The NHS Public Health Outcomes Framework has been published, aiming to tackle public health challenges through moving public health back into local government. It outlines 'a shift away from the focus of process targets' to a framework that describes two 'high level' outcomes: an increase in healthy life expectancy and a reduction in life expectancy gaps across communities.
A DH press release, states:
'Public health will be measured against a framework which sets out 66 health measures so councils and the Government are able to see real improvements being made and take any action needed.
From April next year, councils will be given a ring-fenced budget – a share of around £5.2 billion based on 2012/13 funding – and will be able to choose how they spend it according to the needs of their population. Those who make the most improvements will be rewarded with a cash incentive.'
Investment in alcohol treatment and prevention will be locally determined, and should be reflected in each area's Joint Strategic Needs Assessment and Joint Health and Well-being Strategy.
The 66 indicators will be grouped into four main domains: 'Improving the wider determinants of health'; 'Health Improvement'; 'Health Protection' and lastly, 'Healthcare public health and preventing premature mortality'. Alcohol is addressed within the Health Improvement domain, alongside other lifestyles factors. A set of indicators on premature mortality includes preventable mortality from liver disease.
A specific alcohol indicator will remain for alcohol-related hospital admissions, though the indicator definition is due to be reviewed by NWPHO - 2.18 of the technical specifications states: 'the preferred option is for an indicator based on just alcohol-related primary diagnoses, to minimise the risk of perverse consequences from any changes in coding practice so the indicator rewards local areas for good performance.'
Recently the Health Committee warned over risks to public health budgets within the changes, concerns echoed by the Shadow Health Minister Diane Abbott - see a Press Association release. The Responsibility Deal, a key strand of Lansley's public health strategy, has also been heavily controversial and the 'nudge' focus has been criticised by a Lord's committee.
Last month the DH released a series of factsheets about the new public health system. See news reports in the Daily Mail and Daily Telegraph.
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