Council-provided public health services continue to improve and evolve to tackle health inequalities, according to the LGA’s latest annual report.
Over the past seven years, public health has been the responsibility of local government, and tackling health inequalities across the country is one of the key priorities for the services that councils provide alongside local partners.
Since 2013, against a backdrop of rising demand for health and care services and a reduction in public health grant funding, the progress that councils have made is impressive.
Each year, the LGA publishes its annual report on public health to take stock of the progress councils have made and what more needs to be done. Our latest report – published in May, but written before COVID-19 – shows how public health in local government, working closely with the NHS and others, continues to go from strength to strength.
The report bears witness to good practice from combined authorities and councils from across the political spectrum and the country, regardless of their size, population and deprivation levels.
Councils have continued to build on the work they have done in this area. Directors of public health are increasingly collaborating with public health colleagues in neighbouring authorities. They are pooling expertise and providing mutual support on health issues best tackled at scale and across larger footprints; bringing together more expertise; positioning health and wellbeing as a key priority for services such as transport, housing and the environment; and commissioning public health services to improve access, outcomes and cost-effectiveness.
No doubt this experience and collaboration will have aided councils in dealing with COVID-19 in the way that they have.
“There is much in the Green Paper with which to be pleased”
Over the past year, there has been greater consensus about what needs to be done to improve health and tackle inequalities – and, to its credit, the Government has made real progress on the issue of public health.
As part of the Prevention Green Paper published late last year, the Government set out a framework for making health everyone’s business and shifting the NHS from a model based on treatment to one based on prevention.
The Green Paper signalled a real shift of focus from the length we live our lives to the length we live them in good health, and there is much to be done in this area: a 19-year gap already exists between people in the most deprived areas and their more affluent neighbours.
The Government’s approach emphasises personalised support and creating solutions together – and not just in Westminster. There is much in the long-awaited Green Paper with which to be pleased.
As ministers look ahead to their next steps – which no doubt will look and feel different from what they would have done before COVID-19 – we, as partners across the local government spectrum, remain committed to working with central government, the NHS and Public Health England to ensure our communities live healthier, longer lives.
Our work is far from done, and councils are ambitious to do more in areas such as air pollution, smoking, and what we eat. But amid the current pandemic, this year’s public health report is a useful reminder that while local government is playing a leading role in the health of this nation – and has a track record of delivering first-class public health services – more can still be done with a long-term public health funding settlement.
Case studies
East Sussex
In 2017, East Sussex County Council created an integrated health and wellbeing service.
Its aim is to reduce the gap between the most and least deprived by making support more accessible to people with greater levels of need, delivering a streamlined point of access and supporting residents with a range of issues.
Single-issue services had previously led to users with multiple issues having to navigate a series of support services – so the council’s One You East Sussex programme has brought together provision across smoking, weight loss, physical activity and alcohol misuse. Since the service launched, more than 14,000 people have received support.
The service runs programmes such as the football weight-management scheme Man vs Fat, and is designed to be flexible, with a mobile support unit bringing provision closer to those residents who live in harder-to-reach areas.
In the first nine months of 2019/20, 704 people took part in weight-management interventions, with a further 2,556 beginning interventions to quit smoking. The programme’s Stoptober campaign resulted in the largest number of people beginning a stop smoking programme in a single month – 434 – double the number before these services had been brought together.
Quality has also improved, with 41 per cent of weight-management intervention users within the service achieving at least 5 per cent weight loss, compared with only 16 per cent of users under the previous service.
Cllr Carl Maynard, Lead Member for Adult Social Care and Health, said: “The return of public health to local government enables us to build on the achievements we have made in promoting and protecting the health of residents in East Sussex, and put health and wellbeing at the heart of everything we do.
“Having effective behaviour-change support services in place not only helps us address health inequalities, but it can also impact positively on other parts of the council by, for example, reducing demand for social care support.”
Gateshead
Working in partnership with Teesside University, Gateshead Council has embedded a researcher in its public health team.
Together, they are working on a housing estate with high levels of deprivation, alongside a well-established local ‘anchor’ organisation, Pattinson House, a community project run by the charity Edberts House.
The aim of this project is to identify what local people think would help them to improve their health and wellbeing, and support them to implement their own ideas.
The research carried out by the public health team found residents were conscious of what they needed to do to be healthy, but faced barriers to entry, such as the ability to afford healthy food or to exercise safely.
As a result, the council put in place a series of interventions, brought to life by Pattinson House and the residents themselves.
These included a social enterprise providing weekly healthy pizza and food events, encouraging volunteering, training and paid-employment opportunities for local people. A continuing partnership with Harriers running club was also set up. This allows young people to run with the club, and has resulted in a national award from Athletics England for Innovation Project of the Year.
Gateshead Council supported Pattinson House and covered the cost of seed initiatives to make them self-sustaining.
The success of these projects has resulted in a similar support package attracting substantial further funding from the National Lottery Community Fund to develop work on a neighbouring estate.