1. The New Public Health System
Federation of Sports & Play Associations
Chris Wright
Project Manager - Health
Youth Sport Trust

2. The session will cover...
• Create an understanding of the public health context.
• Your understanding of the new Public Health system.
• What elements of Public Health relate to your organisation(s)
• Identify the implications and opportunities for Sport and Play.
• Share examples of YST interventions.
• Provoke some thinking and action.

3. Understanding Public Health and
its significance.

4. First ‘wave’ of public health

5. Second ‘wave’ of public health

6. Third ‘wave’ of public health

7. Fourth ‘wave’ of public health

8. Fifth ‘wave’ of public health

9. “physical inactivity should be appropriately described as a
pandemic, with far-reaching health, economic, environmental,
and social consequences
inactivity causes 9% of premature mortality which is equal to
the same number of deaths as tobacco
The Lancet (July 2012)
“

10. The cost of physical inactivity

11. The cost of physical inactivity

12. The cost of physical inactivity
• The 2011/12 evaluation by The National Obesity Observatory shows:
One in five children in Reception is overweight or obese (boys 23.5%, girls 21.6%)
One in three children in Year 6 is overweight or obese (boys 35.4%, girls 32.4%)
• Impacts on self-esteem and emotional wellbeing (mental health of young people)
• Reduces risk of over 20 health conditions including cardiovascular disease and
some cancers
• Increases Confidence and competence to be physically active as adults
• Positive links between movement, activity and educational attainment

13. The physical inactivity cycle
Early
Childhood
Adolescence Adulthood
Physically inactive
children
19.2% Year 6
Obese
£21bn cost to
NHS
2 extra days a
year missed
from school
£1750 a
year extra
health
costs
Children with
inactive parents
are far less likely
to be active and
twice as likely to
be obese
Lower
attainment

14. A New Public Health System

15. A New Public Health System
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• Public Health England – a national public health service
• A return of public health leadership to Local Government
• Dedicated resources for Public Health Nationally and Locally
• Health & Wellbeing Boards in operation from April 2013
• Strong relationship between Public Health, NHS and Social
Care ( Health prevention, clinical commissioning and social
care commissioning)
• Focus on outcomes and evidence based practice supported
by co-ordinated information and intelligence system.

16. Health & Wellbeing Boards
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• Health & Wellbeing Boards in every upper tier local authority (150).
• Prepare a Joint Strategic Needs Assessment (JSNA) working with GP
Consortia and local authorities.
• Develop a Health and Wellbeing Strategy based on needs identified
through the JSNA.
• Commission services to deliver the strategy through individual
commissioning plans.
“H&WB’s will have a duty to promote integrated working between
health and social care commissioners that will impact on wider
determinants i.e. Housing and education” (DH 2012)

17. The role of the Local Authority
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• Local authorities will have a duty to take steps to improve
the health of the people in their area
• Regulations will prescribe certain steps local authorities
must take (mandatory functions)
– NHS Health Checks
– National Child Measurement Programme
– Sexual health – testing and treatment of STIs and provision of
contraception
– Ensuring health protection plans are in place
– Providing healthcare public health advice to CCGs.
• The commissioning of other services will be discretionary
including (non-exhaustive)
– Interventions to tackle obesity, physical activity
– Tobacco control
– Drugs and alcohol misuse
– Children’s public health services for 5-19 year olds

18. Public health funding and commissioning
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Department of Health
Public Health
England (within the
Department of Health)
Local
Authorities
NHS
commissioning
architecture
(Commissioning
Board and
Consortia)
Providers
(inc schools
and GPs)
NHS
budget
Health and
wellbeing boards
JSNA & Joint Strategic
Health and Wellbeing
Plans
Public
health
budget
Ring-
fenced
public
health
grant
Funding for commissioning
specific public health
services
integration integration

19. Evidence & Commissioning
• All Health & Wellbeing Boards will be advising the commissioning of
public health services on the basis of outcomes and evidence.
• Local partners (statutory and non-statutory) will have to evidence
their work in a more detailed and prescriptive way i.e. RCTs.
• Partnership will be central to effective and cost efficient delivery as
opposed to lobbying and ‘shouting the loudest’.
• Some services and programmes will be predetermined and funded
straight ‘from source’.
• All of the funding provided to support the delivery of health prevention
work locally will come through Local Authorities and their new public
health teams.

20. Connecting Sport, Physical
Activity and Play with Public
Health

21. Implications for Sport & Play
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• Sport and Play Industry are not statutory partners on Health and
Wellbeing Boards and these remain discretionary.
• Public Health commissioning through credible ‘local’ partners with no
centralised funding.
• Children & Young People health outcome priorities determined locally.
• You will need to be credible partners at a local level with evidence.
• Repositioning national programmes and services to fit locally
determined priorities.

22. Consider the following 3 areas...
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Advocate and influence
•How are you going to communicate your role and contribution?
•How do you get that contribution recognised?
•What are the local health networks you need to work through?
Creating new partnerships
•What good partnerships do you have currently?
•Are you involved in any forums currently that link to this agenda?
•What are the key groups and agencies you need to work with on this agenda? (Is
schools one of them?)
Programme delivery and demonstrating impact
•Do you know which health outcomes your product/services relate to?
•How will you go about positioning these as an intervention?
•How does this fit with your organisational outcomes as well as local
health outcomes?

23. What has the YST done?
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Advocate and influence
•Developed a national model for sport and physical activity in schools.
•Created membership offers and health related products and programmes.
•Created a network of schools to work directly with Local Authorities.
Creating new partnerships
•Created new partnerships and strengthened others i.e. YMCA and PHT
•Revisited our Local Authority engagement and health related work.
•Developed a stronger working relationship with Change4Life/Dept. Health
Programme delivery and demonstrating impact
•Repositioned programmes against health outcomes.
•Developing a knowledge bank and evidence around the health agenda.
•Positioned whole school and health outcomes together.

24. PHYSICAL
EDUCATION
DELIVERED
During curriculum time
LITERACY
LEARNING
LEADERSHIP
HEALTHY
ACTIVE
LIFESTYLES
DELIVERED
Outside curriculum time
ENJOYMENT
ENGAGEMENT
EXERCISE
COMPETITIVE
SCHOOL
SPORT
DELIVERED
Outside curriculum time
COACHING
COMPETITION
CLUBS
COMMUNITY
PROVISION
Pay and play
Leisure and recreation
activities
CLUB SPORT
(NGBs)
Clubs and teams
Coaching
Talent development

25. Bupa Start 2 Move
(KS1)
Matalan TOPs
(KS2)
C4L Sports Clubs
& HLCs
Sainsbury’s School Games
School Sport Clubs &
Coaching

26. What the evidence says……
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• More physically fit children have been found to have improved brain
function, higher academic achievement scores and superior cognitive
performance than less fit children - Chaddock et al (2012) Journal of
Sports Science
• Female adolescents who participated in sports were less likely than their
non-athletic peers to engage in sexual activity and / or report a pregnancy
– Sabo D et al (1999) Journal of Adolescent Health
•Academic reviews are in agreement that physical activity improves self
esteem but opinion varies on which types of activity give the greatest
benefit most show that fitness focused activity and programmes that
encourage skill development i.e. rock climbing rather than competition! –
Biddle, Fox and Boutcher (2000), Physical Activity and Psychological
Well-Being

27. Local Example of this working...
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• Hull City Council local Obesity strategy.
• Additional funding secured through YST Lead Partner Health &
Wellbeing Schools.
• Change4Life Sports Club in every primary school.
• Partner funding through YST for clubs using Dept. Health
investment.
• Programme evaluation around physical activity and wellbeing
through SPEAR.
• Independently evaluated through Local Authority directive and
NCMP.
• Sustainability through internal workforce and pupil premium
spend.

28. What Next?? :-
www.dh.gov.uk/health/tag/public-health-england
www.youthsporttrust.org
- We’re keen to here from you…
Chris.wright@youthsporttrust.org