The Department of Health has set out the information and data analysis services it expects local authorities to deliver to clinical commissioning groups as part of their public health obligations.
Draft guidance from the DH says that, subject to the passage of the Health and Social Care Bill, from April 2013 there will be a mandatory requirement on local authorities to provide public health advice, information and expertise to clinical commissioning groups.
It says there has been “some concern expressed” at the apparent cross-over between the role of the Healthcare Public Health Advice Service, as the local authority offerings will be described, and the commissioning support organisations being set up by the NHS.
But it argues that while there are some similarities between the two services, they will have a different focus.
CSOs will focus on commissioning processes and clinical systems, with detailed analysis of referrals and activity, while the public health advice services look across populations.
It adds: “We envisage that public health teams will provide largely a population focus, synthesising data from a wide variety of sources and applying their public health skills to draw the implications of that data for the local population, and that population’s need for and use of healthcare services.”
The guidance emphasises, however that it will not prescribe where clinical commissioning groups should get their advice from in future.
It adds: “There is a very clear intention that commissioning support services will become free standing organisations and that CCGs will be free, within the usual rules of procurement, to purchase what they need in any combination and from any organisation they choose to enter into partnership with.”
The guidance sets out the kind of information services CCGs can expect to receive from local authority public health services which the DH describes as local authorities’ “core offer”.
These include providing input into the development of health-related data sets to inform commissioning and predictive modelling of activity against outcomes.
They also incude helping CCGs to interpret and understand data on clinical variation in primary and secondary care, helping CCGs decide on priorities and possible areas for dis-investment, and using comparative clinical information to understand the relationship between patient needs, clinical performance and wider quality and financial outcomes.
The draft guidance says such services will need not just directors of public health and public health consultants but also “wider intelligence and analytical resources."
It suggests that roughly 40% of local public health specialist teams might be engaged in this work, but says that the overall cost of public health advice is not expected to be more than that currently provided in the NHS.
It adds that how the service is delivered is a local issue and suggests that some areas may decided to have one service acting on behalf of several local authorities.
The draft guidance has been produced by a task group set up by the DH and including representatives from the BMA and the Royal College of GPs as well as the Association of Directors of Public Health and the Local Government Association. The deadline for comments on the draft guidance is 30 March.