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Statutory guidance

Use of the ring-fenced public health grant to local authorities

Published 2 October 2026

Applies to England

© Crown copyright 2026

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This publication is available at https://www.gov.uk/government/publications/ring-fenced-public-health-grant-to-local-authorities/use-of-the-ring-fenced-public-health-grant-to-local-authorities--2

Introduction

This statutory guidance is issued in accordance with section 73B of the National Health Service Act 2006 (‘the 2006 act’) and supports the ring-fenced public health grant local authority circular. Upper-tier and unitary local authorities in England must have regard to this guidance when planning expenditure from the ring-fenced public health grant issued by the Secretary of State for Health and Social Care in support of their statutory public health duties.

This guidance has been developed in collaboration with the Association of Directors of Public Health (ADPH) and the Local Government Association (LGA) for local authorities in England. It replaces previous guidance on the ring-fenced public health grant conditions and mandated functions in England (PDF, 300KB) published by Public Health England in 2016.

Local authorities are responsible for ensuring compliance with their statutory duties.

Main messages

Local authorities have a statutory duty to take appropriate steps towards improving the health of the people in their area. This duty applies to the local authority as a whole and is not limited to activities funded by the ring-fenced public health grant. In addition to this statutory duty, local authorities have other statutory duties in relation to public health.

The ring‑fenced public health grant supports local authorities in discharging their health improvement duty and certain other statutory public health functions, paid under section 31 of the Local Government Act 2003, which enables the Secretary of State to determine the conditions under which the ring-fenced public health grant is awarded.

Local authorities, as advised by their director of public health, are responsible for ensuring appropriate local decisions on how best to discharge their statutory public health duties and allocate the ring-fenced public health grant in accordance with grant conditions.

Both in‑year ring-fenced public health grant funding and any underspend carried forward into the public health reserve must be used for the purposes of local authorities’ public health functions, as specified by the public health grant conditions.

From the 2026 to 2027 financial year, previously separate public health funding has been consolidated into the ring-fenced public health grant. Specific funding is ring-fenced for drug and alcohol and smoking cessation services. This funding must be used for those services and cannot be used for other public health activities. Any year-end drug and alcohol and/or smoking cessation underspend can be carried forward in the ring-fenced public health reserve, but this funding must continue to be ring-fenced for the purpose of these services.

Local authorities’ compliance with public health grant conditions, including eligibility of spend, will be subject to assurance activities by the Department of Health and Social Care. This assurance will be underpinned by strong, consistent and visible support to strengthen impact and best value.

All expenditure must comply with the local authority’s statutory public health duties, and the conditions of the public health grant and the Best Value Duty. Decisions should be informed by:

Local authorities can support their expenditure decisions by applying a set of eligibility principles, including whether:

  • the primary purpose is public health
  • the activity would be funded without the ring-fenced public health grant
  • funding from the ring-fenced public health grant is additional and proportionate

Local authorities must accurately report their public health grant spend annually using the revenue outturn return.

The director of public health must agree the revenue outturn return alongside the section 151 officer (titled under the Local Government Act 1972), who has responsibility for the proper administration of the local authority’s financial affairs.

Roles, responsibilities and accountabilities

This section describes the statutory framework within which local authority public health functions are exercised and funded through the public health grant (PH grant). It sets out the respective roles and responsibilities of:

  • local authorities
  • directors of public health (DsPH)
  • the Department of Health and Social Care (DHSC)

The section describes the arrangements through which accountability, governance and assurance for the use of the PH grant are maintained.

The role of local authorities

Local authority public health responsibilities

Current public health structures and duties in England reflect legislative reforms under the Health and Social Care Act 2012 (‘the 2012 act’) which, through amendments to the 2006 act, transferred a range of health improvement functions from the NHS to local authorities.

The Secretary of State has overall responsibility for improving health and a duty to promote a comprehensive health service (under section 1 of the 2006 act) that is designed to secure improvement in the:

  • physical and mental health of the people of England
  • prevention, diagnosis and treatment of physical and mental illness

Each local authority has a duty to “take such steps as it considers appropriate for improving the health of the people in its area” (under section 2B of the 2006 act). Section 2B specifies that these steps may include:

  • providing information and advice
  • providing services or facilities designed to promote healthy living (whether by helping individuals to address behaviour that is detrimental to health or in any other way)
  • providing services or facilities for the prevention, diagnosis or treatment of illness
  • providing financial incentives to encourage individuals to adopt healthier lifestyles
  • providing assistance (including financial assistance) to help individuals to minimise any risks to health arising from their accommodation or environment
  • providing or participating in the provision of training for people working or seeking to work in the field of health improvement
  • making available the services of any person or any facilities (for example, making sure staff and resources are in place to provide the service)

Local authorities are local leaders for population health and play a central role in the public health system. They use the PH grant and all the means at their disposal, including taking action on the underlying determinants of health, to improve health and reduce health inequalities. This includes commissioning and delivering a range of treatment and preventative health services in line with their statutory duty to improve the health of their local population under section 2B of the 2006 act.

Core funding for these services and other local authority public health functions is provided through the PH grant using powers under section 31 of the Local Government Act 2003. This also allows for conditions to be attached to PH grant spend, which are set out in the annual PH grant local authority circular.

In addition to their health improvement duty, local authorities also have a duty, acting jointly with the Secretary of State, to appoint a director of public health (DPH). The DPH is:

  • the principal adviser to the local authority on all health matters, including those set out in regulations (see section 73A of the 2006 act)
  • a statutory chief officer within the local authority
  • expected to have day-to-day responsibility for the local authority’s PH grant

The Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) Regulations 2013 (‘the 2013 regulations’), made under section 6C of the 2006 act, set out certain local authority duties in respect of public health such as:

  • the weighing and measuring of children
  • NHS health checks
  • universal health visitor health and development reviews
  • sexual health services
  • public health service advice
  • protecting the health of the local population

Additionally, The NHS Bodies and Local Authorities (Partnership Arrangements, Care Trusts, Public Health and Local Healthwatch) Regulations 2012 (‘the 2012 regulations’), made under section 111 of the 2006 act, require local authorities to take particular steps with regard to dental public health, including relating to the provision of oral health promotion programmes and oral health surveys (to the extent that the local authority considers appropriate). Local authorities must also participate in oral health surveys conducted or commissioned by the Secretary of State where those surveys are conducted within their area.

Further information regarding the 2012 and 2013 regulations is in the ‘Public health functions prescribed by the 2012 and 2013 regulations’ section of this guidance below, as well as in annex A.

In addition to the above public health responsibilities, local authorities hold statutory health protection duties that predate the transfer of public health responsibilities from the NHS to local authorities in 2013. For example, responsibilities as a category 1 responder under the Civil Contingencies Act 2004 and food hygiene and safety enforcement under the Food Safety Act 1990. These pre-2013 health protection duties should primarily be considered out of scope for PH grant usage. Further information at annex A of this guidance helps determine eligibility of health protection spend, including on the complementary roles and responsibilities of local authorities, the UK Health Security Agency (UKHSA) and the NHS.

The role of local authorities is complemented by the statutory duties of combined authorities and combined county authorities that fall under section 107ZB of the Local Democracy, Economic Development and Construction Act 2009 and section 24A of the Levelling-up and Regeneration Act 2023. These duties mean they must, during the exercise of their functions, have regard to the need to:

  • improve the health of people in the combined authority or combined county authority’s area
  • reduce health inequalities between people living in the combined authority or combined county authority’s area

The Greater London Authority and Mayor of London have further health duties set out in section 309 of the Greater London Authority Act 1999.

In addition, as a result of past devolution deals with government, Greater Manchester Combined Authority (GMCA) and East Midlands Combined County Authority (EMCCA) share the duty under section 2B of the 2006 act. This duty is to be exercised alongside  the local authorities in their areas - GMCA and EMCCA do not receive a PH grant.

In this guidance, ‘prescribed’ refers to the public health duties and functions of local authorities that are explicitly set out in legislation (the 2012 and 2013 regulations). The term ‘non-prescribed’ is used where public health activities of local authorities are not explicitly set out in legislation.

Use of the PH grant

The primary purpose of the PH grant is to enable local authorities to discharge their statutory public health duties under the 2006 act, as set out in the PH grant circular.

The PH grant circular confirms local authority-level allocations for the financial year and the conditions that apply to this funding, including interventions by the Secretary of State if the PH grant conditions are breached.

In all cases, service commissioning, investment, joint spend or direct service provision should be informed by robust local data and strategies, including but not limited to:

  • the Public Health Outcomes Framework (PHOF)
  • the local authority’s joint strategic needs assessment (JSNA)
  • the Local Outcomes Framework (LOF)
  • the local authority’s joint local health and wellbeing strategy (JLHWS)
  • National Institute for Health and Care Excellence (NICE) guidance or other clinical guidance
  • relevant corporate plans

All of the above should be underpinned by the professional advice of the DPH. There should be clear contractual or organisational agreements for all PH grant spend.

Through elected members, local authorities are democratically accountable for decisions on the use of their PH grant. Through established governance and scrutiny processes and on the advice of their DPH, local authorities are responsible for making effective and appropriate use of their PH grant.

All PH grant expenditure must comply with grant conditions and relevant public health duties, as well as the Best Value Duty, which requires local authorities to make arrangements to secure continuous improvement in the way their functions are exercised, having regard to economy, efficiency and effectiveness. Further guidance can be found in the Best value standards and intervention: a statutory guide for best value authorities. DHSC will seek assurance that local authorities have put in place robust arrangements to assure appropriate expenditure of the grant.

Local authorities can use the PH grant as part of local joint funding arrangements, including formal pooling of funding with NHS bodies under the terms of section 75 of the 2006 act.

As outlined in the PH grant circular, if underspend exists at the end of the financial year, local authorities can carry this over, as part of a public health reserve, into the next financial year. PH grant reserves are ring-fenced and subject to the same conditions as the PH grant. Local authorities’ drawdown on the reserve will require the endorsement of the DPH, in consultation with the section 151 officer and in line with the principles outlined in this guidance.

The PH grant reserve must be reported in the revenue outturn. Any underspend from the drug and alcohol and smoking cessation ring-fenced funding totals should be identified and held in the public health reserve for use on these services only.

A proportion of the PH grant may be allocated to local authority overheads. The cost of delivering a service can include an appropriate allocation toward central or shared overheads (such as HR, payroll or legal services), provided that such allocations are reasonable, evidence based, and made on a fair and transparent basis. These are management and support service costs that are not directly attributable to the delivery of a specific service.

In determining whether a cost may be treated as an overhead, local authorities should consider whether it is incurred in running and governing the local authority as a whole, rather than in delivering a particular service. If so, it is likely to be a central cost and may therefore be paid from the PH grant as an overhead. These costs should be:

  • an apportionment derived from a fair and transparent calculation of actual cost on a reasonable and evidence-based basis
  • consistent across the local authority’s income

DHSC reserves the right to review such calculations to ensure the value delivered through the PH grant. The Ministry of Housing, Communities and Local Government (MHCLG) publishes guidance on recharging and management and support services to support local authorities in determining legitimate overhead costs - see the ‘General fund revenue account outturn: specific guidance notes’ as part of the General fund revenue account outturn publication.

The section 151 officer has responsibility for the proper administration of the local authorities’ financial affairs. In the context of the PH grant, this may include:

  • ensuring the lawful and compliant use of the PH grant
  • maintaining robust financial controls, audit trails and accounting standards
  • certifying, alongside the DPH, that the revenue outturn return is accurate, appropriately coded and compliant with grant conditions
  • providing assurance that expenditure represents proper stewardship of public funds
  • taking action if expenditure appears unlawful or does not comply with the grant conditions

About the consolidated PH grant

From 2026 to 2027, funding previously provided through the following funding streams has been consolidated into the PH grant:

  • drug and alcohol treatment and recovery improvement grant
  • Individual Placement and Support in Primary Care Initiative
  • local stop smoking services and support grant
  • Swap to Stop scheme

Service‑specific ring‑fences and associated conditions apply to funding for drug and alcohol prevention, treatment and recovery services, and smoking cessation services. These ring-fenced funding totals combine the local authority’s core PH grant allocation (prior to consolidation) and supplementary funding. The local authority must use this funding for its intended purpose and in accordance with the relevant PH grant conditions, including where underspends are carried forward into public health reserves, which remain subject to those conditions when used.

Local authorities in Greater Manchester receive their funding through different arrangements. The 10 Greater Manchester local authorities will continue to receive a notional PH grant allocation through their business rates retention (BRR) arrangement for their core PH grant allocation, in accordance with local devolution arrangements.

Each local authority will also receive a single ring-fenced section 31 grant for the supplementary drug and alcohol and smoking cessation services funding that has been consolidated into the PH grant and which is administered by DHSC. This funding must only be used for these services and is conditional on maintaining baseline spend on these services from notional PH grant allocation received through BRR. The PH grant conditions apply to this funding.

Greater Manchester local authorities report their total public health expenditure as part of their revenue outturn return to MHCLG.

The most up-to-date grant conditions are in the PH grant local authority circular, which is published annually.

The role of the DPH

The DPH is an advocate for the health of the local population and a statutory chief officer of their local authority. The DPH is responsible for the exercise of statutory public health functions, in accordance with section 73A of the 2006 act.

The DPH is usually the principal adviser on all health matters to elected members and officers, with a leadership role spanning all 3 domains of public health:

  • health improvement
  • health protection
  • healthcare public health

Statutory and non-statutory elements of the local authority DPH role are set out in the Role of the director of public health in local authorities guidance.

While overall accountability sits with the local authority, the DPH has responsibility for:

  • leading and overseeing the effectiveness and availability of the local authority’s public health services
  • advising on value for money
  • advising elected members on how the PH grant should improve health outcomes and reduce health inequalities
  • ensuring that the PH grant has been spent in accordance with grant conditions
  • providing expertise and advice on the local authority’s wider activities, ensuring it acts on the determinants of health as part of a ‘health in all policies’ approach
  • providing expert public health advice to the NHS
  • working, through local resilience forums and partnerships, to make sure that all organisations involved in health protection co-operate to put in place robust and appropriate local health protection plans

In accordance with the PH grant conditions, the DPH and section 151 officer must certify annually that the PH grant has been used for appropriate purposes. Each year, local authorities must report their public health expenditure against a set of standard service spend reporting categories specified in the PH grant circular (the revenue outturn return). The DPH is required to agree their local authority’s revenue outturn return alongside section 151 officers - this includes both the provisional and final returns.

Local authorities can access guidance on the reporting categories by consulting the ‘General fund revenue account outturn’ guidance from MHCLG or the Chartered Institute of Public Finance and Accountancy’s Service reporting code of practice for local authorities.

To note: the spend reporting categories are not a statement of what is considered prescribed PH grant spend.

The role of DHSC

DHSC provides strategic leadership, co-ordination and oversight of delivery across the healthcare system in England, covering public health, adult social care and the NHS.

DHSC provides leadership for public health in England, in partnership with other bodies including UKHSA and the NHS. It works with and supports local authorities and local health and care systems to take effective, locally led action to improve and protect health and reduce health inequalities. DHSC:

  • sets direction and priorities
  • allocates resources to local authorities in respect of their public health functions
  • assures ministers and Parliament on the use of public health funding and progress towards improving public health outcomes

The Chief Medical Officer is the professional head of the public health profession in England.

The Permanent Secretary of DHSC, as Principal Accounting Officer, is accountable to Parliament for ensuring that the PH grant has been spent in line with the purposes intended by Parliament, as set out in the grant conditions. DHSC’s role in assuring the use of the PH grant is rooted in this statutory accountability. It operates alongside local authorities’ democratic accountability and on the principle that local authorities are best placed to:

  • make decisions on local plans and priorities
  • ensure that public funds are used for their intended purposes and deliver value for money

DHSC assurance activity

On behalf of the Secretary of State for Health and Social Care, DHSC’s regional directors of public health and their teams undertake assurance activity to ensure principally that the PH grant has been spent in line with the associated conditions and spend is appropriately reported. This assurance activity is based on:

  • local authorities verifying that the PH grant has been spent in accordance with conditions through:
    • their annual grant assurance statement (certified by the DPH and the section 151 officer)
    • local authority revenue outturn returns to MHCLG (agreed by the DPH alongside the section 151 officer)
    • the local authority’s response to DHSC’s lines of enquiry on PH grant spending, governance and impact
    • targeted reviews (deep-dives) into specific spend categories
  • DHSC reviewing this data and other available evidence to identify anomalous spending patterns and concerns. DHSC regional directors of public health and their teams follow up these queries with local authorities and may identify concerns, including errors in reporting or misappropriation of spend

DHSC’s powers around non-compliance

Where issues or potential non-compliance with PH grant conditions are identified, the DHSC regional director of public health may engage directly with the local authority concerned to understand the circumstances, provide support and agree a resolution. This supportive, collaborative improvement approach is intended to ensure the effective use of funding and strengthen local governance.

Where issues remain unresolved or in cases of serious concern and non-compliance, DHSC has the power to intervene. These powers are set out in the PH grant circular and include:

  • requiring a local authority to commission an independent external audit of its grant expenditure
  • withholding or suspending future grant payments
  • if necessary, recovering funding not spent in accordance with the grant conditions

Where an independent audit is commissioned, the local authority will be responsible for any costs associated with the audit, which they can fund from their PH grant.

DHSC assurance activity is underpinned by strong, consistent and visible support to help local authorities to optimise the use of their PH grant.

From 2026, this includes an enhanced public health peer review and external improvement support for local authorities, with an expectation of local authority participation as set out in the PH grant conditions. This will further support local authorities to maximise the impact of public health funding and meet both local and national public health priorities in England.

Eligible expenditure under the PH grant

In discharging their statutory public health responsibilities, local authorities fund a wide range of public health services and activities through the PH grant. 

This section provides guidance on the areas of spend that are considered eligible for the PH grant, including those that:

  • are prescribed by legislation or set out in grant conditions
  • support local authority public health activities that are not explicitly specified in either of the above

This section also sets out principles to support local authorities in determining whether PH grant spend is eligible.

Public health functions prescribed by the 2012 and 2013 regulations

To ensure consistent, high-quality care across England, local authorities must comply with specific requirements in discharging their statutory public health functions.

This section sets out the prescribed functions and duties eligible for PH grant spend.  

National Child Measurement Programme (NCMP)

Regulation 3 of the 2013 regulations states that each local authority must, so far as is reasonably practicable, provide for the weighing and measuring of the children to whom the regulation applies.

Paragraphs 7A and 7B of schedule 1 to the 2006 act set out local authority duties and arrangements in respect of the weighing and measuring of junior pupils, which forms part of the NCMP.

Additionally, The Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013 set out additional requirements on the collection and use of data in relation to the weighing and measuring of children. Any spending under the relevant provisions of those regulations is also considered eligible under the PH grant.

Early years health visiting public health services

Under regulations 5A and 5B of the 2013 regulations, local authorities must, so far as is reasonably practicable, provide or make arrangements to secure the provision of universal health and development reviews for children aged 0 to 5. These reviews must be offered by health visitors to eligible families at 5 set points in time.

NHS Health Check programme

Regulations 4 and 5 of the 2013 regulations require local authorities to provide, or to make arrangements to secure the provision of, NHS Health Checks to eligible people in its area. They must ensure that all eligible people are offered a health check every 5 years.

Sexual health services

Under regulation 6 of the 2013 regulations, each local authority shall provide, or make arrangements to secure the provision of, open access sexual health services in its area. These include:

  • contraceptive services
  • services for preventing the spread of sexually transmitted infections (STIs)
  • services for treating, testing and caring for people with STIs
  • services for notifying sexual partners of people with STIs

Provision of public health advice to integrated care boards (ICBs)

Under regulation 7 of the 2013 regulations, for the purpose of assisting ICBs in relation to their commissioning duties, each local authority must provide, or make arrangements to secure the provision of, a public health advice service to any ICB whose area falls wholly or partly within its area.

This must consist of such information and advice to the ICB as the local authority considers necessary or appropriate with a view to protecting and improving the health of the people in the local authority’s area.

Health protection information and advice

Regulation 8 of the 2013 regulations requires local authorities to provide information and advice to responsible people and relevant bodies to enable the preparation of, or participation in, appropriate local health protection arrangements for their local population.

Dental public health functions

The 2012 regulations require local authorities to provide, or make arrangements to secure the provision of, oral health surveys and, to the extent that they consider appropriate for improving the health of the people in their area, oral health promotion programmes (such as supervised toothbrushing).

Note: section 520 of the Education Act 1996 also applies in respect of dental public health.

Annex A provides further information on the statutory public health functions and duties described in this section, as well as further detail on what discharging those duties may look like in practice.

PH grant conditions

PH grant expenditure must comply with all conditions set out in the PH grant circular. This includes those for the ring-fenced drug and alcohol and smoking cessation funding, and the need to have regard to reducing health inequalities.

Consolidation of the PH grant

As set out in the previous ‘About the consolidated PH grant’ section of this guidance, both the drug and alcohol and smoking cessation funding totals, which are the minimum level of spend for these services, are ring-fenced and must be used solely for their intended purposes.

Further information on the ring-fenced drug and alcohol and smoking cessation funding can be found in annex B of this guidance.

Health inequalities

Tackling health inequalities is a fundamental pillar of public health and a priority for the government. In discharging their public health functions (including the health improvement duty in the 2006 act), local authorities should consider how their activity can contribute to reducing health inequalities.

As set out in the PH grant circular, local authorities must, in using the PH grant, have regard to the need to reduce inequalities between the people in their area. Putting this into practice will involve identifying and understanding where inequalities are greatest, and considering what targeted actions through PH grant-funded services would tackle them. Local data and indicators, such as healthy life expectancy (HLE), should inform the approach.

Local authorities should consider how to use the PH grant to: 

  • improve and protect the local population’s health equitably
  • improve health in areas and communities with the lowest HLE
  • reduce the inequalities that exist in health outcomes between people of all backgrounds, and between communities, taking a proportionate universalism approach[footnote 1]

Local authorities should ensure that all services funded through the ring‑fenced PH grant are proactively designed and delivered in ways that make them fully accessible to the communities that experience the poorest health outcomes and/or may experience challenges accessing services. This includes action to identify and remove barriers for underserved groups, including those who:

  • face stigma or discrimination
  • are socially excluded
  • experience multiple disadvantages and/or deprivation

This should be through targeted action, where possible, and follow intersectional approaches across the life course that are:

  • inclusive of socio‑economic class, gender and sex, race and ethnicity, disability and vulnerability, and levels of digital access
  • culturally appropriate and language specific, where appropriate

Alongside commissioning and delivery of services and activities funded through the PH grant, local authorities may draw on their DPH leadership role across the 3 domains of public health (health improvement, health protection, and healthcare public health) to work with partners to enable whole-system action on health inequalities.

Public health activities that are not prescribed in legislation

In discharging their statutory health improvement duty, local authorities can fund a wide range of public health services using their PH grant in addition to the public health functions prescribed in legislation. This can include services such as:

  • obesity and healthy weight programmes
  • physical activity initiatives
  • public mental health
  • health at work
  • public health programmes for children and young people aged 0 to 19

DHSC does not set out a comprehensive list of the public health services that local authorities must commission or provide. Instead, local authorities are responsible for delivering services that fulfil their statutory duties.

Annex C of the PH grant local authority circular provides a list of public health spend reporting categories against which local authorities must report each year. These spend reporting categories are not a statement of what is prescribed as PH grant spend, but are instead an aid to consistent, comparable reporting and spend analysis. DHSC will continue to work to refine and update guidance that supports the completion of these spend reporting categories within the revenue outturn. 

Principles to determine whether local authority expenditure is eligible for funding from the PH grant

This section supports local authorities in determining whether PH grant expenditure is compliant. This may be especially helpful for expenditure that may relate to the wider determinants of health. Such spend should make a clear contribution to health outcomes and support efforts to reduce health inequalities.

The principles described in this section apply to all PH grant spend. They aim to help local authorities to adhere to their existing public health statutory duties and meet the PH grant conditions - they are not intended to introduce new requirements or conditions.

Where spend is delivered through local authority services outside the responsibility of the DPH, clear service-level agreements or memoranda of understanding (MoUs) should be in place to provide assurance of their primary health purpose and set out the expected public health outcomes.

The following set of tests and principles (intended to be considered together) can be used by local authorities to determine whether local authority expenditure is eligible from the PH grant.

Primary purpose test

Question: is the primary purpose of the proposed PH grant expenditure to improve or protect the health of the local population?

Principle: expenditure decisions must:

  • be focused on improving health outcomes
  • be incurred in support of local authorities’ statutory health improvement duty or public health functions prescribed in regulations
  • comply with grant conditions

Counterfactual test

Question: would this investment still be likely to be funded by the PH grant if the grant was given to an organisation other than a local authority?

Principle: if the activity would not continue to be appropriate were the local authority no longer responsible for the PH grant, then one or both of the following is likely:

  • it is required under other local authority statutory duties
  • the activity’s primary purpose is not a public health function intended to be funded by the PH grant

Additionality (not substitution) test

Question: does the spend deliver additional public health activity or outcomes beyond the primary purpose of the service and add value above existing activity and/or to the local health system, rather than replace or subsidise activity funded from other sources?

Principle: PH grant funding may contribute to other services where appropriate, but only where it:

  • provides additional public health benefit
  • makes a clear contribution to health outcomes
  • is not a substitute for general funding (or other grant) spend

It should not substitute other funding sources to balance local authority financial pressures where the main purpose is not public health.

Proportionality test

Question: for proposals spanning services delivering multiple outcomes, is the public health component clearly defined and is expenditure proportionate to the outcomes delivered?

Principle: the PH grant should fund only the proportion of activity directly linked to specific public health outcomes - not broader service costs or other statutory responsibilities. An external contract or internal agreement should be in place that states specific outcomes to enable audit and monitoring.

Best value test

Question: does the spend demonstrate continuous improvement and provide best value?

Principle: all PH grant expenditure must comply with the local authority’s Best Value Duty, delivering impact, value for money and continuous improvement in an economic, efficient and effective manner. In addition, it should comply with Provider Selection Regime procurement principles where funding is used to commission NHS organisations.

Annex A: what the statutory public health functions mean in practice

This annex provides further information on statutory public health functions for local authorities, as set out in the ‘Public health functions prescribed by the 2012 and 2013 regulations’ part of the ‘Eligible expenditure under the PH grant’ section of the main guidance above.

For each of the prescribed functions, a description is given of ‘what this means in practice’ against which local authorities can self-assess with a view to reviewing and improving.

National Child Measurement Programme

The NCMP is intended to provide robust public health surveillance data on child growth, including weight and height, to understand and monitor prevalences and trends in height and underweight, healthy weight, overweight and obesity at England-wide and local levels. Public health functions related to the NCMP help local authorities and other local and national organisations understand school-age child health inequalities, and inform child healthy weight and growth service planning and commissioning. 

Statutory aspects of the NCMP relevant for local authorities include:

  • in accordance with paragraphs 7A and 7B of schedule 1 to the 2006 act, and regulation 3 of the 2013 regulations: the weighing and measuring of reception (aged 4 to 5 years old) and year 6 (aged 10 to 11 years old) pupils in attendance at a school that is maintained by the local authority, an academy school in the local authority’s area, or a school known as a city technology college or a city college for the technology of the arts that is in the local authority’s area. Additionally, a local authority may, by arrangement with the proprietor of any school in its area that is not maintained by the local authority, provide for the weighing and measuring of junior pupils in attendance at that school
  • in accordance with regulations 8 to 19 of the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013: the collection, processing, disclosure and onward use of children’s height and weight data, parental involvement, information sharing and guidance

What this means in practice

Local authorities are responsible for collecting measurement data for all eligible children in their area, including those attending:

  • maintained schools (such as community, foundation, voluntary and local authority-maintained faith schools, but not community special schools or foundation special schools in the local authority’s area)
  • academy schools (including free schools, but not a school that is specially organised to make special educational provision for pupils with special educational needs)
  • city technology colleges

A list of state-funded schools can be found in the National Child Measurement Programme: operational guidance.

This is part of a wider programme to promote child health by:

  • supporting healthy weight and growth during childhood and providing robust data to underpin the PHOF indicators for this topic
  • monitoring and taking action to improve child health, including preventative action in a child’s wider health environment such as in schools and the local community
  • engaging with parents prior to and after measurements. This provides an opportunity to promote a child’s health, growth and offer support for healthy lifestyle choices to over a million children on an annual basis

Local authorities are not obliged to share information resulting from the weighing and measuring exercise about an individual child with the child’s parents, but are permitted to do so with a view to the information being used to help the child concerned to improve their health. Many local authorities do use the opportunity to offer early help and action by proactively offering support to children and families to enhance their health.

Early years health visiting public health services

Universal health and development reviews (also known as ‘early years (ages 0 to 5) health and development reviews’ or ‘universal health visitor reviews’) must be offered by local authorities at 5 specified stages. They can be commissioned by local authorities or provided directly by local authorities themselves.

Local authorities must, so far as is reasonably practicable, provide or make arrangements to secure the provision of a universal health visitor review to be offered to or in respect of the following eligible people:

  • a woman who is more than 28 weeks’ pregnant (referred to as the ‘antenatal health and development review’)
  • a child who is aged between 1 day and 2 weeks old (referred to as the ‘new birth health and development review’)
  • a child who is aged between 6 and 8 weeks old (referred to as the ‘6-to-8-week health and development review’)
  • a child who is aged between 9 and 15 months old (referred to as the ‘12-month health and development review’)
  • a child who is aged between 24 and 30 months old (referred to as the ‘2-to-2-and-a-half-year health and development review’)

Additional health and development reviews may be completed between ages 0 to 5 in response to assessed need. These are not statutory and are typically offered to those aged 3 months, 6 months or 3 and a half years old.

Note that universal health and development reviews are a statutory aspect of the healthy child programme. Further guidance for local authorities in respect of commissioning and delivery of the programme can be found at Healthy child programme.

What this means in practice

Local authorities must offer universal health and development reviews at the 5 specified stages. They should be delivered face to face and at home (where this is the most suitable location clinically and for the family). These health and development reviews must be led by qualified health visitors, with additional contacts prompted by needs uncovered during the reviews. Additional contacts can often be delegated by the health visitor to members of their team. 

Completion of the 5 statutory health and development reviews at the specified stages is essential, but alone does not ensure a safe, effective and equitable health visiting service. Each review should ensure meaningful and therapeutic contact with the family, including:

  • a holistic assessment of the infant’s health, development and wellbeing
  • a comprehensive assessment and evaluation of family circumstances, including parental physical and mental health, caregiving, family relationships and environmental factors
  • recognition and sensitive discussion of any additional needs or disabilities children or their parents may have, including learning, physical, sensory or neurodivergent needs, and how these may influence child development and parenting
  • active identification and exploration of family needs, concerns and aspirations
  • support to strengthen parental capacity, resilience and confidence in caregiving through tailored guidance and evidence-informed strategies
  • consideration of safeguarding or child protection concerns, where relevant
  • supportive exploration of caregiving practices, sleep routines, infant or child supervision, and risks of substance misuse (where appropriate), with a focus on building parental awareness, confidence and capacity to create safe, nurturing environments for their child

While health visitors should facilitate access to wider services such as financial advice, housing support or mental healthcare, the primary focus of each review is to assess and support the child’s health and development and their family’s overall health and wellbeing.

NHS Health Check programme

Regulations 4 and 5 of the 2013 regulations require local authorities, in the exercise of their public health functions, to provide, or make arrangements to secure the provision of, health checks to be offered to eligible people in their area. Information related to each check must be recorded and processed in accordance with the 2013 regulations. Local authorities must ensure that all eligible people are offered an NHS Health Check assessment every 5 years in accordance with the 2013 regulations.

Local authorities shall act with a view to securing continuous improvement in the percentage of eligible people in their area participating in health checks. Achieving continuous improvement in the percentage of eligible people participating in the NHS Health Check may require a proportionate universalism approach. This means that local authorities may target a greater extent of their resource towards higher-risk and vulnerable communities to increase the likelihood of equity of health outcomes, while keeping a universal offer to all eligible people.

What this means in practice

All local authorities must offer, or make arrangements to secure the offer of, health checks to all eligible people once every 5 years in accordance with the specified content in the regulations. Official NHS Health Check statistics are published by DHSC on a quarterly basis, including helpful data resources to assess local delivery of the programme.

Local authority and NHS colleagues supported the development of best practice guidance and programme standards, which promote a strong focus on quality improvement, including effective risk communication, supporting behaviour change and risk management at a local level.

With the aim of increasing flexibility and access to the NHS Health Check programme, an online version is currently being tested in a small number of local authorities. Subject to the outcomes of this testing phase and successful completion of a Government Digital Service assessment, this delivery model may be available more widely in the future.

Sexual health services

Sexual health services are one of the larger areas of spend within the PH grant.

Commissioning responsibilities are shared across different organisations, including local authorities and ICBs. This requires co-operation in commissioning and/or delivery between different organisations across geographic areas and populations of different sizes, such as locally, sub-regionally and regionally.

Effective joint planning and joint working between local authorities and ICBs on the sexual and reproductive health needs of their populations, and at different phases of the life course, is critical given these shared responsibilities. For example:

  • local authorities have certain duties in respect of contraception (as outlined below)
  • ICBs commission contraception where it is provided as part of gynaecology services, vasectomy and sterilisation, and as part of non-specialist abortion care pathways
  • commissioning of contraceptive services provided under the GP Contract and the NHS Pharmacy Contraception Service is delegated to ICBs and overseen by DHSC

Regulation 6 of the 2013 regulations requires each local authority to provide, or make arrangements to secure the provision of, open access sexual health services in its area including:

  • exercising the Secretary of State’s function to make arrangements for contraceptive services under paragraph 8 of schedule 1 to the 2006 act, which covers the:
    • giving of advice on contraception
    • medical examination of people seeking advice on contraception
    • treatment of such people
    • supply of contraceptive substances and appliances
  • preventing the spread of STIs
  • treating, testing and caring for people with STIs
  • notifying sexual partners of people with STIs
  • preventing, testing and partner notification relating to human immunodeficiency virus (HIV). The duty does not include a requirement to offer services for treating or caring for people living with HIV

Local authorities must ensure that the following are made available:

  • advice on, and reasonable access to, a broad range of contraceptive methods
  • advice on preventing unintended pregnancy

Local authorities do not have the statutory responsibility for the provision of sterilisation, vasectomy or termination services, other than the giving of preliminary advice on availability and as an appropriate method of contraception for the person concerned. Local authority-commissioned sexual health services are not required to offer services for treating or caring for people infected with HIV, as this is typically commissioned by ICBs.

In terms of non-prescribed aspects of sexual health, local authorities also provide information, advice and support on a range of sexual health issues (such as on STIs, contraception, relationships and unplanned pregnancy), and infectious disease surveillance and control. Establishing good links between services and local schools in terms of their effective delivery of statutory relationships, sex and health education is encouraged, including providing young people with information on local sexual health service provision. 

For HIV specifically, DHSC has published the HIV Action Plan for England, 2025 to 2030 in order to end new transmissions of HIV in England by 2030. The plan includes a range of locally led actions for local authorities to consider, co-developed with local system colleagues. The collaboration emphasised in the HIV Action Plan provides a useful model for wider sexual and public health commissioning and delivery.

What this means in practice

Local authority and ICB commissioners are expected to work collaboratively to map service user pathways and plan services according to population need, which may include the formal joint commissioning of services.

Section 75 of the 2006 act allows NHS bodies and local authorities to form formal partnerships to pool budgets and commission on behalf of or jointly commission services, while section 65Z5 of the 2006 act allows them to make delegation arrangements or jointly exercise functions.

All local commissioners should work together to provide a seamless and efficient service for their service users and population. Each commissioner is expected to discuss plans as early as possible with other commissioners in the area to identify and mitigate risks to services that they may not commission, but which their commissioning decisions may impact upon. For example, commissioners can work together across organisational boundaries to increase cohesion of services such as:

  • teenage pregnancy prevention
  • school nursing
  • community and post-pregnancy contraception
  • cervical screening (carried out in community clinics for women who do not access GP services for sexual health)
  • drug and alcohol services (particularly in respect to prevention and treatment of sexualised drug use, also known as ‘chemsex’)

Some local authorities may also choose to commission with their neighbouring authorities to realise economies of scale. Local authorities should also make arrangements to cover users from outside their local authority boundary or region where their residents access services elsewhere. Materials such as LGA’s Collaboration and co-operation: sexual and reproductive health commissioning in local government and ‘What good sexual and reproductive health and HIV provision looks like (PDF, 266KB)’, part of the ADPH What good looks like series, may be helpful for local authorities.

Provision of public health advice to ICBs

Regulation 7 of the 2013 regulations requires local authorities to arrange for the provision of public health advice to ICBs to support the exercise of their commissioning functions.

This provision is described in regulation 7 as “each local authority shall provide or shall make arrangements to secure provision of a public health advice service to any ICB whose area falls wholly or partly within the authority’s area” and, further, that a public health advice service “consists of provision of such information and advice to an ICB as the local authority considers necessary or appropriate with a view to protecting or improving the health of people in the local authority’s area”.

In addition, section 14Z38 of the 2006 act gives each ICB a duty to obtain advice appropriate for enabling it to effectively discharge its functions from people who (taken together) have a broad range of professional expertise in the:

  • prevention, diagnosis and treatment of illness
  • protection or improvement of public health

The local authority public health advice service is intended to support ICBs in relation to their duties under the 2006 act - specifically in their commissioning duties.

The 2013 regulations require the range of matters covered by the public health advice service to be:

  • kept under review by the local authority
  • determined by having regard to local population needs and by agreement with the relevant ICB, or by the local authority in default of agreement

The 2013 regulations also set out a non‑exhaustive list of matters that the public health advice service may include, such as:

  • population health summaries
  • condition‑specific needs assessments
  • advice on planning for anticipated care needs
  • advice on meeting ICBs’ duty to reduce inequalities

These responsibilities are further described in DHSC guidance for local authorities Providing healthcare public health advice to integrated care boards, which was issued in January 2026.

That guidance is non-statutory. However, section 73B of the 2006 act requires local authorities to have regard to any document published by the Secretary of State for the purpose of local authority public health duties in the 2006 act. The guidance recognises that changes to ICB and local authority boundaries will require local authorities to review the best way to provide this function most efficiently. These models may be determined locally and can be guided by the following principles:

  • the DPH, as professional lead, should ensure that the ICB has access to all the skills needed within the ICB and local authority teams. If necessary, additional support should be commissioned separately by the ICB
  • the delivery of public health advice needs strategic leadership from the DPH and input from registered specialists in public health
  • working arrangements will need to support embedding public health advice into ICB decision making, rather than it being a transactional arrangement
  • arrangements will need to reflect the need for public health advice to support actions at ICB, place and neighbourhood levels

It is good practice for an MoU and annual work plan to be agreed between the DPH and the ICB. This should include:

  • how the DPH is represented in the relevant decision making
  • what is required from the ICB - for example, data-sharing agreements or honorary contracts

The June 2012 DHSC publication Public health advice service for clinical commissioning groups is historic guidance produced for the former clinical commissioning groups system and is relevant only as background to the original policy intent. Current arrangements for ICBs are set out in DHSC’s January 2026 guidance on providing healthcare public health advice to integrated care boards (linked above). However, the 2012 publication provides useful background to the public health advice service and complements the 2026 guidance on providing healthcare public health advice to ICBs.

What this means in practice

The type of public health advice local authorities may provide ICBs includes:

  • demonstrable strategic leadership for the service by the DPH to build collaborative relationships across the commissioning landscape
  • input from registered specialists in public health and an agreed specialist capacity devoted to the service
  • a written agreement between the local authority and each ICB in the area describing the service
  • an agreed annual work plan to provide public health advice to inform the ICB’s strategic commissioning decisions
  • arrangements to monitor and review the service at regular intervals
  • a demonstrable contribution through the service to priorities in the JSNA, JLHWSs, ICB population health improvement plans and improved outcomes

The service must be offered free of charge to each ICB in the area covered by the local authority.

Health protection information and advice

The duty of the local authority, under regulation 8 of the 2013 regulations, is to provide information and advice to relevant people and organisations, including ICBs, to ensure that appropriate arrangements are in place to help protect the local population from events or occurrences that threaten or are liable to threaten their health.

The DPH will usually oversee and deliver those functions on the local authority’s behalf. Additionally, under section 73A(1)(d) of the 2006 act, DsPH have responsibility for the exercise by the local authority of any of its functions that relate to planning for, or responding to, emergencies involving a risk to public health.

In discharging their duty under the 2013 regulations, local authorities might incur spend on the following activities, which should also be considered as in scope of the PH grant:

  • staffing, analysis, partnership and co-ordination, and communication campaigns and messaging
  • commissioning of services delivering public health leadership, advice, prevention and support to reduce infection risks and inequalities in community settings
  • for environmental incidents such as floods, air quality events or chemical releases, the DPH’s leadership, advice, public health risk communication and assessment of health impacts

Local authorities considering PH grant spend to fund activities that go beyond fulfilment of regulation 8 of the 2013 regulations should apply the tests and principles set out in the ‘Principles to determine whether local authority expenditure is eligible for funding from the PH grant’ part of the ‘Eligible expenditure under the PH grant’ section of the main guidance above, as is the case for all PH grant spend.

There are a range of complementary roles and responsibilities in relation to health protection held across the public health system. Effective local health protection depends on relevant organisations working in partnership and taking a collaborative approach.

Local authorities may wish to refer to relevant guidance relating to health protection responsibilities to determine if the activity the proposed spend relates to falls within the remit of:

  • the DPH
  • the wider local authority
  • wider system partners

This may be particularly useful in determining resource allocation in response to specific incidents, including where the DPH or wider local authority wishes to support members of the local population impacted by the incident, and when the incident occurs outside of NHS settings. For example:

Broadly, UKHSA is the national expert body providing leadership for health protection, including:

  • surveillance
  • epidemiology
  • expert scientific and operational advice and guidance to local systems
  • targeted advice and guidance to the public through case and contact follow-up

The NHS is responsible for the provision of clinical and healthcare services such as:

  • immunisation
  • screening
  • medical triage
  • clinical response to local communicable disease outbreaks
  • infection control and management within NHS settings

The DPH, in exercise of their responsibility (under section 73A(1)(d) of the 2006 act), should assure themselves that local health needs have been appropriately considered, and that there is agreement among local partners around roles and responsibilities (including funding). They will work closely with UKHSA and the NHS as part of the local health protection system.

Where the DPH identifies an issue, they should be able to escalate any concerns as necessary with the appropriate partner organisations, including UKHSA and the NHS, to ensure that robust local health protection plans are in place. Where appropriate, DsPH should work through local resilience forums.

What this means in practice

Health protection incident management will be appropriately informed by the expert advice and leadership of the DPH. This will help ensure health protection incidents are effectively managed through emergency planning and multi-agency response arrangements agreed by relevant local partners, in accordance with statutory duties.

UKHSA provides the specialist health protection response, while the NHS leads the clinical and operational response in accordance with relevant national operating procedures in England.

The DPH:

  • has a statutory responsibility for their local authority’s public health functions
  • provides expert public health advice and leadership
  • plays a critical role in seeking assurance that local arrangements for responding to health protection incidents are effective

Dental public health functions

Section 111 of the 2006 act states that a local authority has functions in relation to dental public health in England as may be set out in legislation. Functions may be discharged by:

  • a local authority itself
  • local authorities working together
  • any other person or body in accordance with arrangements made by the local authority

Regulations 16 and 17 of the 2012 regulations prescribe functions and duties on local authorities in respect of dental public health. Regulation 16 defines an:

  • ‘oral health promotion programme’ as a health promotion and disease prevention programme, the underlying purpose of which is to educate and support members of the public about ways in which they may improve their oral health
  • ‘oral health survey’ as a survey to establish the prevalence and incidence of disease or abnormality of the oral cavity

Regulation 17 requires each local authority to provide, or make arrangements to secure the provision of:

  • oral health promotion programmes, to the extent the authority considers appropriate for improving the health of the people in its area
  • oral health surveys to facilitate:
    • the assessment and monitoring of oral health needs
    • the planning and evaluation of oral health promotion programmes
    • the planning and evaluation of the arrangements for provision of dental services as part of the health service
    • where there are water fluoridation programmes affecting the local authority’s area, the monitoring and reporting of the effect of water fluoridation programmes

Local authorities must also participate in oral health surveys conducted or commissioned by the Secretary of State where those surveys are conducted within their area.

These functions inform oral health improvement programme planning, commissioning and evaluation. The data from oral health surveys also aids understanding of oral health inequalities and is used for local and national policy development in England.

What this means in practice

Local authorities are responsible for exercising prescribed dental public health functions in addition to their wider duty to improve population health. In practice, this includes:

  • supporting oral health improvement during childhood, such as supervised toothbrushing programmes, and providing robust data to underpin the PHOF and LOF indicators relating to the reduction in tooth decay rates in 5-year-old children
  • making provision for the collection of tooth decay data for randomly selected children in schools (including local authority-maintained schools) - the local authority shall participate in any oral health survey commissioned by the Secretary of State so far as that survey is conducted within the authority’s area
  • monitoring and taking action to improve the local population’s health, including preventative action in schools and the local community

The PH grant includes funding for supervised toothbrushing programmes. Local authorities may enter into a range of local funding arrangements with NHS bodies to discharge their wider dental public health functions. These arrangements may vary by local authority area.

Annex B: ring-fenced funding conditions

This annex provides guidance on ring-fenced drug and alcohol and smoking cessation funding.

Drug and alcohol

Public health grants to local authorities: 2026 to 2027 includes conditions that require the ring-fenced drug and alcohol funding total to be used solely for the purposes of commissioning and providing drug and alcohol prevention, treatment and recovery-related services. 

In using the funding, local authorities must have regard to the need to improve the take-up of and outcomes from its drug and alcohol misuse treatment services, in accordance with grant conditions. This should be based on an assessment of local need and ensure equity of access to guideline-recommended medicines and interventions, including residential treatment.

Conditions also require that local authorities must provide DHSC annually with a comprehensive prevention, treatment and recovery plan for agreement, which has been developed with local health, housing, employment, children and families, and criminal justice partners.

Where a local authority’s current allocation is made up of one or more of the following funding components, this should be reflected in the annual plan:

  • in-patient detoxification
  • individual placement and support
  • rough sleeping drug and alcohol treatment
  • housing support

DsPH are required to complete a report twice a year for protected drug and alcohol funding. This should cover any underspend from the drug and alcohol protected funding held in the public health reserve, which must only be used on those services.

The publicly available mechanism for monitoring the outcomes of treatment and recovery is through the data published on the National Drug Treatment Monitoring System (NDTMS) website. More frequent monthly data on drug treatment and recovery outcomes is available to local authorities and providers.

What this means in practice

In each local authority, there should be:

  • an accessible drug and alcohol treatment and recovery system that includes a full range of NICE and clinical guidance-compliant drug and alcohol interventions. These interventions should aim to treat both alcohol and drug dependence and reduce harm, based on local authority prevalence, need and current outcomes
  • evidence-based prevention activities to reduce harm and improve resilience among young people and vulnerable groups, such as:
    • homeless people or hostel dwellers
    • offenders
    • men who have sex with men
    • new psychoactive substance users
  • compliance with NDTMS reporting
  • improving rates of retaining adults in treatment for at least 12 weeks (or successful completion of treatment in that period of time) - or stability if performance is already in the upper quartile
  • improving rates of substantial treatment progress for adults in treatment - or stability if performance is already in the upper quartile
  • widely available needle exchange, particularly as an entry point to treatment
  • clarity on clinical governance arrangements including reporting of serious untoward incidents
  • effective partnership arrangements with wider health systems to enable improved outcomes including:
    • mental health services
    • housing services
    • employment support
  • effective pathways between police, court or prison and community treatment for people with drug and alcohol needs
  • evidence-based commissioning with service reconfigurations driven by improving cost-effective outcomes

Smoking cessation

The PH grant circular includes conditions that require the ring-fenced smoking cessation funding to be used for the purposes of providing smoking cessation services to support smokers to quit and is the minimum amount that must be spent on this provision.

The aim of this funding is to ensure that there is a comprehensive offer to help people stop smoking across England and increase the number of smokers engaging with effective interventions.

This aim should be achieved by:

  • stimulating more quit attempts by providing more smokers with advice and support
  • building capacity in local authority areas to respond to increased demand for support to quit
  • providing high-quality, accessible and evidence-based stop smoking interventions
  • ensuring effective referral and self-referral pathways so that all smokers can access evidence-based stop smoking interventions
  • strengthening partnerships in local healthcare systems to identify, refer and support more smokers

What this means in practice

Local authorities may use this funding to invest in the following:

  • leadership, co-ordination and commissioning by:
  • supporting smokers to quit by:
    • ensuring a range of high-quality, accessible and evidence-based stop smoking interventions are available
    • recruiting dedicated specialist staff to provide smoking cessation interventions and support to non-specialist advisers. They should also ensure all staff are appropriately trained and mentored to deliver high-quality interventions
    • improving the knowledge and skills of non-specialist staff (other healthcare professionals including nurses and pharmacists) to extend the reach of stop smoking interventions
    • providing access to specialist and non-specialist advisers in locations where smokers routinely attend, such as GP surgeries, mental health services and employers
    • ensuring all first-line stop smoking aids are available for all smokers accessing support to quit, as set out in NICE and NCSCT guidance
    • enhancing the overall service infrastructure, including digital and remote support, establishing physical presence in prominent locations and conducting targeted outreach efforts, particularly for local priority populations
  • building demand for local stop smoking services through:
    • effective referrals and pathways into support through a range of different mechanisms, such as routine screening and recording of smoking status
    • active promotion of services with materials, social media marketing and advertising of tailored messaging for communities with the greatest need
    • using funding across the region to work together to co-ordinate marketing, service design and delivery, and wider activities geared to stimulate quitting

Local authorities are expected to obtain their own legal advice to ensure compliance with their statutory duties.

Annex C: resources

Local authority and public health guidance, responsibilities and frameworks

Useful guidance and resources include:

Public health functions prescribed by 2012 and 2013 regulations

Useful guidance and resources include:

  1. ‘Proportionate universalism’ is a term originally coined by Professor Sir Michael Marmot in Fair Society, Healthy Lives: the Marmot Review - a strategic review of health inequalities in England post-2010. The approach is defined in the executive summary of Health Equity in England: The Marmot Review 10 Years On as “policies and interventions which are universal but developed to be more intense where need is higher - to be proportionate to need”. ↩

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