From transition to transformation in public health – update

An updated resource to assist the transfer of public health to local authorities

Gateway Number 18204

"Local authorities are well placed to understand the challenges of key areas of public health which has been central to local government since its foundation. This timely resource shows how councils are already making huge strides in turning transition into transformation. The LGA will continue to seek a resolution to any outstanding issues of transition and will work with public health and NHS partners to help establish strong local public health systems"

Councillor David Rogers, Chair, LGA Community Wellbeing Board.

"We must not miss the generational opportunity given to us through the leadership of local government and creation of Public Health England to transform the nation's health. This refresh demonstrates the many encouraging examples of innovative practice being implemented across the country."

Duncan Selbie, Chief Executive Designate Public Health England.

Introduction

The transfer of the public health function from the NHS to local government is now well underway, with the pace of change set to accelerate. The purpose of this resource is to assist local authorities and public health to develop a local public health system that is designed to have the greatest potential for improving health, not just in councils but with all local partners. The focus is on transformation, showing how councils and public health are going beyond the practical steps of transition to develop a local vision public health, supported by new models for implementation. The resource complements other information focused on transactional issues such as HR and finance; it incorporates guidance issued up to the end of August 2012.

Information in resource sheets 1 to 6  reflects a snapshot of progress in January 2012, based on discussions with regional public health, case study areas, local public health, local authority representatives and a review of progress reports from several regions. It does not provide a comprehensive picture of public health transition. Resource sheet 7 provides an update of the first 6 as at September 2012. Resource sheets 8 to 12 provide a review of progress and a snapshot on additional topics, including how plans are developing to transform specific services during and beyond the transition. 

The resource sheets include information, examples of good practice, key messages and questions for areas to consider, based on discussions with the wide range of people involved in the snapshot. Some resource sheets will be of interest both to public health teams and to local authorities and wider stakeholders. Others will be of more interest to particular groups. The brief descriptions below indicate the likely audience. The resource includes eight cases studies chosen to represent different types of local authority from across England which have already started to implement elements of their new local public health systems. Each case study has been updated with information on progress to September 2012. A link to the update for each can be found under the link to the original text.

Findings from the snapshot in September 2012 include the following:

• Councillors and senior teams in local authorities have developed a good understanding of how public health can add value; this is now being cascaded throughout councils and their partners.
• Safe transition is the key priority but public health is also involved in major initiatives in joint health and wellbeing strategies (JHWS) to integrate and transform services.
• Clinical commissioning groups (CCGs) are providing significant opportunities for public health and councils to work more closely with GPs at a neighbourhood level.
• Recommendations from the Marmot review  are being adopted by health and wellbeing boards to shape JHWSs meaning that public health is fundamental to system-wide planning and delivery.

Key messages for success from those who have begun the process of transformation include:

• embed public health across the whole council and with partner organisations such as clinical commissioning groups
• use principles and evidence from the Marmot report and a ‘lifecourse approach' from the beginning
• involve all the council's directors in developing the new function and share responsibility for public health outcomes
• provide opportunities for councillors and council staff to learn about the full extent of the public health function, including health protection, and for public health specialists to learn more about working in local government
• a strong lead from the local authority chief executive and the executive member for health is important.

The resource will be refreshed with additional information and further case studies over the coming months as local authorities and public health teams progress their arrangements.

Resource sheets

Resource sheet 1 – Transition so far: key issues and findings (PDF, 8 pages, 70KB)
Describes themes and trends emerging from transition including models, vision, leadership, culture, commissioning and partnerships (Likely readership: all)

Resource sheet 2 – Understanding public health (PDF, 7 pages, 230KB) 
A brief overview of the scope of public health as discipline and profession. (Likely readership: local authorities and wider stakeholders.)

Resource sheet 3 – Understanding the health role of local government ( PDF, 8 pages, 220KB)
Describes how the main local authority functions can be developed to improve health with reference to social determinants and the lifecourse approach. (Likely readership: those not familiar with the potential of local authorities for improving health.) 

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29 January 2013