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Government announces £5.2bn public health spend in Outcomes Framework

23/01/12

The government has published its first Public Health Outcomes Framework, and announced a £5.2 billion spend on public health next year.

In a speech today, Andrew Lansley confirmed that the £5.2 billion will be ring-fenced; and also that public health spending will be increased in real terms in subsequent years.

The £5.2 billion figure is higher than the £4 billion estimate of current public health spending as mentioned in the public health white paper; and it is thought that around £2.2 billion will be handed to local authorities, £2.2 billion to the NHS Commissioning Board for national programmes (such as screening), £210 million to Public Health England, and £620 million will be given to the DH for public campaigns.

The DH also published the first Public Health Outcomes Framework, which sets out 66 health measures so councils and the government are able to see real improvements being made and take any appropriate action.

From April next year, councils will be given a ring-fenced budget – a share of the £5.2 billion - and will be able to choose how they spend it according to the needs of their population. Those who make the most improvements will be rewarded with a cash incentive.

These improvements will be measured against the following results:

• Fewer children under five will have tooth decay
• People will weigh less
• More women will breastfeed their babies
• Fewer over 65s will suffer falls
• Fewer people will smoke
• Fewer people will die from heart disease and stroke

The framework concentrates on two high-level outcomes, to be achieved across the public health system. These are increased healthy life expectancy, and reduced differences in life expectancy and health life expectancy between communities.

The DH said that the outcomes in the framework ‘reflect a focus not only on how people live but on how well they live at all stages of life’. It said:

‘Using a measure of both life expectancy and healthy life expectancy will enable the use of the most reliable information available to understand the nature of health inequalities both within areas and between areas.’

A set of supporting public health indicators has also been developed to ‘help focus understanding of progress year by year nationally and locally on those things that matter most to public health’. The indicators are grouped into four ‘domains’, as follows:

• Improving the wider determinants of health
• Health improvement
• Health protection
• Healthcare public health and preventing premature mortality

Andrew Lansley commented:

‘The framework is about giving local authorities the ability to focus on the most effective ways to improve the public’s health and reduce health inequalities, long-term, from cradle to grave.

‘Moving away from an old-style, top-down, target-driven regime, and towards outcomes that we all want to see […] Some are straightforward and obvious. Others are more complex, maybe things you wouldn’t immediately think of’.

Senior fellow on public health at The King’s Fund, David Buck, said:

‘We support the focus in on improving health outcomes and reducing health inequalities.

‘However, publishing data alone will not be enough. The key tests of whether ministerial rhetoric on public health in matched by reality will follow in the next few weeks, with the announcement of how shadow budgets will be allocated to local authorities and the publication of the alcohol strategy.’

You can read the Public Health Outcomes Framework here.