SLI is the approach to quality and performance improvement put in place by local authorities (LAs), The Association of Directors of Public Health (ADPH) and The Local Government Association (LGA) following the abolition of the previous national performance framework. It is based on the principle that local organisations and systems take responsibility for their own performance and improvement and assume collective responsibility for the performance of the sector.

As a concept, it works to promote peer support and learning through collaboration across the system and places emphasis on the use of data in shaping practice. It is a methodology that is formally recognised as an improvement activity within the narrative of PI.

Public health assurance is the process of monitoring and providing evidence that health outcomes are improving via quality assurance, performance monitoring of projects and programmes (not top-down inspection), regulation and compliance, risk management, data collection and analysis, accountability and collaboration.

Assurance takes place at different levels, and strong system leadership is essential to ensure mutual accountability and system-wide assurance. In participating in improvement activities, we are committed to assuring:

• The public
• Government
• Local authorities
• Councillors and elected officials
• Service providers
• Commissioners
• Voluntary and community sector organisations
• The wider public health workforce across the four countries and dependent territories

DsPH play a crucial role in providing assurance to government bodies, ensuring that public health functions are effectively delivered. This is achieved through:

• Reporting and accountability to government bodies, including DHSC and UKHSA.
• Contributing to Public Health Outcomes Framework (PHOF) metrics and submitting data on key health indicators.
• Working within the LGA Assurance Framework, which ensures that councils are fulfilling their statutory public health duties and continuously improving health outcomes.
• Strategic leadership and coordination with ICSs, NHS partners and regional health bodies to align public health goals with national health strategies.
• Ensuring that public health funds, including the public health grant, is allocated efficiently and delivers value for money. DsPH also have a broader role in health improvement including addressing the wider determinants of health, including local policies and embedding health considerations into all local government policies.

Providing assurance in times of public health emergencies through rapid response planning, data-driven decision making and transparent communication with government bodies.

Public Health Audit tools are used to provide confidence to both internal and external stakeholders and the public by demonstrating continuous improvement in PH practice. They should enable clear evaluation, challenge and measurable improvement.

A public health audit involves a systematic examination and evaluation of the processes, performance, and outcomes of public health programmes, services, or organisations. The goal is to assess the effectiveness, efficiency, and quality of public health activities, ensuring that they align with established standards and objectives.

QI is the framework for improving quality in the delivery of public health functions and services that can support SLI. It involves developing and sharing resources to assist in delivering high quality services. As emphasis is placed on delivery and is often associated with clinical settings, QI can encompass activities that focus on early intervention, adopting a life-course approach across primary, secondary and tertiary care settings and integrated services.[i]

[i] Quality in Public Health: A Shared Responsibility (2019)