Rt. Hon Andrew Lansley Secretary of State for Health Department of Health Richmond House 79 Whitehall
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Secretary of State for Health Department of Health Richmond House 79 Whitehall London SW1A 2NS 21 June 2011 Dear Mr Lansley We are writing following the response from government to the NHS Futures Forum report published recently. FPH was pleased that government has committed to establishing Public Health England as an executive agency of the Department of Health. This will ensure that the new organisation – if implemented correctly – will become a trusted, authoritative, evidence-based source of public health advice, one that will have the confidence of the public, professionals and government. Critical to the new system will be a robust, fit-for-purpose public health workforce. The NHS Futures Forum recognised the need for compulsory regulation and registration of all public health specialists, including those from backgrounds other than medicine. This position is strongly advocated by the public health workforce and those organisations representing them. Ensuring public protection through statutory regulation – as with doctors, dentists, nurses and midwives – is vital. FPH is extremely disappointed that government has again failed to acknowledge this important safeguarding measure. Ensuring public health capacity though this newly extended period of transition is critical – particularly with the forthcoming Olympics. FPH seeks your personal assurance that all appropriate measures will be taken to maintain and strengthen capacity, and prevent further loss of vital public health skills and expertise during this period of transition. FPH will also scrutinise the proposed “non-legislative proposals” – as described in section 3.63 of government’s formal response – when they are published, and comment in due course. 4 St Andrews Place London NW1 4LB Tel: 020 7935 0243 Fax: 020 7224 6973 Email: enquiries@fph.org.uk Website: www.fph.org.uk Registered Charity No: 263894 FPH welcomes the explicit reference to the involvement of public health specialists in clinical senates to “support the better integration of services”, and that “commissioners will need to work with public health experts, and in line with public health guidance”. However, we are concerned that the government has not specified that there should be a public health specialist in the constitution of the clinical commissioning consortia governing body. Further detail is required on how this will work in routine commissioning practice. The NHS Futures Forum also recommended that the governing body of each commissioning group should also have multidisciplinary representation on it to ensure that commissioning decisions were fully informed and appropriate for their local population. Public health and health organisations have strongly recommended this body should include specialist public health advice. FPH was therefore disappointed that, whilst government explicitly stated that the governing body should contain a nurse and a doctor, there would be no duty on these bodies to have public health specialist representation. Commissioning consortia need to understand fully the principles of population health and apply these across all the areas of health needs assessment, assessment of evidence of clinical effectiveness, understanding of ‘best buys’ for health gain, and to influence priority setting, and service monitoring, They also need to understand the preventive and protective public health services that they must provide support to or work in partnership with. These competencies are those of public health specialists and these capabilities must be enshrined in the governing bodies of clinical commissioning consortia. FPH welcomes the retention of the deaneries and the continuation of specialist public health training through the current mechanisms of the deaneries. We seek your specific assurance that levels of training funding to support the public health specialty registrar recruitment and training programme which has been so successful will continue. Appropriate strategies must be developed to support public health specialty registrars/trainees currently in the system, particularly those who about to complete their training, particularly in view of the extended transition period. We seek explicit government recognition of the potential loss of this highly skilled, keen and committed workforce which will be greatly needed to deliver the Government’s public health reforms. Your assurance is sought that resources currently in the NHS system for training public health professionals will be available to them in the future – irrespective of who their employer is. The strengthening of the role of Health and Wellbeing Boards is welcome in principle. FPH has recommended that Health and Wellbeing Boards should be given the power to sign off local commissioning plans as well as to ensure they align with joint strategic needs assessments. We will examine the amendments to the Bill when they are published and respond to this as appropriate. FPH will be seeking further meetings with yourself, Anita Marsland and Anne Milton to discuss how we can continue to work together to protect public health capacity and ultimately the public’s health during this period of continued uncertainty and transition. Yours sincerely, 
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