UPDATE The new public health landscape
David Stalker, CEO of ukactive, outlines the changes to public health commissioning that took effect on 1 April and examines the impact these will have on all providers, both in the health and wellness sectors and in the wider healthcare industry
parliament. It represented a radical shake-up of the NHS and has brought extensive changes to the entire NHS and public health landscape, setting out a major programme of reforms to restructure healthcare services and public health responsibilities. A new public health structure, born
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out of these wide-ranging reforms, came into force on 1 April 2013.
Background Te coalition government’s strategy for public health was originally laid out in the white paper Healthy Lives, Healthy People, which envisaged moving to a more local and patient-focused health system. Te White Paper proposed changes to the way public health services are commissioned and delivered, which were subsequently formalised in the Health and Social Care Act 2012. Te rationale for the change is to better
meet the needs of local populations, and to enable the integration of public
The new public health structures
NHS Commissioning Board (NHSCB) An independent board established to allocate resources and provide commissioning guidance. It will have responsibility for a budget of around £80bn. Its functions will include delivering improved health outcomes, supporting quality improvements, developing commissioning guidance, championing patient interests, overseeing the commissioning budget, and supervising the development and overall outcomes of CCGs (see below).
Clinical Commissioning Group (CCGs) CCGs replace Primary Care Trusts (PCTs) as the new health commissioning organisations. Tey will be responsible for commissioning the majority of local health services and will have a statutory duty to obtain advice from other health and care professionals and involve patients and the public. In each NHS region, GP surgeries are grouping together to form CCGs (there will be 221 in total). Tey will be responsible for
around £60bn of the NHS annual budget, which will be allocated to them directly by the NHSCB. Each CCG will have a governing board comprising healthcare
professionals including GPs, nurses, hospital doctors and others including physiotherapists and patient representatives. CCGs will work closely with the newly established Health and Wellbeing Boards (see below) to ensure services are integrated and deliver the best quality health and care outcomes for their population.
Health and Wellbeing Boards (HWBs) Te aim of HWBs is to bring together local commissioners to improve the health and wellbeing of their population and reduce health inequalities. Tey will be made up of local commissioners across the NHS, public health and social care, elected representatives and patient representatives. At a minimum, a HWB must include one local elected
representative, the director of adult social services for the local authority, the director of children’s services for the local authority, the director of public health for the local authority, a representative
26 Read Health Club Management online at
healthclubmanagement.co.uk/digital April 2013 © Cybertrek 2013
ast March, the coalition government’s Health and Social Care Act passed through
Reform of the NHS Structures April 2013
National Monitor
April 2014 Becomes sector regulator for health
Public Health England - responsible for improving public health outcomes
NHS Commissioning Board
Regional SHAs
Local PCTS
Local Authorities NHS Trusts
CCGs - Te new commissioners
Foundation Trusts
More responsibility for public health HealthWatch
Health and Wellbeing Boards Local HealthWatch
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