The Chartered Institute of Environmental Health (CIEH) today welcomed the publication of the Government’s Public Health Outcomes Framework. CIEH members will play a central role in the new Public Health Service for England.

The Public Health Outcomes Framework sets out the desired outcomes for public health and how these will be measured and gives the lead role for achieving this to local authorities. A set of supporting public health indicators will help focus understanding of progress year by year nationally and locally on those things that matter most to public health. The indicators, which cover the full spectrum of public health and what can be currently realistically measured, are grouped into four ‘domains’.

*  improving the wider determinants of health
*  health improvement
*  health protection
*  healthcare public health and preventing premature mortality

Commenting, David Kidney, CIEH Head of Policy, said:

“The Government’s approach is consistent with the Marmot agenda of tackling the wider determinants of health and wellbeing through all the life stages. The CIEH has always argued that local authorities should take the lead role for public health, but we also believe that there needs to be partnerships across sectors as well as voluntary agreements, where practical, and national regulation where necessary.

“During the planning for the Outcomes Framework, we argued for the inclusion of a number of indicators aimed directly at improving the wider determinants of health. We are therefore very pleased to see in the published document indicators for air quality, falls, fuel poverty, noise and the utilisation of green space.

“Having said this we would have liked to see a stronger emphasis in the Outcomes Framework on housing conditions, because the link between health and housing is very clear. The opportunity is being missed to take up the challenges of reducing disrepair and overcrowding in all housing sectors and especially in the private rented sector.

“The other key health protection indicators that are missing are the detection and remediation of contaminated land as well as the provision of wholesome water and food to reduce disease.

However, we welcome those indicators which have a bearing on people’s home lives, including:

*  Domestic abuse
*  Excess winter deaths
*  Falls and injuries in the over 65s
*  Fuel poverty
*  People with mental illness or disability in settled accommodation
*  Statutory homelessness

The CIEH understands that the public health partners, including local authorities and the Clinical Commissioning Groups, will select from the Outcomes Framework the indicators most relevant to the needs of their local populations. The local joint health and wellbeing strategy will set out how they will then be addressed.

Concluding, David Kidney, said:

“The pieces of the jigsaw that are still missing are first the basis of the proposed incentive payments (the health premium) and secondly the indicative ring-fenced budgets for local authorities for their public health functions. We look forward to the Department publishing these crucial elements as soon as possible.”