Funding for the future

There’s always a slight feeling of trepidation around this time of year. What is the Public Health Grant allocation going to be? Will we receive the funding we need so that public health teams can provide adequate services for their populations, or will the settlement equate to real-term cuts, and having to make the difficult decisions that go along with that? 

The new Government has put delivering economic growth at the centre of its policy commitments, alongside its other key ambitions of reducing health inequalities, reducing poverty, and building an NHS fit for the future. Local public health teams play a critical role in keeping the nation healthy, but without the necessary funding, improving people’s health is not possible. Over the past decade, there have been substantial cuts to public health funding across the UK, including over a quarter real-terms per person cut in the value of the Public Health Grant in England. That is why, in our 2025 Spending Review submission, we are calling for more investment in prevention and public health to help deliver economic growth.   

Earlier this month, the Government announced a 5.4% increase in the Public Health Grant allocation for England for 2025/26. The £3.858 billion represents a 3% real-terms increase, which is very welcome, and indicates that the Government is serious about the need to invest in prevention and build stronger, healthier communities. The increase will also help to ease the recent extra burdens placed on the Grant, such as the impact of pay inflation and employers’ National Insurance Contributions, and allow us to focus on meeting the needs of local residents. 

However, there is a caveat. Public health teams need to have enough money and resources to work with local partners to create a healthy environment and be able to implement measures and services that support their residents to live healthier lives. While the increase is a definite step in the right direction, the Government should restore the Grant to its 2015/16 real-terms per person value. One-off funding pots for specific areas such as drug and alcohol treatment are not sufficient to improve public health in the long term. When this type of short-term funding stops this puts the services it is paying for at risk, meaning that this could affect the health of the public and continue to widen health inequalities.   

To really make a difference, we need consistent, multi-year settlements, to be able to work with local communities to implement longer term plans to improve health and wellbeing. Directors of Public Health need the flexibility to fund the services that are most needed in their areas, based on evidence and what solutions are likely to have the biggest impact, depending on the populations involved. 

Cuts to public health funding over the past decade have had a severe effect on health and wellbeing. In public health, measures to give an additional year of good health to someone’s life is three to four times lower than the cost resulting from NHS interventions for that same additional year. The argument for funding prevention and public health therefore seems obvious and although it is absolutely right that we invest in the NHS and improve access to treatment, it is only one piece of the puzzle.  

Improving the nation’s health will improve the economy through increased productivity and less demand for health and social care, and consideration for the consequences of people’s health should be at the centre of all Government policies. So, investing more in public health to promote healthier lives would help conserve funds, create a healthier, more productive society and reduce demand on the NHS. If the Government is serious about the need for prevention, and genuinely wants to help people avoid getting largely preventable diseases, it needs to make this long term commitment to how our local public health services are funded. 

We are working with Government to highlight the role of Directors of Public Health and public health teams, and the challenges they face in achieving their health mission, and we wait with interest the announcement of the Spending Review in June.