Changes to public health-what's in store?

Report published

…health inequalities that are avoidable by reasonable means are quite wrong. Putting them right is a matter of social justice.” Professor Sir Michael Marmot

From April 2013 there is a huge shift of powers (and some allocation of funding) from the NHS to local authorities. Health and wellbeing boards at borough and London-wide level will have responsibilities including vetting the annual plans of GP commissioning consortia and considering the wider determinants of health in their area. Directors of public health will be part of the senior management team in each borough.

While some are relishing the opportunities this will bring and the scope to link health improvement to local economic development, housing and other key policy areas, there are many concerns about areas of work that could suffer from this change: community mental health services and approaches to addiction and sexual health are among specific areas that are seen to be at risk. There are big questions about the lines of accountability of directors of public health and uncertainty about the basis of transfer of funds from the Department of Health to boroughs. The London Health Improvement Board is a new partnership between the London boroughs and the Mayor, with public health priorities to tackle – how are their plans shaping up?

This year, London Funders’ AGM helped funders learn from about the challenges facing the new system and how (separately and together) public bodies are approaching change. Speakers came courtesy of Laurie Thraves, Policy Officer, Local Government Information Unit, Dr Helen Walters, Health Improvement Programme Director, Greater London Authority (slides here) and Kieron Williams, Head of Health and Wellbeing, London Borough of Lambeth, (slides here).

A full report of this meeting is now available here.  

Factors that promote and hinder joint and integrated working between health and social care services
Social Care Institute for Excellence, 2012
This briefing gives those who provide and use social care services an overview of the research evidence for joint and integrated working. It looks at three broad themes which are used to organise the factors that support or hinder joint or integrated working: organisational issues; cultural and professional issues; and contextual issues.

Healthy places: councils leading on public health
New Local Government Network, 2012
This report draws on a survey of over 50 councils and interviews with 28 senior officials involved in setting up the new health and wellbeing boards. It argues that in order to be effective, health and wellbeing boards need to have strengthened powers and a wider scope.

London's business case for employee health and well-being
GLAEconomics, 2012
London has a greater percentage of people with health problems being workless in London than nationally, with fewer people with disabilities finding work, whilst the majority of Londoners on incapacity benefits have preventable and/or treatable conditions. At the same time, employee ill health has costs to employers as well as to the individual and society. It has been estimated that an average London firm of 250 employees loses around £250,000 a year due to ill health. Evidence suggests that well designed employee welfare programmes that are integrated into the core of the firm can more than cover the costs of such a programme to the firm. The benefits of these programmes accrue not only to the firms running them but to the employee and society as a whole.

London Poverty Profile-The relationship between poverty and health
Trust for London, 2012
Useful resource for indicators of poverty including infant mortality, mental health and premature death rates across the capital.

A shot in the arm of localism
Ingrid Torjesen, The Guardian, 20 June 2012
Article exploring the implementation of local authorities responsibilities for public health and the organisations who will be working in partnership to deliver services.

Sustainable health and social care: a briefing for commissioners and health and wellbeing boards
Social Care Institute for Excellence, 2012
This briefing provides a summary guide for commissioners and health and wellbeing board members. It sets out the key policy and operational drivers for a sustainable development approach to health and social care design and delivery, including specific detail regarding climate change and other environmental issues, as well as social and economic sustainability. The report also refers to short case studies of good practice at a local level to illustrate the gains for health, efficiency, risk management, reputation and legislative compliance.


Public health must include environmental health, clean streets, good housing and more