Shared Intelligence: Learning the lessons from the transfer of public health

This report, produced by Shared Intelligence, assess the impact of the 2013 transfer of public health responsibilities from the NHS to local authorities, with a focus on county areas. Drawing on interviews with directors of public health, senior council leaders and health partners across 14 counties, it finds that the transfer has largely strengthened the ability of councils to take a preventative, place‑based approach to health.

CCN members report that locating public health within local government has improved influence over the wider determinants of health, such as housing, planning, transport and economic development. Councillors are seen as strong advocates for public health, and councils’ commissioning and procurement expertise has supported innovation and value for money despite reductions in the public health grant. Evidence shows that several key public health outcomes have improved despite constrained resources.

The report also highlights tensions. The effectiveness of the transfer varies, shaped by organisational leadership, county‑district relationships, geography and the capacity to maintain strong links with health commissioners and providers.

The report concludes that county councils are well placed to lead preventative activity, but this requires stronger place‑based leadership and a renewed partnership between local government and the NHS.

Recommendations to local authorities include:

• Strengthen the place‑based role of public health within county councils.
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• Support directors of public health to operate at the corporate centre of councils.
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• Improve collaboration between counties and district councils on wider determinants.
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• Rebuild and formalise relationships between public health teams and the NHS.
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• Share good practice across CCN members on commissioning and prevention.
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• Ensure geography and scale are reflected in national public health policy design

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