Healthy Lives, Healthy People: Transparency in Outcomes

Closed 31 Mar 2011

Opened 20 Dec 2010


1.Society, government and individuals share the collective responsibility to improve and protect the health of the population. In our White Paper Healthy Lives, Healthy People, we set our overarching ambition for public health for the future. A core element of this will be the establishment of Public Health England as part of the Department of Health, and the return of local public health leadership and responsibility to local government.

2.In recent years there have been far too many central initiatives and targets, often well meaning, but without a hope of success when dictated to local areas. It is time to free-up local government and local communities to decide how best to improve the health and wellbeing of their citizens, deciding what actions to take locally with the NHS and other key partners, without interference from the centre. Its time also to restate the national responsibilities of Government, of business and industry; and it is time to reassert the voluntary sector’s critical role in connecting with communities.

3.Public health challenges are not static, and our system will have to respond actively to evolving challenges. The new public health system will effectively protect and improve the health of the nation through a dynamic new system approach that involves integration, localism, partnership and collaboration.

4.At the local level, an integrated approach through Health and Wellbeing Boards and Health and Wellbeing Strategies will enable an efficient and effective focus and response to local health needs. We will focus on enabling and incentivising local government with the wider public health sector, the NHS, the voluntary sector and local communities, through local partnerships to do this, but will not prescribe how it should be done.

5.At the same time, the national level has its responsibilities too. Public Health England and across Government, we will focus on those functions that are best performed at the national level either because they are irreducibly Government’s responsibility or where an economy of scale can be achieved. The role of Government should be strong leadership to support local delivery and to add value – not hinder it with top-down performance management.

6.Ultimately we want to achieve the same goal whether we work at a national or a local level; whether we work in local government or in the NHS or in the voluntary sector – we want to improve and protect the health and wellbeing of all people and especially those with the poorest health in our society. This means that we need a system where everyone at all levels understands the contribution they can and should make to this goal.

7.We propose to put in place a new strategic outcomes framework for public health at national and local levels, based on the evidence of where the biggest challenges are for health and wellbeing, and the wider factors that drive it. This will be different to old style top down frameworks used to drive targets and performance management – rather it will set out the outcomes for public health across public services and at all levels of responsibility – national to local.

8.We make these proposals for a new Public Health Outcomes Framework in light of the recent consultations on the NHS Outcomes Framework and the ongoing consultation on Transparency in Outcomes: A Framework in Adult Social Care Together these three aligned frameworks will set out the outcomes that local government, the health and care sectors are responsible for achieving.  It is essential that outcomes and indicators are aligned across the frameworks to enable joined up working and where it matters most to people, hold organisations to account for delivering integrated services.

Why We Are Consulting

In this consultation, we make detailed proposals for a public healthoutcomes framework in parallel with the Public Health White Paper, so that local government, the wider public health sector and local communities can take the lead in designing it.

In particular, we are seeking views on the overall structure and scope of the framework and the range of outcomes and measures within it, including views on those measures that should be incentivised.

We have worked closely witht he public health communitiy and consulted the Local Government Association informally on the current set of outcomes and indicators that we think may be included within the framework. The co-operation and direct involvement of Directors of Public Health (DsPH) from across the country and specialist representative bodies including the Faculty of Public Health, the Royal Society of Public Health, the UK Public Health Association and the Association of Directors of Public Health has been critical to the development of the proposals in this framework document, The LGA, represented on the Chief Medical Officer's Stakeholder Group, has also contributed to th the development of proposals for the public health outcomes.

We do not want to stop there with our plans for engagement. We need to consult on the outcomes framework and we will continue to work closely with public health and local government colleagues to do so. However, we want to go further and co-produce the final set of outcomes with our partners in the public health sector and local government, to ensure that we arrive at a robust set of indicators. We would very much appreciate your responses to the consultation questions.


The consultation process

Criteria for consultation

The consultation follows the Government Code of Practice on consultation. In particular we aim to:

  • formally consult at a stage where there is scope to influence the policy outcome;
  • consult for at least 12 weeks and consider longer timescales where feasible and sensible;
  • be clear about the consultation's process in the consultation documents, what is being proposed, the scope to influence, and the expected costs and benefits of the proposals;
  • ensure that the consultation exercise is designed to be accessible to, and clearly targeted at, those people it is intended to reach;
  • keep the burden of consultation to a minimum to ensure consultations are effective and to obtain consultees’ buy in to the process;
  • Analyse the responses carefully and give clear feedback to participants following the consultation
  • ensure officials running consultations are guided in how to run an effective consultation exercise and share what they learn from the experience.

The full text of the code of practices is on the Better Regulation website.   


How to comment on the consultation process

If you would like to make any comments about the consultation process we have followed, please contact the Consultations Co-ordinator, Department of Health, 3E58 Quarry House, LEEDS, LS2 7UE. Email:  Please do not send answers to the consultation questions to this address or mailbox.


Confidentiality of information

We manage the information you provide in accordance with the Department of Health’s Information Charter.

Information we receive, including personal information, may also be published or disclosed in accordance with the access to information regimes (primarily the Freedom of Information Act 2000 (FOIA), the Data Protection Act 1998 (DPA) and the Environmental Information Regulations 2004).

If you want the information you provide to be treated as confidential, please be aware that, under the FOIA, there is a statutory code of practice with which public authorities must comply and which deals, among other things, with obligations of confidence. In view of this, it would be helpful if you could explain to us why you regard the information you have provided as confidential.  If we receive a request for disclosure of the information, we will take full account of your explanation, but we cannot give an assurance that confidentiality can be maintained in all circumstances.  An automatic confidentiality disclaimer generated by your IT system will not, of itself, be regarded as binding on the Department of Health.

The Department of Health will process your personal data in accordance with with DPA and in most circumstances this will mean that your personal data will not be disclosed to third parties.

What Happens Next

 We are required to consult on the proposals set out in this paper. However, we want to do more than that. We want to co-produce this outcomes framework with you, and see the consultation period as a continuation of the engagement and involvement we have already begun. We want your help in shaping this framework further and in particular, we want to work with you to refine and clarify the indicator set.

We intend to run a consultation period for the next 14 weeks ending on 8 March 2011, where we want to hear your views and have your input to the questions we’ve posed throughout this document. Following this consultation period, we will pull together responses and publish a final outcomes framework in Summer 2011.

The new framework will be in operation from April 2012. During 2011/12, we will continue our work with the NHS and local government in preparing for and implementing transition arrangements.


  • Voluntary groups
  • Community groups
  • Charities
  • Civil society
  • Advocacy or support organisations
  • GPs
  • Nurses
  • Health visitors
  • Clinicians
  • Managers
  • Commissioners
  • Directors of Public Health
  • Pharmacists
  • Doctors
  • Midwives
  • Healthcare scientists
  • Paramedics
  • Dentists
  • Dieticians
  • Occupational therapists
  • Foundation Trusts
  • Regulatory body
  • Academic/ Professional institution
  • Local authority
  • Social care provider
  • Directors of Adult Social Care Services
  • Members of the public
  • Service users
  • Information providers


  • Children's health and development
  • Physical health
  • Health inequalities
  • Infectious disease
  • Vascular disease
  • Obesity
  • Environment
  • Sexual health
  • Alcohol misuse
  • Drug misuse
  • Maternity services