In 2019, despite the huge financial constraints facing public health and councils overall, public health teams have continued to do an excellent job across the whole spectrum of activity.
This activity includes mental health and wellbeing for children and adults, the best start for children and young people, supporting healthy behaviours, better data and intelligence, healthy places – both rural and urban, addressing the wider determinants of health including economic growth, tackling health inequalities by working with neighbourhoods.
A theme identified in this annual report is that having built a sound foundation of services that have been effectively reshaped and recommissioned, public health is able to give more time to developing partnerships. Key partnerships for upper-tier councils are with districts and boroughs, many of which are now extremely proactive in shaping their work to promote health. In 2019, the LGA will publish a report on good practice in districts to help all reach the level of the best.
Partnerships with the NHS are also a high priority, with many DsPH leading the prevention strand of sustainability and transformation partnerships (STPs). Unfortunately, while relationships are good and there are examples of excellent joint work, there is also disappointment that the main focus has been on tackling NHS priorities, such as reducing A&E attendance and organisational deficits. This is a missed opportunity to collaborate to improve health and wellbeing and reduce future demand on health and care services.
All of this excellent work is in the context of a reduction to public health grant funding of over £700 million in real terms between 2015/16 and 2019/20 at a time when the NHS is to receive additional funding of £20.5 billion over five years, and prevention was high on the national agenda. The forthcoming government Green Paper on Prevention should allow us to consider the opportunities for prevention from a system-wide perspective which includes all the social determinants of health. However, it must be based on engagement with councils and with the public health community, and for any progress to be made it must be accompanied by proper funding for local government public health.
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