The value of public health – Embedding Prevention into NHS services (the NHS Prevention Pledge)

The Champs Public Health Collaborative is a formal partnership of public health teams in Cheshire and Merseyside, which is made up of nine local authorities. It was established in 2003 and is led jointly by the subregion’s Directors of Public Health (DsPH).

The DsPH make up an Executive Board and act as a public health system, working closely with key partners including NHS Cheshire and Merseyside, the Office for Health Improvement and Disparities, the UK Health Security Agency and NHS England and NHS Improvement. This work is facilitated by the Champs Support Team, a small team hosted by Wirral Council.

By working together on priority areas, the Collaborative pools resources, shares expertise, communicates with one voice, and enables a consistent approach across a large geography. Below is an example of the day-to-day activities that DsPH support and the impact this makes on local communities.

Embedding Prevention into NHS services – The NHS Prevention Pledge

The issue

Despite dramatic improvements over the last 20 years, Cheshire and Merseyside continues to experience widespread preventable illness and inequalities in health.
It is widely acknowledged that a renewed focus on prevention measures is needed at scale to help address the gaps identified by the NHS Five Year Forward View, the NHS Long Term Plan, and the NHS Phase 3 COVID response.

 The solution

Cheshire and Merseyside’s Population Health Board has commissioned the development and implementation of an NHS Prevention Pledge for all 18 provider Trusts in the subregion.
Adoption of the pledge within trusts is led by Health Equalities Group (HEG), a public health charity that designs, develops and evaluates evidence-based programmes and policies that seek to tackle non-communicable diseases and health inequalities. HEG works closely with provider Trusts to support adoption of the NHS Prevention Pledge across a three-year period. HEG has developed tools and guidance materials to ensure the adoption is a success and coordinates a community of practice to foster joint working between Trusts.
The Pledge is underpinned by 14 ‘core commitments’ that were co-developed in 2019 by HEG following extensive consultation with Trusts, NHS England, local authority public health teams, the Office for Health Improvement and Disparities, academic partners and third sector organisations.

The core commitments cover the following key themes:

  • Promoting workforce development, quality improvement, workplace health & wellbeing
  • Embedding brief advice and making every contact count (MECC) across all services
  • Promoting healthier lifestyles for patients & visitors, including:
    • healthier catering
    • smoke-free environments
    • active environments
  • Enhancing anchor institution practices, including sign up to the C&M Social Value Charter and the C&M Anchor Institution Charter
  • Using Marmot principles to address health inequalities
  • Signing up to the C&M Concordat for Better Mental Health
  • Embedding prevention within governance structures

The results

To date, eight Trusts have adopted the Prevention Pledge at an intermediate level (minimum of seven core commitments and aligned KPIs adopted) and HEG is working with the remaining 10 Trusts across Cheshire and Merseyside on the start of their adoption journey. This work is being overseen by the Population Health Board and Cheshire and Merseyside’s Directors of Public Health.

Lessons learned

Leadership from an executive sponsor for the NHS Prevention Pledge, clear governance pathways and effective internal communications across the workforce have been key to Trust’s developing and implementing well-honed action plans.
Sensitising Trusts to other prevention programmes across Cheshire and Merseyside, for example the All Together Fairer programme addressing health inequalities, has also helped to build connectivity and impetus across the system.