Public health grants to local authorities 2021/22

This briefing gives the LGA’s views on the public health settlement for local authorities.

View allPublic health articles

Introduction and references

1. This briefing gives the LGA’s views on the public health settlement for local authorities.

2. The following are key announcements and hyperlinks to accompanying documents:

a. Ministerial Statement

b. Department of Health and Social Care public health allocations 2021/22


Key announcements

3.  The public health ringfenced grant to local government for 2021/22 is £3.24 billion. This represents a £45 million increase (1.4 per cent) since 2020/21. Every local authority will receive at least a 0.67 per cent cash terms increase.

Public health grant


(£ billion)


(£ billion)


(£ billion)

Change (%)






4.  The grant includes £23 million to cover costs of routine pre-exposure prophylaxis (PrEP) commissioning with bespoke distribution.

5. The 2021/22 grant will continue to be subject to conditions, including a ring-fence requiring local authorities to use the grant exclusively for public health activity which may include public health challenges arising directly or indirectly from COVID-19.

LGA view

6.  Public health services run by councils have more than proven their worth through the pandemic, helping to reduce the spread of coronavirus while helping to keep people healthy and well, as part of the tremendous local response. 

7.  It is disappointing that the public health funding announcement is so late. We are now just 2 weeks away from the start of the financial year and only now are councils being formally told how much money is being made available for councils to tackle costly public health issues such as sexual health, drug and alcohol services and obesity. Government must accept that delaying the announcement has made it extremely difficult for councils to plan effectively.

8.  We are pleased the public health grant includes £23.4m to cover local authority costs of routine commissioning of pre-exposure prophylaxis (PrEP). Local authorities have invested hundreds of millions of pounds in offering sexual health services since taking over responsibility for public health eight years ago, and we firmly believe that PrEP could significantly reduce levels of HIV in this country.

9.  Councils have seen a £700m real terms reduction in funding between 2014/15 and 2020/21 – a fall of almost a quarter (23.5%) per person. If the Government’s prevention agenda is to be taken seriously, then this must be re-evaluated in future spending rounds.

10.  Every pound invested by Government in council-run services such as public health is helping to relieve pressure on other services like the NHS and the criminal justice system. Just as pressures exist within NHS and social care, pressures are mounting within statutory public health services. Analysis shows that local authority public health funding is three to four times more cost-effective in improving health outcomes than money spent in the NHS.

11.  We know that one thing that marked England out as COVID-19 hit was our poor public health including our high rates of inequalities, of smoking, and of overweight people and obesity. Whilst the pandemic makes it vitally important that prevention is not sidelined, it should be given prominence at all times, with 40 per cent of avoidable deaths are as a result of tobacco, obesity, inactivity and alcohol harm. Increases in the public health grant are vital to improve these characteristics.

12.  It is vitally important that this dialogue continues to address challenges which arise over the coming months and years, and to secure sufficient ongoing funding to ensure all local authorities can continue to meet their public health responsibilities beyond 2021/22.

13.  To match the growth in overall NHS funding as part of the Long Term Plan, the Government should commit to increasing the public health grant in future years to at least £3.9 billion by 2024/25. This would allow councils to not only continue to provide current services, but also consider expanding other initiatives where financially possible and locally desirable.