Clinical commissioning leaders have expressed serious concerns about the current state public health services.

In the latest HSJ CCG Barometer survey, carried out with PwC, 40.6 per cent of respondents said it was worse and 39.6 per cent said the same.

NHS Clinical Commissioners chair Steve Kell said it was because of concern that local authorities, which have been responsible for most of the public health budget since April last year, were cutting services. He said councils – most of which are very hard pressed financially – were spending part of the budget in other areas such as housing or environments which, while important to public health, had not in the past received spending from the budget.

Dr Kell said: “There is certainly evidence that public health services aren’t being ringfenced. The worry is CCGs will have to pick up the consequences.”

North East Lincolnshire CCG chief clinical officer Peter Melton said the problem was because “all local authorities are receiving actual cash reductions in their budget”. They are “rebadging” spending in a way in which “CCGs might not automatically support”.

The government’s main justification for moving public health budgets to councils was they would be able to consider it alongside their responsibilities for wider determinants of health.

There were 103 respondents to the survey across 93 CCGs, 96 of whom were chairs or accountable officers, the equivalent of a chief executive. The remainder were other governing body members. There are 211 CCGs in total.

CCG leaders: Reforms have not improved control of cost and activity