HEALTH

Priorities must come first

Councils are in urgent need of practical guidance to shape their public health activities, writes David Buck, who signposts where health and wellbeing boards can find examples of what works

Local authorities have a renewed leadership role in improving the public's health and reducing health inequalities, with a ring-fenced budget to help them take on specific functions around behaviour change.

However, with so much of their core business having an impact on the health of their populations, directly or indirectly, how they spend their mainstream budgets is perhaps even more important than how they spend their ring-fence funding.

Sir Michael Marmot's Fair Society, Healthy Lives report set out the case for action, and its impact has been shown in the priorities of most health and wellbeing Boards. However, there remains a chronic lack of practical guidance on how local authorities can shape their wider work to improve public health.

Public Health England and its partners will have an important role to play in supporting local authorities but there is currently little to help local leaders identify ‘what works', with the impact on health, or to help them develop the business case to support their proposals.

Where information does exist, it is in many different places. How then, can councils decide which areas to prioritise, and through which interventions and actions?

A new set of resources published by The King's Fund aims to fill this gap. The resources draw on academic evidence and practical examples of where local authorities can help improve the health of their populations across nine key areas, from early years, schools and employment through to green space, planning and public protection.

They do not provide an exhaustive list of where councils can act and influence, but identify the areas where there is strongest evidence of impact, often with a local executive member and director with direct responsibility who can be a focus for decision making.

Taken together, they cover the broad sweep of council functions.  During our research, it became clear how strong the business case for action is, not least because councils are acting in these areas anyway. Doing so with an eye on the health consequences of their core business often costs little if anything more, while contributing to the wider goals of a healthy population.

We know that a healthier population is more productive, more likely to be in work and to pay local taxes. We document many cases across the nine areas where actions both have intrinsic economic value and where they can lead to cost savings to local authorities and other public services.

Acting in these areas will also strengthen councils' hand at the health and wellbeing board table, showing how their actions can help reduce NHS costs, as well as improve health.

Health and wellbeing Boards present a key opportunity to develop new health partnerships.

David Buck

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