Policy responses and statements

Name of organisation:

Department of Health

Name of policy document:

Informing healthier choices - Information and intelligence for healthy populations

Deadline for response:

5 May 2006

Background: This consultation invites comments from all interested parties and stakeholders on the public health information and intelligence strategy, devised as part of the delivery plan for the White Paper Choosing Health: Making Healthier Choices Easier.

The strategy supports wider health priorities such as action on health inequalities, health protection and effective commissioning of health and wellbeing. It aims to improve the availability and quality of health information and intelligence across England and to increase its use to support population health improvement, health protection and work on care standards and quality. The strategy will support the delivery of Choosing Health and the new White Paper Our health, our care, our say: a new direction for community services by making information and knowledge available to local communities to inform their decisions

COMMENTS ON
DEPARTMENT OF HEALTH
INFORMING HEALTHIER CHOICES: INFORMATION AND INTELLIGENCE FOR HEALTHY POPULATIONS

The Royal College of Physicians of Edinburgh is pleased to have the opportunity to comment on this consultative document, particularly as it is only too evident to practitioners that currently public health information systems are substantially underdeveloped.   This situation applies across the UK, and accordingly the College suggests that such developments of these information services as are now being considered should apply not only to England, but to all the nations of the UK; indeed, public health information requirements differ little within the UK.

However, the College supports the general objectives of the strategy for development as described, which would, amongst other benefits, make much more relevant information and knowledge, than is currently obtainable on a regular basis, available to health care workers, to inform their decisions, and also to support directors of public health in their preparation of reports on states of health of the residents of the local communities for which they are responsible.   However, the College notes the intention to collect data from many sources and organisations, and is concerned that such data may not have uniform quality of accuracy and validity etc unless special care is taken to ensure that this is the case.   The College would therefore favour development of fewer datasets which have been subjected to rigorous scrutiny, rather than a rapid development of many more datasets of lower credibility, even if this slows down the development of the intended project overall.  Lessons learned from the development of such datasets of high credibility could then be applied to the developments of further datasets of many types and in many areas of public health.

The document describes the work of many organisations, referring to their resources, policy priorities, websites etc and discusses joint working and how health indicators might be modelled.  However, it is not clear how work linking all these disparate activities might be coordinated.  There is also is no flow diagram in the document to indicate the specific timescale of the actions proposed, nor of the desired outcomes of each in relation to that timescale.  Flow diagrams could be derived from the statement on page 5 about the lessons to be learned from the second Wanless Report.

The College also notes that, as stated in the document, health-related information mainly relating to individuals is usually more readily available than are data relating to social variables, such as poverty, deprivation, housing, transport etc, but also notes that the document does not indicate how such data might be related to the developments planned by the Department of Health (it does indicate locations where some of these data may become available).

Accordingly, while the College supports the general thrust of the documents, and regards the development of improved public health information as a most desirable objective, and one that is necessary for sustained improvements to population health, it regards this consultative document as being inadequate as regards how these objectives might be achieved, by whom, on what timescale, and as regards identification of the resource requirements to achieve this.   It is clear that much more work needs to be done in this area.  The document indicates on page 30 that two working parties would be set up to oversee this work, but more work needs to be done first if they are to be given clear direction and terms of reference.  The College also hopes that these working groups will include within their membership users of public health information working in the field.

As regards the specific questions posed within the document (page 35) for the consultation, the answers provided by the College are as follows:

1. In a rather vague manner the current position has been described, and the main problems identified, but much more research and refinement is required before a more precise agenda for development can be defined.

2. The proposed National Analysts Forum should be useful, but more involvement of users of information is required, including at the stage of defining precisely the task to be addressed.  A Strategy Implementation Steering Group will be needed, but there is much work to be done before implementation can be discussed.

3. The overall vision seems appropriate, but more work needs to be done in particular in defining the necessary data areas in the fields of social and economic determinants of health.

4. The vision, in so far as it is defined, seems appropriate; however, much more clarification and detail is required.

5. To answer this question properly, a representative group of public health information users should be sounded out on these issues.

6. Priority should be given to indicators of social and economic determinants of health in communities, as such indicators are essential for targeted actions designed to reduce health inequalities.

7. There will always have to be a balance between developing new data sources and using existing ones, and, on the basis of information currently available, the indicated balance seems about right.

8. It is far from clear who should accept responsibility for developments in this area, although the inferences are that responsibility would be located somewhere within the Department of Health.  More success might be achieved if the regional public health observatories were to be invited to accept the lead in this area.

9. The likely obstacles are likely to include lack of a will over a long period to complete the job properly, a failure in involve adequately those working at the “shop floor” of public health, and inadequate resourcing of the project.

10. The College would be pleased to identify experts in the field who could, with others, advise the Department on how best to develop further thinking in the area of public health information and data, and also on how to implement the desired developments.

Copies of this response are available from:

Lesley Lockhart,
Royal College of Physicians of Edinburgh,
9 Queen Street,
Edinburgh,
EH2 1JQ.

Tel: 0131 225 7324    ext 608
Fax: 0131 220 3939

[5 May 2006]