This article needs to be updated. The reason given is: Content needs to be amended following dissolution. Please help update this article to reflect recent events or newly available information.(October 2021)
Proposals for reorganising 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".[8] This was followed by a more detailed paper "Healthy Lives, Healthy People: Our strategy for public health in England" in November.[9]
The bill to implement the proposals was introduced to the House of Commons in January 2011, and was the subject of a report by the Health Select Committee in October.[1] Responding to criticism, the government published "Healthy Lives, Healthy People: Update and way forward" in July.[10] 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.[1]
The Department of Health and Social Care set out PHE's remit and priorities in 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.[11]
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.[12] It announced plans to move its headquarters and 2,750 staff to Harlow on a former GlaxoSmithKline site in 2017.[13]
PHE laboratories provided an extensive range of microbiological diagnostic tests.[14]
The Secretary of State set the total budget for public health, and determined how it was allocated between PHE and local authorities.[15]
Relationship with 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 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.[15]As of 2020[update] there were 134 of these posts.[16]
2020–2021 reorganisation
A reorganisation of public health protection in England was announced by the Secretary of State for Health and Social Care, Matt Hancock, in August 2020.[17] The move 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.[18]
Several health experts, including Jeremy Farrar, Director of the Wellcome Trust, criticised the move to abolish PHE during an ongoing pandemic,[19][20] with Richard Murray, Chief Executive of The King's Fund, stating that PHE "appears to have been found guilty without a trial" and it is "unclear what problem government are hoping to solve".[21] 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.[22]
The new UKHSA would focus on infectious disease control, particularly the ongoing COVID-19 pandemic. Options for PHE's other roles, such as preventing ill health and reducing health inequalities, were to be discussed,[17] 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.[25] This was subsequently re-named the Office for Health Improvement and Disparities and launched 1 October 2021.[27] A few PHE staff moved to NHS England/Improvement or to NHS Digital.[citation needed]
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.[28][29] The PHE name and employment contracts remained until 1 October.[30]
Structure
PHE had the following public-facing divisions:[citation needed]
Health protection:
Immunisation, hepatitis and blood safety department
Alcohol, drugs, tobacco and justice (including substance misuse treatment monitoring)
Health promotion (such as healthy diet or anti-smoking marketing)
Health screening programmes (such as cancer screening, STD checks, cardiovascular disease screening, etc.) – supervised by the UK National Screening Committee
Yvonne Doyle, Medical Director and Director of Health Protection from 2019, replacing Paul Cosford who became Emeritus Medical Director until his death in 2021.[34]
Mary Ramsay, Head of Immunisation, Hepatitis and Blood Safety.[35]
Alison Tedstone, nutritionist, Director of Diet, Obesity and Physical Activity.
Campaigns
PHE took over the responsibility for 'Be Clear on Cancer' campaigns after it was created in the Health and Social Care Act 2012.[36] Campaigns have been run on lung cancer, bowel cancer, oesophago-gastric and kidney & bladder cancer.[37]
In January 2014 it launched a campaign against smoking called 'Health Harms' on television and billboards across England.[39]
COVID-19
The bullet points setting out PHE's priorities for 2019/20 in 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.[40]
PHE carried out contact tracing in the early stages of the COVID-19 pandemic, but this ceased on 12 March 2020 in view of the wide spread of infection in the population.[41]
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 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.[42]
Mortality data
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 the pandemic.[43] 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.[44][45]
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 the Centre for Evidence-Based Medicine[46][47] 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.[47] The cumulative total was recalculated as 41,329, a 12% decrease.[48]John Newton, 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.[49]
Handling of test results
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[50] (notifications of test results to individuals were not affected).[51] PHE retrieved the missing results after determining that the cause was ill-thought-out use of Microsoft's Excel software.[52]Matt Hancock, Health Secretary, said in Parliament that the error "should never have happened".[53] 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,[54] although PHE disputed their findings.[55]
Criticism and other published comment
Public Health England has been criticised for downplaying mental health within its overall resourcing and agenda; in 2011 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".[56]
The agency was criticised by Professor Martin McKee in January 2014. He said that continuing health inequalities among London boroughs was a scandal, and claimed coalition reforms had left it unclear who was supposed to analyse health data and tackle the problems highlighted.[57]
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 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."[58] 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.[59] 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 the various relationships and funding connections" in question, and that this "adds to questions about the credibility of the organisation's advice".[60]Scientific evidence accumulated since has cast further doubt on PHE's claim. [61]
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 a significant risk to public health remains valid", was asserted in advance of the results having been obtained from a study commissioned by Public Health England to answer the question whether municipal waste incinerators did, in fact, constitute a significant risk to public health.[62]
Diana Mary "Dido" Harding, Baroness Harding of Winscombe is a British businesswoman and life peer who served as chair of NHS Improvement from 2017 to 2021 and as interim chief executive of the UK Health Security Agency (UKHSA) and head of NHS Test and Trace from 2020 to 2021.
Professor Kevin Andrew Fenton, is a Public Health Physician and Infectious Disease Epidemiologist. He is the London Regional Director at Office for Health Improvement and Disparities, Regional Public Health Director at NHS London and the Statutory Health Advisor to the Mayor of London, Sadiq Khan. He is the current President of the United Kingdom Faculty of Public Health and holds Honourable Professorships with the University College London and London School of Hygiene and Tropical Medicine.
Duncan Selbie is a British government official who is a senior advisor to the Department of Health and Social Care on global and public health. He served as Chief Executive of Public Health England from its foundation in 2013 until he was removed in August 2020 by the Govt which in 2021 formed it into the UK Health Security Agency. Since December 2020, he has been president of the International Association of National Public Health Institutes.
Sir Paul Anthony Cosford was a British emeritus medical director at Public Health England (PHE), the UK's public health agency, later replaced by the UK Health Security Agency. He had executive roles from 2010 at PHE's predecessor, the Health Protection Agency. From April 2013 to 2019 he was PHE's Medical Director and Director for Health Protection, making him responsible for advising on services to prevent and control infectious diseases and for preparations and responses to public health emergencies. He led the MMR vaccine catch-up campaign in response to the resurgence of measles following the MMR Scare, and contributed to the response to the 2014 Ebola outbreak, the Grenfell disaster in 2017, and the 2018 Novichok poisonings in Salisbury and Amesbury. Over the course of his career in public health he led programmes to reduce hospital-acquired infections and tuberculosis, and oversaw ways of dealing with health inequalities, tobacco, obesity, and responses to pandemic flu.
Dame Jennifer Margaret "Jenny" Harries is a British public health physician who has been the chief executive of the UK Health Security Agency (UKHSA) and head of NHS Test and Trace since May 2021. She was previously a regional director at Public Health England, and then Deputy Chief Medical Officer for England from June 2019 until her UKHSA appointment in 2021.
The COVID-19 pandemic in Scotland is part of the COVID-19 pandemic of coronavirus disease-2019, caused by the virus SARS-CoV-2. The first case of COVID-19 was confirmed in Scotland on 1 March 2020. Community transmission was first reported on 11 March 2020, and the first confirmed death was on 13 March 2020.
The Scientific Advisory Group for Emergencies (SAGE) is a British Government body that advises central government in emergencies. It is usually chaired by the United Kingdom's Chief Scientific Adviser. Specialists from academia and industry, along with experts from within government, make up the participation, which will vary depending on the emergency. SAGE gained public prominence for its role in the 2020 COVID-19 pandemic in the United Kingdom.
The COVID-19 pandemic was first confirmed to have spread to England with two cases among Chinese nationals staying in a hotel in York on 31 January 2020. The two main public bodies responsible for health in England were NHS England and Public Health England (PHE). NHS England oversees the budget, planning, delivery and day-to-day operation of the commissioning side of the NHS in England, while PHE's mission is "to protect and improve the nation's health and to address inequalities". As of 14 September 2021, there have been 6,237,505 total cases and 117,955 deaths in England. In January 2021, it was estimated around 22% of people in England have had COVID-19.
Exercise Cygnus was a three-day simulation exercise carried out by the UK Government in October 2016 to estimate the impact of a hypothetical H2N2 influenza pandemic on the United Kingdom. It aimed to identify strengths and weaknesses within the United Kingdom health system and emergency response chain by putting it under significant strain, providing insight on the country's resilience and any future ameliorations required. It was conducted by Public Health England representing the Department of Health and Social Care, as part of a project led by the "Emergency Preparedness, Resilience and Response Partnership Group". Twelve government departments across Scotland, Wales and Northern Ireland, as well as local resilience forums (LRFs) participated. More than 950 workers from those organisations, prisons and local or central government were involved during the three-day simulation, and their ability to cope under situations of high medical stress was tested.
NHS COVID-19 was a voluntary contact tracing app for monitoring the spread of the COVID-19 pandemic in England and Wales. It had been available since 24 September 2020 for Android and iOS smartphones, and can be used by anyone aged 16 or over.
NHS Test and Trace is a government-funded service in England, established in 2020 to track and help prevent the spread of COVID-19. The programme is part of the UK Health Security Agency; the service and the agency are headed by Jenny Harries.
The following is a timeline of the COVID-19 pandemic in England from January 2020 to June 2020. There are significant differences in the legislation and the reporting between the countries of the UK: England, Scotland, Northern Ireland, and Wales.
The UK Health Security Agency (UKHSA) is a government agency in the United Kingdom, responsible since April 2021 for England-wide public health protection and infectious disease capability and replacing Public Health England. It is an executive agency of the Department of Health and Social Care (DHSC).
Operation Moonshot was a UK government programme to introduce same-day mass testing for COVID-19 in England as a way of enabling large gatherings of people to take place in that country while maintaining control over the virus. According to the British Medical Journal, the programme aimed to deliver 10 million tests per day by 2021.
The Vaccine Taskforce in the United Kingdom of Great Britain and Northern Ireland was set up in April 2020 by the Second Johnson ministry, in collaboration with Chief Scientific Advisor Patrick Vallance and Chief Medical Officer Professor Chris Whitty, in order to facilitate the path towards the introduction of a COVID-19 vaccine in the UK and its global distribution. The taskforce coordinated the research efforts of government with industry, academics and funding agencies in order to expedite vaccine development and deployment.
The Joint Biosecurity Centre (JBC) is a scientific body which seeks to advise United Kingdom government policy as part of the response to outbreaks of COVID-19, such as on testing deployment, international travel, and the UK 'COVID-19 alert level'. Its existence was announced by Prime Minister Boris Johnson in May 2020. The body has been part of the UK Health Security Agency since the establishment of that agency on 1 April 2021.
This article presents official statistics gathered during the COVID-19 pandemic in the United Kingdom.
The COVID-19 vaccination programme in the United Kingdom is an ongoing mass immunisation campaign for coronavirus disease 2019 (COVID-19) during the COVID-19 pandemic in the United Kingdom.
The United Kingdom's response to the COVID-19 pandemic consists of various measures by the healthcare community, the British and devolved governments, the military and the research sector.
The Parliamentary Under-Secretary of State for Public Health, Start for Life and Primary Care is a position in the Department of Health and Social Care in the Government of the United Kingdom. The role has previously been known as the Minister of State for Public Health.
This page is based on this Wikipedia article Text is available under the CC BY-SA 4.0 license; additional terms may apply. Images, videos and audio are available under their respective licenses.
