FIA UPDATE A new public health service
David Stalker, CEO of the FIA, reports on July’s public health Vanguard focus group, which looked at ways in which the health and fitness industry can play its part in the restructured health service
the importance of making local connections and having a strong evidence base for exercise interventions. T e focus group, which took place in
T
July – sponsored by Cosmed – looked at the structure of the new Health and Wellbeing Boards, which will co-ordinate public health activity in each local authority as part of the health reforms in England. T e group was led by Jo Webber, deputy director of policy at the NHS Confederation – the body representing 95 per cent of all organisations that deliver and commission NHS services.
Public health model Webber opened the session by explaining that the reforms represent a move towards local determination and a reduction in central control over fi nances and commissioning of services, with £65bn being handed to GPs and commissioners and £5bn passed to local authorities to deliver on public health. T e new system, which is taking a long
time to implement in its entirety, has been designed to be “locally responsive to the needs of communities,” said Webber. She continued: “Our ageing population
is a huge concern; over one million people will soon reach their 100th birthday. T e NHS has made signifi cant progress in increasing life expectancy, but the key now lies in reducing the number of years of ill health.” T e 150 Health and Wellbeing Boards (HWBs) will work with the new Clinical Commissioning Groups (CCGs) and the local authorities (LAs) to decide the priorities for local health spending. For physical activity providers, it will be
impossible to target HWBs collectively as they will all be driven by local priorities, some of which will come from an annual conducted assessment of local health needs and inequalities (Joint Strategic Needs Assessment – the JSNA).
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he second in a series of public health reform focus groups, for FIA Vanguard members, highlighted
Physical activity providers
will therefore need to understand each Health and Wellbeing Board’s JSNA, and approach them with a business case for an intervention which shows a return on investment, supported by strong, relevant evidence. T e HWBs have statutory
membership of at least one local representative. Making contact with local councillors – likely to be these local representatives – could be a good way to build a relationship with the boards, as the councillors will have an interest in the needs of local employers. Public Health England
Health Club Management is the FIA’s Public Affairs Media Partner
NEWS
Health changes: Fitness leaders have a chance to redefi ne their role
is the national body sitting above the HWBs, LAs and CCGs. It will shape the national public health marketing strategy – a strategy to which individual marketing strategies might usefully be aligned. Webber stressed that the new system is
all about local relationships and infl uence – who you know, as well as what you know and whether you can back this up with evidence.
Changing perspectives T e group discussed the fact that exercise referral schemes are not well evidenced, and that their continuing fl aw is adherence; a focus on motivational interviewing or physical activity counselling will be key as part of a holistic off ering from physical activity providers. However, Webber cautioned that at this
stage, exercise referral and physical activity will not be a priority for many HWBs, as it is not included in statutory legislation or the Quality and Outcomes Framework (QOF). T e boards will therefore initially be concerned with a focus on the crisis care end of the spectrum.
Read Health Club Management online at
healthclubmanagement.co.uk/digital Webber asked FIA members to think
about how to get innovation into our off ering as exercise providers, to bring the focus back to the preventative end of the scale and suggest new ways to deliver within the restructured health service that will mean costs do not increase. Ultimately the sector has to take a multi-
faceted approach that’s based around engaging with Public Health England, HWBs, LAs, CCGs and GPs in order to change their culture and thinking. A similar analogy could be made with the recent smoking ban; this was just the tipping point and came aſt er years of pressure that fi rst started with encouraging GPs themselves to stop smoking.
The value of evidence T e meeting underlined the importance of the nationwide investigation being carried out by the FIA Research Institute. We need to collect a good set of local case studies to be able to infl uence commissioning groups and present our evidence to Health and Wellbeing Boards. It’s a massive undertaking, but will be of signifi cant value to our sector going forward.
september 2012 © cybertrek 2012
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