Delay to Public Health Grant will cause ‘avoidable and unacceptable’ harm

The coalition, led by the Association of Directors of Public Health (ADPH), the NHS Confederation, the Local Government Association (LGA), the Faculty of Public Health (FPH) and the Royal Society for Public Health (RSPH),  are also urging ministers to increase investment in public health and prevention – a strategy which although known to have a long-term benefits to individuals, communities, the NHS and wider economy, has been repeatedly overlooked in recent years.

In the joint statement, leaders across the sector have said:

The government’s delay in publishing the Public Health Grant allocation for 2023/24 is putting public health services at risk and adding unnecessary strain on an already pressured system.

In addition to not yet knowing what the public health budget will look like for the coming year, we are extremely concerned that the delay will be exacerbated by either only a small increase or another flat cash settlement.

Despite several important government strategies being sidelined or delayed, including the health disparities and gambling reform white papers and Khan review, there have been a series of promising announcements giving a commitment to public health initiatives. However, these initiatives are not being adequately – or consistently – funded.

Instead, funding has been cut in real terms by almost a quarter since 2015. While the current investment is of course welcomed, anything less than inflation is in effect a cut and, as a result, it is impossible for providers to keep up, either with policy ambitions or the growing demand on these vital public health services. We simply cannot keep delivering more for less.

Without investing in evidence-based measures that are proven to prevent and reduce physical and mental ill health, demand on the NHS will continue to rise, sickness in the workforce will continue to increase and the economy will continue to suffer as a result.

Greg Fell, ADPH vice-president and director of public health for Sheffield, said:

“This grant directly funds local services that protect and improve people’s health. With just four weeks to go until the start of the new financial year, directors of public health and their teams are having to second guess how much money they will have to spend on areas like sexual and reproductive health, drug and alcohol treatment, stop smoking services and early years support.

“We can’t plan high quality, value for money, services without knowing how much money there is to spend on them. As a result, individuals, their families – and therefore their communities – will undoubtedly suffer purely as a result of an avoidable and unacceptable delay in decision making.”

Matthew Taylor, chief executive of the NHS Confederation said:

“Health leaders across the NHS system know the critical role public health provision plays in reducing pressure on services and crucially, keeping people and communities well.

“In their first year as statutory bodies, integrated care systems know they have a driving role to play in building population health and reducing health inequalities, and ICS leaders are raring to go with this part of their role, with many ICSs already undertaking important and innovative work. They do however need adequate support from government to enable them to work effectively in partnership with local authorities, the VCSE sector and others to bring about the shift needed in how we approach health.

“The ongoing uncertainty around funding for services for the next financial year is undermining the ability of local health leaders to make the best use of the allocations in the interests of the communities they serve. After eight years of real terms cuts to the Public Health Grant a rise by anything less than the current rate of inflation will stymie progress in the face of increasing need.”

Councillor David Fothergill, chairman of the LGA’s Community Wellbeing Board, said:

“Demand for vital treatment including mental health support was high before the pandemic. In the aftermath of the pandemic, it is even more urgent that these services are properly funded.

“Councils continue to be in the dark about public health funding and this can’t go on. Residents and our communities need clarity.

 “Every pound invested by government in council-run services such as public health helps to relieve pressure on other services like the NHS and the criminal justice system.

“The government needs to give councils the clarity they need so they can increase investment to protect the health of our local communities over the coming months and years and to ensure all local authorities can continue to meet their public health responsibilities into the future.”

Professor Kevin Fenton, FPH President, said:

“As local services respond to multiple concurrent threats to health, exacerbated by the mounting cost-of-living crisis, councils desperately need clarity on funding allocations to make critical decisions on frontline services which are in place to protect and improve the public’s health.

“We hope that this year’s Public Health Grant will reflect the mounting pressures on these services and recognise the proven value that they offer in promoting population health and economic productivity.”

William Roberts, RSPH CEO, added:

“Public health grants fund essential local services that help keep communities healthy, productive, and prosperous. Delaying this critical local funding makes no sense.  With government focusing again on prevention, it is essential that local teams are given the resources to do what they do brilliantly.”