Public Health & Local Authorities

Public Health England brand and web address (April 2013) PHE’s email address from 1 April 2013 will be @phe.gov.uk and web address will be www.gov.uk/phe. Public Health England has adopted the Royal Coat of Arms as its corporate logo from 1 April, capitalising on research, which indicates the public have confidence in the Royal Arms.

Health improvement in local government: challenges and opportunities (April 2013)

This report is the third in a series of briefings reviewing changes in commissioning public health in England, with a particular focus on public health improvement. Based on in-depth interviews with a range of professionals working in public health and associated fields, it provides an update on health improvement commissioning as public health moves into local authorities, while also identifying key opportunities and challenges that arise as a result of the transition. For further information click on More

Public Health England Centres and Regions (April 2013)

Public Health England centres will be responsible for assuring that the services and expertise provided focused on local needs. Its director will be a full partner in the local public health system, which includes the voluntary and community sector, and their role will be to provide a range of services and expert advice that is tailored to the needs, wishes and aspirations of local government, clinical commissioning groups and the local NHS.

Each centre will provide leadership and support across all three domains of public health – health protection, health improvement and healthcare public health. This will include:

• supporting local government in their leadership of the local public health system;
• supporting directors of public health across the range of their responsibilities enabling them to access specialised advice and support when required;

• working with the NHS Commissioning Board to support it in its role as a direct commissioner of key services, including specialist services and national public health programmes;

• providing leadership in responding to emergencies where scale is necessary. 

PHE’s four regions are coterminous with those of the NHS Commissioning Board and other national partners and they also map onto the nine regional local government groupings. Each will nurture, assure and support the local public health system and maintain an overview of the whole system’s progress in implementing the Public Health Outcomes Framework. They will have a special responsibility for workforce development.

'Enhanced services' advice for public health teams (Mar 2013)

PCC is offering to support public health teams in their new roles. Most local authority public health teams are now in post but face imminent challenges in commissioning services previously known as enhanced services including smoking cessation, sexual health promotion and health checks.  PCC is able to advise public health teams with concerns about managing contracts, making the right payments to GPs and, where necessary, recommissioning services.

Public health surveillance strategy overview published (Feb 2013)

An overview of the vision and plans for the delivery of a public health surveillance strategy, as part of Public Health England ’s broader information strategy, has been published. To read on, please click here.

Shaping the goals for Public Health England(Feb 2013)

Duncan Selbie reports on a meeting with the national executive team about the goals for PHE, and meets new colleagues and close partners in the regions. For more information, please click here.

District action on public health (Feb 2013)

This report explores the role of district councils in the new public health system in England. It demonstrates the sector’s impact across the wider determinants of health improvement and health protection, and provides essential information for public health stakeholders including best practice case studies of service delivery and public health collaboration in two-tier areas. More ….

Public health grants to local authorities 2013/14 and 2014/15

The ring-fenced grants for 2013/14 and 2014/15 provide local authorities with £2.66bn and £2.79bn to spend on public health services for their local populations. The funding for 2013/14 has been increased by 5.5% and by 5% in 2014/15, and a significant number of local authorities will see growth of 10% in each year, representing a major investment in health and the prevention of illness.

PGD authorisation in new organisational structures – DH update (Jan 2013)

The Medicines and Healthcare products Regulatory Agency (MHRA) and Department of Health are amending medicines legislation to (i) enable Clinical Commissioning Groups and Local Authorities to authorise PGDs from April 2013; and, (ii) to ensure that existing PGDs with an expiry date after 31 March 2013 will continue to be legal until the PGD either expires or is replaced. These changes are consequential to the Health and Social Care Act 2012, and will enable the continued use of PGDs in new health system organisational structures.

The legislation will also incorporate transitional arrangements to ensure the continued availability of PGDs during organisational change, and to ensure that staff and organisations are not acting outside the law. These arrangements will allow PGDs to remain legal after the original authorising body (e.g. a PCT) has been abolished, and until expiry or authorisation by the new body responsible for the service in question. Responsibility for PGDs will transfer to these new bodies, and organisations ‘inheriting’ PGDs will need to put in place clear arrangements and a timetable for review and adoption/authorisation of all existing PGDs. Further advice is available in the FAQs section of this website. See links below.

The National Prescribing Centre (NPC) (now the Medicines and Prescribing Centre (MPC) at NICE) has published a practical guide and framework of competencies for organisations and professionals developing and using PGDs. See link below.

The MPC are reviewing this document, including to take account of changes to legislation and organisational structures, with the aim of re-publishing by April 2013. In advance of this updated edition, organisations delivering services under PGDs can still use the existing document to help guide them through the legal framework governing the development and authorisation of PGDs, and to provide practical guidance on their use. 

For further information click on: Link to FAQ - when organisations merge/cease to exist, FAQ- is extension of PGD expiry dates allowed, and NPC PGD Guidance 2009 

Public health services non mandatory contracts and guidance (Feb 2013)

The DH has published a non-mandatory contract designed for use by local authorities in commissioning services to meet their new public health functions. It is adaptable for use for a broad range of public health services and delivery models.  Although the contract is non-mandatory it provides a robust framework to hold providers to account for the delivery of high quality public health funded services to achieve improved health outcomes. A copy of the contract with accompanying guidance can be downloaded by clicking on contract.

‘Catch it. Bin it. Kill it.’ campaign to help reduce flu infections (Jan 2012)

The Department of Health has relaunched  the ‘Catch it. Bin it. Kill it.’ campaign this month to encourage the public to adopt good respiratory and hand hygiene practices to help stem flu infections. You can find out more by clicking here.

Department of Health issues communications strategy agreed for potential flu pandemic (Dec 2012)

The Department of Health has published a communications strategy to assist in planning its response to a potential flu pandemic. This is a companion document to the UK Influenza Pandemic Preparedness Strategy, published in November 2011, and the Health and Social Care Influenza Pandemic Preparedness and Response Guidance for the health and social care community, published in April 2012, and should be read alongside these. This strategy covers health-related communication in the stages leading up to a UK pandemic, during a pandemic itself, and during the recovery phase.  It focuses on mainstream communications channels with targeted elements for specific audiences. For further information click on this Link

NICE guidance and public health outcomes  (Nov 2012)

The public health outcomes framework for England sets out objectives for the public health system in the three years from April 2013. It consists of four domains and over 60 indicators for measuring progress. This document provides links to NICE guidance relevant to more than 40 of these indicators and shows how it can help local authorities tackle their public health priorities.

Public health commissioning in the NHS from 2013  (Nov 2012)

The NHS Commissioning Board (NHS CB) and the Department of Health have published their detailed agreement showing how the NHS CB will drive improvements in the health of England’s population through its commissioning of certain public health services. The agreement sets out the outcomes to be achieved in exercising these public health functions and provides ring fenced funding for the NHS CB to commission public health services. 

The services commissioned as part of this agreement are those where there is, for example, alignment with national clinical pathways and added value of central commissioning. Read public health functions to be exercised by the NHS Commissioning Board

The services included in the agreement are: 
  national immunisation programmes
  national routine screening programmes (non-cancer)
  national routine cancer screening programmes
  children’s public health services from pregnancy to age 5
  child health information systems
  public health services for people in prison and other places of detention
  sexual assault referral centres

The agreement provides the NHS CB with £1.8bn from the public health budget for these programmes, in addition to other funding provided for public health in primary care. The agreement sets out how the NHS CB is accountable for the successful delivery of these programmes, and arrangements for expert support from Public Health England. It provides service specifications which include the public health evidence and advice needed to support effective commissioning.

Structure of Public Health England (Aug 2012)

This factsheet sets out how Public Health England will be structured to achieve its ambitions of protecting and improving health and wellbeing, while reducing health inequalities. It also shows the proposed structure for when the organisation comes into being in April 2013, and will be used as the basis for transition. It aims to provide a guide for staff who will join the new agency and for its partners.

The human factor: re-organisations in public health policy (May 2012)

Public health policy-making activities are currently split between local authority and NHS organisations.  Despite an increasing body of research on evidence-based policy (EBP), few studies explore the process of policy-making.  This paper reports on an analysis of public health policy making networks in Greater Manchester which are described. The analysis found that formal executive roles are loosely related to perceived influence and power.  Evidence-seeking networks are less coherent, with key organisations not represented.  These data indicate the importance of collaboration and good relationships between researchers and policy-makers, but few academic researchers with a direct impact on health policy were identified within the networks. For further information click on Abstract link (ScienceDirect)

Public Health England Update (May 2012)

Duncan Selbie, Chief Executive Designate, will take up his post from 1st July. PHE are currently finalising their organisation structure, a process which Duncan has been involved in. Duncan hopes to have his top team put in place over the summer, after which he will begin looking at recruiting for the rest of the organisation. In the meantime, Regional Directors of Public Health have been working closely together across the North of England, and are starting some initial work to help the design process for the new North sector for PHE.

Transforming Public Health Bulletin – Issue 8 (May 2012)

In this month’s edition, Anita Marsland welcomes Duncan Selbie as the new Chief Executive Designate of Public Health England, and hear from Duncan himself as he gets to grips with his new role. The next steps following the Royal Assent of the Health and Social Care Bill are explained and Spotlight takes a look at the specialised services commissioning teams. Click on the links to view

   View from the MD’s chair          Duncan Selbie 
    News                                         Spotlight on… 
    Local public health                    People matters 
    Other news                                Dates to note 

Download the Transforming Public Health Bulletin – May 2012 (PDF, 144KB)

Duncan Selbie confirmed as chief executive designate of Public Health England (April 2012)

Duncan Selbie has been confirmed as the chief executive designate of Public Health England. Mr Selbie, currently chief executive of Brighton & Sussex University Hospitals NHS Trust, will head up Public Health England (PHE), the new public health body that will be the expert voice for public health, when it is established in April 2013. It will support local health services, protect the nation’s health through better-integrated working, and help the public make healthier choices.

Web resource to support public health move to Local Authorities (April 2012)

The Department of Health and the Local Government Association have developed an online resource to support the transition of public health to local government. It includes fact sheets, case studies, a glossary and policy summary. The transition of public health to local government from April 2013 is one of the most significant extensions of local government responsibilities in a generation.  Transition plans are already in train and the councils will be working closely with their PCTs to put in place arrangements. The LGA have circulated a briefing to Chief Executives and Directors of Finance which summarises the Department of Health document published on 7 February on baseline spending estimates on public health.  The briefing also gives the LGA's key messages in relation to public health funding and provides Chief Executives and Directors of Finance with advice on how they can assure themselves that the PCT estimate of public health spending will be adequate to meet the future resource requirements for public health from 2013. The LGA is calling for: 

• a wider debate about the quantum of resource necessary for public health 
• a greater proportion of the public health resource to be allocated to local government 
• a distribution formula that is based on the level of need rather than historic PCT spend, which in some cases reflected varying degrees of commitment to public health 
• local government involvement in the development of the distribution formula for public health funding 
• a public consultation on the proposals for public health funding.

Future for public health improvement, education and learning (Mar 2012)

This report examines the future learning and development landscape for the wider public health workforce. The findings highlight the complexity of developing effective education and learning to support health improvement and the changes that will be needed to ensure that the workforce can operate effectively in the new environment. 

NICE the “key” for delivering public health services (Feb 2012)

NICE has published a press release relating to a “webinar” in which the Director of Public Health for NHS North Lancashire and President of the Association of Directors of Public Health said that NICE was needed to lead on providing evidence to local authorities. The Director of Public Health at NICE adds that NICE is in the process of developing public health briefings to make it easier for Directors of Public Health, elected members and senior officers in local authorities to find out which public health actions are most effective whilst also providing the best value for money. The briefings will focus on a wide range of topics (such as alcohol misuse, smoking and obesity) with the first of the briefings expected to be published in June this year. The deadline for comments on the draft guidance is 30th March 2012. Please see links for further details: EHI story, Working draft guidance and NICE press release

Responsibility deal showcases collaborative work to improve public health (Feb 2012) 

If you’re interested in finding out more about how to get involved in improving public health – as an employer, or through commercial actions or community activities – you can now get all the up-to-date information you need about the Public Health Responsibility Deal. You’ll find out what the Responsibility Deal is all about, as well as details on all the pledges and how they can be delivered, the current partners, and information on how to sign up.

Planning guide for public health transition published (Jan 2012)

To help the process of local decision-making around the public health transition, the Department and the Local Government Association have published a planning guide for local authorities and primary care trusts. The guide was co-produced with the NHS and local government to support PCTs and LAs as they develop transition plans for the transformation of the local public health system.

Public Health Update – (Dec 2011)

More details on the design of the new public health system, including the role and responsibilities of local government in public health, the operating model for the new executive agency Public Health England and an overview of how the whole system will work, were published on 20th December 2011.

The factsheets, which aim to help the partner organisations and staff involved to understand and implement these reforms, include:
- A summary of the new Public Health System
- Factsheets on public health in Local Government
- Factsheets on Public Health England's Operating Model
- Factsheets on Workforce and the new Public Health system

To view any of the above factsheets, please click here to visit the Department of Health website.

Transforming Public Health – Issue 4 December 2011

In this issue 4 Managing Director, Anita Marsland, provides her update on the new public health system; Spotlight takes a look at Public Health Observatories; and there is a report on the recent regional visits from Anita and Ruth Hussey. 
  Anita Marsland – View from the MD’s chair 
  Spotlight on the network of England’s Public Health Observatories 
  Regional visits 
  People matters 
  Other news 
  Dates to note

Download the Transforming Public Health Bulletin (PDF, 386KB)

Public health reform updates published  (Dec 2011)

Further information has been published about the design of the new public health system, specifically the role and responsibilities of local government in public health, the operating model for the new executive agency Public Health England and an overview of how the whole system will work.

Greater support for local government in new public health role (Dec 2011)

Government sets out updated vision for public health (July 2011)

The Government’s Healthy Lives, Healthy People: Update and Way Forward report published last week confirmed its commitment to improving public health and tackling health inequalities. The report highlights the aim to give local authorities responsibility for public health and says a public health workforce strategy is being developed. Find out more.

Letter from the CMO regarding Public Health system reform (June 2011)

Letter: Public Health England (March 2011)

This letter from the Transition Managing Director, Public Health England, provides an update on the progress in the development of Public Health England (PHE) and includes a list of members of the Transition Executive Team to support the creation of PHE and the transfer of public health functions to Local Authorities. To read the letter clink on this Link

 Healthy Lives, Healthy People: Our Strategy for Public Health in England

The secretary of state for health has written to NHS chief executives following the publication of the government white paper on public health. Read the letter here. The white paper sets out the government's long-term vision for the future of public health in England. The aim is to create a wellness service (Public Health England) and to strengthen both national and local leadership. For details see the Department of Health website.

This suite of impact assessments covers five critical workstreams: structure of public health England; commissioning within the public health system; the ring fenced funding of public health England; public health outcomes; and information and intelligence

Government launches public health ‘Responsibility Deal’

 The Health Secretary Andrew Lansley has launched the ‘Responsibility Deal’, an agreement between the government, the industry, and health organisations, containing a series of voluntary pledges aimed at improving public health in England.  It is hoped that this method of joint working will allow the delivery of faster and better results than a regulatory route to improve poor diet and alcohol misuse.  

Mr Lansley unveiled more than 170 signatories to the first phase of the deal.  Five networks have been working since September 2010 on the development of a series of pledges for action, including:
• Calories on menus from September 2011 
• Reducing salt in food so people eat 1g less per day by the end of 2012 
• Removal of artificial trans-fats by the end of 2011 (agreed to by fast food outlets including McDonald’s and Kentucky Fried Chicken)
• Achieving clear unit labelling on more than 80% of alcohol by 2013; 
• Increasing physical activity through the workplace 
• Improving workplace health

According to the BMJ, several health bodies and charities have refused to sign up to the deal.  They have cited a number of reasons for doing so, including their opinion that the deal was too limited with a focus on voluntary interventions, the failure to tackle issues such as promotion of alcohol, and their view that the views of the industry were prioritised.  

Local authorities at the forefront of public health

Local authorities will be handed control of commissioning public health services from a new ring-fenced budget, under plans set out in the government's public health white paper. To help support local authorities and oversee national issues, such as childhood immunisation programmes, screening and nutrition, a new dedicated public health service - Public Health England - will be created.

This will ensure excellence, expertise and responsiveness, particularly to health protection, nationally. During 2011 more documents will be published to build on this new approach – Mental Health, tobacco control, obesity and sexual health.

The new approach ‘reach across and reach out’ addresses the root causes of poor health and wellbeing, reaching out to the individuals and families who need the most support – and be:

·         Responsive – owned by communities and shaped by their needs
·         Resourced – with ring-fenced funding and incentives to improve
·         Rigorous – professionally-led, focused on evidence, efficient and effective
·         Resilient – strengthening protection against current and future threats to health.

The local Director of Public Health (Ruth Hussey) will be employed by the Local Authority. The ring-fenced PH budget will be devolved to Local Authorities, so local government will have responsibility for this health budget. There will be a new ‘health premium’ to promote action to improve population wide health and reduce health inequalities. This will be linked to delivering local outcomes.

There will be a new PH outcomes framework which is being developed at present. It covers 5 broad domains:

·         Health protection and resilience: protecting people from major health emergencies and serious harm to health
·         Tackling the wider determinants of ill health: addressing factors which affect health and well being
·         Health improvement: positively promoting the adoption of healthy lifestyles
·         Prevention of ill health: reducing the numbers of people living with preventable ill health
·         Healthy life expectancy and preventable mortality: preventing people from dying prematurely

There will be a cross party cabinet sub-committee on Public Health. The Public Health Service will be set up in April 2012 (in shadow form in April 2011). Shadow allocations to Local Authorities for 2012/13. Full allocations will go to the Local Authorities for 2013/14. Public Health England will commission NICE to provide authoritative, independent advice on the evidence of effectiveness and cost effectiveness for public health interventions.