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Maintain local approach to public health after pandemic, says NHS Providers

NHS building

By Jess Hacker
25 February 2021

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The national leadership approach seen during the pandemic should not be embedded into a future public health system, NHS Providers has said.

In a briefing published yesterday (24 February) the organisation said doing so could result in local government and local partners becoming ‘further disempowered’ to support their communities.

The briefing outlined key issues to address when Public Health England (PHE) is replaced by the National Institute for Health Protection (NIHP).

In August last year, health secretary Matt Hancock announced plans to scrap PHE and replace it with the new health protection body, which will span all four UK nations.

NHS Providers said that ‘no expertise should be lost’ in the transfer of functions and responsibility, and that ‘sufficient financial investment’ should be available at a local level to ensure services are sustainable.

The body acknowledged that the role of national leadership during the pandemic has been ‘critical’, but added that there is ‘a risk that embedding this into a future public health system will result in local government and local partners including trusts becoming further disempowered to act for the good of their local communities’.

It also said that an ‘overly centralised’ response to public health threats will hinder local health partners’ ability to tailor their services to their communities.

‘Local leaders, who are closest to and understand most about their communities, who can tailor services and communications to meet their needs must be empowered to work flexibly according to what they know works,’ the briefing said.

Saffron Cordery, deputy chief executive of NHS Providers, said: ‘Any reforms to public health must make sure that local leaders, who are closest to their communities, are empowered to work flexibly according to what they know works. There should be stronger partnerships between NHS organisations, local government and the voluntary sector within systems.’

Role of ICSs

The briefing also highlighted the proposals to place Integrated Care Systems (ICSs) on a statutory footing, which were outlined earlier this month in a Government white paper.

Under the proposals, an ICS will be made up of a statutory ICS NHS body and a separate statutory ICS Health and Care Partnership.

NHS Providers said the differing roles of the two bodies – with one expected to be responsible for planning and commissioning, and the other for developing a plan that addresses the ‘wider health, public health, and social care needs of the system’ – raises questions about how they will work together.

But it added that the proposals signal ‘a direction of travel towards a much stronger role for NHS organisations in population health’.

The briefing also said that the move to a new public health body offers an opportunity to reconsider commissioning arrangements for some public health services, which it said have become ‘fragmented and vulnerable to funding cuts’.

‘Alongside a strengthened role for ICSs in public health and a robust voice for local government within systems, we believe clinical public health services would be better commissioned alongside other NHS services,’ it added.

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