• School nurses and health visitors to stay within local government remit
  • NHS and councils to share sexual health commissioning
  • Announcement ends speculation NHS was going to take control of all three services

A departmental review has decided local government will “continue to lead” on public health, putting to an end speculation the NHS would take control of these services.

However, the Department of Health and Social Care’s report concluded sexual health commissioning should be shared between local councils and the NHS. 

The review was launched following the publication of the long-term plan. It considered “whether there is a stronger role for the NHS in commissioning sexual health services, health visitors, and school nurses”, leading to speculation the NHS was going to take control of all three services

The ring-fenced public health grant fell by £700m between 2014-15 and 2018-19. HSJ understands NHS England had signalled it was ready to take over these services unless the Treasury funded them adequately.

Health and social care secretary Matt Hancock revealed the review’s findings at a meeting of councillors at the Local Government Association yesterday, before announcing them formally in a lecture to the Royal College of Physicians.

He told the RCP: “Day in, day out, local authorities continue to provide excellent public health services. Whether that’s local action to reduce HIV transmissions or experimenting with innovative ways to reach people for sexual health services – such as offering online access to testing for thousands of people.

“We are committed to supporting and encouraging joined-up commissioning of these services by local government and the NHS.

“Our prevention green paper, which we will publish soon, will give people an opportunity to let us know their views on how we achieve this and build on the excellent local practice happening across the country.”

Duncan Selbie, chief executive of Public Health England, said: “This review recognises that local government are best placed to lead on commissioning local public health services and the invaluable skill and expertise they bring to this.”

He added: “The best services are always those commissioned collaboratively with the NHS and this review emphasises the importance of this for every part of England, as does the NHS long-term plan, including making the best use of shared resources.”

The chair of the Local Government Association, Ian Hudspeth, welcomed the announcement. He said: “We are delighted that the Secretary of State has accepted the LGA’s powerful case for councils to keep their vital role and valued responsibilities for providing public health services, rather than transferring them back to the NHS.”

He added: “Commissioning of sexual health, reproductive health and HIV services is complex. The only way forward is through a whole system approach where together we commission services in a more collaborative way.”

NHSE, in a statement on Friday responding to yesterday’s announcement, said the proposals were a “potentially workable solution” but said the “quid pro quo will obviously need to be an end to cuts in local authority public health services, and a guaranteed continuation of the ring fence around the public health grant”.

Labour shadow health secretary Jon Ashworth said: “It’s surprising that a decision of this importance was announced as part of the secretary of state’s leadership campaigning and not in Parliament.

“In the week when data revealed increases again in some sexually transmitted infections for example, ministers need to give urgent guarantees that public health cuts will be abandoned and funding protected for the future.”

Updated on 7 June at 3.45pm to include a statement provided by NHSE and at 4.55pm after receiving comment from Mr Ashworth.