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'Public health workers must make a better case for investment'

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Public health workers must get better at making the case for investment. That was the message of John Middleton, the Faculty of Public Health’s president, arguing in LGC a few months ago that it was a necessary corrective to cuts on public health budgets.

He wrote that our arguments for whole system investment in prevention – which those of working in public health believe are strong and compelling – have been lost in translation when presented to local and national decision-makers.

When it comes to a specialism encompassing a wide variety, from health visiting to flood protection, distilling public health for non-specialist consumption isn’t that simple. The desire to be exhaustive can muddy our message.

That’s one of the reasons why we’re pleased that Public Health England’s Public Health Dashboard has been officially released.

This new dashboard is a digital resource allowing a general audience to compare different local authorities on key public health services. These include best start in life, child obesity, drug treatment, alcohol treatment, NHS Health Checks, sexual health services, tobacco control and air quality.

By clicking an area on the interactive map users can see how different local authorities rank, with each service area separated into summary rank quartiles.

For example, if you click on Devon and select ‘All local authorities’ from the options on the left-hand side, you will see that the region is in the second quartile for tobacco control (ranked 52 out of 149) and the first quartile for sexual and reproductive health (ranked 27 out of 150).

You can read more about the indicators and how to fully interpret the data on Public Health England’s blog. There’s a lot to look at and play around with.

It’s important to emphasise that the dashboard is not meant to replace the Public Health Outcomes Framework. Its purpose is to bring existing comparative data into one place in an accessible way for a general audience.

It’s intended to support senior council officers when they are prioritising resource for public health or wider council services, and to help different areas learn what works and why.

This has the potential to be a useful tool for directors of public health and their teams as they seek to influence spending decisions for when – at some future date – the public health grant ringfence is removed.

This is why Faculty of Public Health members told us that, as part of our public health funding campaign, we needed to advocate for an improved dashboard tool to allow us to show where more investment may be needed.

We know that public health services are not delivered in a vacuum. An enormous range of factors influence population health, for better or for worse.

Some of these factors are within a local authority’s influence. Many are not. But it is within this context of the wider determinants of health – education, employment, poverty, the built and natural environment – that local public health services are commissioned, outcomes are measured, and decisions should be taken.

Informed decision-making relies on realistic expectations of what can be achieved. This, in turn, requires a deeper understanding of population health, in which measures of residents’ health and wellbeing are understood and interpreted within the broader local context.

We think this context needs to be represented in the dashboard as well. To facilitate this, the Faculty of Public Health will be working with Public Health England over the summer and autumn to explore introducing indicators for the wider determinants of health into the tool as well.

Public Health England’s Wider Determinants of Health resource incorporates over 100 different indicators that could be included, so we’ll be consulting our members and others on which they believe are the most important, and which their teams and the local authority most influence.

To learn more about our public health funding campaign and how you can get involved in our dashboard consultation, please contact policy@fph.org.uk.

Public health workers have a great story to tell. Now more than ever we need to figure out how.

Andrew Turner, specialty registrar in public health, and Lisa Plotkin, policy officer, Faculty of Public Health

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