7 Priorities and Strategic Objectives 5

Strategic Direction Engagement Report

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

Contents

1 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...... 7 What do you want Wales to be like from a public health perspective in five years time?...... 7

APPENDIX B: MISSION...... 21 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?”...... 21

APPENDIX C: VALUES...... 33 What type of organisation do we want Public Health Wales to be?...... 33 What should be important to us?...... 33 In 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 Introduction

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. 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

Date: 27 September 2010 Version: 1 Page: 2 of 66 Public Health Wales Strategic Direction Engagement Report

 key values underpinning the organisation, which will guide future strategic decisions and the setting of priorities within Public Health Wales  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 consultation

There 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 Principles

The 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 Vision

All 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 Mission

All 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 Values

All 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

Date: 27 September 2010 Version: 1 Page: 6 of 66 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 Commentary Don’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 Europe These responses – the greatest concentration We want to be Swedish / Finnish received - focus on health outcomes and can be summarised as: Health of population in Wales – best in UK  A healthier, more prosperous Wales with Healthier / Reduction of ill-health (9) reduced inequities To carry on improving health of the population of This visionary statement focuses on outcomes. Wales The words ‘more prosperous’ have not been accepted. Fewer people accessing services for ill-health The phrase ‘reduced inequities’ is covered by the word Narrowing inequalities gap / Reducing inequalities in fair. health (9) Reducing inequity / more equitable society (5) Tackling health divide – levelling up Fairer society (3) Public Health Wales Strategic Direction Engagement Report

Redistribution of income Health gains across the entire health sector Change in health outcomes Reducing avoidable death / premature death Increasing longetivity Wealthier / prosperous (2) Realisation of the aims of Our Health Future Add quality to life High aspirations

Equality of opportunity These responses focus on opportunities and can be Everyone has an equitable opportunity summarised as: Equality of opportunity for all Opportunities for all / young people  A land of opportunity for living a full and healthy life This is a visionary statement but is not focussed on for all health and wellbeing outcomes. It is covered by the word fair. Making healthy choices the easiest choices Everyone has an opportunity for a quality death

Seamless and integrated services (3) These responses focus on the way public services Joined up and integrated should be provided and can be summarised as: Joined up working between agencies to have a bigger  Public services should be provided impact seamlessly

Joined up WAG departments This is a visionary statement but is not focussed on Inroads into effective partnerships with WAG and health and wellbeing outcomes so has not been other organisations to improve public health accepted. The point is taken on in the strategy in the section on ‘How we achieve our objectives’. Better relationship between Public Health Wales and primary care A system that is better integrated Breaking down barriers Reduction in organisational boundaries / make a holistic approach Joined budgets Everyone knows what everyone is doing with public health organisations Effective partnerships Reducing 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 These responses focus on the need for health to be health considered by all agencies when making decisions Everybody doing public health / everyone’s business and can be summarised as: Public health needs to be more engrained in the NHS  Health is everyone’s business (less about fire fighting) and population This is a visionary statement but is not focussed on Mainstreaming health promotion into all areas of health and wellbeing outcomes so has not been accepted. The point is reflected in the mission

everyday life – making it the norm statement. Trained multidisciplinary public health workforce Making health easy for people Shared sense of accountability Commitment to personal and community responsibility for health and well-being A more enlightened attitude to public health Health in all policies to be mainstreamed Health Impact Assessment in government to proof new policies Understanding of the impact of decisions have on public health Keeping people well – tools in the toolbox Using legislation to reinforce / encourage behaviour change More proactive government Fully integrate a public health perspective with vision for primary, community, and specialist healthcare and partnership working Wales 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 services These responses focus on the way public services are Welcoming public services provided and can be summarised as: Engaged public services  Public services should be effective, responsive, efficient, accessible and Patient centred services continuously improving Public services doing things ‘with people’ rather than This is a visionary statement but is not focussed on ‘to people’ health and wellbeing outcomes so has not been Confidence in systems and organisations accepted. The point is reflected in the section in the strategy on ‘How we achieve our objectives’. Confidence in the service Continuously improving (health and wellbeing) Improve quality in healthcare Timely services Economically self-sustaining More effective services (3) More preventative service Collaboration 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 Wales More efficient delivery of healthcare (2) Equity of service provision but also equip people to stay healthy Equality of access to services Services positioned innovatively Services accessible in the local community Equal services are provided across Wales Ensuring those in most need have the support they need Cradle to grave services Have a range of choices National leadership for the health agenda People value the contribution of the public sector

Empowerment of individual (9) These responses focus on people’s power over, and Empowerment for public to have responsibility for understanding of, their own health and can be own health summarised as: Skilled / empowered people – support at right time  Empowered, informed people and agencies Empowering communities – well informed users of This is a visionary statement but is not focussed on

services health and wellbeing outcomes so has not been People are proactive to improve their own health accepted. The point, however, is reflected within the mission statement. Enablement Engaged population Reduction in dependency culture Public to have responsibility for own health – reduced dependency on public sector (GPs) to fix problems To help the Welsh population take more responsibility for their own health Increased public involvement Better understanding (4) Understanding health is about prevention Better informed (5) Informed to make own decisions Increased use of public health data More aware of stats on health service /lifestyle Increased use of information technology Increased understanding of communities distinct needs Confident population People know what public health is Wiser

Community wellbeing These responses focus on wellbeing and can be Recognition of holistic model of ‘health – including summarised as: mental wellbeing (2)  Happier people No stigmatisation of mental ill health This visionary statement focuses on a wellbeing Confidence to talk about mental health – normalising outcome and is accepted. it Happier (5) Increased sense of wellbeing

Wonderful Wales These responses focus on the nature of communities Pride in Wales (2) and can be summarised as: Exploiting small country  Strong, confident communities Children and young people encouraged to stay in This is a visionary statement but is not focussed on Wales health and wellbeing outcomes. However, the point is reflected in the section on ‘How we achieve our Wales having autonomy to make key decisions objectives’. independently of Wales More cohesive society in which people look after themselves and each other (social capital) Greater community cohesion Health vibrant community Thriving community People feel connected

Community spirit Communities which focus on positives Where people feel valued and included Inclusive communities (2) Mitigating the effects of the coming spending cuts for communities Forward thinking / confident people / self worth Service delivery and Welsh language Recognition of different cultures in Wales Positive media coverage More socially responsible Restore trust between people and their institutions / society Shared public ownership No blame culture

Wider determinants These responses focus on the wider determinants of Rebalancing priorities from individual lifestyle issues health. They link to other sections above and can be to creating healthy environments through advocacy summarised as: with others in the public and private sector  Where action is taken to address the wider Everyone understands the wider determinants determinants of health Reduction in poverty This point has been accepted as a strategic objective. Fewer children in poverty

Employment / able to work (3) Fulfilling jobs for all who want work Tackle worklessness Tackle cycle of long term sickness /disability People unable to work are cared for Minimum people on benefits Healthier workforce Healthier place to live – environment (2) Environments are supportive of and conducive to good health and people being empowered Planning decisions support healthy choices Education for everyone / better educated (4) Lifelong continuous learning Better access to public facilities More artistic and creative society No stigmatisation of poverty

Less reliance on the car These responses focus on environmental issues which Better and cleaner public transport can be summarised as: Better affordable transport to reduce use of cars  Sustainable Greener travel as the norm This is a visionary statement but is not focussed on health and wellbeing outcomes. Then point is reflected Increased recycling in the section on ‘How we achieve our objectives.’

Coordinated campaign These responses focus on coordinated marketing Improve marketing techniques campaigns and is discussed under the question on strategic objectives. Targeting the population Consistency of messages – across the organisation and across Wales Have key lifestyle messages the public take on board

Reducing the impact of communicable disease and These responses focus on health protection issues environmental hazards and fit better under the question on strategic Feeling protected objectives. Increase in immunisation targets To meet vaccination targets

Supported by appropriate and effective public health These responses focus on Public Health Wales and services public health services and fit better under the Value for money public health services question on strategic objectives. Evidence based programmes Advocacy role Safe public health In Public Health Wales – avoid duplication and improve departmental coordination Public Health Wales more visible

Enhanced profile of public health People to know about public health Long term commitment to Public Health Wales To ensure greater awareness of, and engagement with, Public Health Wales services Respected workforce Exemplar for leading on public health Sustainability of public health services More trust and confidence in health improvement agenda

Reduction in chronic conditions These responses focus on general and specific Focus on lifestyle issues lifestyle issues and fit better under the question on strategic objectives. Change in bad habits culture Less obesity (2) Fitter Inroads in tackling healthy eating More physical exercise People using the outdoor environment Less drinking (2) Drinking is deeply uncool Reduce 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 drugs Less reliance on prescribed drugs – alternate services available – linked to community wellbeing and increased community facilities Improved engagement with employers to develop workplace health initiatives Better health education Motivated and supported to change behaviour Reducing injuries Reduction in all Sexually Transmitted Infections Reduction in all cases of HIV infections All new diagnosis of HIV to be made in individuals early in their disease Reduction in the number of unplanned pregnancies in all ages

Improvement in Psychosexual services available Reduction 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 This response focuses on health information and fit outcomes better under the question on strategic objectives.

To look at Designed for Life and ensure we are This response fits better under the question on meeting it and fulfilling Our Healthy Future's strategic objectives. commitments and aims.

Vision should be complementary to Our Healthy All these points are included in the summary Future – Public Health Strategic Framework and statements above. include “An active, healthy inclusive Wales, where making healthy 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 Commentary The current mission statement is snappy and This was a minority view. Most people felt it needed accurate adding to or changing in some way This is an appropriate mission statement Needs to be broader to reflect Public Health Wales These are general comments reflecting a widely held function – health intelligence, screening view that the interim mission statement does not Statement doesn’t capture it all adequately define the purpose of Public Health Wales because it could apply to other organisations as well. I'm used to seeing also an expanded mission statement This is accepted. Capture what we do which is unique to us / distinct Could apply to various organisations (LA, LHB, WAG) More for health system as a whole As 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 missing

Public Health Wales needs a unique selling point Separate session statements for sub groups of the organisation Needs high level aims underpinning this Should stretch us Aspirational Simple These are comments saying it is important that the Something public can understand statement should work for all audiences with which Public Health Wales communicates. Language not technical This is accepted.

Paternalistic These are comments primarily around perceptions of What is the public perception of ‘protect’ – is this the phrase ‘health protection.’ Health protection, different to ours? however, is a widely used and understood term in the context of public health and public protection. It Protect and improve – which comes first? is also an accurate representation of the function of Should ‘protect’ be first many staff in Public Health Wales. Protect is paternalistic (2) For these reasons, it is proposed that the phrase ‘health Protect suggests we have a level of health worth protection’ should be retained. protecting Change protect to protection

Emphasise our population focus There is an issue about use of the word ‘population.’ Population rather than individual Some argue that it is not a friendly word and it would be better to use ‘people’ or ‘everyone’. Others argue

Change population to people that it promotes the unique focus of Public Health Use community instead of population Wales which is primarily focussed at a population level rather than at individual citizens and the way “The people of Wales” not population they receive personal services. Delete “of the population of” Because of the need to use accessible language, the Perhaps ‘population of Wales’ could be changed to word ‘people’ has been adopted. ‘everyone’

What is the difference between health and well- These comments focussed on the need for Public being? Health Wales to focus on wellbeing as well as health. Well-being This point was already accepted in the interim Develop happiness mission statement.

Promote health as well as improve A number of comments advocated the inclusion of Promoting the improvement of health and well-being the word ‘promote’ instead of, or in addition to, in Wales ‘improve’. Others argued for the use of the word ‘prevent’ and others used the phrase ‘prolong life’. Improve health and well-being of the population of The phrase ‘health promotion’ is well used by many Wales through promotion, prevention and protection Public Health Wales staff, stakeholders and the To protect, promote and improve the health and public. well-being of the population of Wales by providing The phrase ‘health improvement’ however, covers specialist public health contribution to partnerships ‘health promotion’ and the ‘prevention of disease’ so Promote, protect, prevent is preferred. Prevent, inform, respond Prevent, improve, protect

Promote physical and mental health and prevent disease, illness and disability Change improve to improvement Promote To promote better health and wellbeing To prolong life To prevent disease

Monitoring These comments relate to the need for Public Health Could map progress under mission Wales to be able to measure progress against its mission statement. Measurable This point is accepted. Development of systems (people, practices, procedures and machinery) to monitor and deliver these improvements.

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

Science and art of preventing disease, prolonging life These comments refer to the Faculty of Public Health and promoting health through organised efforts of definition of public health. This is a useful reference society because it ties Public Health Wales to established Science and art of protection and improvement terminology. Recognise art and science However, it does not describe a unique role for Public

Through the organised efforts of society (2) Health Wales and it does not provide a measurable mission. It is therefore not accepted.

Engaging with the public to encourage them to take These comments focus on the more responsibility for their own health ‘enablement’/’empowering’ role of Public Health To enable people in Wales and their services to Wales. This is a fair description of what Public Health continuously protect and improve their health and Wales does but is not a unique role: many health well-being professionals and public servants seek to empower citizens. Working with individuals, communities and organisations to protect and improve the health and The point is therefore accepted but not alone. well-being of the people of Wales and reduce This is a difficult aspect of the mission to measure. inequities To protect and empower the people of Wales to maximise their health To work with and influence individuals and communities to promote and improve the health of the population of Wales To engage with communities and services to protect and improve the health and wellbeing of the population of Wales to the highest standards in Europe Support Wales to improve its own health and wellbeing and tackle inequalities Maximise people’s opportunities to be as healthy as they can Contribute 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) . . . Engagement Engaging other orgs Empower Enabler Empower the people of Wales to maximise their health (2) Must: skilling (thus maximising potential) Support

Brings together other organisations These comments focus on the role of Public Health Public Health is everyone’s business Wales on working in partnership with others. This is a fair description of what Public Health Wales does but Working with others is not a unique role: all public bodies work in Partnership working / work in partnership partnership with others on health issues. Together with . . . The point is therefore accepted but not alone. Working with the population to protect and improve… This is a difficult aspect of the mission to measure. Working with other services Joined up work/work across boundaries

Make links Integration Coordinated approach Connecting Hub at centre 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

Our purpose is also to provide national leadership These comments focus on a leadership role for Public and expert advise for the delivery of modern and Health Wales. This is potentially contentious, effective clinical services conflicting with the roles of the Chief Medical Officer, the Directors of Public Health and others. The Leadership 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 These comments focus on the expert or specialist role of Public Health Wales being unique. However Add specialist ‘specialist public health’ does not describe the provision of services such as Stop Smoking Wales, Specialist public health Trust or a Trust incorporating a screening programmes and microbiology services. It specialist public health workforce

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 These comments focus on delivering healthcare and expert advise for the delivery of modern and services. This is a fair description of some of what effective clinical services public Health Wales does but is covered by the term Healthcare services is missing ‘health improvement’ because Public Health Wales work in healthcare services is taken on with a view to Improving quality of healthcare by education of improving health outcomes. practitioners and public This point is therefore not accepted. Ensuring quality of service provision

. . . by delivery and influencing This is a description of what Public Health Wales does Influence national politician and put them into action but is not a unique role.

Advocacy (3) The point is therefore accepted but not alone. Enhance

Add “…and reduce inequalities” These comments focus on the need to refer to Reducing inequity reducing inequalities / inequities. Some people argue that it is an aspect of health improvement. Others Health inequalities argue that it needs to be referred to specifically Understanding of the factors that . . . and action because improving everyone’s health equally will in to . . . and reduce inequities itself not reduce the gap between the healthiest and least healthy. Which reduce inequalities, tackle the challenges described in Our Healthy Future, and address the Inequity is currently favoured over inequality wider determinants of health. 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 education These points focus on some of what Public Health Through research (and devt) Wales does. However, education and research are not roles unique to Public Health Wales. Innovator / innovation The point is therefore accepted but not alone.

Raise awareness of the screening and early detection This is a description of some of what Public Health role Wales does but is not a unique role. The point is therefore accepted but not alone.

Add inform / information This is a description of what Public Health Wales does Inform people about matters relevant to their health but is not a unique role. Increase people’s awareness of other people’s health The point is therefore accepted but not alone. problem and disabilities Understanding of the factors that . . . and action to . . . and reduce inequities Evidence to the table Improving evidence base

Independent brokers Public Health Wales does provide a professionally Independent (2) independent view which has the right and ability to be challenging to government, agencies and the Challenging public. However, as a publically accountable body, Critical friend the word doesn’t fit in a way everyone would understand it. Mediation 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 vision These points relate to Public Health Wales having a We are about the bigger picture 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.

Safeguarding The use of the word ‘safeguard’ raises similar Improve and safeguard paternalistic issues to those raised under ‘health protection’ (see above). However, the word is not as Securing better health and wellbeing 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 This does not relate to the mission of Public Health disadvantaged communities) 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 This does not relate to the mission of Public Health development Wales. Recruiting and training This point is therefore not accepted.

The purpose needs to use public health terminology This point better relates to the strategic objectives of consistently e.g. that used in Our Healthy Future – Public Health Wales rather than the purpose of an with its 6 strategic themes (health throughout the life organisation. course, inequities, sustainable communities, prevention and early intervention, health as a shared goal, strengthening evidence and monitoring progress)

Happier, healthier and safer Wales These are alternative mission statements proposed Promote and influence the public health agenda in which make some of the points already discussed Wales above. Adding 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.

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 Commentary Firstly, acknowledge all public health interventions This is a well made point. 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.

Professional (11) These words are all aspects of professionalism and Specialist / Expert (10) can therefore be summarised by the word professional. Skilled Non political Informed Informative Knowledgeable An authority

Ethical Responsible Objective Independent Challenging (3) Professional pride Motivating These words are all factors which contribute to being Enabling persuasive. Promoting Educating Developmental Innovative (4) Creative Inspirational Dynamic (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 lives Enthusiastic Passionate

Sense of belief Positive team culture Achieve rather than do Committed Doing your best Visionary Progressive Strategic Transformational Outcome focussed Aspirational Ambitious Determined Focused Resourceful Can-do A facilitative organisation that promulgates its knowledge, expertise, evidence and skill, while acting as a clearing house for health promoting initiatives Lead by example These words are all aspects of honesty and can Walking the walk therefore be summarised by the word honest. Honesty is a characteristic of being professional. Honest

True to values Truthful Plain speaking Integrity Open These words are all aspects of openness and can Transparent (2) therefore be summarised by the word open. Transparency: The organisation should be open, accountable and communicative. These values should apply as much inside the organisation as in its interface with others. Thoughtful These words are all aspects of reflection and can Reflective therefore be summarised by the word reflective. Evaluative Trusting Listening Learning Perceptive Receptive Respectful Caring Compassionate Forgiving

No blame culture Non judgemental Apologise when needed Peace, Respect and Tolerance (PHA Cymru): The danger of promoting health as a value is that we run the risk of stigmatising those who make different choices outside the norm. Empowering These words are all aspects of empowerment and can Empowerment: Put emphasis on positive and therefore be summarised by the word empowering. supportive messages, have a grown-up conversation The word is used in the mission statement. about risk and the limits of scientific certainty. Inclusive (3) Consultative Engaging (3) Engagement Engaged with our partners Works partnership with stakeholders, continuing to consult and liaise with BASHH on strategic issues of mutual concern Patient focussed Autonomy: Freedom of choice is highly valued: any public health intervention must increase autonomy. First do no harm These words are all aspects of quality and can The safety of the people is the highest law therefore be summarised by the word quality. Quality

Best practice should be an aspect of being professional. Consistent Improving Nurtures excellence Quality Quality services Quality driven Services second to none Problem solving Measurement for improvement / measurement driven Protecting Fair and equal These words are all aspects of fairness and can Equitable therefore be summarised by the word fair. Professional behaviour should be fair. Fair is used Equity in the vision statement. Respecting differences Social justice Social 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 .

Effective (13) These words are all aspects of being persuasive and Cost effective (2) can therefore be summarised by the word persuasive. Efficient (9) Value for money (2) Accountable Outcome driven Has clear focus on supporting transformation of healthcare (and public services) at local level for the benefit of patients and communities Coordinated Integrated Unified Alignment Cohesive Ability to help shape services for the future Sustainable These words are all aspects of sustainability and can Sustainable development (3) therefore be summarised by the word sustainable. This is reflected in a strategic objective. Sustainable Development: This should be a central principle of public health for obvious reasons. Green Better communicating organisation These words are all aspects of communication and Good communication and listening (2) can be summarised by the words persuasive, open, reflective and responsive.

Tactful Political Accessible These words are all aspects of responsiveness and Flexible (2) can therefore be summarised by the word responsive. Responsive (3) Adaptable (2) Approachable (2) Supportive Supportive of clinical services Reliable (5) Relevant Invaluable Helpful Delivers Useful (2) Valued (6) Respected (6) Trusted Dependable Role model Inspires confidence

First place to go Influential (2) Credible Hard working Easy to do business with Making a difference Timely Public service ethos Able to provide timely STI & HIV data to inform outbreak management Partnership These words are all aspects of collaboration. They are Collaborative (2) reflected in a statement on ‘How we achieve our objectives.’ Stakeholder involvement Public facing Patient focused / citizen focused Client focused Community focused Cooperation 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 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 centred These words are more descriptive of the type of Non elite employer staff would like to see. They were given in response to the question ‘what type of organisation Values staff do we want Public Health Wales to be?’ Value staff in a meaningful way Good employer Reward and recognition Provides opportunities Opportunity Stability and security High profile These words are more descriptive of what Public Established identity Health Wales should achieve and reflect answers to the question about how others would describe Public Well known Health Wales in five years time. They are not values. Recognised Visibility (2) Visibility at local level Understood Evidence based (8) People locally have support of the organisation Leaders in our field

Internationally renowned Cutting edge System thinking Systematic Successful Unique Modern / High tech Educators Research and development organisation Learning organisation Shared learning Part of NHS National to local Encompassing whole population Facilitation Independent advocacy Advocated / advocacy Multi professional working Lobbyist Strong and decisive leadership Demonstrates 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 organisations Delivers influence, advocacy and challenge to ensure public health is everyone business Has developed high quality health intelligence (data and evidence) to inform and support implementation of local service. Visible leadership Clear commissioning policy Risk aware Recognises complexity

Appendix D: Strategic objectives and priorities

What should these be for the next five years? What stakeholders and staff told us Commentary Meet statutory duty These responses focus on the requirements set of Support implementation of OHF Public Health Wales by the Welsh Assembly Government. They can be summarised as: Develop and deliver 5 year promotion and prevention plan To meet the requirements of the Annual Operating Framework, Our Health Future and OHF – 10 strategic objectives other Government policy and strategy Deliver against givens – AOF, OHF, 5 year plan However, as many of the requirements of these Our Healthy Future – Public Health Framework 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 determinants These comments focus on the need to reduce health Ill health prevention (upstream) inequalities by addressing the wider determinants of health. They can be summarised as: Upstream prevention – LHB, LA To reduce health inequities by addressing the Inequalities wider determinants of health Health inequalities strategy (all parts of organisation) There is a strongly held collective view that this Reduce inequalities in health should be a priority. Understanding of inequity, how we address it & how The objective is measurable. we measure it

Support socio-economic policies which improve and This objective links to the Our Healthy Future themes protect public health of: Influence improvements in health – most benefit to  Reduced Inequities in Health the greatest number of people  Healthy and Sustainable communities Narrowing the gap in health inequalities Profile underlying factors of inequality and ill health Reducing health inequalities – previous action not worked Health economics modelling Take action that addresses the underlying social and environmental determinants of health not just the lifestyle behaviours Lack 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 Work with LHBs to prioritise healthcare improvement, These comments focus on healthcare improvement chronic conditions, prevention, treatment, and support for the LHBs in particular. They can be management summarised as: Help improve health services – more effective and To improve the quality and effectiveness of efficient healthcare services Support service reconfiguration (LHBs) Criteria would need to be agreed by which

Care pathway at local level achievement of this objective could be measured. Contributing tangible improvement to the quality and This area of work should be a priority. effectiveness of healthcare delivery More prevention – 1000 Lives Campaign Support LHBs in healthcare service improvement Providing 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 services Developing ‘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 quality Reduce waste, harm and variation All 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 Publication of Service Specifications for Integrated Sexual Health Services and SARC Improved access to LARCS & Termination of Pregnancy Services

Lifestyle issues These comments focus on particular health topics Supporting LHBS, LAs and local partnerships to which mainly relate to people’s lifestyle. develop and deliver, systematic, evidence based Public Health Wales could choose to prioritise responses to a smaller number of health particular lifestyle issues or it could agree an improvement priorities that will deliver most impact objective to address them collectively, e.g. on burden of poor health. To prevent disease and ill health by reducing That Public Health Wales adopts a social marketing the risks in people behaviour approach to its lifestyle information and advice. This objective is measurable. Furthermore, that in conjunction with interested partners, PHW encapsulates key lifestyle messages in This objective links to the Our Healthy Future a consistent, easily assimilated and relevant manner priorities. adapted to suit individual cultures and concerns. Tobacco control To 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 rates Young people are not receiving adequate cessation support or consistent prevention programmes. A greater focus is needed on working with rather than working on young people Lack of maternity [smoking] cessation services There is a need for a more diverse and accessible range 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 misuse Harm reduction Drugs – healthcare consumption, economic impact and PH Alcohol Mental health and wellbeing Public health and wellbeing

Dementia Chronic disease prevention Heart disease Cancer Breast cancer in later life We would welcome Public Health Wales’s backing to support numerous issues of importance to diabetes Diabetes Stroke Injury prevention Malnutrition amongst older people Obesity Physical activity Diet Sexual health Reduction of STIs, HIV infection and unplanned pregnancy in all age and risk groups These 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 Health These comments all focus on the need to develop Support DPH – annual report etc strong partnerships. They can be summarised as: Bring together the UPHS To build and maintain strong and effective partnerships with other agencies and the LHB Strategic direction and 5 year plans public. To support LHBs to become exemplar organisations Criteria would need to be agreed by which in adopting a public health and sustainable achievement of this objective could be measured. development approach to business. This is a way of achieving strategic objectives. Work with partners to ensure everyone has the basics – food, shelter Partnership working Good partnership working with stakeholders and partners Joined up High profile organisation, clearly recognised and respected within Welsh public services and UK, by achieving harmonious and effective relationships with stakeholders Strategic way of working with partners Clear and strong external partnerships in place Strengthening relationship with stakeholders Effective relationships

Partnership Engagement with LHBs, LA, Education etc Effective collaboration to maximise health Partnership working / agreements – influencing partners on their priorities Work in partnership with others to achieve the above aims Lack 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 These comments focus on the approach to work delivered in a timely manner taken by Public Health Wales, the need to be Integrated and coherent work plans – consistent with systematic and evidence based. They can be national and WAG priorities summarised as: Developing programmes that will be embedded in 10 To work innovatively, systematically, effectively years time and on the basis of evidence to achieve measurable outcomes. High quality info to translate into deliverable actions Criteria would need to be agreed by which Expert advice and support – toolkit – evidence base achievement of this objective could be measured. Measure outcomes This is a way of achieving strategic objectives. Continuous improvement Ottawa charter – public policy etc

Whole system smarter Systematic approach as organisation What PH issues are under control and how could we reproduce for new priorities Systems approach Build, develop and integrate systems of people and practices to achieve our vision The 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 wellbeing and from environmental issues to sustainable development Early detection Innovation and evaluation Cost effectiveness – society and health Continually evaluating resources Intelligent resource allocation defined by priority and backed up by evidence Ensuring adequate resources for teams More flexible deployment of staff What should we stop doing? Technologies

Advocacy These comments focus on the advocacy role of Public Leading contribution to setting public health agenda Health Wales and the need to influence policy. They in Wales can be summarised as: Providing clear public health advocacy and influence To influence government policy effectively. to local and national policy Criteria would need to be agreed by which Influence government policy and strategy by greater achievement of this objective could be measured. use of HIA This is a way of achieving strategic objectives. HIA programme More proactive in lobbying for change at a policy level More involved in developing policy Development of policy/programme unit

Make health everyone’s business These comments focus on supporting and building Empowerment of people and communities capacity in other agencies, and in the population, so they can take decisions which protect and improve Empowering population to initiate change public health and reduce health inequities. They can Empower individuals and communities be summarised as: To support LHBs and LAs in a systematic approach to To empower people, communities and agencies develop ownership of personal and community to protect and improve health and reduce responsibility for health health inequities. Increased citizen engagement Criteria would need to be agreed to measure empowerment by which achievement of this Engagement with public objective could be measured. Social marketing This is a way of achieving strategic objectives.

Welsh language / bilingual Improving health literacy Skilling wider workforce in Mental Health promotion Build and support PH involvement and capacity in local communities Provide evidence and support for all organisations and individuals that influence health of public Support LHBs and LAs to become health promoting organisations as they have most resources Capacity building in other organisations Supporting 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 Make sure public health dimension is not lost in LHBs Influence performance management framework Develop outcome based performance management plan That 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-being

Comms issues – large print etc Hub role – collect, disseminate etc

Ensuring LHBs deliver their statutory health These comments focus on the health protection protection responsibilities to the highest quality and function. They can be summarised as: efficiency, transforming service delivery in line with To protect the population from infectious other healthcare services disease and environmental hazards and to That the principle of providing mass public health respond effectively to the public health aspects protection and disease prevention programmes both of emergencies. endures and evolves on grounds of evidence for Criteria would need to be agreed to measure efficacy, health gain, moral acceptability and value effective health protection by which achievement of for money. this objective could be measured. Able to respond to emergencies effectively and This should be a priority area for action. maintain surge capacity It 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 responder Investment in health protection Maintain and improve resilience to respond to public health emergencies Hand washing Infectious diseases Vaccination and immunisation Seasonal flu vaccination

Health protection Microbiology

Service delivery (screening etc) These comments focus on prioritising screening Screening – development (2) 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 These comments focus on health intelligence. They Evidence base (2) can be summarised as: Observatory To provide health intelligence to guide and underpin action to protect and improve health More research, information and data is required in and reduce inequalities. order to effectively develop, deliver and monitor tobacco control public health interventions e.g. This objective does not have a measurable outcome. minority ethnic communities, smuggled tobacco use, It does, however, represent an important part of youth attitudes and smoking prevalence rates more Public Health Wales’ business. frequently than Health Behaviour of School aged This is a way of achieving strategic objectives. Children surveys, smokers toolkit model from England, how smokers in Wales quit and effectiveness, ASSIST effectiveness at scale In 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.

Improving the evidence base These comments focus on the role of Public Health Generating research ideas Wales in developing an evidence base. They can be summarised as: Established and progressive R&D function in partnership with academic sector and others To work with academics to improve the evidence base for taking public health action. Relationship with academia This objective does not have a measurable outcome. R&D It does, however, represent an important part of Use the existing evidence base to influence, develop Public Health Wales’ business. and add to the evidence base where it does not exist This is a way of achieving strategic objectives. Some long term backbone to more innovative practice Institute A 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 working These comments focus on information systems as a Information for action (IT and information systems) way to improve ways of working. They can be Embracing new technology summarised as: Increasing automation of routine reporting To develop information systems which promote requirements, enabling scientists greater time on the more effective working. analysis and interpretation of data, and in follow-up This objective does not have a measurable outcome. action planning. This is a way of achieving strategic objectives. 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 the day: by sharing work and knowledge so that information for action is coherent and action is coherent.

Local expertise to feed national strategy These comments focus on the role and importance of National scheme delivery at local level staff working locally, regionally and nationally. There is a clear tension between pressures to work at an all Balancing local v national Wales level and pressures to have a strong local Greater exploitation of regional opportunities 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 years These comments focus on prioritising public health Health of children and young people work with children and/or the elderly. They can be summarised as: Pregnancy and early years To prioritise public health action with children Child protection And/or Frailty / older people To prioritise public health action with the

Elderly elderly Ageing population These objectives are repeated by other strategic, and Elderly care services more general, objectives about protecting and improving health. Healthy ageing is essential to the quality of later life. The risks of the most common conditions - heart and They link to the Our Healthy Future theme of Health circulatory diseases, respiratory disease and cancer – Through the Life Course can be reduced by lifestyle modifications, and their progress can be delayed.

Develop reputation for world / euro excellence These comments all focussed on the need to Do what we do well (quality v quantity) establish a strong and coherent organisation, one that is better able to achieve its public health Organisation which is fit for purpose objectives. Particular elements include organisational Organisational structure established structure, workplace health, a skilled and learning workforce, integration and specialisation, Developing an integrated and cohesive organisation prioritisation, sustainability, innovation, financial Configured in way that works strength, open and effective communication and compliance. Effective future proof structures All these comments can be summarised as: Platinum CHS To establish Public Health Wales as a cohesive, Workplace health (inward and outward) – keep effective and sustainable organisation which people in ‘good’ work and good health leads by example. Improving the health of the organisation Criteria would need to be agreed by which Learning organisation – less introspective achievement of this objective could be measured. More cohesive workforce Develop workforce

Secure and stable staffing within the organisation Stocktake of skills – most effective use of resources Use our people to the full resources Investors in people Training Leading organisation in sustainability Being green and more efficient Sustainable ways of working Financial balance and the development of a sustainable and cost effective organisation. Support innovative working Encourage people to innovate Budgets – business cases Strict but fair finance management Saving decisions are made on the evidence to improve health Protecting specialism within each discipline Define level of integration needed to deliver our aims and priorities Redefine roles in line with priorities to maximise impact Improve integration of teams Ensure we are configured to deliver the above

Be more effective internally so we can be more effective externally Streamline Integrate teams Re-evaluate how we deliver our programmes Who are we responding to and how do we prioritise Audit of services Service reviews to determine what is needed to ensure sustainability and integrity of services and where investment is needed To decide priorities of strategy v delivery Be in better position for prioritising our work and moving towards truly integrated PH service Better at prioritisation – balance between obesity etc and wider determinants Negotiate key areas to focus on what is the key role of specialist public health services Define local outputs as part of Board structure / role Domain to maintain focus within divisions Being more joined up to avoid duplication Minimising duplication of efforts More collaborative working in the organisation to cut down on duplication. We never seem to have the critical mass to finish things

Get rid of silo mentality Staff forums ‘Directory’ of ‘experts’ / areas of interest Information about projects is patchy and not always readily/easily available Transparency Better communication / self promotion Visibility Effective communication about what we do Organisation to have higher profile Sort 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 important

Need 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 – governance Get 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 This contribution is addressed under mission advice and services to all partners and stakeholders including NHS Wales

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.

Date: 27 September 2010 Version: 1 Page: 66 of 66