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Councils must ensure that spending cuts and short term targets do not undermine long-term investment in the prevention of ill health in old age.

‘Public health responses to an ageing society’, published by the International Longevity Centre – UK (ILC-UK), with the support of Sanofi Pasteur MSD, explores the extent to which England’s public health structures are able to respond to our ageing population after the radical reforms introduced by the Health and Social Care Act in 2012.

The think piece argues that some localities are embracing the opportunities provided by their new public health responsibilities, by taking a life-course approach to health and by commissioning services that both encourage healthy ageing and improve the health of the current old.

But the think piece argues that some local authorities still need support to deliver effective policies in an area as complex and fast-changing as public health. It also contends that transferring responsibility to local authorities risks politicising the sector.

ILC-UK expresses fears that localism might deliver a ‘postcode lottery’, where the health services available depend on the agenda of the local government. The think piece also argues that the introduction of a system that pays on results may encourage a culture of short-termism and target-hitting at the expense of our society’s future health.

‘Public health responses to an ageing society’ finds that local authorities may face barriers which prevent them from taking advantage of any benefits created by the Act. The new system encourages greater collaboration between departments; however, some councils report that they are unable to exchange data due to data protection and organisational ‘security’.

Jonathan Scrutton, Senior Policy and Research Officer at ILC-UK, said “There is a huge invest-to-save argument. Early investment in preventing ill health in old age can reduce long-term care costs. Localism has the potential to transform public health and deliver better and more targeted services. But if local authorities are to maximise the long-term benefit of investing in preventative health, they must not get drawn into simply achieving short-term targets.”

The think-piece argues that local authorities know their residents best. They are also well placed to develop innovative health strategies as they can utilise resources from a wide range of different actors, both within local government and beyond it.

ILC-UK argues that to reduce costs and improve the public health of older people today and in the future, they should prioritise 8 areas as part of their local health and wellbeing strategies: smoking cessation, physical activity, nutrition, road safety, housing, loneliness, falls and immunisation.

In the report, ILC-UK argues that:

• Local health strategies should prioritise long-term health initiatives over short-term target hitting. For example, Ageing Well strategies could usefully focus on increasing physical activity earlier in life to ensure people have an active, healthy old age.
• Health and Wellbeing Boards should make use of local authority’s links into communities to maximise the potential of public health impact and to ensure that the voices of older residents are heard, and incorporated into health strategies. 
• The NHS Commissioning Board should monitor healthcare commissioning to support consistency of quality across the country and help reduce differences in healthy life expectancies. 
• Government should ensure that local authorities’ public health budgets continue to meet the needs of local citizens after the 2 year ring fenced period.
• Government should ensure that data protection and organisational security do not discourage information sharing between departments and stunt integrated working.

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