Local authorities placed "right 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.
Public Health England will commission NICE to provide authoritative, independent advice on the evidence of effectiveness and cost effectiveness for public health interventions.
It will also build on work already started by NICE to develop intelligence about the relative cost effectiveness of different interventions that could provide the basis for decision making and priority setting by GP consortia and local authorities, enabling effective commissioning by Directors of Public Health.
Local authorities will receive public health funds that will amount to at least £4 billion a year from the overall NHS budget, as part of a radical plan to go further and faster in tackling the causes of premature death and illness and reducing health inequalities.
Health Secretary Andrew Lansley said: “Too often in the past, public health budgets have been raided by the NHS to tackle deficits. Not anymore. The money will be ring-fenced to be used as it should be - for preventing ill health.
“We want to have local authorities right at the forefront of public health, supported by evidence on behaviour change from Public Health England.”
Directors of Public Health will be employed by the local authorities and will be ambassadors of health issues for the local population. They will ensure that public health is always considered when local authorities, GP consortia and the NHS make decisions.
Local authorities will be rewarded for making improvements in areas such as obesity and smoking.
Although the white paper aims to encourage schools, employers, communities and industry to do their bit to make the nation healthier, it still acknowledges the key role that health professionals can play.
It recommends that the public health role of GPs is strengthened. GP consortia will be encouraged to maximise their impact on improving population health and reducing health inequalities, and will be given greater incentives through the quality and outcomes framework (QOF).
The Department of Health recommends that at least 15 per cent of the current value of the QOF should be devoted to evidence-based public health and primary prevention indicators from 2013.
Information on achievement by practice will be made available publicly to allow people to choose their GP practice based on how well it performs.
The white paper also outlines plans for a Public Health Responsibility Deal which will see the government working in collaboration with business and the voluntary sector across five networks on food, alcohol, physical activity, health at work and behaviour change.
The Deal will be launched early next year and is expected to announce agreements on further reformulation of food to reduce salt, better information for consumers about food, and the promotion of more socially responsible retailing and consumption of alcohol.
Additionally, during January 2011's Change4Life “Great Swapathon” £250 million of vouchers will be made available to help people make healthy lifestyle choices more easily.
Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE, said: “We are pleased that NICE's advice will continue to underpin public health activity, and look forward to working closely with Public Health England in supporting the robust development of future public health services.
“It's clear that prevention is better, and also cheaper, than cure. Using NICE's cost-effective evidence-based advice on what works to prevent ill-health is a good way to help the NHS provide the best outcomes for the limited resources available.
“Conditions such as cardiovascular disease and obesity are largely preventable, so it's essential that action to tackle the cause of poor health is effective and good value for money.”
1 December 2010