Tag Archives: Local Government

The English local government public health reforms An independent assessment

By The King’s Fund (2020)

This report, commissioned by the Local Government Association, assesses the success of the 2013 reforms to public health in England, which were part of the Coalition government’s wider health reform programme. These reforms, which saw the responsibility for many aspects of public health move from the NHS to local government, involved transition of staff and services and required the formation of new relationships to ensure public health was embedded across local government services.
The report looks at the effects of the reforms in both the short and longer term and looks at the impact of the changes, which have brought opportunities for innovation and integration, as well as challenges, at a time when funding for public health has been cut. The author then takes a look into the future and the implications for public health in the context of the NHS long term plan, the government’s prevention consultation and the wider shift to population health systems.

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A ‘Whole Council’ Approach to Gambling A guide for public health and other council officers to support the revision of borough statements of policy

By London Councils (2018)

Gambling is often described as a ‘hidden addiction’ and problem gambling is now recognised as a complex public health issue that has an impact on individuals, families, and communities. This guidance outlines the areas in which public health can add value and support local gambling policies.

Click here to view this guidance

 

Practical Guidance to SPOT for Improving Sexual and Reproductive Health

By Public Health England (2017)

The Spend and Outcome Tool (SPOT) was first published in 2014 and gives an overview of spend and outcomes across key areas of business for Local Authorities (LAs). It uses previously published data on both spend and outcomes. It contains three years of data on spend and outcomes for a wide range of measures. SPOT can be used to compare with other geographical areas and a range of benchmarks.
SPOT can be a useful tool for LAs who are interested in comparing spend data on sexual and reproductive health with sexual and reproductive health outcomes. There are some issues which make drawing these comparisons complicated and potentially misleading.

Click here to view these guidelines

Directors of public health as ‘a protected species’: qualitative study of the changing role of public health professionals in England following the 2013 reforms

Jehu, L.M. et al. Journal of Public Health, https://doi.org/10.1093/pubmed/fdx154

Published: 07 November 2017

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Background

The Health and Social Care Act 2012 gave councils in England responsibility for improving the health of their populations. Public health teams were transferred from the National Health Service (NHS), accompanied by a ring-fenced public health grant. This study examines the changing role of these teams within local government.

Methods

In-depth case study research was conducted within 10 heterogeneous councils. Initial interviews (n = 90) were carried out between October 2015 and March 2016, with follow-up interviews (n = 21) 12 months later. Interviewees included elected members, directors of public health (DsPH) and other local authority officers, plus representatives from NHS commissioners, the voluntary sector and Healthwatch.

Results

Councils welcomed the contribution of public health professionals, but this was balanced against competing demands for financial resources and democratic leverage. DsPH—seen by some as a ‘protected species’—were relying increasingly on negotiating and networking skills to fulfil their role. Both the development of the existing specialist public health workforce and recruitment to, and development of, the future workforce were uncertain. This poses both threats and opportunities.

Conclusions

Currently the need for staff to retain specialist skills and maintain UKPH registration is respected. However, action is needed to address how future public health professionals operating within local government will be recruited and developed.

Evidence-based medicine meets democracy: the role of evidence-based public health guidelines in local government

Kelly, M.P. et al (2017) Journal of Public Health. pp. 1–7 doi:10.1093/pubmed/fdx002

In 2013, many public health functions transferred from the National Health Service to local government in England. From 2006 NICE had produced public health guidelines based on the principles of evidence-based medicine. This study explores how the guidelines were received in the new environment in local government and related issues raised relating to the use of evidence in local authoritites.

Methods

In depth, interviews with 31 elected members and officers, including Directors of Public Health, from four very different local government organizations (‘local authorities’).

Results

Participants reported that (i) there were tensions between evidence-based, and political decision-making; (ii) there were differences in views about what constituted ‘good’ evidence and (iii) that organizational life is an important mediator in the way evidence is used.

Conclusions

Democratic political decision-making does not necessarily naturally align with decision-making based on evidence from the international scientific literature, and local knowledge and local evidence are very important in the ways that public health decisions are made.

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Supporting integration through new roles and working across boundaries

By The King’s Fund (2016)

This report looks at the evidence on new roles and ways of spanning organisational workforce boundaries to deliver integrated health and social care. Commissioned by NHS Employers and the Local Government Association, it finds increasing focus on roles which facilitate co-ordination and management of care, development of existing roles to increase the skill-mix and enable the provision of more holistic care, and a limited number of truly innovative roles, the most notable being care navigators and community facilitators, enablers or link workers. Given that many of the skills required for integrated care already exist within the workforce, it suggests the central question is how to use those skills more effectively to support boundary-spanning activities.

Click here to view this report

Supporting integration through new roles and working across boundaries

By The King’s Fund (2016)

This report looks at the evidence on new roles and ways of spanning organisational workforce boundaries to deliver integrated health and social care. Commissioned by NHS Employers and the Local Government Association, it finds increasing focus on roles which facilitate co-ordination and management of care, development of existing roles to increase the skill-mix and enable the provision of more holistic care, and a limited number of truly innovative roles, the most notable being care navigators and community facilitators, enablers or link workers. Given that many of the skills required for integrated care already exist within the workforce, it suggests the central question is how to use those skills more effectively to support boundary-spanning activities.

Click here to view this report