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42-747: In 2002, the 95 health authorities (HAs) and eight regional offices of the NHS Executive established under the Health Authorities Act 1995 , along with 400 or more primary care groups, were abolished by the National Health Service Reform and Health Care Professions Act 2002 . The functions of the HAs were mostly taken up by 300 primary care trusts (PCTs), and 28 larger strategic health authorities (SHAs) were established (which were reduced in number to 10 in 2006). 20,000 staff changed jobs and

84-539: A PHE director, wrote that the method established in April was designed to avoid undercounting, and that PHE always intended to review the approach as the pandemic progressed. On 2 October 2020, it was realised that almost 16,000 COVID-19 test results received by PHE from commercial laboratories since 25 September had not been loaded into dashboards or passed to the outsourced Test and Trace operation (notifications of test results to individuals were not affected). PHE retrieved

126-521: A failure of the management system to respond quickly or firmly enough. This, combined with some ministerial ambivalence about the effectiveness of SHAs and a promise in the 2005 election to reduce NHS management spending, led to Patricia Hewitt , Secretary of State for Health to announce that, following an NHS consultation which ended in March 2006, the SHAs were to be reorganized. They were reduced to ten in number by

168-460: A former GlaxoSmithKline site in 2017. PHE laboratories provided an extensive range of microbiological diagnostic tests. The Secretary of State set the total budget for public health, and determined how it was allocated between PHE and local authorities. The 2012 Act, which established PHE as a national body, also returned the responsibility for a range of community and public health services to local authorities. Each upper tier local authority

210-685: A letter to its chief executive. The last of such letters, published in July 2021, included tasks to implement the transition to the UK Health Security Agency and the Office for Health Improvement and Disparities . PHE's mission was "to protect and improve the nation's health and to address inequalities". It employed approximately 5,000 staff (full-time equivalent), who were mostly scientists, researchers and public health professionals. It announced plans to move its headquarters and 2,750 staff to Harlow on

252-785: A result of the reorganisation of the National Health Service (NHS) in England outlined in the Health and Social Care Act 2012 . It took on the role of the Health Protection Agency , the National Treatment Agency for Substance Misuse and a number of other health bodies. It was an executive agency of the Department of Health and Social Care , and a distinct delivery organisation with operational autonomy. On 29 March 2021,

294-584: A specific and sensitive laboratory test, the availability of which continues to increase. The statement said "the need to have a national, coordinated response remains" and added "this is being met by the government's COVID-19 response ". This meant cases of COVID-19 were no longer managed by HCID treatment centres only. PHE began publishing a weekly COVID-19 epidemiology surveillance summary each Thursday from 23 April, combining community, primary care, secondary care, virology and mortality surveillance data to support national and regional planning in relation to

336-519: A trial" and it is "unclear what problem government are hoping to solve". In response, Hancock said the move was needed to bring together disparate leadership to strengthen the UK's response to the pandemic, and that the change would not result in disruption. PHE would be combined with NHS Test and Trace to form a National Institute for Health Protection, under a new leadership structure headed by Conservative peer Dido Harding as interim CEO. Her appointment

378-454: The Centre for Evidence-Based Medicine and others – that PHE's figures were over-estimates, since they included anyone who had a positive COVID-19 test, no matter how long ago. On 12 August it was agreed to publish the numbers of deaths within 28 days of a positive test, as was already done by other UK administrations. The cumulative total was recalculated as 41,329, a 12% decrease. John Newton ,

420-609: The Health Authorities Act 1995 . They took on the functions of the abolished district health authorities (DHAs) and family health services authorities (FHSAs). There were five HAs in Wales, reporting to the National Assembly. The HAs were divided into a total of 22 local health groups (LHGs), one in each of the Welsh unitary authorities. These HAs and LHGs were abolished when the Welsh NHS

462-456: The Health and Social Care Act 2012 . Facilities owned by SHAs were transferred to NHS Property Services , and their public health functions to Public Health England . Each SHA area contained various NHS trusts which took responsibility for running or commissioning local NHS services, and the SHA was responsible for strategic supervision of these services. The types of trust included: The SHAs had

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504-618: The Royal College of Psychiatrists , commenting on the plan to create PHE, stated its concern that there appeared to be "few, or no, commitments or resources within either the Department of Health or Public Health England to take the public mental health agenda forward". The agency was criticised by Professor Martin McKee in January 2014. He said that continuing health inequalities among London boroughs

546-816: The Secretary of State for Health . It took over public health activity from the department and from the regional strategic health authorities (which were abolished), and all activities of the Health Protection Agency , the National Treatment Agency for Substance Misuse , the Public Health Observatories , the cancer registries , the National Cancer Intelligence Network , and the UK National Screening Committee together with its screening programmes. The Department of Health and Social Care set out PHE's remit and priorities in

588-533: The UK Government announced that PHE would be disbanded and that its public health functions would be transferred, in proposals to reform public health structures. From 1 October 2021, PHE's health protection functions were formally transferred into the UK Health Security Agency (UKHSA), while its health improvement functions were transferred to the Office for Health Improvement and Disparities ( DHSC ), NHS England , and NHS Digital . Proposals for reorganising

630-403: The board and governance structures common to all NHS trusts . † known as the 'Coventry, Warwickshire, Herefordshire and Worcestershire SHA until 2004. The London boundaries were: These SHAs were replaced by a single London SHA in 2006. The ten SHAs established on 1 July 2006, and abolished on 31 March 2013, were: These SHAs are coterminous with government office regions , except that

672-498: The Isle of Wight & Portsmouth and South-East Hampshire. [1] Also, the area of Norfolk and Cambridgeshire was partitioned between three authorities : Cambridge & Huntingdon, East Norfolk, and North West Anglia. North West Anglia included from Cambridgeshire : Peterborough , Fenland , part of Huntingdonshire , and from Norfolk : King's Lynn and West Norfolk and part of Breckland . [2] [3] Also, "East Riding and Hull"

714-673: The National Health Service were published in the early months of the Cameron–Clegg coalition , in a July 2010 white paper from the Department of Health (under Andrew Lansley ) titled "Equity and excellence: Liberating the NHS". This was followed by a more detailed paper "Healthy Lives, Healthy People: Our strategy for public health in England" in November. The bill to implement the proposals

756-509: The Office for Health Improvement and Disparities and launched 1 October 2021. A few PHE staff moved to NHS England / Improvement or to NHS Digital . While it was originally announced that PHE would be wound up on 31 March 2021, the body continued to have a 'shadow existence' until 1 October 2021, to support the transition of responsibilities to its successor organisations. The PHE name and employment contracts remained until 1 October. PHE had

798-614: The SHAs was set out in the white paper , Shifting the Balance of Power within the NHS – Securing Delivery , and included the following: "Strategic Health Authorities will provide strategic leadership to ensure the delivery of improvements in health and health services locally by PCTs and NHS Trusts within the national framework of developing a patient-centred NHS. They will lead the development and empowerment of innovative and uniformly excellent frontline NHS organisations. The wider span of control will enable Strategic Health Authorities to consider

840-470: The Strategic Health Authorities (Establishment and Abolition) (England) Order 2006, as amended, and this was expected to produce substantial financial savings. At the same time there were other important changes that had implications for the functioning of SHAs: The period from 2006 saw financial control being restored and key targets were generally achieved. However, further questions about

882-536: The annual directive from the Department of Health and Social Care included coordination of the response to public health emergencies under a heading "Leaving the EU". In addition, an "integrated surveillance system" and "investigation and management of outbreaks of infectious diseases" were listed in an annex. PHE carried out contact tracing in the early stages of the COVID-19 pandemic , but this ceased on 12 March 2020 in view of

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924-403: The context: "Part of the reason for doing it is that the SHAs' responsibilities are changing as we speak", he said at the time. SHAs in this period were expected to develop a more directly strategic approach than was the case in the earlier period, following the launch of Lord Darzi's 'Next Stage Review' report in 2008. There were some examples of successful strategic changes being introduced e.g.

966-420: The effectiveness of SHAs and the regulatory process more generally were raised by the 2008 scandal at Mid Staffordshire Hospitals Foundation Trust . During 2009, SHAs were subject to an assurance process to examine their performance, role in developing their systems and to give developmental feedback.  David Nicholson , NHS Chief Executive, said that the recession was one of several factors that had changed

1008-606: The following public-facing divisions: Duncan Selbie was the chief executive of PHE from its formation until 2020; he was previously chief executive of Brighton and Sussex University Hospitals NHS Trust . In the reorganisation announced in August 2020, Michael Brodie was appointed as interim CEO. Brodie was finance director at PHE from its formation until 2019, when he became CEO of the NHS Business Services Authority . Other senior personnel include: PHE took over

1050-821: The implementation of trauma networks , the redesign of stroke services in London, and changes to the shape of services in Manchester, But many strategic issues remained unresolved. This was not helped by the period having an election followed by the introduction of stricter controls on reconfiguration by the incoming government and then an almost two-year period of uncertainty when the government announced its intention to abolish SHAs in May 2010. This led to SHAs being 'clustered' from ten to four in October 2011. Strategic health authorities and primary care trusts were abolished on 31 March 2013 as part of

1092-560: The large South East England region is divided into two: South Central and South East Coast. Health authority Between 1996 and 2002, the National Health Service in England and Wales was organised under health authorities (HAs). There were 95 HAs at the time of their abolition in England in 2002, and they reported to the eight regional offices of the NHS Executive . They generally covered groups of one or more complete local authority districts (LADs), but there were cases where LADs were split. They were established in 1996 by

1134-702: The major conclusion and message of its report" ... this "raises serious questions not only about the conclusions of the PHE report, but also about the quality of the agency's peer review process." Authors of the PHE report subsequently published a document clarifying that their endorsement of the 95% claim did not stand on the single study criticised in The Lancet , but on their broad review of toxicological evidence. The agency has also been criticised for "serious questions about transparency and conflicts of interest" regarding this review, that PHE's response "did not even begin to address

1176-649: The missing results after determining that the cause was ill-thought-out use of Microsoft's Excel software. Matt Hancock , Health Secretary, said in Parliament that the error "should never have happened". The following month, economists at the University of Warwick estimated that the delayed contact tracing led to more than 125,000 additional infections and 1,500 deaths, although PHE disputed their findings. Public Health England has been criticised for downplaying mental health within its overall resourcing and agenda; in 2011

1218-401: The ongoing COVID-19 pandemic . Options for PHE's other roles, such as preventing ill health and reducing health inequalities, were to be discussed, with the decision made in March 2021 that these functions would move to "new homes within the health system" including the creation of an Office for Health Protection within the Department for Health and Social Care . This was subsequently re-named

1260-401: The overall needs of the health economy across primary, community, secondary and tertiary care, and work with PCTs and NHS trusts to deliver a programme to meet these needs." The goal was to create a coherent strategic framework for the development of services across the full range of local NHS organisations, including: A pivotal event seems to have been a loss of financial control in 2005/6 and

1302-447: The pandemic. From 29 April, PHE collated daily reporting of the number of deaths of people in England with a positive COVID-19 test; the numbers published each day by the UK government had previously only counted deaths in hospital. By July, as the number of deaths continued to fall, PHE reported significantly more deaths than those collated weekly by the Office for National Statistics from death certificates. Concerns were raised – by

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1344-474: The process was often unclear with little clear guidance given. Many of the changes took place in advance of the legislation. Following 22 public consultations on the boundaries of the proposed SHAs, the names of the 28 new SHAs were announced on 18 December 2001. The 28 new organisations operated in shadow form until section 1 of the Act came into force on 1 October 2002, and they were formally renamed SHAs. The role of

1386-472: The responsibility for 'Be Clear on Cancer' campaigns after it was created in the Health and Social Care Act 2012 . Campaigns have been run on lung cancer, bowel cancer, oesophago-gastric and kidney & bladder cancer. PHE was also responsible for Change4Life and ACT FAST. In January 2014 it launched a campaign against smoking called 'Health Harms' on television and billboards across England. The bullet points setting out PHE's priorities for 2019/20 in

1428-460: The various relationships and funding connections" in question, and that this "adds to questions about the credibility of the organisation's advice". Scientific evidence accumulated since has cast further doubt on PHE's claim. A 2017 question in the House of Lords revealed that a position underpinning UK Government policy, namely "that well run and regulated modern municipal waste incinerators are not

1470-468: The wide spread of infection in the population. From 19 March, consistent with the opinion of the Advisory Committee on Dangerous Pathogens , PHE no longer classified COVID-19 as a "high consequence infectious disease" (HCID). This reversed an interim recommendation made in January 2020, due to more information about the disease confirming low overall mortality rates, greater clinical awareness, and

1512-407: Was a scandal, and claimed coalition reforms had left it unclear who was supposed to analyse health data and tackle the problems highlighted. The agency was criticised by The Lancet for allegedly using weak evidence in a review of electronic cigarettes to endorse an estimate that e-cigarette use is 95% less hazardous than smoking: "it is on this extraordinarily flimsy foundation that PHE based

1554-610: Was in response to mistakes in decision making during the COVID-19 pandemic, including issues with the supply of personal protective equipment for healthcare workers, low community testing capabilities, and insufficient data resourcing. Several health experts, including Jeremy Farrar, Director of the Wellcome Trust, criticised the move to abolish PHE during an ongoing pandemic, with Richard Murray, Chief Executive of The King's Fund, stating that PHE "appears to have been found guilty without

1596-578: Was introduced to the House of Commons in January 2011, and was the subject of a report by the Health Select Committee in October. Responding to criticism, the government published "Healthy Lives, Healthy People: Update and way forward" in July. The Health and Social Care Act gained royal assent in March 2012, with all elements of the new system to be operative by April 2013. The Act established Public Health England as an executive body accountable to

1638-482: Was later found to be unlawful. Michael Brodie, current CEO of the NHS Business Services Authority , was appointed as interim PHE CEO, replacing Duncan Selbie . In March 2021, it was announced that the new agency would instead be called the UK Health Security Agency , commencing on 1 April and led by Jenny Harries (formerly a regional director at PHE and Deputy Chief Medical Officer for England ). The new UKHSA would focus on infectious disease control, particularly

1680-411: Was originally known as "East Riding", [4] , "County Durham and Darlington" was originally known as "County Durham" [5] Public Health England Public Health England ( PHE ) was an executive agency of the Department of Health and Social Care in England which began operating on 1 April 2013 to protect and improve health and wellbeing and reduce health inequalities. Its formation came as

1722-401: Was required to appoint a director of public health, an officer of the authority who was responsible for the authority's public health functions including responding to emergencies. As of 2020 there were 134 of these posts. A reorganisation of public health protection in England was announced by the then Secretary of State for Health and Social Care , Matt Hancock , in August 2020. The move

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1764-824: Was restructured on 1 April 2003. The HAs in England were themselves divided into Primary Care Organisations (PCOs) created in 1999. When PCOs were first established, there were 481 primary care groups (PCGs). However, by 2002, a significant number had converted to primary care trusts (PCTs). The numbers of both HAs and PCOs varied slightly until 2002. In 2002, the HAs were abolished by the National Health Service Reform and Health Care Professions Act 2002 . Their functions were mostly taken up by 300 PCTs, and 28 strategic health authorities (SHAs) were established (which were reduced in number to 10 in 2006). There were originally separate authorities for Barnet and Enfield & Haringey, for Bexley & Greenwich and Bromley, for East & North Hertfordshire and South Hertfordshire, and for

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