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Strategic Direction Engagement Report

Author: Chris Lines, Director of Communications Date: 27 September 2010 Version: 1Publication/ Distribution:

InternetReview Date: 4 October 2010 Purpose and Summary of Document:This document reports on the development of the strategic direction for Public Health Wales. It reports on, and synthesises, discussions by the Public Health Wales Board and discussions with staff and stakeholders.Work Plan reference: Transition Programme, Strategic Direction Project

Public Health Wales Strategic Direction Engagement Report

Contents1 INTRODUCTION....................................................................3

2 ENGAGEMENT AND CONSULTATION.......................................3

3 PRINCIPLES.........................................................................4

4 VISION................................................................................4

5 MISSION..............................................................................4

6 VALUES...............................................................................5

7 PRIORITIES AND STRATEGIC OBJECTIVES...............................5

APPENDIX A: VISION..................................................................7What do you want Wales to be like from a public health perspective in five years time?........................................................................................7

APPENDIX B: MISSION..............................................................21Can we improve on the interim statement that the purpose of Public Health Wales is “To protect and improve the health and wellbeing of the population of Wales?”............................................................................21

APPENDIX C: VALUES...............................................................33What type of organisation do we want Public Health Wales to be?........33What should be important to us?...........................................................33In five year’s time, if asked to describe Public Health Wales, what words would you like others to use?.................................................................33

APPENDIX D: STRATEGIC OBJECTIVES AND PRIORITIES...............45

IntroductionThis document reports on the development of the strategic direction for Public Health Wales.

It reports on, and synthesises, discussions by the Public Health Wales Board and discussions with staff and stakeholders. It makes proposals for the following:

the purpose of Public Health Wales the type of organisation that Public Health Wales wishes to be the added value of the unified public health system and an all Wales

public health organisation key values underpinning the organisation, which will guide future

strategic decisions and the setting of priorities within Public Health Wales

Date: 27 September 2010 Version: 1 Page: 2 of 64


what Public Health Wales is seeking to achieve, in broad terms what Public Health Wales aims to contribute and deliver over the

next five years, which should, ideally, be outlined through a maximum of eight key priorities

how the priorities will be addressed, in order to achieve the stated aims

These discussions have been taken forward as part of a Strategic Direction Project set up by the Board. The aim of the project is to produce a short strategic document which guides the work of the whole organisation over the next five years.

The discussions and comments reported on are those received by 9 September.

1 Engagement and consultationThere have been a number of discussions taken into account in this report:

Informal and formal discussions held by the Board and summarised in the paper ‘Strategic Direction Discussion Paper’ (30 June 2010)

Interviews by the Director of Planning and Performance and the Planning and Performance Manager with members of the Board and Interim Senior Management Team

Round table discussions at the meeting of the Public Health Wales National Forum on 5 May 2010

Facilitated discussion at eight meetings open to all staff and held in July and August 2010

Various meetings held by staff with stakeholders to get their views

Various meetings held by teams of staff

Individual comments received via the staff Web Forum and via the Public Health Wales website

2 PrinciplesThe intention is to produce “a short document, ideally no more than a few pages, which can be easily distributed to, and readily understood by, all Public Health Wales staff and stakeholders.”

To be readily understood, jargon should be avoided and sentences should be short. Ideally, the language should be powerful and memorable.



One point which arose repeatedly in discussions was the need for the vision, mission, values and objectives to be measurable.

3 VisionAll the comments received from discussions about a vision for Public Health Wales, together with commentary, are listed in Appendix A.

Many of the visionary statements proposed focus on the way services are provided rather than on outcomes. Generally, many of the comments during the process of engagement encouraged a focus on measurable outcomes. For this reason, the following vision is proposed for Public Health Wales:

Everything we do will be to achieve a healthier, happier and fairer Wales.

Such a vision is not unique to Public Health Wales. It is compatible with the One Wales vision of ‘Improved quality and length of life and fairer outcomes for all’ and with the vision set out in ‘Delivering a Five-Year Service, Workforce and Financial Strategic Framework for NHS Wales.’

4 MissionAll the comments received from discussions about a mission statement for Public Health Wales, together with commentary, are listed in Appendix B.

Although it is short and easy to remember, there was a generally held view that the interim mission statement - ‘to protect and improve the health and wellbeing of the population of Wales’ - does not apply uniquely to Public Health Wales. Discussions therefore focussed primarily on adding to the statement so that it reflects the unique purpose of the organisation.

The proposed additions include:

Reducing inequities

Empowering people, communities and institutions

Working in partnership

Expertise

Advocacy

Informing

All Wales



It is not possible to make all these additions and maintain a mission statement at a memorable length. It is therefore proposed that the mission statement should be:

Our purpose is to give people power to protect and improve health and wellbeing and reduce inequities by informing, advising and speaking up for them.

5 ValuesAll the comments received from discussions about values for Public Health Wales, together with commentary, are listed in Appendix C.

A number of the discussions focussed on a differentiation between ‘internal facing values’ and ‘external facing values’. However, most of the values chosen were the same for both so the approach taken here is to propose a set of values which works for all, and to make this explicit.

The proposed statement about Public Health Wales values is as follows:

We will aim to lead by example. In all our actions, whether with colleagues, stakeholders or partners, we will seek to be professional, persuasive, open, reflective and responsive.

6 Priorities and strategic objectives All the comments received from discussions about priorities and strategic objectives, together with commentary, are listed in Appendix D.

The following strategic objectives are proposed, to:

Improve health and reduce health inequities by addressing the social and economic factors which determine people’s health

Prevent disease and ill health by reducing the risks in people’s behaviour

Improve the quality and effectiveness of healthcare services

Protect the population from infectious disease and environmental hazards and respond effectively to the public health aspects of emergencies

Reduce illness and death through the management and development of evidence based screening programmes

Establish Public Health Wales as a cohesive, effective and sustainable organisation which leads by example.



The achievement of these objectives will meet the requirements of the Annual Operating Framework, Our Healthy Future and other government policies and strategies.

Each of these objectives will be underpinned by a plan of work setting out the specific actions we will take locally and nationally.

In the discussions on priorities and objectives, the following actions were identified as ways of achieving strategic objectives:

Working innovatively, systematically, effectively and on the basis of evidence to achieve measurable outcomes

Empowering people, communities and agencies

Building and maintaining strong and effective partnerships with other agencies and the public

Influencing government policy

Providing health intelligence to guide and underpin public health action

Working with academics to improve the evidence base for taking public health action

Developing information systems which promote more effective working


Appendix A: Vision

What do you want Wales to be like from a public health perspective in five years time?

What stakeholders and staff told us CommentaryDon’t go backwards – be aware of the financial risk Our vision has to be focused on what we want Wales to

be like – a positive picture

Healthiest population in EuropeWe want to be Swedish / FinnishHealth of population in Wales – best in UKHealthier / Reduction of ill-health (9)To carry on improving health of the population of WalesFewer people accessing services for ill-healthNarrowing inequalities gap / Reducing inequalities in health (9)Reducing inequity / more equitable society (5)Tackling health divide – levelling upFairer society (3)Redistribution of incomeHealth gains across the entire health sectorChange in health outcomesReducing avoidable death / premature death

These responses – the greatest concentration received - focus on health outcomes and can be summarised as:

A healthier, more prosperous Wales with reduced inequities

This visionary statement focuses on outcomes.The words ‘more prosperous’ have not been accepted.The phrase ‘reduced inequities’ is covered by the word fair.

Increasing longetivityWealthier / prosperous (2)Realisation of the aims of Our Health FutureAdd quality to lifeHigh aspirations

Equality of opportunityEveryone has an equitable opportunityOpportunities for all / young peopleA land of opportunity for living a full and healthy life for allMaking healthy choices the easiest choicesEveryone has an opportunity for a quality death

These responses focus on opportunities and can be summarised as:

Equality of opportunity for allThis is a visionary statement but is not focussed on health and wellbeing outcomes. It is covered by the word fair.

Seamless and integrated services (3)Joined up and integrated Joined up working between agencies to have a bigger impactJoined up WAG departmentsInroads into effective partnerships with WAG and other organisations to improve public healthBetter relationship between Public Health Wales and primary care

These responses focus on the way public services should be provided and can be summarised as:

Public services should be provided seamlessly

This is a visionary statement but is not focussed on health and wellbeing outcomes so has not been accepted. The point is taken on in the strategy in the section on ‘How we achieve our objectives’.

A system that is better integratedBreaking down barriersReduction in organisational boundaries / make a holistic approachJoined budgetsEveryone knows what everyone is doing with public health organisationsEffective partnershipsReducing the burden of tobacco on the public health of Wales will require improved partnership working and innovation across sectors in the statutory, voluntary and private sectors.

Full range of agencies / public engaged with public healthEverybody doing public health / everyone’s businessPublic health needs to be more engrained in the NHS (less about fire fighting) and populationMainstreaming health promotion into all areas of everyday life – making it the normTrained multidisciplinary public health workforceMaking health easy for peopleShared sense of accountabilityCommitment to personal and community responsibility for health and well-being

These responses focus on the need for health to be considered by all agencies when making decisions and can be summarised as:

Health is everyone’s businessThis is a visionary statement but is not focussed on health and wellbeing outcomes so has not been accepted. The point is reflected in the mission statement.

A more enlightened attitude to public healthHealth in all policies to be mainstreamedHealth Impact Assessment in government to proof new policiesUnderstanding of the impact of decisions have on public healthKeeping people well – tools in the toolboxUsing legislation to reinforce / encourage behaviour changeMore proactive governmentFully integrate a public health perspective with vision for primary, community, and specialist healthcare and partnership workingWales will have embedded the principles of health protection, promotion and improvement into all aspects of public life. Wales will be the country that supports public health through infrastructure and system. Moving away from glossy campaigns and high publicity drives, Wales will be supporting community-based initiatives that put health at their core. Such initiatives will be managed and provided, in the main, by social enterprises and the not for profit sector.Responsive servicesWelcoming public servicesEngaged public services

These responses focus on the way public services are provided and can be summarised as:

Public services should be effective, responsive, efficient, accessible and

Patient centred servicesPublic services doing things ‘with people’ rather than ‘to people’Confidence in systems and organisationsConfidence in the serviceContinuously improving (health and wellbeing)Improve quality in healthcareTimely servicesEconomically self-sustainingMore effective services (3)More preventative serviceCollaboration between public services, which is citizen focused and includes a much stronger and embedded public health awareness in all public services – (health in all policies) ensuring appropriate focus on agreed prevention and early intervention priorities including ‘investment to save’Systematic implementation of evidence base actions to reduce harm waste and variation in services.Services valued by the people of WalesMore efficient delivery of healthcare (2)Equity of service provision but also equip people to stay healthyEquality of access to servicesServices positioned innovatively

continuously improvingThis is a visionary statement but is not focussed on health and wellbeing outcomes so has not been accepted. The point is reflected in the section in the strategy on ‘How we achieve our objectives’.

Services accessible in the local communityEqual services are provided across WalesEnsuring those in most need have the support they needCradle to grave servicesHave a range of choicesNational leadership for the health agendaPeople value the contribution of the public sector

Empowerment of individual (9)Empowerment for public to have responsibility for own healthSkilled / empowered people – support at right timeEmpowering communities – well informed users of servicesPeople are proactive to improve their own healthEnablementEngaged populationReduction in dependency culturePublic to have responsibility for own health – reduced dependency on public sector (GPs) to fix problemsTo help the Welsh population take more responsibility for their own healthIncreased public involvement

These responses focus on people’s power over, and understanding of, their own health and can be summarised as:

Empowered, informed people and agenciesThis is a visionary statement but is not focussed on health and wellbeing outcomes so has not been accepted. The point, however, is reflected within the mission statement.

Better understanding (4)Understanding health is about preventionBetter informed (5)Informed to make own decisionsIncreased use of public health dataMore aware of stats on health service /lifestyleIncreased use of information technologyIncreased understanding of communities distinct needsConfident populationPeople know what public health isWiser

Community wellbeingRecognition of holistic model of ‘health – including mental wellbeing (2)No stigmatisation of mental ill healthConfidence to talk about mental health – normalising itHappier (5)Increased sense of wellbeing

These responses focus on wellbeing and can be summarised as:

Happier peopleThis visionary statement focuses on a wellbeing outcome and is accepted.

Wonderful WalesPride in Wales (2)

These responses focus on the nature of communities and can be summarised as:

Strong, confident communities

Exploiting small countryChildren and young people encouraged to stay in WalesWales having autonomy to make key decisions independently of WalesMore cohesive society in which people look after themselves and each other (social capital)Greater community cohesionHealth vibrant communityThriving communityPeople feel connectedCommunity spiritCommunities which focus on positivesWhere people feel valued and includedInclusive communities (2)Mitigating the effects of the coming spending cuts for communitiesForward thinking / confident people / self worthService delivery and Welsh languageRecognition of different cultures in WalesPositive media coverageMore socially responsibleRestore trust between people and their institutions / society

This is a visionary statement but is not focussed on health and wellbeing outcomes. However, the point is reflected in the section on ‘How we achieve our objectives’.

Shared public ownershipNo blame culture

Wider determinantsRebalancing priorities from individual lifestyle issues to creating healthy environments through advocacy with others in the public and private sectorEveryone understands the wider determinantsReduction in povertyFewer children in povertyEmployment / able to work (3)Fulfilling jobs for all who want workTackle worklessnessTackle cycle of long term sickness /disabilityPeople unable to work are cared forMinimum people on benefitsHealthier workforceHealthier place to live – environment (2)Environments are supportive of and conducive to good health and people being empoweredPlanning decisions support healthy choicesEducation for everyone / better educated (4)Lifelong continuous learning

These responses focus on the wider determinants of health. They link to other sections above and can be summarised as:

Where action is taken to address the wider determinants of health

This point has been accepted as a strategic objective.

Better access to public facilitiesMore artistic and creative societyNo stigmatisation of poverty

Less reliance on the carBetter and cleaner public transportBetter affordable transport to reduce use of carsGreener travel as the normIncreased recycling

These responses focus on environmental issues which can be summarised as:

SustainableThis is a visionary statement but is not focussed on health and wellbeing outcomes. Then point is reflected in the section on ‘How we achieve our objectives.’

Coordinated campaignImprove marketing techniquesTargeting the populationConsistency of messages – across the organisation and across WalesHave key lifestyle messages the public take on board

These responses focus on coordinated marketing campaigns and is discussed under the question on strategic objectives.

Reducing the impact of communicable disease and environmental hazardsFeeling protectedIncrease in immunisation targetsTo meet vaccination targets

These responses focus on health protection issues and fit better under the question on strategic objectives.

Supported by appropriate and effective public health servicesValue for money public health servicesEvidence based programmesAdvocacy roleSafe public healthIn Public Health Wales – avoid duplication and improve departmental coordinationPublic Health Wales more visibleEnhanced profile of public healthPeople to know about public healthLong term commitment to Public Health WalesTo ensure greater awareness of, and engagement with, Public Health Wales servicesRespected workforceExemplar for leading on public healthSustainability of public health servicesMore trust and confidence in health improvement agenda

These responses focus on Public Health Wales and public health services and fit better under the question on strategic objectives.

Reduction in chronic conditionsFocus on lifestyle issuesChange in bad habits culture

These responses focus on general and specific lifestyle issues and fit better under the question on strategic objectives.

Less obesity (2)FitterInroads in tackling healthy eatingMore physical exercisePeople using the outdoor environmentLess drinking (2)Drinking is deeply uncoolReduce smoking (2)To achieve a smoking prevalence of 17% or lower.Smoking is deeply uncool

ASH Wales would like to see tobacco control – not only cessation but also prevention – play a greater role in the work of all agencies in Wales. The current rates of smoking have remained at 24% for the last three years. Tobacco control measures are an essential part of improving public health across a wide spectrum of areas. Reduced drugsLess reliance on prescribed drugs – alternate services available – linked to community wellbeing and increased community facilitiesImproved engagement with employers to develop workplace health initiativesBetter health educationMotivated and supported to change behaviour

Reducing injuriesReduction in all Sexually Transmitted InfectionsReduction in all cases of HIV infectionsAll new diagnosis of HIV to be made in individuals early in their diseaseReduction in the number of unplanned pregnancies in all agesImprovement in Psychosexual services availableReduction in psychological morbidity post sexual assault through investment in Sexual Assault Referral Centres (SARC)To link together co-related risk taking behaviours especially in young people – alcohol, recreational drugs, smoking with unplanned pregnancy, STIs & HIV acquisition

Better systems to measure health and health outcomes This response focuses on health information and fit better under the question on strategic objectives.

To look at Designed for Life and ensure we are meeting it and fulfilling Our Healthy Future's commitments and aims.

This response fits better under the question on strategic objectives.

Vision should be complementary to Our Healthy Future – Public Health Strategic Framework and include “An active, healthy inclusive Wales, where making healthy

All these points are included in the summary statements above.

choices is second nature, where communities are healthier as a result of the actions they take and are supported by the environments and organisations to prevent ill health, improve health and promote well-being’.

Appendix B: Mission

Can we improve on the interim statement that the purpose of Public Health Wales is “To protect and improve the health and wellbeing of the population of Wales?”

What stakeholders and staff told us CommentaryThe current mission statement is snappy and accurateThis is an appropriate mission statement

This was a minority view. Most people felt it needed adding to or changing in some way

Needs to be broader to reflect Public Health Wales function – health intelligence, screeningStatement doesn’t capture it allI'm used to seeing also an expanded mission statement Capture what we do which is unique to us / distinctCould apply to various organisations (LA, LHB, WAG)More for health system as a wholeAs currently written the purpose is very generic. It could equally apply to Health Boards, hence Public Health Wales needs a unique purpose (e.g. a unique selling point USP) stating its role and direction of travel and its contribution (“how to”) as these are currently missingPublic Health Wales needs a unique selling pointSeparate session statements for sub groups of the organisation

These are general comments reflecting a widely held view that the interim mission statement does not adequately define the purpose of Public Health Wales because it could apply to other organisations as well.This is accepted.

Needs high level aims underpinning thisShould stretch usAspirationalSimpleSomething public can understandLanguage not technical

These are comments saying it is important that the statement should work for all audiences with which Public Health Wales communicates. This is accepted.

PaternalisticWhat is the public perception of ‘protect’ – is this different to ours?Protect and improve – which comes first?Should ‘protect’ be firstProtect is paternalistic (2)Protect suggests we have a level of health worth protectingChange protect to protection

These are comments primarily around perceptions of the phrase ‘health protection.’ Health protection, however, is a widely used and understood term in the context of public health and public protection. It is also an accurate representation of the function of many staff in Public Health Wales.

For these reasons, it is proposed that the phrase ‘health protection’ should be retained.

Emphasise our population focusPopulation rather than individualChange population to peopleUse community instead of population“The people of Wales” not populationDelete “of the population of”

There is an issue about use of the word ‘population.’ Some argue that it is not a friendly word and it would be better to use ‘people’ or ‘everyone’. Others argue that it promotes the unique focus of Public Health Wales which is primarily focussed at a population level rather than at individual citizens and the way they receive personal services.

Perhaps ‘population of Wales’ could be changed to ‘everyone’ Because of the need to use accessible language, the

word ‘people’ has been adopted.

What is the difference between health and well-being?Well-beingDevelop happiness

These comments focussed on the need for Public Health Wales to focus on wellbeing as well as health. This point was already accepted in the interim mission statement.

Promote health as well as improvePromoting the improvement of health and well-being in WalesImprove health and well-being of the population of Wales through promotion, prevention and protectionTo protect, promote and improve the health and well-being of the population of Wales by providing specialist public health contribution to partnershipsPromote, protect, preventPrevent, inform, respondPrevent, improve, protectPromote physical and mental health and prevent disease, illness and disabilityChange improve to improvementPromoteTo promote better health and wellbeing To prolong life

A number of comments advocated the inclusion of the word ‘promote’ instead of, or in addition to, ‘improve’. Others argued for the use of the word ‘prevent’ and others used the phrase ‘prolong life’. The phrase ‘health promotion’ is well used by many Public Health Wales staff, stakeholders and the public. The phrase ‘health improvement’ however, covers ‘health promotion’ and the ‘prevention of disease’ so is preferred.

To prevent disease

MonitoringCould map progress under missionMeasurableDevelopment of systems (people, practices, procedures and machinery) to monitor and deliver these improvements.

These comments relate to the need for Public Health Wales to be able to measure progress against its mission statement. This point is accepted.

Important to say Wales Promotion of Wales

These points are not accepted because the name of the organisation makes it clear that the organisation relates to Wales only.

Science and art of preventing disease, prolonging life and promoting health through organised efforts of societyScience and art of protection and improvementRecognise art and scienceThrough the organised efforts of society (2)

These comments refer to the Faculty of Public Health definition of public health. This is a useful reference because it ties Public Health Wales to established terminology. However, it does not describe a unique role for Public Health Wales and it does not provide a measurable mission. It is therefore not accepted.

Engaging with the public to encourage them to take more responsibility for their own healthTo enable people in Wales and their services to continuously protect and improve their health and well-being

These comments focus on the ‘enablement’/’empowering’ role of Public Health Wales. This is a fair description of what Public Health Wales does but is not a unique role: many health professionals and public servants seek to empower citizens.

Working with individuals, communities and organisations to protect and improve the health and well-being of the people of Wales and reduce inequitiesTo protect and empower the people of Wales to maximise their healthTo work with and influence individuals and communities to promote and improve the health of the population of WalesTo engage with communities and services to protect and improve the health and wellbeing of the population of Wales to the highest standards in EuropeSupport Wales to improve its own health and wellbeing and tackle inequalitiesMaximise people’s opportunities to be as healthy as they canContribute to . . .To help . . .Working with communities to . . .To provide a significant lead on setting the public health agenda in Wales . . .To provide the specialist public health expertise (and support) . . .EngagementEngaging other orgs Empower

The point is therefore accepted but not alone.This is a difficult aspect of the mission to measure.

EnablerEmpower the people of Wales to maximise their health (2)Must: skilling (thus maximising potential)Support

Brings together other organisationsPublic Health is everyone’s businessWorking with othersPartnership working / work in partnershipTogether with . . .Working with the population to protect and improve…Working with other services Joined up work/work across boundaries Make linksIntegrationCoordinated approach ConnectingHub at centre of WalesBy working across organisational boundaries (public, private, political and third sector) and within organisational hierarchies to effect positive and lasting changes in health

These comments focus on the role of Public Health Wales on working in partnership with others. This is a fair description of what Public Health Wales does but is not a unique role: all public bodies work in partnership with others on health issues.The point is therefore accepted but not alone.This is a difficult aspect of the mission to measure.

Our purpose is also to provide national leadership and expert advise for the delivery of modern and effective clinical services

Leadership

These comments focus on a leadership role for Public Health Wales. This is potentially contentious, conflicting with the roles of the Chief Medical Officer, the Directors of Public Health and others. The statutory responsibility for health of the population rests with health boards, local authorities and the Welsh Assembly Government so some people argue that this is where leadership should be.For these reasons, it is proposed that the word ‘leadership’ should not be included in the mission statement.

Add expert / expertise

Add specialist

Specialist public health Trust or a Trust incorporating a specialist public health workforce

These comments focus on the expert or specialist role of Public Health Wales being unique. However ‘specialist public health’ does not describe the provision of services such as Stop Smoking Wales, screening programmes and microbiology services. It may also limit or conflict with further growth of the organisation.Public Health Wales is also not the only source of specialist public health advice: the Directors of Public Health and CMO are also public health specialists.For these reasons, the reference to expert is preferred to specialist. This is a difficult aspect of the mission to measure.

Through caring professionals This focuses on Public Health Wales staff being caring. This is a fair description but is not unique to Public Health Wales staff. This point is therefore not accepted.

Our purpose is also to provide national leadership and expert advise for the delivery of modern and effective clinical servicesHealthcare services is missing

Improving quality of healthcare by education of practitioners and public

Ensuring quality of service provision

These comments focus on delivering healthcare services. This is a fair description of some of what public Health Wales does but is covered by the term ‘health improvement’ because Public Health Wales work in healthcare services is taken on with a view to improving health outcomes.This point is therefore not accepted.

. . . by delivery and influencingInfluence national politician and put them into actionAdvocacy (3)Enhance

This is a description of what Public Health Wales does but is not a unique role. The point is therefore accepted but not alone.

Add “…and reduce inequalities”Reducing inequityHealth inequalitiesUnderstanding of the factors that . . . and action to . . . and reduce inequitiesWhich reduce inequalities, tackle the challenges described in Our Healthy Future, and address the wider determinants of health.

These comments focus on the need to refer to reducing inequalities / inequities. Some people argue that it is an aspect of health improvement. Others argue that it needs to be referred to specifically because improving everyone’s health equally will in itself not reduce the gap between the healthiest and least healthy.Inequity is currently favoured over inequality because some inequalities are inevitable and cannot be reversed whereas inequities refer to inequalities where action can be taken.

It is accepted that there should be a reference to reducing inequities.

Through educationThrough research (and devt)Innovator / innovation

These points focus on some of what Public Health Wales does. However, education and research are not roles unique to Public Health Wales.The point is therefore accepted but not alone.

Raise awareness of the screening and early detection role

This is a description of some of what Public Health Wales does but is not a unique role. The point is therefore accepted but not alone.

Add inform / informationInform people about matters relevant to their healthIncrease people’s awareness of other people’s health problem and disabilitiesUnderstanding of the factors that . . . and action to . . . and reduce inequitiesEvidence to the tableImproving evidence base

This is a description of what Public Health Wales does but is not a unique role. The point is therefore accepted but not alone.

Independent brokersIndependent (2)Challenging

Public Health Wales does provide a professionally independent view which has the right and ability to be challenging to government, agencies and the public. However, as a publically accountable body, the word

Critical friendMediation

doesn’t fit in a way everyone would understand it.These points are therefore not accepted into the mission statement but are considered under values.

Change that is of benefit (non harm principle) This comment better fits in the section on strategic objectives.

Recognise our long term visionWe are about the bigger picture

These points relate to Public Health Wales having a special focus on the long term and on a bigger picture than is provided by the NHS or local government alone.There is validity in these comments but they are unlikely to be accepted by the Welsh Assembly Government, NHS Wales or local authorities as unique to Public Health Wales.The points are therefore not accepted.

SafeguardingImprove and safeguardSecuring better health and wellbeing

The use of the word ‘safeguard’ raises similar paternalistic issues to those raised under ‘health protection’ (see above). However, the word is not as well used in public health as health protection so is not accepted for the mission statement.

A lot of barriers in Wales (eg culture in disadvantaged communities)

This does not relate to the mission of Public Health Wales.This point is therefore not accepted.

Provision of services This is a description of what Public Health Wales does but is not a unique role. The point is therefore accepted but not alone.

Local and national This point and others made as part of the wider strategic direction discussions refer to the need for Public Health Wales to be understood as an All Wales organisation providing services locally as well as nationally.The need to reflect this point is accepted.

Give This does not relate to the mission of Public Health Wales.This point is therefore not accepted.

Train and develop internal staff to deal with service developmentRecruiting and training

This does not relate to the mission of Public Health Wales.This point is therefore not accepted.

The purpose needs to use public health terminology consistently e.g. that used in Our Healthy Future – with its 6 strategic themes (health throughout the life course, inequities, sustainable communities, prevention and early intervention, health as a shared goal, strengthening evidence and monitoring progress)

This point better relates to the strategic objectives of Public Health Wales rather than the purpose of an organisation.

Happier, healthier and safer WalesPromote and influence the public health agenda in WalesAdding years to life and life to years (2)

Improve public health in Wales Public Health Wales aims to protect and improve the health and wellbeing of the population of Wales • By working across organisational boundaries (public, private, political and third sector) and within organisational hierarchies to effect positive and lasting changes in health, • Which reduce inequalities, tackle the challenges described in Our Healthy Future, and address the wider determinants of health.To protect, support and promote the health and wellbeing of people who live in or visit Wales and to improve the health status and wellbeing of our residents.

These are alternative mission statements proposed which make some of the points already discussed above.

Appendix C: Values

What type of organisation do we want Public Health Wales to be? What should be important to us? In five year’s time, if asked to describe Public Health Wales, what words would you like others to use?

What stakeholders and staff told us CommentaryFirstly, acknowledge all public health interventions begin with values i.e. that interventions are chosen on moral and political grounds, not purely scientific. Make these values transparent and acknowledge they may be in conflict with other values held in the population.

This is a well made point.

Professional (11)Specialist / Expert (10)SkilledNon politicalInformedInformativeKnowledgeableAn authorityEthicalResponsible

These words are all aspects of professionalism and can therefore be summarised by the word professional.

ObjectiveIndependentChallenging (3)Professional prideMotivatingEnablingPromotingEducatingDevelopmentalInnovative (4)CreativeInspirationalDynamic (2)Proactive (4)A move from a reactive health service treating ever more and more patients suffering the adverse health effects of smoking to a more proactive public health service, promoting and protecting people’s health throughout their livesEnthusiastic Passionate Sense of beliefPositive team culture

These words are all factors which contribute to being persuasive.

Achieve rather than doCommittedDoing your bestVisionaryProgressiveStrategicTransformationalOutcome focussedAspirationalAmbitiousDeterminedFocusedResourcefulCan-doA facilitative organisation that promulgates its knowledge, expertise, evidence and skill, while acting as a clearing house for health promoting initiativesLead by exampleWalking the walkHonest True to valuesTruthfulPlain speaking

These words are all aspects of honesty and can therefore be summarised by the word honest. Honesty is a characteristic of being professional.

IntegrityOpenTransparent (2)Transparency: The organisation should be open, accountable and communicative.These values should apply as much inside the organisation as in its interface with others.

These words are all aspects of openness and can therefore be summarised by the word open.

ThoughtfulReflectiveEvaluativeTrustingListeningLearningPerceptiveReceptiveRespectfulCaringCompassionateForgivingNo blame cultureNon judgementalApologise when neededPeace, Respect and Tolerance (PHA Cymru):

These words are all aspects of reflection and can therefore be summarised by the word reflective.

The danger of promoting health as a value is that we run the risk of stigmatising those who make different choices outside the norm.EmpoweringEmpowerment: Put emphasis on positive and supportive messages, have a grown-up conversation about risk and the limits of scientific certainty.Inclusive (3)ConsultativeEngaging (3)EngagementEngaged with our partnersWorks partnership with stakeholders, continuing to consult and liaise with BASHH on strategic issues of mutual concernPatient focussedAutonomy: Freedom of choice is highly valued: any public health intervention must increase autonomy.

These words are all aspects of empowerment and can therefore be summarised by the word empowering. The word is used in the mission statement.

First do no harmThe safety of the people is the highest lawBest practiceConsistentImprovingNurtures excellence

These words are all aspects of quality and can therefore be summarised by the word quality. Quality should be an aspect of being professional.

QualityQuality servicesQuality drivenServices second to noneProblem solvingMeasurement for improvement / measurement drivenProtectingFair and equalEquitableEquityRespecting differencesSocial justiceSocial Justice: Social justice generally refers to the idea of creating an egalitarian society or institution that is based on the principles of equality and solidarity, that understands and values human rights, and that recognises the dignity of every human being .

These words are all aspects of fairness and can therefore be summarised by the word fair. Professional behaviour should be fair. Fair is used in the vision statement.

Effective (13)Cost effective (2)Efficient (9)Value for money (2)AccountableOutcome driven

These words are all aspects of being persuasive and can therefore be summarised by the word persuasive.

Has clear focus on supporting transformation of healthcare (and public services) at local level for the benefit of patients and communities CoordinatedIntegratedUnifiedAlignmentCohesiveAbility to help shape services for the futureSustainable Sustainable development (3)Sustainable Development: This should be a central principle of public health for obvious reasons.Green

These words are all aspects of sustainability and can therefore be summarised by the word sustainable. This is reflected in a strategic objective.

Better communicating organisationGood communication and listening (2)TactfulPolitical

These words are all aspects of communication and can be summarised by the words persuasive, open, reflective and responsive.

AccessibleFlexible (2)Responsive (3)Adaptable (2)Approachable (2)

These words are all aspects of responsiveness and can therefore be summarised by the word responsive.

SupportiveSupportive of clinical servicesReliable (5)RelevantInvaluableHelpfulDeliversUseful (2)Valued (6)Respected (6)TrustedDependableRole modelInspires confidenceFirst place to goInfluential (2)CredibleHard workingEasy to do business withMaking a differenceTimelyPublic service ethos

Able to provide timely STI & HIV data to inform outbreak managementPartnershipCollaborative (2)Stakeholder involvementPublic facingPatient focused / citizen focusedClient focusedCommunity focusedCooperation and collaboration: We won’t achieve anything without working in partnership and working with people much more than we have, particularly in asking them about their priorities.Coordination and partnership of all agencies

These words are all aspects of collaboration. They are reflected in a statement on ‘How we achieve our objectives.’

Sense of humour This phrase was given in answer to the questions on ‘what should be important to us’ but has not been included as it is not in itself a value.

People centredNon eliteValues staffValue staff in a meaningful wayGood employerReward and recognition

These words are more descriptive of the type of employer staff would like to see. They were given in response to the question ‘what type of organisation do we want Public Health Wales to be?’

Provides opportunitiesOpportunityStability and securityHigh profileEstablished identityWell knownRecognisedVisibility (2)Visibility at local levelUnderstoodEvidence based (8)People locally have support of the organisationLeaders in our fieldInternationally renownedCutting edgeSystem thinkingSystematicSuccessfulUniqueModern / High techEducatorsResearch and development organisation

These words are more descriptive of what Public Health Wales should achieve and reflect answers to the question about how others would describe Public Health Wales in five years time. They are not values.

Learning organisationShared learningPart of NHS National to localEncompassing whole populationFacilitationIndependent advocacyAdvocated / advocacyMulti professional workingLobbyistStrong and decisive leadershipDemonstrates effective leadership in health protection, prevention of ill -health and promotion of good health and well-being ( wider determinants of health)Provides leadership in public health education and research to support workforce development, inform change and action to improve health and healthcare.Provides leadership in methods of communication with the population and between organisationsDelivers influence, advocacy and challenge to ensure public health is everyone businessHas developed high quality health intelligence (data and evidence) to inform and support implementation of local service.Visible leadership

Clear commissioning policyRisk awareRecognises complexity

Appendix D: Strategic objectives and priorities

What should these be for the next five years?What stakeholders and staff told us CommentaryMeet statutory dutySupport implementation of OHFDevelop and deliver 5 year promotion and prevention planOHF – 10 strategic objectivesDeliver against givens – AOF, OHF, 5 year planOur Healthy Future – Public Health Framework

These responses focus on the requirements set of Public Health Wales by the Welsh Assembly Government. They can be summarised as:To meet the requirements of the Annual Operating Framework, Our Health Future and other Government policy and strategyHowever, as many of the requirements of these policies and strategies fit into other strategic objectives, and because policy and strategy can change with government, this should not be adopted as a strategic objective.

Wider determinantsIll health prevention (upstream)Upstream prevention – LHB, LAInequalitiesHealth inequalities strategy (all parts of organisation)Reduce inequalities in healthUnderstanding of inequity, how we address it & how we measure it

These comments focus on the need to reduce health inequalities by addressing the wider determinants of health. They can be summarised as:To reduce health inequities by addressing the wider determinants of healthThere is a strongly held collective view that this should be a priority. The objective is measurable. This objective links to the Our Healthy Future themes of:

Support socio-economic policies which improve and protect public healthInfluence improvements in health – most benefit to the greatest number of peopleNarrowing the gap in health inequalitiesProfile underlying factors of inequality and ill healthReducing health inequalities – previous action not workedHealth economics modellingTake action that addresses the underlying social and environmental determinants of health not just the lifestyle behavioursLack of control over non-devolved agencies with a specific emphasis on the crucial role of Trading Standards and Justice in enforcing under age sales. But the Forum also noted the importance of improved representations to the UK government on issues relating to smuggling and taxation. Take action that increases health and wellbeing and reduces inequity

Reduced Inequities in Health Healthy and Sustainable communities

Work with LHBs to prioritise healthcare improvement, chronic conditions, prevention, treatment, managementHelp improve health services – more effective and efficientSupport service reconfiguration (LHBs)Care pathway at local level

These comments focus on healthcare improvement and support for the LHBs in particular. They can be summarised as:To improve the quality and effectiveness of healthcare servicesCriteria would need to be agreed by which achievement of this objective could be measured.

Contributing tangible improvement to the quality and effectiveness of healthcare deliveryMore prevention – 1000 Lives CampaignSupport LHBs in healthcare service improvementProviding specialist public health expertise to LHBs and NHS Wales to deliver agreed local objectives including undertaking service transformation and delivering high quality, safe and effective healthcare services. Supporting LHBs in making decisions in relation to service redesign and reconfiguration of servicesDeveloping ‘best in class’ specialist expertise in needs assessment and evidence base to support service review and delivery.Providing leadership on a range of modernisation and efficiency initiatives, providing the evidence for best practice across NHS Wales.Providing evidence for others to improve health service qualityReduce waste, harm and variationAll individuals to have access to high quality integrated Sexual Health Services provided and networked across hospital and Community settings including Primary Care.All Sexual Health Services to be provided by appropriately trained health professionals – Public Health Wales having a role in training.All services to have access to NAATs tests for Chlamydia and Gonorrhoea –as urine and self taken swabs

This area of work should be a priority.

Publication of Service Specifications for Integrated Sexual Health Services and SARCImproved access to LARCS & Termination of Pregnancy Services

Lifestyle issuesSupporting LHBS, LAs and local partnerships to develop and deliver, systematic, evidence based responses to a smaller number of health improvement priorities that will deliver most impact on burden of poor health.That Public Health Wales adopts a social marketing approach to its lifestyle information and advice. Furthermore, that in conjunction with interested partners, PHW encapsulates key lifestyle messages in a consistent, easily assimilated and relevant manner adapted to suit individual cultures and concerns. Tobacco controlTo ensure that our new local health boards have tobacco control public health prevention and cessation programmes embedded in their strategic work programmes and targets for reducing smoking prevalence ratesYoung people are not receiving adequate cessation support or consistent prevention programmes. A greater focus is needed on working with rather than working on young peopleLack of maternity [smoking] cessation servicesThere is a need for a more diverse and accessible range

These comments focus on particular health topics which mainly relate to people’s lifestyle. Public Health Wales could choose to prioritise particular lifestyle issues or it could agree an objective to address them collectively, e.g.To prevent disease and ill health by reducing the risks in people behaviourThis objective is measurable. This objective links to the Our Healthy Future priorities.

of cessation services delivered to the people of Wales - especially those who are under 18, from minority ethnic communities, socially excluded, socio-economically deprived and/or suffering from mental health conditions - in a manner that is consistent with their sense of culture, language and community.ASH Wales would like Public Health Wales to play an important role in ensuring that the forthcoming Tobacco Control Action Plan is fully implemented in Wales and not a document without outcomes and accountability for its success. Substance misuseHarm reductionDrugs – healthcare consumption, economic impact and PHAlcoholMental health and wellbeingPublic health and wellbeingDementiaChronic disease preventionHeart diseaseCancerBreast cancer in later lifeWe would welcome Public Health Wales’s backing to support numerous issues of importance to diabetesDiabetes

StrokeInjury preventionMalnutrition amongst older peopleObesityPhysical activityDietSexual health Reduction of STIs, HIV infection and unplanned pregnancy in all age and risk groupsThese could be taken from the existing Local Delivery Plans and Our Healthy Future priorities (tobacco, physical activity, diet, substance misuse, teenage pregnancy, accidents and injuries, mental wellbeing, health at work, vaccinations and health inequity)Overall, the general consensus was that the revised version should be more detailed and link to work of the frontline teams. There was also a willingness to be involved in such consultations in the future.

Supporting the Directors of Public HealthSupport DPH – annual report etcBring together the UPHSLHB Strategic direction and 5 year plansTo support LHBs to become exemplar organisations in adopting a public health and sustainable development

These comments all focus on the need to develop strong partnerships. They can be summarised as:To build and maintain strong and effective partnerships with other agencies and the public.Criteria would need to be agreed by which achievement of this objective could be measured. This is a way of achieving strategic objectives.

approach to business.Work with partners to ensure everyone has the basics – food, shelterPartnership workingGood partnership working with stakeholders and partnersJoined upHigh profile organisation, clearly recognised and respected within Welsh public services and UK, by achieving harmonious and effective relationships with stakeholdersStrategic way of working with partnersClear and strong external partnerships in placeStrengthening relationship with stakeholdersEffective relationshipsPartnershipEngagement with LHBs, LA, Education etcEffective collaboration to maximise healthPartnership working / agreements – influencing partners on their prioritiesWork in partnership with others to achieve the above aimsLack of joined up, cross boundary responsibility for tobacco control. Public Health campaigns conducted in partnership

between statutory, corporate, professional and voluntary sector agencies

Evidence based, quality assured ‘products’ which are delivered in a timely mannerIntegrated and coherent work plans – consistent with national and WAG prioritiesDeveloping programmes that will be embedded in 10 years timeHigh quality info to translate into deliverable actionsExpert advice and support – toolkit – evidence baseMeasure outcomesContinuous improvementOttawa charter – public policy etcWhole system smarterSystematic approach as organisationWhat PH issues are under control and how could we reproduce for new prioritiesSystems approachBuild, develop and integrate systems of people and practices to achieve our visionThe arbiter of health protection, promotion and improvement in all aspects of public life, from buildings design to transport policy, events organisation to urban and rural planning, criminal justice to workforce

These comments focus on the approach to work taken by Public Health Wales, the need to be systematic and evidence based. They can be summarised as:To work innovatively, systematically, effectively and on the basis of evidence to achieve measurable outcomes.Criteria would need to be agreed by which achievement of this objective could be measured. This is a way of achieving strategic objectives.

wellbeing and from environmental issues to sustainable developmentEarly detectionInnovation and evaluationCost effectiveness – society and healthContinually evaluating resourcesIntelligent resource allocation defined by priority and backed up by evidenceEnsuring adequate resources for teamsMore flexible deployment of staffWhat should we stop doing?Technologies

AdvocacyLeading contribution to setting public health agenda in WalesProviding clear public health advocacy and influence to local and national policyInfluence government policy and strategy by greater use of HIAHIA programmeMore proactive in lobbying for change at a policy levelMore involved in developing policyDevelopment of policy/programme unit

These comments focus on the advocacy role of Public Health Wales and the need to influence policy. They can be summarised as:To influence government policy effectively.Criteria would need to be agreed by which achievement of this objective could be measured. This is a way of achieving strategic objectives.

Make health everyone’s businessEmpowerment of people and communitiesEmpowering population to initiate changeEmpower individuals and communitiesTo support LHBs and LAs in a systematic approach to develop ownership of personal and community responsibility for health Increased citizen engagementEngagement with publicSocial marketingWelsh language / bilingualImproving health literacySkilling wider workforce in Mental Health promotionBuild and support PH involvement and capacity in local communitiesProvide evidence and support for all organisations and individuals that influence health of publicSupport LHBs and LAs to become health promoting organisations as they have most resourcesCapacity building in other organisationsSupporting the education and workforce development of the NHS workforce so as to maximise potential in promoting health and wellbeing in all front line clinical and other service delivery

These comments focus on supporting and building capacity in other agencies, and in the population, so they can take decisions which protect and improve public health and reduce health inequities. They can be summarised as:To empower people, communities and agencies to protect and improve health and reduce health inequities.Criteria would need to be agreed to measure empowerment by which achievement of this objective could be measured. This is a way of achieving strategic objectives.

Make sure public health dimension is not lost in LHBsInfluence performance management frameworkDevelop outcome based performance management planThat Public Health Wales helps smaller organisations, community groups and local social enterprises to publicise their health and wellbeing successes and share their innovations across Wales.Providing leadership in communication with the public and between organisations in relation to health and well-beingComms issues – large print etcHub role – collect, disseminate etc

Ensuring LHBs deliver their statutory health protection responsibilities to the highest quality and efficiency, transforming service delivery in line with other healthcare servicesThat the principle of providing mass public health protection and disease prevention programmes both endures and evolves on grounds of evidence for efficacy, health gain, moral acceptability and value for money.Able to respond to emergencies effectively and maintain surge capacityIt is hoped that during these current difficult funding times for all our agencies, Public Health Wales will continue to fully play their part as category one

These comments focus on the health protection function. They can be summarised as:To protect the population from infectious disease and environmental hazards and to respond effectively to the public health aspects of emergencies.Criteria would need to be agreed to measure effective health protection by which achievement of this objective could be measured. This should be a priority area for action.

responder Investment in health protectionMaintain and improve resilience to respond to public health emergenciesHand washingInfectious diseasesVaccination and immunisationSeasonal flu vaccinationHealth protectionMicrobiology

Service delivery (screening etc)Screening – development (2)

These comments focus on prioritising screening programmes. They can be summarised as:To reduce illness and death through the management and development of evidence based screening programmes.This objective is measurable. It covers a substantial part of Public Health Wales business but repeats, in more specific language, objectives about preventing chronic disease, improving and protecting health.

Improve quality of public health information Evidence base (2)Observatory

These comments focus on health intelligence. They can be summarised as:To provide health intelligence to guide and underpin action to protect and improve health

More research, information and data is required in order to effectively develop, deliver and monitor tobacco control public health interventions e.g. minority ethnic communities, smuggled tobacco use, youth attitudes and smoking prevalence rates more frequently than Health Behaviour of School aged Children surveys, smokers toolkit model from England, how smokers in Wales quit and effectiveness, ASSIST effectiveness at scaleIn addition to being a leading source of high-level data, information and health intelligence, that Public Health Wales develops a rigorous “Learning Framework” tool for utilisation by small scale initiatives. Building on its assessment of a select number of interesting community-based projects, PHW could specify which operational techniques prove most efficacious. The Learning Framework would include guidance on evaluation, achieving impact, longevity and sustainability and adding value.

and reduce inequalities.This objective does not have a measurable outcome. It does, however, represent an important part of Public Health Wales’ business.This is a way of achieving strategic objectives.

Improving the evidence baseGenerating research ideasEstablished and progressive R&D function in partnership with academic sector and othersRelationship with academiaR&DUse the existing evidence base to influence, develop and add to the evidence base where it does not exist

These comments focus on the role of Public Health Wales in developing an evidence base. They can be summarised as:To work with academics to improve the evidence base for taking public health action.This objective does not have a measurable outcome. It does, however, represent an important part of Public Health Wales’ business.This is a way of achieving strategic objectives.

Some long term backbone to more innovative practiceInstituteA recognised source of expertise in all areas of public health planning, policy development, research validation and health measurement. Where PHW lacks expertise, this is co-opted as a temporary or permanent measure.Extends the reach of public health through education and training for NHS staff and other public sector workers whose role directly or indirectly affects the health and wellbeing of the people of Wales. Much of the education could be provided through interactive IT: ensuring a standardised base for knowledge. The remainder would involve training that focuses on skills development.

Information systems and ways of workingInformation for action (IT and information systems)Embracing new technologyIncreasing automation of routine reporting requirements, enabling scientists greater time on the analysis and interpretation of data, and in follow-up action planning.A Public Health Data Library - a data analysis portal fed automatically from multiple source, enabling research/enquiry-driven cross-dimensional analysis of public health data.Enterprise networking solutions to bring together dynamic groups to address the public health concerns of

These comments focus on information systems as a way to improve ways of working. They can be summarised as:To develop information systems which promote more effective working.This objective does not have a measurable outcome.This is a way of achieving strategic objectives.

the day: by sharing work and knowledge so that information for action is coherent and action is coherent.

Local expertise to feed national strategyNational scheme delivery at local levelBalancing local v nationalGreater exploitation of regional opportunities

These comments focus on the role and importance of staff working locally, regionally and nationally. There is a clear tension between pressures to work at an all Wales level and pressures to have a strong local presence.It is not possible to develop a measurable objective from these comments. The point is better taken on board in the section on mission.

Workplace health This comment seeks to make workplace health a priority. It could be written as an strategic objective as follows:To protect and improve the health of employees through action in the workplace.Criteria would need to be agreed to measure effective workplace health by which achievement of this objective could be measured. This objective is repeated by other strategic, and more general, objectives about protecting and improving health.

Early yearsHealth of children and young peoplePregnancy and early yearsChild protection

These comments focus on prioritising public health work with children and/or the elderly. They can be summarised as:To prioritise public health action with childrenAnd/or

Frailty / older peopleElderlyAgeing populationElderly care servicesHealthy ageing is essential to the quality of later life. The risks of the most common conditions - heart and circulatory diseases, respiratory disease and cancer – can be reduced by lifestyle modifications, and their progress can be delayed.

To prioritise public health action with the elderlyThese objectives are repeated by other strategic, and more general, objectives about protecting and improving health.They link to the Our Healthy Future theme of Health Through the Life Course

Develop reputation for world / euro excellenceDo what we do well (quality v quantity)Organisation which is fit for purposeOrganisational structure establishedDeveloping an integrated and cohesive organisationConfigured in way that worksEffective future proof structuresPlatinum CHSWorkplace health (inward and outward) – keep people in ‘good’ work and good healthImproving the health of the organisationLearning organisation – less introspectiveMore cohesive workforceDevelop workforce

These comments all focussed on the need to establish a strong and coherent organisation, one that is better able to achieve its public health objectives. Particular elements include organisational structure, workplace health, a skilled and learning workforce, integration and specialisation, prioritisation, sustainability, innovation, financial strength, open and effective communication and compliance.All these comments can be summarised as:To establish Public Health Wales as a cohesive, effective and sustainable organisation which leads by example.Criteria would need to be agreed by which achievement of this objective could be measured.

Secure and stable staffing within the organisationStocktake of skills – most effective use of resourcesUse our people to the full resourcesInvestors in peopleTrainingLeading organisation in sustainabilityBeing green and more efficientSustainable ways of workingFinancial balance and the development of a sustainable and cost effective organisation. Support innovative workingEncourage people to innovateBudgets – business casesStrict but fair finance managementSaving decisions are made on the evidence to improve healthProtecting specialism within each disciplineDefine level of integration needed to deliver our aims and prioritiesRedefine roles in line with priorities to maximise impactImprove integration of teamsEnsure we are configured to deliver the aboveBe more effective internally so we can be more effective

externallyStreamlineIntegrate teamsRe-evaluate how we deliver our programmesWho are we responding to and how do we prioritiseAudit of servicesService reviews to determine what is needed to ensure sustainability and integrity of services and where investment is neededTo decide priorities of strategy v deliveryBe in better position for prioritising our work and moving towards truly integrated PH serviceBetter at prioritisation – balance between obesity etc and wider determinantsNegotiate key areas to focus on what is the key role of specialist public health servicesDefine local outputs as part of Board structure / roleDomain to maintain focus within divisionsBeing more joined up to avoid duplicationMinimising duplication of effortsMore collaborative working in the organisation to cut down on duplication. We never seem to have the critical mass to finish thingsGet rid of silo mentality

Staff forums‘Directory’ of ‘experts’ / areas of interestInformation about projects is patchy and not always readily/easily availableTransparencyBetter communication / self promotionVisibilityEffective communication about what we doOrganisation to have higher profileSort out the organisational structure and communicate it to staff and stakeholders.Encourage better understanding of communication in the organisation (e.g. in a project where raising awareness is an aim, the communications budget is the first to get cut usually).Start taking new media a lot more seriously by making time for it and developing in-house skills. As people rely on websites more, we need to recognise we’re competing with others to promote public health messages.Develop a public facing website. Our website is not that interesting for the public – more geared towards stakeholders. Raising the profile of Public Health Wales is not vital, the services we deliver are more importantNeed to be doing targeted comms with middle managers / Regional and National Fora members. They

are gatekeepers of comms/info for their staff. Need to concentrate on building trust in this group.Compliant organisation – governanceGet on with it

Short/medium/long term (2) These comments propose that there should be different objectives set by Public Health Wales according to timescale. The Strategic Direction project is seeking to agree Strategic Objectives with a five year timescale. Each of the strategic objectives will lead to the development of work plans with shorter term objectives.

Provide professional and independent Public Health advice and services to all partners and stakeholders including NHS Wales

This contribution is addressed under mission

Act ethically This better fits as a value

Work in the ‘real world’ It’s not clear how this comment can be translated into an achievable and measurable objective.

public health wales · web viewsecuring better health and wellbeing the use of the word...

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