UKACTIVE UPDATE VANGUARD
GP commissioning groups will be in charge of around £60bn of the NHS annual budget
• Local authorities will need to demonstrate improvements in public
Local authorities will be guided by a new structure, Public Health England, on how to distribute their £2.7bn ringfenced public health budget.
health outcomes, measured in terms of progress against indicators of local health needs. Tese needs will be set out by the local authorities and CCGs in Joint Strategic Needs Assessment (JSNA) and reflected in Joint Health and Wellbeing Strategies (JHWS).
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• GPs are charged with making decisions on commissioning – prescriptions will
come out of their own budget, so they will be seeking cost-effective solutions and preventative interventions. Te reforms mark the first time there
has been structural recognition of the importance of prevention in healthcare and the role of public health. Physical activity levels among the UK population are one of the indicators in the Public Health Outcomes Framework (see below) – that will be used to measure the outcomes of the changes detailed above.
Measuring outcomes Te outcomes of these changes to public health delivery will be measured through a number of frameworks:
NHS Outcomes Framework A framework to provide a national overview of how well the NHS is performing, wherever possible in an international context. It will also act as a catalyst for driving quality improvement and outcome measurement in the NHS by encouraging a change in culture and behaviour, including a stronger focus on tackling health inequalities.
Quality Outcomes Framework (QOF) A voluntary annual reward and incentive programme for all GP surgeries in England, detailing practice achievement results. It’s not about performance management but rather resourcing and then rewarding good practice.
Public Health Outcomes Framework From April 2013, all local councils will receive a ringfenced budget (a share of around £5.2bn based on 2012/2013 funding) for public health spending, and will be able to choose how they spend it according to the needs of their population. Tere are 353 councils in
England and their performance will be measured against this framework, of which physical activity is one of the sixty-six indicators. Other indicators include: sickness
absence rate, excess weight in four- to five-year-olds and 10- to 11-year-olds, excess weight in adults, recorded diabetes, falls and fall injuries in the over-65s, mortality from causes considered preventable, mortality from all cardiovascular diseases, mortality from cancer, and health-related quality of life for older people.
• Te NHS Commissioning Board has taken on its full statutory functions
So what’s the situation now? As of 1 April 2013:
as the national independent body to allocate resources to CCGs and provide commissioning guidance for predominantly primary care services.
• All Strategic Health Authorities and Primary Care Trusts are abolished.
• Health and Wellbeing Boards are established and assume statutory
responsibilities (see p24).
• Local authorities have taken on new responsibility to improve the health
of their populations. Tey will have employed directors of public health, received ringfenced funding for public health, and started the process of developing their local JSNAs and JHWSs through the new HWBs.
• Local HealthWatch is established to give local people a say in how health and
social care services are provided.
• Monitor takes on the role of economic regulator for all providers of health
and adult social care services, with all providers of NHS services expected to hold a Monitor license.
• Public Health England is established as an executive agency of the Department
of Health and will allocate ringfenced budgets (weighted for inequalities) to local authorities to commission public health services, build evidence bases and co-ordinate service integration.
• Clinical Commissioning Groups are established and assume statutory
responsibilities for the healthcare budgets of their local communities (211 in total). GP practices must be members of either an authorised CCG or shadow CCG.
28 Read Health Club Management online at
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previously oversaw local NHS trusts) responsibilities for the areas of local education and training. ●
For further information
For more information on public health reforms, visit
www.ukactive.com See also p30 for expert comment on how these changes will affect the physical activity sector.
April 2013 © Cybertrek 2013
• Health Education England takes over strategic health authorities’ (which
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