PUBLIC HEALTH DELIVERY PAPER Trusts told to 'align and pool' funding with local authorities

Published: 10/03/2005, Volume II5, No. 5946 Page 7

Primary care trusts will need to work more closely with councils to ensure their local delivery plans include key local public health targets.

The government's 132-page public health delivery plan, published yesterday, also says PCTs will be strongly encouraged to 'align and pool' funding streams with local authorities.

The document reminds PCTs that 'a significant proportion of the delivery of health improvement will be funded from PCTs' main allocations and will form part of their core business planning'.

Nick Lawrence, head of programme co-ordination for the delivery plan at the Department of Health, told HSJ that the£342m additional funding allocated to PCTs for 20062007 and 2007-08 to implement the public health agenda should be used to deliver on six key areas: improving diet and nutrition; reducing alcohol dependency; strengthening local stop smoking services and reducing smoking prevalence; modernising sexual health services and increasing chlamydia screening; expanding the health improvement workforce; and developing health trainers and other health professionals.

Mr Lawrence said PCTs should be examining how their local population was affected by each of these issues and examining whether service provision was adequate.

He added: 'PCTs also need to look at what benefits they could expect from improving these services - for example, reducing the level of chronic diseases or admission rates to the acute sector'.

The delivery plan gives greater detail on how last year's public health white paper should be implemented.

The document highlights the government's 'big wins' for improving public health and details the economic arguments for taking action in each area. It also includes a 70page section detailing the delivery timetable on all issues over the next three years. It is accompanied by two documents which deal with improving physical activity and nutrition across the country (see boxes below).

Mr Lawrence said PCTs should by now be focusing their attention on local delivery plans to decide their own local priorities.

'PCTs need to set targets for delivery implementation which should also form the basis for discussions with other local partners, including local authorities, ' he said.

He said that the benefit to PCTs 'could be some time off'.

'However, the impact in some areas, such as reducing levels of smoking, could have 'a significant short-term impact on reducing the call on the NHS.' 'The NHS must be about promoting health, not just about providing care. It cannot see promoting a healthier population as being added on top [of what it already does] but as an integral part.' Strategic health authorities will also have to play a key role in ensuring that PCTs have drawn up appropriate local delivery plans to address health inequalities in their population.

Money where the mouths are

The government will provide primary care trusts with an additional£55m between 2006 and 2008 for action on diet, physical activity and obesity.

Choosing a Better Diet: a food and health action plan, which accompanies the delivery paper, also envisages a 'comprehensive care pathway' for obesity to deliver co-ordinated activity in each PCT and clear referral mechanisms to NHS and independent providers.

Each PCT will have to provide a specialist obesity service.

The DoH has allocated a further£50m to PCTs over the period for capacity expansion, strengthening the local health improvement workforce.

The government will develop an obesity campaign by September, consult on tighter rules for food advertisements aimed at children, work with the food industry to reduce fat and sugar levels and fund for more school nurses.

Time to get physical

Health professionals will be employed by PCTs to 'increase the provision of advice to patients on lifestyle, particularly on physical activity, both routinely and opportunistically'.

The DoH document Choosing Activity: a physical activity action plan outlines the government's goals for promoting and delivering its white paper commitments on physical activity.

The paper sets out how information will be communicated to the pubic so that they 'get the information they need to understand the links between healthy activity and better health' and 'where the opportunities exist in daily life to be active'.

Plans for local, regional and national delivery, governance, monitoring and evaluation are also summarised.

See next week's HSJ for a full analysis of the delivery paper.

2005 highlights: the programme rolls out


Deputy chief medical officer and national clinical directors make recommendations on how to build an integrated prevention framework across all national service framework areas.

Local area agreements between NHS and local government designed to tackle health inequalities agreed in 21 pilot areas.


National clinical directors asked to champion key areas in the white paper.

Launch of the health trainers project, designed to promote healthy lifestyles to the local population.

Begin to improve access to genito-urinary medicine clinics to a maximum of 48 hours by 2008.

Twelve 'communities for health' chosen by the Department of Health to 'promote action across local organisations on a locally chosen priority.' . Define the role of school nurses and health trainers in promoting access to sexual health services and raising awareness of sexually transmitted infections among young people.


Regional co-ordinators of local exercise pilots start to work with primary care trusts.

By the end of spring . Creation of the national partnership for obesity, which will promote practical action on prevention.

Diabetes: the DoH is to develop a work plan to see if the independent sector can 'have a key role in providing effective behaviour change programmes in ways that are more acceptable than traditional NHS care'.

Introduction of the 'Together' support programme for smokers who want to quit, rolled out nationwide as part of a range of services linked to information service Health Direct.

Publication of a best-practice guide for joint-working between PCTs and sports clubs.


Discussions with food industry on how it might contribute to funding national [health education] campaigns.


The introduction of 'health champions', initially in local government, to share good practice.

Dissemination of standards for adolescent health services.


DoH defines the scope for extending the health communities collaborative to more deprived communities.

www. dh. gov. uk