A sign asking for people to maintain social distancing due to COVID-19 at a grocery stall at an outdoor market in Richmond, North Yorkshire

PHE replacement due to be up and running by spring

Health prevention work not forgotten, says Westminster.
17 September 2020 , Katie Coyne

Health prevention “remains a top priority”, the English government said as it published a timeline with a spring 2021 deadline for breaking up Public Health England (PHE) and disseminating its powers and responsibilities.

PHE health protection functions are due to be merged with NHS Test and Trace, alongside the new Joint Biosecurity Centre set up in May, and other organisations, into a new single body – the National Institute for Health Protection (NIHP).

Just under a month since Westminster made its original announcement, a policy paper from Department of Health and Social Care (DHSC) said the merger will happen immediately to create a “single command structure” to tackle COVID-19 through the winter. DHSC said the aim was to create an agency with a “razor-sharp” focus on COVID-19, as well as the “challenges posed by domestic and global threats to health”.

However, the final structure of the new institute will not be determined for another six months until spring 2021, and PHE staff will continue in their roles until at least then.

After the shakeup was announced in August, concern was raised about the prudence of its timing in the midst of the pandemic, with some arguing PHE had been scapegoated. A huge question mark remained over where public prevention work would sit, particularly when Prime Minister Boris Johnson’s flagship obesity reduction initiative only launched in July.

In the latest news DHSC said the government was still keen to consider how best to support greater focus on public health improvement and ill-health prevention work, and would work closely with directors of public health and “explore ways” to support them in expanding their roles in this area.

A DHSC statement said: “As we establish the new NIHP with a focus on our capacity and capability to respond to health threats, we also need to establish the right future system and organisational arrangements for improving the health of individuals and our population. The impact of COVID-19 on key groups of the population has highlighted the importance of levelling up health to support future resilience.”

DHSC praised PHE and its staff highly, but argued a new approach was needed to tackle a pandemic. It said: “PHE has a superb professional and scientific base on combating infectious disease, other health hazards and other risks to health such as obesity. PHE’s dedicated and highly skilled workforce has an excellent track record in dealing with health protection incidents both large and small. But, as with most public health agencies globally, PHE has not had the at-scale response capacity we have needed to handle a full-blown pandemic.”

A range of options to replace PHE prevention work have been put forward including: devolving these responsibilities to local government; creating another separate national body; retaining it within DHSC and/or other departments; or a combination of the above.

A new Population Health Improvement Stakeholder Advisory Group has been set up to bring experts together to advise the government on this issue, which will publish a paper outlining the options in October. Submissions to the group are invited, and a series of roundtables will also be organised.

The future budget for prevention and health improvement will be agreed in the autumn spending review, and the delivery plan published at the end of the year.

As part of the announcement last month, Baroness Harding was revealed to be heading up the institute temporarily until a permanent chief executive was found. Michael Brody was named as interim CEO of PHE, taking over from Duncan Selbie.

To see the full list of the responsibilities of the new institute read the policy paper here.


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