Reaching Out: Influencing the Wider Determinants of Health

November 28, 2017   By Lucy Terry with Abigail Gilbert, Pawda Tjoa and Clare Vaughan

  • Government must acknowledge health as an economic asset that boosts workforce productivity
  • Over 85% of senior public health officers surveyed1 found that economic development departments are not as engaged as they could be
  • £65m should be invested in Health and Wellbeing Boards to enable them to invest in innovative public health pilots that address the wider determinants of health
Research published today by the New Local Government Network (NLGN) calls for public health to be more fully recognised as contributing to our nation’s growth potential. The Industrial Strategy White Paper published this week recognises the role of people as a key driver of productivity, but largely ignores the role of public health, which is a missed opportunity if we want our workforce to be fit for the future.

The research found that, while public health teams have integrated well with people-focused services in local authorities, there are weaker connections with economic development teams and Local Enterprise Partnerships (LEPs). The new Local Industrial Strategies now planned need to incorporate a much clearer focus on public health as a driver of workforce productivity.
As only 12.8% of senior public health officers felt that they were very engaged with economic development teams, there is clearly a lot of potential for closer working, which would lead to a healthier and more productive workforce.

To improve their effectiveness, the research recommends that central government should invest £65m2 into Health and Wellbeing Boards. This money would be used to support a 5-year ‘upstream prevention’ programme, which could fund pilots within their area that address the wider determinants of health. It could also be used to secure dedicated staff to engage with stakeholders where relationships could be strengthened, such as with Local Enterprise Partnerships and local authority economic development teams.

Lucy Terry, lead report author and senior researcher at NLGN said:
“Our research found plenty of evidence that public health teams had made substantial inroads in addressing the wider determinants of health through their strong relationships with areas like social care – and this is a positive step forward.
“But several years on from the transfer, there needs to be stronger relationships between public health and economic development for productive growth.”

Coming shortly after the publication of the government’s White Paper on the Industrial Strategy, this research offers a timely analysis of how effective the transfer of public health to local government has been.

The report makes additional recommendations:

  • Central government should amend legislation to clarify that ‘all local public services must have regard to the Joint Strategic Needs Assessment (JSNA) and Joint Health and Wellbeing Strategy in their area’. This would ensure that Health and Wellbeing Boards, and the strategies which they produce, are better positioned to drive action across local systems.
  • NHS England should produce guidance that requires Sustainability and Transformation Partnerships to engage with Health and Wellbeing Boards on the wider determinants of health
  • Local authorities should take part in peer-led training and development initiatives for public health teams on influencing and communication skills, facilitated by national bodies such as the Local Government Association;
  • Public health teams should develop ‘health champions’ across local services, who already advocate for improving health among their peers; and
  • Local authorities should work more closely with bodies such as Public Health England to develop approaches to evidencing the business case for investing in public health over the long term.
Notes to editors
1. 99 people responded to this question
2. Figure of £65 million assumes £100,000 each year over 5 years for 130 HWB areas.
3. For further information, please contact Claire Porter, Head of External Affairs on 07743065875 or cporter@newlocal.org.uk
4. This research was funded by the Health Foundation, and independently written by NLGN.
5. The research in this report was carried out between April and October 2017, consisting of literature reviews, in-depth interviews, workshops, roundtables, case studies and surveys of members, senior officers and directors of public health. Research spanned councils in different tiers across England, and there was a fairly proportional geographic spread to respondents.

November 28, 2017
Authored by

Lucy Terry with Abigail Gilbert, Pawda Tjoa and Clare Vaughan
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