincerely, Professor Tim Swanwick Senior Clinical Adviser, North Central and East London

3 Building the public health capability of all health improving organisations: An Academy of Public Health for London and the South East

4 Project outline and business case: 1. Summary Investment Proposed: Project Name: An investment of 1M for a transformational project in 2016/17. Building the public health capability of all health improving organisations : An Academy of Public Health for London and the South East. Date: 29/02/16 Release: V1.0 Details of Leads: Executive sponsor: Professor Tim Swanwick, Senior Clinical Adviser and Therese Davies, Local Director Health Education England (NCEL) tim.swanwick@ncel.nhs.hee.uk therese.davies@ncel.nhs.hee.uk Julie Screaton Director, London and South East julie.screaton@southlondon.hee.nhs.uk 2. Purpose This paper outlines the business case to establish a multi-agency academy of public health and will be used to develop the outline model and develop a consensus on priorities for investment. It builds on a paper considered by Health Education England London and South East Executive in January 2016 where the development was agreed together with an initial investment of 1M. The Academy will support place-based learning and workforce transformation and enable health and well-being priorities to be delivered at scale and at pace. For all those working in health, social care, local authorities and the third sector in connection with health improvement and prevention, the Academy will: provide a coordinated offer of training and resources provide clearly signposted further development opportunities enable knowledge exchange and networking The development and commissioning of provision will be led by small workforce development team collaboration between Public Health England, local authorities and Health Education England - and will be headed up by HEE London and South East s Head of Public Health Education and Development. 2

5 This business case has been developed with the input of: Judy Curson, Public Health Consultant (workforce), PHE, South East Paul Plant, Deputy Director (workforce), PHE, London Louise Holden, Public Health Workforce Development Manager, PHE, London Mike Robinson, Association of Directors of Public Health, London Members of LKSS School of Public Health Members of the HEE London and South East DEQ Advisory Group 3. Strategic Context The future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health. (NHS 5 Year Forward View, 2014, p10) The NHS 5 Year Forward View makes it clear that the prevention of ill health and promotion of wellbeing is a key priority for the NHS. Its tripartite message requires us all to break down the barriers about how care is delivered empower patients and get serious about prevention. Similarly, the Department of Health s Shared Delivery Plan: articulates a vision to reduce the demand on our health and care system and contribute to its long term sustainability, we will take action to improve people s health focusing as much on the prevention of poor health as we do on treating illness. The government s 2016/17 Mandate to NHS England also makes a requirement on the system to improve local and national health outcomes, particularly by addressing poor outcomes and inequalities. All of this can only be achieved with a clear focus on workforce development for public and population health. HEE has undertaken to work with Public Health England, local authorities and other stakeholders to better understand the wider workforce implications and how we use our levers to drive improvements in health. This includes ensuring the health and social care workforce is able to manage health and wellbeing proactively rather than simply responding to illness. Workforce development initiatives need to be future proofed for at least 15 years ahead and the HEE Strategic Framework (F15) informs this work. Supporting local authorities to meet the continuing professional development needs of their current staff is not technically one of HEE s statutory responsibilities. However, a focus on health improvement is a central responsibility of HEE, and has obvious benefits for the NHS. Increasingly, other provider organisations are developing their public health offer, for instance, there are around 40 acute trusts across the country that have their own public health team. It is anticipated that the diversity of health improving organisations will increase rapidly over the next few years as new models of care emerge, within new integrated organisational frameworks spearheaded by NHS England s vanguard sites. This creates a need for a broader view of workforce development in this area, one that transcends current organisational boundaries and looks beyond the NHS into local authorities and social care. This is a particularly timely development given that the government has commissioned PHE to review and make recommendations on the current operation of the public health system in relation to the future (next five years) capability, skills and experience of the public health workforce. The report is due for completion in March 2016 and is likely to highlight a 3

6 number of capability and capacity gaps but strong themes are already emerging of the need for an agile skilled workforce working across organisations, sectors and settings. More locally, although HEE s KSS team have historically been ahead of the curve in their relationship with public health, this is a great opportunity for HEE to pilot such a development as the London and South East geography. There is a window of opportunity whilst the public health grant to local authorities is still ring-fenced and there are strong Director of Public Health networks with four local offices of HEE all working collaboratively and sharing resources. Ensuring capacity and capability to maximise opportunities of the London Health Devolution Agreement (2015) in which partners, including government, the mayor s office, NHS England and HEE, have collectively signed up to ten joint aspirations and have agreed a number of actions to help London become the healthiest major global city. Health improvement is at the heart of that collective ambition. 4. Case for Change A. Business needs Transform the way individuals and organisations see their role. Prevention of ill health and population-based approaches are interventions delivered by people, and people require training and development to effectively deliver their role. Similar initiatives have previously been developed but these have either been small scale (e.g. Wessex) or ad hoc (e.g. previous investments in the public health workforce in London). This is an opportunity to make a difference at scale, and assuming successful, is a geography model of provision that could be developed England-wide. B. Benefits Joined up and system wide approach An academy for public health would mean a joined up approach to the development of the public health capacity and capability across all health improving organisations. The Academy would allow development of a system-wide approach to priority issues for London and South East that transcends organisational boundaries, improving connectivity between Health Education England and those engaged in workforce development, education and training for health improvement. The Academy would ensure there would be a coherent public health strand in all local delivery plans that delivers HEE strategy and aligns with that of NHS England and Public Health England. Clear professional development offer There would be a provision of a clear professional development (CPD) offer to staff in those organisations, though a coordinated offer of clearly signposted development opportunities, from seminars to Masters programmes, from elearning to coaching, all accessible through an on-line portal. 4

7 Improved workforce planning and development Improved workforce planning and development of clear career pathways for the public health workforce wherever that workforce might be. Financial Prevention of ill health and population-based approaches are inherently cost effective and are the backbone of the economic strategy supported in the Five Year Forward View. Financial benefits are dependent on uptake of training but would be realised through the larger NHS and public bodies with the delivery of prevention of ill health and population-based approaches. C. Risks The strategic risks if HEE were not to proceed with this project: The Department of Health and its agencies may fail to deliver on priorities articulated in the Shared Delivery Plan NHS England and HEE may struggle to deliver the objectives of their mandates. Vanguard sites may not be able to revolutionise their approach to the health of the populations that they serve. Emerging accountable care organisations will not have the capability within them to illness prevention, health promotion and population health. London may not be able to deliver the aspirations of the health devolution agreement. Health Education England will fail to play a full part in delivering the aspirations of the Five Year Forward view and may then not be considered as a serious player in workforce transformation, with this remit transferring elsewhere. The operational risks that are associated with this project are minimal and have been detailed in Annexe Scope and operating model The aim of the Academy is to provide a structured and sustainable professional development offer in public and population health for all staff with health and well-being responsibilities. A multi-agency academy will provide coordinated offer of clearly signposted development opportunities for all those working in health improving organisations. This includes all those working in NHS, local authority, social care and the third sector. Direct public health service provision is outside of scope. The operating model for the Academy will be developed by small workforce development team collaboration between Public Health England, local authorities and Health Education England - and will be headed up by HEE London and South East s Head of Public Health Education and Development. 5

8 This geographical model of provision that could be developed England-wide and its development and potential has already been discussed with HEE s national lead for public health. The delivery team will ensure that opportunities for spread, dissemination and economies of scale across HEE will be considered at every stage. 6. Priorities for delivery Priorities areas for delivery are listed below. The priorities will be discussed and further refined at a multiagency public health workforce event planned for 21 st April Making public health everybody s business How? (examples of activity) 1.1 Establish and sustain a vibrant learning network and community of practice 1.2 Develop a consensus of early priorities for development. Agree priorities with service commissioners in light of the shared delivery plan, strategic transformation plans and local priorities identified 1.3 Identify the learning and development needs of the wider public health workforce at a local level 1.4 Increase opportunities to develop skills and competencies in public health, leadership and project management 1.5 Scale up the involvement of the wider health and social care workforce around place as the key setting for workforce development Provide a core CPD offer accessible in one place for clearly articulated levels of the workforce and a space for networking and engagement. Conduct a mapping exercise and develop and a suite of evidence based training, tools and resources to meet skills gaps identified. Make systematic use of existing resources e.g. MECC training and other NHS toolkits Building on projects such as Team Up and working with HEI s to increase skill-based learning within their curriculums Working with HEIs, professional and regulatory bodies to identify and embed public health values, approaches and competencies into undergraduate and postgraduate curriculum, practice and CPD for all clinical training Establish mechanisms to support placebased learning working with service delivery partners on health improvement priorities and identifying key staff groups for shared development (e.g. NHS Vanguard pilot initiatives offer an opportunity to test and evaluate approaches to developing the wider public health workforce) 6

9 2. Developing strategic leadership for public health 2.1 Provide a system leadership development offer for public health specialists and practitioners aimed at supporting service transformation 2.2 Working in partnership with the NHS Leadership Academy and others, to identify gaps in leadership development provision for all those working in health improving organisations 2.3 To signpost available provision and commission additional courses and programmes as appropriate 2.4 Establish structured programmes of development for aspiring and future leaders in health prevention and improvement How? (examples of activity) Continuing to develop a variety of skills for influencing in a political environment and transformational leadership styles Develop a deeper knowledge of other council roles to enable increased joint working with planners, community safety, licensing Develop multi-disciplinary training/integrated systems approach training on priority issues for London e.g. childhood obesity, sexual health Establish a mentoring /coaching scheme e.g. sourcing senior local government figures who have navigated the complexity and pace of change Ensure access to personal effectiveness skills e.g. negotiating, influencing, marketing, change agent, engagement, customer service skills, story-telling skills Establish a public health Fellowship programme Support career pathways providing stepping stones to roles of increasing responsibility and complexity. 3. Equipping the workforce with public health skills fit for the 21 st Century 3.1 Ensure the workforce is equipped with a modern public health skillset and able to respond to future challenges 3.2 Address emerging global issues in public health in relation to London as a Global City and migration patterns in the workforce and population as a whole How? (examples of activity) Ensure training for new technical skills are commissioned and embedded in training programmes e.g. training for PH scientists and analysts in big data handling and bioinformatics Ensure healthcare public health skills remain well embedded in the public health core workforce such as, health 7

10 economics, return on investment, prioritisation/resource management, leadership in clinical settings, critical appraisal, evaluation, data interpretation Contribute to the transformation of the nursing and health visitor workforce, aligning their knowledge, skills and competences with public health and prevention priorities Working with appropriate partners identify the future need and provide development opportunities in global health 4. Supporting recruitment, retention and progression in public health 4.1 Empower and create opportunities for the workforce at all levels to recognise the competencies they have, those they need to maintain and those they need to develop to remain fit for purpose How? (examples of activity) Utilisation of the digital Public Health Skills and Knowledge Framework and Skills Passport being developed Develop and collate a suite of tools for self-reflection, 360 feedback, selfmanagement of careers Provide clarity of career progression and clear signposting as to what s helpful to know at what stage of development Build on the current structured approach to PH practitioner development responding to recommendations from recent commissioned workforce reports 8

11 7. Costs This transformation project builds on previous investment and a direction of travel agreed by HEE London and South East in August Recruitment is in progress for a Head of Public Health Education and Development for the geography and all four local HEE offices have previously invested in specific public health workforce development activities. Non-recurrent resources required in 2016/17 Resource description: Estimated cost 000 Scoping, discovery and development 65,000 Commissioned development of educational interventions 130,000 Subsidised delivery of educational interventions 455,000 Marketing, promotion and production of materials 45,000 Project infrastructure 210,000 Delivery platform 60,000 Evaluation 35,000 Total indicative cost for 2016/17: 1,000, Procurement Any procurement activities will be in accordance with the HEE s standing financial Instructions and the EU Consolidated Public Sector Procurement Directive (2004). Digital investment will need to follow Cabinet Office spend control processes. 9. Sustainability Following the initial set up phase, it is envisaged that further funding needs will be met through partnership working, revenue generated and workforce development investment. 10. Governance The Academy Operational Group will comprise representatives from partner organisations; local authorities, Public Health England and HEE from across London and Kent, Surrey and Sussex. The group will be chaired by a Head of Public Health Education and Development who will act as project lead. The Head of Public Health Education and Development is a HEE appointment and will report to the London and South East Director of Education Quality or nominated senior deputy. The Operational Group will be accountable and report to the London and South East Executive Group of Health education England. The activities of the Academy will be informed by wider stakeholder groupings accessed through the partner organisations. 9

12 11. Next Steps An indicative timescale for the project is outlined as below: March 2016 Authorisation to proceed April 2016 Development of model with internal and external stakeholders Multi-agency event and priority setting for the academy Appointment of Head of PH Education and Development Establishment of working group and governance May 2016 Needs analysis Appointment to posts as identified e.g. project manager Digital development pre-work July 2016 Amalgamation with existing School July 2016 Delivery model and priority areas agreed Commissioning commences October 2016 First tranche of Academy products available 10

13 5. Catastrophic 4. Major 3. Moderate 2. Minor 1. Negligible Academy of public health project outline and business case Annexe 1: RISKS Risk Description Category Likelihood Impact RAG Rating Impact Date Mitigating Action Risk Owner Failure to appoint to HoPHED Operational Work with colleagues in PHE to identify suitable candidate Leads Digital spend controls delay implementation Technical Early engagement and use of HEE support team Leads Categories Likelihood (including but not limited to) strategic, political, financial, legal/legislative, external/internal dependency, organisational/operational, reputational, stakeholder, service delivery, technical, delivery implementation 1 rare, 2 unlikely, 3 possible, 4 likely, 5 almost certain Impact 1 negligible, 2 minor, 3 moderate, 4 major, 5 catastrophic Likelihood RAG RATING MATRIX 5. Almost Certain Likely Possible Unlikely Rare RAG Rating Using the chart calculate the risk score for the risk Impact 11