Public Health Outcomes Framework published by Department of Health

The Department of Health has published its draft Public Health Outcomes Framework, setting out the criteria by local authorities and their partners will be appraised under their proposed new responsibilities for public health.

The framework, which is now the subject of a consultation process ending on 31st March, focuses on five key areas of responsibility:

• health protection and resilience
• tackling the wider determinants of ill health
• promoting healthy choices and healthy lifestyles
• preventing ill health
• focusing on premature mortality and the health of the most vulnerable.

The government described the The Public Health Outcomes Framework as “outcomes focused” rather than prescriptive and aimed at “enabling and incentivising” local government, the NHS and the wider public sector to respond to local health needs and insisted that it is not is not a performance management tool and will not replicate the approach of the previous National Indicator Set.

Instead, it said that framework will provide “a context for public health activity across the whole of the public health system”. The government's plans for public health will see the establishment of a new body, Public Health England, as part of the Department of Health, and the transfer of public health leadership and responsibility to local government.

The government said that the framework would have three purposes:

• to set out the government’s goals for improving and protecting the nation’s health, and for narrowing health inequalities through improving the health of the poorest, fastest;
• to provide a mechanism for transparency and accountability across the public health system at the national and local level for health improvement and protection and inequality reduction; and
• to provide the mechanism to incentivise local health improvement and inequality reduction against specific public health outcomes through the ‘health premium’.

Data relating to the public’s health at national and (where possible) at local level will be collated by Public Health England and analysed against a set of national indicators before being made publicly available.

The consultation paper proposes that these indicators would focus on health improvement relating to the causes of the greatest burden on disease and death (such as obesity, smoking, alcohol and level of physical activity), health protection and preventative services.

The Department of Health insisted that it was open to suggestions from local government and wanted its input to shape the final form of the framework.

“This will not just be about central government inviting public health and local government to join in the consultation process, but about a real shared endeavour, which reflects localism,” the consultation paper said. “We are seeking views on the overall structure and scope of the framework and the range of outcomes and measures within it, including views on those measures that should be incentivised.  We want to go further and co-produce the final set of outcomes with our partners in the public health sector and local government, to ensure that we arrive at a robust set of indicators.”

The framework will be used in conjunction with a new framework for the NHS , which was also published this week, and a third framework, covering Adult Social Care, which is expected to be published shortly.

The consultation also emphasised the need for second tier councils to be involved in the process, despite the fact that the new Directors of Public Health will sit at county level in two-tier parts of the country. It also said that child protection indicators may be added to the framework, subject to the conclusions of the Munro review of Child Protection which is due to report in April 2011.

Health Secretary Andrew Lansley said: ‘Public Health is everyone’s business and through this consultation, people have the chance to comment on our plans for how success will be judged. These are important changes that will be far reaching and I urge everyone who has a view to take part.’

The consultation paper is available at the following link: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_122966.pdf