Provision to support good health

The Department of Health and Social Care provides funding for activities that prevent ill health.

  • £1.2bn a year from within the NHS core budget for preventive services such as immunisation and cancer-screening programmes.
  • £0.3bn for Public Health England (in 2017/18), a non-departmental public body of the Department of Health and Social Care. It provides a range of services, from monitoring and controlling infectious diseases to providing support to local authorities and the NHS.
  • £3.3bn for the public health grant (in 2018/19), predominantly spent on preventive and treatment services, such as sexual health clinics, help to stop smoking and children’s health services. Public health teams work for local authorities and also help steer the development of wider local policies and services, such as housing, planning and children’s services, to support improvements in health.

The public health grant supports primary prevention services and also intervenes more widely, helping influence the social determinants of health at a local level. It is specifically dedicated to improving health and is relatively straightforward to quantify, but it should not be considered in isolation. Other services provided by councils also have a key role in supporting the population’s health.

Local authority budgets have been significantly reduced in recent years. The National Audit Office reported a 32.6% fall in spending between 2010/11 and 2016/17 on non-social-care services such as libraries, public transport, children’s services and leisure facilities, which can negatively affect people’s health in the long term. Other forms of support, such as affordable housing, early-years education and the benefits system, also help maintain and improve people’s health. (The extent to which different types of provision affect health is difficult to specify and will be the subject of future research by the Health Foundation.)

The Public Health Grant is provided in England, the other nations of the UK have their own provision models which tend to be a mix of NHS, local public health board and local authority provision. In all three nations, funding has either remained stable and in some elements increased in recent years.

* Throughout this report, unless otherwise stated, spend figures are presented in 2018/19 price terms using a gross domestic product (GDP) deflator.

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