The role of public health in the NHS in England

Why we have written this paper

It is important that public health works closely with the NHS in England. The NHS, as an anchor institution, has great potential to promote health and prevent illness, and with the number of interactions with patients and families being so high, it provides millions of opportunities to engage with the population and promote positive behaviour change.  

In addition to providing effective and equitable health care services, the NHS has an important contribution to make to address the wider determinants of health and reduce health inequalities. Health and wellbeing are influenced most strongly by the social, economic, environmental, and other conditions in which people live. The NHS cannot tackle health inequalities in isolation, neither can local public health authority partners or indeed our voluntary sector partners. Coordinated action is needed. 

The NHS must be a strong partner to other organisations and sectors (both nationally and in local communities), as well as contributing to tackling wider issues such as poverty, through its role as an anchor institution and by understanding the social value it can help create. The sustainability of the health and care sector is hugely dependent upon the impact of the wider determinants of health on the population.  

Our recommendations

• Prevention must become a well-defined, well-funded and mandatory part of the NHS and all Integrated Care Systems (ICSs). 

• The NHS should act as an anchor institution by influencing the health and wellbeing of communities locally and positively. 

• ICSs should prioritise prevention and ensure the role of local authority colleagues is clearly understood. 

• The NHS should employ suitably qualified people to deliver population health.  

• DsPH require access to data on the health of their local population and the resources in order to manage and analyse this data.

• The DPH role in Section 7a should be more clearly defined and there should be closer links between the NHS and local DsPH who provide oversight of the services. 

• The NHS should integrate secondary prevention into existing pathways, ensuring that these pathways take account of inequalities and population needs. 

• The NHS needs to ensure population health is a key priority of the primary care agenda and collaborate with DsPH to achieve the best prevention outcomes for local populations.