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The local health protection system

Health protection · Position statements · Public health funding · Public health workforce | September 27, 2023

Why we have written this paper

Public health in local government is at the heart of work to ensure positive population health outcomes. It provides the leadership, expertise, partnership-working, and access to local resources that are fundamental to strong place-based coordination of health protection.  

While we have welcomed the increased recognition of local public health teams as a result of the Covid-19 pandemic, there are still key fault lines which need to be addressed to ensure a strong and resilient local health protection system. These include issues around governance and accountability arrangements, local input into national conversations and programmes, data and intelligence flow, and a lack of local health protection capacity and resource. The sections below explore these issues further and set out the key recommendations of DsPH.  

Our recommendations

  • Local health protection responsibilities need to be clarified, with an emphasis on subsidiarity and sufficient resourcing.


  • A standing mechanism and playbook should be established for forecasting and responding to major public health threats. 


  • Local resilience forums (LRFs) and local health resilience partnerships (LHRPs) should ensure effective plans are in place for the wider health sector to protect the local population. 


  • The NHS Long Term Workforce Plan should develop core competencies in health protection knowledge and skills for the whole system. 


  • Clarity is required on how Integrated Care Boards (ICBs) will commission immunisations, including the assurance responsibilities of DsPH. 
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