Professor John Newton

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Professor John Newton South East Regional
Director of Public Health
12th February 2009
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Public Health information requirements?

• How to specify our requirements?
• Scope and congruence with public health
  priorities
• Geography / population
• Quality
• Validity
• Timeliness
• Access
• Presentation
• Service and technical support
• Governance
• Cost

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Three types of knowledge

• Statistics
• Evidence
• Experience

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Three areas of Public Health practice

• Health improvement
• Health protection
• Health and social care service commissioning

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Regional determinants of health
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Health in later life
There are significant differences in hospital
admission rates for hip fracture across the South
East
Life expectancy at age 65 for males (and females)
also varies considerably across the region
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Health protection

• Surveillance
• The continuous analysis, interpretation and
  feedback of systematically collected data,
  generally using methods distinguished by their
  practicality, uniformity and rapidity rather than
  by accuracy or completeness
• (Eylenbosch and Noah, 1988).

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Flu surveillance
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• Actual or potential surveillance systems or data
  sources that could feed surveillance systems
• CoSurv communicable disease reports
• Spotter GP practices (e.g. RCGP)
• Large scale GP databases (QResearch and GPRD)
• Cancer registration
• Congenital anomaly registers
• Adverse drug reactions
• Accident databases (ROSPA HASS/LASS)
• Occupational health statistics
• Hospital activity data (especially SUS, AE data)
• Mortality statistics
• NHS Direct
• Bespoke surveillance systems (e.g. BPSU, UK OSS)
• Disease registers and device registers (heart
  valve registers, hip replacement register, CJD
  etc. etc.)

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Commissioning Health services
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Setting priorities within allocated budgets

• Programme Budgeting data
• marginal analysis to guide investment and
  disinvestment decisions
• opportunity costs
• local valuations and preferences

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Population surveys
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Monitor and review the quality of services

• clinical activity by threshold / indications
• process information adherence to evidence-based
  pathways
• close to real-time financial and activity
  information to manage within budget
• outcome and patient experience data

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Systematic approaches

• JSNAs
• Annual reports
• Health profiles
• LAAs
• Life-course model

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Health Strategy theme 1 health inequalities
The health inequalities gap between the most and
least deprived appears to be narrowing across the
South East
But significant geographic differences in smoking
prevalence remain
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Health Strategy theme 3 safer communities
There are significant variations in hospital
admissions for alcohol-attributable conditions
across the South East
And significant differences in rates for children
killed or seriously injured in road traffic
accidents
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Delivering public health top LAA health
priorities in the SE region
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Regional Health Profiles
Key messages
Summary scarf/rug plots
Spine chart
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Local Health Profiles
Key messages
Deprivation maps
Spine chart
Health trends
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Health Profile interactive maps
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Life course approach to prevention
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Health Strategy theme 5 children and young
people
Child obesity rates vary significantly across
South Central
Teenage pregnancy rates also remain high in many
parts of the region
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How are we doing?

• Good in parts
• Fragmented systems
• Barriers to access
• Multiple agencies with multiple aims
• Leadership?

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An integrated public health system?
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A personal wish list

• More local data on determinants from surveys
• Close to real-time health care activity data
• Person-based social care data
• Record linkage / shared GIS
• Secure surveillance systems / registers
• Better use of available GP data
• Accessible integrated information systems