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The Coalition Government’s July 2010 White Paper “Equity and Excellence: Liberating the NHS” has recognised Local Government as a key player in the fight to improve the health of local people and tackle health inequalities, working with other local partners through Health and Wellbeing Boards, and using means such as Joint Strategic Needs Assessments to agree health priorities for the future and influence the delivery of services to meet those needs.

Councils can have a tremendous impact on health – through sports, open space, housing, planning, social care and a range of other services. However many members are largely unfamiliar with the territory of health services. They will increasingly be required to get involved, particularly through the new health and wellbeing boards. These 20 ‘Must Knows’ are designed to provide the key information members need, in bite size chunks.

The term ‘safeguarding’ covers a whole range of multi-agency activities to protect vulnerable adults and children, beginning with dignity and respect and ultimately aimed at upholding people’s fundamental right to be safe, while respecting their right to make choices. It involves empowerment, protection, justice and includes the whole community.

Your Director of Public Health will be the central figure in organising the transfer of the public health function from the PCT to the local authority. This is likely to be a complicated and difficult process, involving the transfer of large numbers of staff, while at the same time keeping the public health function going, including dealing with any issues of public protection and safety. Your DPH will need a lot of understanding and support at what will be a stressful time.

Health and wellbeing boards offer the opportunity for system-wide leadership to improve both health outcomes and health and care services. They will have a duty to promote integrated working, and their core purpose is to drive improvements in health and wellbeing by promoting joint commissioning and integrated delivery.

Government policy is moving in the direction of greater local accountability with ‘lighter touch’ regulation from the centre. This means an increased responsibility for councillors in ensuring that their electorates are in a position to hold them and other public services to account.

nvolving users and carers and members of the public in assessing needs, developing strategies and planning and commissioning services can both increase democratic accountability and improve services.

Performance management is one way elected Members and chief officers can ensure the quality and effectiveness of their council’s work and allow the public to make judgements about services. At a time of significant change and a loosening of national regulatory systems, the performance management carried out by individual councils of their own work is increasingly important.

Evidence-based practice (see the ‘Must know’ on evidence) is only half the story of a systematic and rigorous approach to commissioning that will improve health outcomes and be cost effective. To use evidence to underpin practice, but not to evaluate its effectiveness is short sighted. As innovations are implemented, it is crucial to evaluate them carefully so that they can add to the evidence base.

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Research on the causes of poor health and health inequalities between different population groups increasingly shows the connections between people’s social and economic circumstances and their health status. The Marmot review on health inequalities in England made recommendations in key policy areas where action is likely to be most effective in reducing health inequalities.

For some years, social care has been undergoing major changes to transform services. The objectives of this reform include: working with the NHS, and other agencies, taking a whole system approach to the integration of health and social care

Because people’s health and wellbeing are determined by such a multiplicity of complex factors, no one organisation can possibly hope to improve health and wellbeing on its own. Local public sector organisations, voluntary sector bodies and the private sector (for example, in the form of local employers) need to work together and involve their communities to develop coherent strategies and action plans if they are collectively to make a significant positive impact on the health and wellbeing of communities.

Understanding, and justifying, the impact of any health care intervention has become increasingly necessary in the current economic climate. It is now widely accepted that the way to understand and demonstrate the benefits is to measure the outcomes that are meaningful to people. A focus on outcomes in health and wellbeing requires an understanding that, as the causes of ill health and loss of wellbeing are complex and multi-faceted, interventions to bring about desired outcomes will require a multi-agency approach.

There is increasing emphasis in public policy on public health and its role in preventing illness and promoting the circumstances in which people can lead a fulfilled and healthy life. Reducing the cost of expensive treatment and acute care by preventive strategies and early intervention is particularly important at any time but particularly when budgets are under severe strain.

Commissioning is how local authorities and the NHS seek to improve the health and wellbeing of their populations by procuring services from the public sector, the voluntary sector and, increasingly, from private sector providers. It is a complex and frequently technical process, often not well understood by lay people. Nonetheless, it is central to assuring that good quality services are available, provide value for money deliver good health and wellbeing outcomes.

Public policy should be informed by reliable evidence. An emphasis on the evidence for the effectiveness of health - and especially public health -interventions has taken off only recently in the public sector. (For example, Baker (1996) estimated that only about 15 per cent of health care was research based.)

Mental illness is the largest single cause of disability in our society and costs the English economy at least £77 billion a year. One child in ten between 5 and 16 has mental health problems, often continuing into adulthood.

To intervene effectively to improve health and reduce inequalities between different groups, you need to understand the baseline you are working from and the broad social and economic factors that influence people’s health. Different public health interventions impact differently on different populations. To understand why and to take a strategic approach to health improvement, you need a detailed analysis of your population’s health and an explanation of the variations between different groups, seen in a social and economic context.

People with good health can live life to the full and function actively in society. So it is very serious that there are systematic health inequalities between different population groups, with a strong connection between poverty and ill health. Professor Sir Michael Marmot’s (2010) review, Fair Society, Healthy Lives, whose findings the current Government has accepted, makes important points about the extent of health inequalities in England: