Public health transformation nine months on: bedding in and reaching out

Public health made the formal transfer to local government in April 2013, and in the subsequent months great strides have been made to tackle the wider social and economic determinants of poor health. This resource commissioned by the LGA and PHE describes how public health in a number of councils has started to use the opportunities of a local government setting to improve health and wellbeing.

The case studies were chosen because they show a range of ways in which public health in councils is approaching its new roles. They include councils spread across England, covering both rural and urban environments and with varying levels of deprivation and affluence.

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The detailed case studies provide key messages from the area, a description of the work they are undertaking to best meet local health priorities and plans for the future. Those areas featured include:

Bedford and Central Bedfordshire


The three unitary authorities in the county have a joint DPH. A proactive approach is being taken to the ‘core offer' to the NHS. Public health is developing a corporate role in helping identify health impacts of council activities and prioritising action.

Blackburn with Darwen


The council has established an investment framework for the Public Health Grant which involves a shift from a medical to a social model, and uses the World Health Organisation's tool for evidence-informed decision making in public health.

Brighton and Hove


A number of partnerships and a strategy involving a parallel inter-linked range of initiatives have been set up to tackle the increasing problem of alcohol misuse in the city. Pioneering use has been made of the council's traditional functions in the service of health. Involving the public and service users has been a key component.



Proposals for a major shift in health and wellbeing services have been supported by local evaluation and national evidence. A person-centred approach to behaviour change is demonstrating improvements in terms of individual satisfaction, health outcomes and cost effectiveness.



Development of an interactive JSNA has been used as an opportunity to open up information and accountability to the community, enabling data to be used by community groups. The website is monitored and continually updated.



The county has a public health team covering three upper-tier authorities in a three-year arrangement with a pooled budget. The new arrangement is a good test bed for other joint working, eg on integration of health and social care.



The county council is taking a phased approach to embedding new ways of working into opportunities for improving health both locally and regionally.


Public health department with additional council functions and targeted health improvement interventions (PDF,
The new Public Health Department includes environmental health, trading standards, licensing and sports and recreation. Interventions are shaped by local research as well as national evidence and their impact on health is regularly monitored.



The public health team is taking an inclusive strategic approach to building a public health movement among all those whose work impacts on health. Council and other public sector and VCS staff are given access to development resources. A mixed model ensures both dispersed and central expertise is available.

Royal Borough of Kingston upon Thames


The council is using public health evidence-based practice to tackle health inequalities through innovative community development approaches.



Building on a strong history of joint work, the transfer of public health is enabling community assets approaches to be systematically embedded across all council functions.



A history of joint working has ensured that health issues are built into planning policies. Healthy urban planning is now high on the council's priority agenda and a toolkit is being developed to embed health issues further into planning.

North Lincolnshire


Sharing public health funding with responsibilities for the public health outcomes framework (PHOF) is proving to be a useful way of achieving ownership of health across the council.



Moving to become a ‘strategic commissioning council' whose work is based on improving outcomes, building on assets and using a ‘local action: central support' operating model to tackle wider determinants of health at a local level.

West Sussex


As the council moves towards a stronger commissioning role, the DPH is now the ‘Commissioner for People', bringing new resources to the council and highlighting synergies with other council functions such as social care. Certain public health commissioning functions has been devolved to district councils and joint work with district councils is taking a lifecourse approach to housing and homelessness.



Combining the roles of director of public health, director of adult social services