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Key points

  • As yet, there has not been a marked change in quality indicators.
  • Looking at quality measures across five key areas (stop smoking services, sexual health, immunisation, childhood obesity and substance misuse), the majority of public health indicators continue to follow past trajectories.
  • Differences in trends across local authorities are evident – for example, the most deprived areas had worsening trends in STI rates, but did demonstrate significantly better improvement in teenage pregnancy rates compared to the national trend. 
  • Although the quantitative indicators do not show a marked change in outcomes resulting from the changed legislative and financial environment, the survey evidence points to concerns about increasing difficulties ahead in the form of tougher prioritisation decisions and the need to maintain effective and equitable access to services with diminishing funds. 

Against a backdrop of substantial changes to the way public health services in England are commissioned and increasing funding constraints on local government, this QualityWatch report provides an overview of public health outcomes in recent years.

Combining quantitative data from 20 indicators across five key areas of public health with a survey and in-depth interviews with senior public health professionals, the report provides a glimpse into the current state of public health services and explores the potential impact of recent financial and legislative developments on key health outcomes.

This report is a timely exploration of the quality of public health and should serve as a useful reference point for assessing the quality of public health in England in the coming years.

QualityWatch is a major research programme from the Nuffield Trust and the Health Foundation that provides independent scrutiny into how the quality of health and social care is changing over time.

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