Councils understand that their new duty involves improving the public’s overall health rather than simply providing a public health service, says the chief executive of Public Health England
Councils are best placed to decide what is important for the people who live in their communities and how best to direct all available resources to achieve maximum impact in health improvements.
Although population needs and profiles vary, all councils understand that their new duty involves improving the public’s overall health rather than simply providing a public health service.
Good health and wellbeing is not solely the absence of illness: decent homes, employment, companionship, the environment we live in and our own individual choices all play an important part. Local government is perfectly placed to use all available resources to engage on these fronts because they have the ability to lever public health benefits from the whole of their spending power.
Supporting local authorities in this task involved the transfer of about 3% of the health budget funding from the NHS, in the form of a ringfenced public health grant. At the beginning of September the Department of Health announced that this would amount to £2.79bn for 2015-16.
Councils are free to spend these budgets to tackle local health inequalities in ways that they see fit. Local authorities don’t have to ask permission as to how they spend their public health grant but they will, ultimately, be judged on their outcomes against the measures in the public health outcomes framework.
As the accountable officer for the totality of this spend, I expect directors of public health to work with their colleagues across the council to ensure that the grant is being used appropriately. I have written to every local authority in England explaining what I need by way of assurance that councils are using their ringfenced public health grant in line with the grant conditions.
There is no ‘one-size-fits-all’ approach and we are energised by the diverse evidence-based approaches
Councils are operating in an unprecedented financial environment; all have tough decisions to make. Local government has proved its ability time after time to flourish in challenging situations.
We are here to ensure local authorities have what they need, whether it’s examples of best practice, expert advice, data or evidence of cost effectiveness. PHE maintains a constant dialogue with local authorities and where there are fine judgments to be made, we work closely with them and offer our advice. Our job is to help and support local government in every way we can, including occasionally connecting authorities with others facing similar challenges.
We know the scale of the change has not been easy but we are seeing a rising tide of confidence from directors of public health about being based within local government and a huge desire for people to join the profession, with our training programmes heavily oversubscribed.
There is no ‘one-size-fits-all’ approach and we are energised by the diverse evidence-based approaches being taken to improve health. From free access to swimming and to exercise in places such as Blackburn with Darwen, to creating thousands of new jobs from Hartlepool in the north to Medway in the south – what we’re seeing in local government is extraordinary and able leadership from officers and politicians.
We didn’t give a blueprint for implementation. It is natural that local authorities will have different priorities and spending plans from the pattern that they inherited and we are pleased to see the ringfence being combined with other funding streams and focused on innovative ways of addressing the wider determinants of health. In fact we are seeing many local authorities putting additional investment into public health services.
We have been impressed by how all councils, are each in their own way getting on with their public health responsibility.
Duncan Selbie, chief executive, Public Health England
The scale of the change is difficult but confidence is rising