From April 2013 Portsmouth City Council formally took on its new, statutory Public Health duty, but what does that mean for the council and the city?
Local government has a long and proud history of promoting and protecting the public’s health dating back to Victorian times. It was only in 1974 that the NHS took over most public health functions, but the Government is returning responsibility for improving public health to local government for several reasons, namely:
- population focus
- ability to shape services to meet local needs
- ability to influence wider social determinants of health
- ability to tackle health inequalities
Why is public health part of the council?
Portsmouth City Council’s new responsibility for public health is set out in the Health and Social Care Act 2012. The changes brought in by this Act mean that local government is now be responsible for a range of health services including local health improvement functions, with a ring-fenced budget to deliver them.
Factors such as education, employment, environment, transport, planning, housing, and leisure services are crucial determinants of people’s physical and mental wellbeing and impact on their life expectancy. These wider social factors generally lie outside of the NHS and fit more closely with the work of local authorities.
The 2010 Marmot Review ‘Fair Society Healthy Lives’ gives more information about the impact of social factors on physical and mental wellbeing.
Under the 2012 reforms, local government now works on the three key domains of public health:
- health improvement
- health protection
- health services
In addition to having a general duty to improve local public health, local authorities are taking specific responsibilities for commissioning a list of services, some of which (such as initiatives to tackle smoking, alcohol and drug misuse, obesity, increase physical activity and improve nutrition) are already part of this council’s work, while others (such as the NHS Health Check programme) will be less familiar.
Some responsibilities will be mandatory, including:
- appropriate access to sexual health services
- ensuring there are plans in place to protect the health of the population, including immunisation and screening plans
- ensuring NHS Commissioners receive the public health advice they need
- the National Child Measurement Programme (NCMP)
- NHS Health Check assessment
Who is the director of public health?
The principal adviser on health in the council is the Director of Public Health (DPH), who is appointed in coordination with Public Health England. The DPH is a Strategic Director of the council and provides leadership, expertise and advice to elected members and senior officers on a range of issues, from outbreaks of disease and emergency preparedness to improving local people’s health and concerns around access to health services.
The DPH is a statutory member of the Health and Wellbeing Board and will also be required to produce an annual report on the health of the local population, which the council will publish.
A decision was made in summer 2016 to share a DPH with Southampton City Council, as the two cities have many similarities in terms of their health profiles and the needs of their residents. The joint position will also make better use of resources and save money for both organisations. Dr Jason Horsley has been appointed to this joint DPH position and joined in January 2017.