Local authorities have been given renewed responsibility for public health as part of the health and social care reforms introduced in April 2013, alongside dedicated funding and a new public health outcomes framework. But given the scale of need and the challenges facing different local communities, how can councils decide which aspects of public health to prioritise, and what actions are most effective?
While detailed guidance is yet to be developed, this report fills the gap by providing information and resources in nine key areas to help council leaders answer these questions. It brings together a wide range of evidence-based interventions about 'what works' in improving public health and reducing health inequalities. It presents the business case for different interventions and signposts the reader to further resources and case studies.
The broader determinants of health – people's local environment, housing, transport, employment, and their social interactions – can be significantly influenced by how local authorities deliver their core roles and functions. Local authorities also now have to demonstrate that they are delivering 'social value' – that is, that they have considered the social, environmental and economic impacts of their commissioning decisions. The report considers nine key areas where local authorities can have a significant impact on the public's health:
public protection and regulatory services (including takeaway/fast food, air pollution, and fire safety)
For local authorities, improving the public's health requires clarity of purpose and a robust local framework based on outcomes-focused partnerships, and commitment to systematic health impact assessment.
Local authorities need to be supported by central government policy, reforms such as welfare, which are likely to have significant public health impacts, should be subject to macro-level health impact assessments.
Health impact assessments should be championed across central and local government. For that to happen, public health needs to be prioritised across government departments – not just within the Department of Health.