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Countdown to ‘momentous’ transfer of 0-5 public health commissioning to councils

The responsibility of commissioning key public health childhood services, including health visitors and family nurses, will transfer to the hands of councils this Thursday (1 October).

The “momentous” move forms the “final piece of the jigsaw” in the reshaping of public health services, originally commissioned and controlled by the NHS before being transferred to councils in April 2013.

The Local Government Association (LGA), which has previously campaigned for the under-five transfer, says the change will ensure councils are “responsible for health from the cradle to the grave”.

It believes the transfer will provide a more holistic, joined-up approach to healthcare by focusing on improved access to a range of services – such as housing, benefits, employment and leisure – as well as the clinical care itself, all of which are linked to healthy living.

Cllr Izzi Seccombe, LGA community and wellbeing spokesman, said: “The transfer of public health commissioning responsibilities for under-fives to councils marks a momentous opportunity to transform healthcare for children, young people and families. It is one of the biggest shifts in public health services in generations.

“Giving children a healthy start in life is one of the most important jobs councils do and we all have a duty to make sure that children, along with their mums and dads, have access to the services they need.

“Health visitors are at the frontline of children’s healthcare and are perfectly positioned to spot problems early and spot them from escalating.

“Councils, as new commissioners of these services, understand the needs of their local communities, providing quality and cost-effective services. It’s the rich information that school nurses, health visitors and family nurses hold that councils will value when commissioning and designing services.”

Councils and school nurses are already working together ahead of this week’s transfer to co-ordinate and deliver public health interventions for children – particularly by tackling childhood obesity, under-18 conception rates, the prevalence of chlamydia and mental health disorders.

Prof Viv Bennett, chief nurse at Public Health England (PHE), said: “Local authorities understand the needs of local communities. The transfer of commissioning of the Healthy Child Programme gives them the opportunity to commission evidence-based services to support families to give children the best start, integrated with early and additional help when needed.

“The transfer also provides the opportunity to integrate public health services for 0-19-year-olds to support children and young people as they grow up.”

PSE reported in August that the King’s Fund has described the Spending Review as the government’s public health “litmus test”, in which the government will show how committed it is to invest in public health and prevention.

The think tank said that, to date, Whitehall has done little in the way of tangible policy initiatives, with the government’s “only notable intervention being to rule out a tax on sugar when it was suggested by a junior health minister”.

At the time, Seccombe had stressed that councils could only continue tackling obesity, drinking and smoking across the board if they were “adequately resourced”.

But Duncan Selbie, chief executive of PHE, assured that local government had already made “significant progress” in improving public health as they were “best-placed to manage and prioritise resources”.

Public health budgets, which will now lie entirely outside the NHS ring-fence, are expected to face increased pressure when the final service commissioning for children aged 0-5 is transferred to councils this week. They will start facing the same £200m cuts that the rest of the public health sphere already faces, which councils have criticised for making “no economic sense”.

The in-year cuts announced in the Summer Budget could also force several local authorities to save on money already allocated to long-term contractual health work in the NHS and other organisations, many of which require six-month notice of changes and are required by law.


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