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Focus on: Public health and prevention: Research summary

Has the quality of services changed over recent years?

This report provides a summary of changes in key public health indicators, supported by qualitative evidence from professionals closely involved with the delivery of public health services.

We examined trends and regional differences in 20 indicators of quality across five areas of public health (sexual and reproductive health and HIV; substance misuse; smoking; childhood obesity; and immunisations). The research uses nationally available indicators from the Public Health Outcomes Frameworks and other validated sources to examine changes in public health indicators in England between 2009 and 2014, and regional variation in trends. A full list of these indicators is available in the appendix document.

In order to provide a more nuanced view of the current picture in England, we carried out an online survey among directors of public health (DsPH). The survey response rate among DsPH was 28% (34/120). There were three additional unexpected responses from public health consultants, which made a total of 37 responses from senior public health professionals. The aim of the survey was to deepen our understanding of how recent system reforms and funding pressures
have affected the quality of public health services and functions. This survey was also used to identify topic areas to explore in more detail using quantitative analysis. This information was supplemented by interviews with 11 DsPH and 11 individuals from other service provider and advocacy organisations for public health in order to triangulate findings between the local views and national data.

It is important to note that the numbers of individuals surveyed and interviewed was small, so the views expressed are not necessarily generalisable or representative of all those working in these areas across England. However, the reflections do provide valuable context and highlight important issues that would not have been evident from examination of the population-level indicators alone.