Public health: policy and reports - England

Introduction

Public Health England (PHE) came fully into operation on 1 April 2013 as an executive agency of the Department of Health. It encompasses health protection and health improvement functions and has established a health and wellbeing directorate. “PHE will work with national and local government, industry and the NHS to protect and improve the nation’s health and support healthier choices and will be addressing inequalities by focusing on removing barriers to good health”. 
 
At the same time local authorities are also taking on new responsibilities for public health with a ringfenced budget, to enable a more holistic approach across health and other related areas such as housing, leisure, transport and social care. The emphasis is on preventive and more integrated approaches.
 
PHE has identified five priority areas it will focus on using the public health outcomes framework for 2013-2016. The framework presents the overarching vision for public health ‘to improve and protect the nation’s health and wellbeing, and improve the health of the poorest fastest’ and sets out the outcomes to be achieved.

Viv Bennett has been appointed as Director of Nursing for Public Health and so for the first time Public Health Nursing in England has clear professional leadership.

"It is a real privilege to be the professional lead for public health nursing and midwifery in England. My role across the Department of Health and Public Health England provides a real opportunity to join up policy with practice to further developing the nursing and midwifery contribution to improving the 'public's health,' improving health outcomes and reducing inequalities.

The new vision and strategy for nurses, midwives and care staff sets out actions for all nurses and midwives to make every contact count and to promote the role of specialist public health nurses and midwives.

I look forward to working with the RCN and with you, to ensure our contribution is visible and valued and we support you to deliver best public health nursing and midwifery practice. 
Viv Bennett, Director of Nursing, Public Health England and Department of Health."
 
For further information see the policies below. See also agencies and topics.

Policy and reports

The following section includes key strategic documents and related reports which shape the public health agenda - most recent first.

These resources were last accessed on 19 April 2013. Some of them are in PDF format - see How to access PDF files.

Public Health England
Public Health England (PHE) is an executive agency of the Department of Health and has been established as part of the major reforms brought about by the Health and Social Care Act 2012 which has also transferred the majority of public health responsibilities and services to local authorities. These reforms came fully into operation on 1 April 2013. The Government's strategy for public health was initially set out in the 2010 white paper Healthy lives, healthy people.

Public Health England brings together health improvement and health protection and it encompasses the work of a number of other agencies and bodies including the former Health Protection Agency. It has established a health and wellbeing directorate which will work with partners to develop and implement health programmes and address the social factors that affect people's health. Currently PHE is focussing on five key priorities - see the Press release - 25 March 2013.
PHE will provide the strategic direction and support the development of the new public health system. The PHE priorities for 2013/2014 have been published. See: Public Health England: Public Health England priorities.

For more information see: RCN Policy and International Department (2013) Policy briefing 5/13: Public health reforms in England: a guide to the changes and the RCN position (PDF 174KB).

See also the Local Government Association: From transition to transformation in public health - update. This section of the LGA website provides a series of resource lists to assist the transfer of public health to local authorities. These will be refreshed with additional information and further case studies as local authorities and public health teams progress their arrangements.

Creating a personal, fair and diverse health and care service: survey guide (2013)
NHS England as part of the NHS Equality and Diversity Council, has requested views to inform the development of a national strategy to promote equality and reduce inequalities which will embed the principles of the NHS Constitution. The survey closed on 31 March 2013.

Living well for longer: a call to action to reduce avoidable premature mortality (2013)
This Department of Health publication details Jeremy Hunt’s ‘call to action’ on reducing premature mortality in England, primarily for the 5 biggest killer diseases: cancer, stroke, heart, liver and respiratory disease. It is directed at the health and care system locally and nationally. The RCN has been involved in developing the DH premature mortality ‘Call to action’ along with many other professional organisations and Royal colleges. The emphasis now is to implement strategies to reduce the incidence of premature mortality across the population and with a range of different nursing specialities.

Healthy lives, healthy people: improving outcomes and supporting transparency (2012)
Published by the Department of Health this presents a public health outcomes framework for England 2013-2016 and associated documentation. The framework concentrates on two high-level outcomes to be achieved across the public health system which are: increased healthy life expectancy; reduced differences in life expectancy and healthy life expectancy between communities. “The outcomes reflect a focus not only on how long people live but on how well they live at all stages of life. The second outcome focuses attention on reducing health inequalities between people, communities and areas”. Indicators which “cover the full spectrum of public health and what can realistically be measured" are grouped in four domains. These are: improving the wider determinants of health; health improvement (People are helped to live healthy lifestyles, make healthy choices and reduce health inequalities); health protection; healthcare public health and preventing premature mortality (reduced numbers of people living with preventable ill health and people dying prematurely, while reducing the gap between communities).

Working for Health Equity: the role of health professionals (2013)
This report from the UCL Institute of Health Equity demonstrates that “the health care system and those working within it have an important and often under-utilised role in reducing health inequalities through action on social determinants of health” and launches a new programme of activities to tackle health inequalities through action by health professionals. The RCN is also one of more than 20 health organisations has also made a commitment to act in support of this programme. The report presents the evidence base for actions and makes recommendations on how this can be achieved illustrated with case studies showing effective action that is already in place

Public Health White Paper

Health Select Committee - Public health (2011)
This report from the House of Commons Health Select Committee, published in November 2011, presents a short background to the changes and current plans for the new public health system with conclusions and recommendations on each of the constituent parts of the reforms.

Healthy lives, healthy people: update and way forward (2011)
This follows on from the listening exercise for the Health and Social Care Bill. The document, published in July 2011 sets out the next steps and what is being done to tackle some of the concerns that were raised around the White Paper concerning the need to avoid fragmentation of services and the need to support the continued development of a strong specialist public health profession and the wider public health workforce.

Healthy lives, healthy people: our strategy for public health in England (2010)
This White Paper sets out the Government’s long-term vision for the future of public health in England. The vision includes the creation of Public Health England and strengthening local and national leadership. This section of the Department of Health website provides information about the White Paper and the consultation process on this and related consultations.

Chief Medical Officer annual reports

Chief Medical Officer: Annual report volume 1
This volume of the Chief Medical Officer Professor Dame Sally Davies’s annual report provides a comprehensive picture of England’s health.
Volume 2 provides a comprehensive overview of the threat of antimicrobial resistance and infectious diseases.

Earlier policy and related documents

Fair society, healthy lives
This website is based around the Marmot Review report ‘Fair society, healthy lives’ published in 2010. The strategic review was tasked with identifying the evidence most relevant to underpinning future policy and action for addressing the health inequalities challenges facing England, and to show how this evidence could be translated into practice. The final report identifies six policy objectives. This website includes downloadable copies of the report and executive summary along with information about implementation and related activities including Sir Michael Marmot’s blog.

Our health and well-being today (2010)
This summary of evidence aims to set out the state of the nation’s health and wellbeing in 2010. The evidence base informed the development of the White Paper Healthy lives, healthy people.

Be active, be healthy: a plan for getting the nation moving (2009)
This plan establishes a new framework for the delivery of physical activity alongside sport for the period leading up to the London 2012 Olympic Games, Paralympic Games and beyond. It includes a breakdown of the estimated health care related costs of physical inactivity. The plan sets out new ideas on how primary care trusts will engage with other bodies to identify and respond to the needs of local populations to improve levels of physical activity.

Choosing a better diet: A food and health action plan (2005)
This document describes the Government's food and health action plan which builds on the strategy presented in 'Choosing health' and its delivery plan. It describes the aims and objectives of the plan and the time by which these will be achieved. This document has an accompanying physical activity plan - see Choosing activity: a physical activity plan (2005).

Securing good health for the whole population (2004)
This final report in a series chaired by Derek Wanless on longer term health trends focuses on preventive health care and the need to develop structures enabling people to be fully engaged in their own health improvements. The report makes recommendations around identifying key targets and using cost-effective and evidence-based interventions, where these exist, and piloting and evaluating promising interventions where evidence is less clear.

Liberating the public health talents of community practitioners and health visitors (2003)
This illustrates the contribution that all community practitioners and health visitors can make by using a public health approach in their practice. It describes the key principles of this approach and provides examples of how this is being implemented across different settings.