Put prevention at a premium for place-based health dividend, Localis urges

Ministers should fully fix cuts to public health funding and put a premium on preventative care budgets, targeting resources and funding to parts of the country that would benefit most from immediate help, a new report from the think-tank Localis has recommended.

In a report entitled ‘Local Practice – long-term sustainability through place-based health’, Localis calls for the introduction of a Prevention Premium – modelled after the schools’ Pupil Premium – to support the joined-up delivery of public health in an area.

The Prevention Premium would be calculated on population factors such as unemployment rate, numbers of children in low-income families and percentage over-65s as well as lifestyle factors such as smoking, childhood obesity and physical inactivity in adults.

According to analysis undertaken by Localis, residents of Blackpool, Hull and North East Lincolnshire are the top three areas that would benefit most from a prevention premium, followed by four North East areas including Middlesbrough, South Tyneside, Hartlepool and Sunderland.

The report also calls for major local employers to have a bigger role in improving community health alongside pleas for better use of NHS data and property assets.

To fix a looming crisis in the healthcare labour market, the report recommends local authorities should work hand-in-hand with NHS Trusts in filling gaps for overseas health and care workers after-Brexit, and also urges an overhaul to how we recruit and retain UK born nursing and social care staff in areas where they are most needed.

Report co-author, Localis research officer, Zayn Qureshi, said: “This report stresses the need for individuals to take back control over their own health and shows what could be possible by taking a whole-place view - one focused on delivering better health outcomes at local level.

“Where we live, and the communities in which we grow up in shape who we become, and this has a profound effect on our continual health. We must, therefore, help communities to constantly improve their collective health through a radical emphasis on the preventative as a first line of defence.”

Localis chief executive, Jonathan Werran, said: “The Spending Round announcement of a real terms increase in the Public Health grant, helping local authorities continue to provide prevention and public health interventions is clearly a welcome step. But funding needs to be restored to 2015 levels as a minimum.

“Local Practice makes this funding case for a stronger place-based health system, offering a pragmatic argument for liberating resources, assets and the huge latent potential that exists within every community for generating greater wellbeing and prosperity.

“It is a call to rationally manage limited resources and deploy data and new technology for the best results. As such the report offers, we hope, a prescription to astutely integrate agents of health with guardians of place for the sake of delivering the best and most appropriate care to people through all stages of life.”

Report co-authors, Dr Geoffrey Boxer and Linda Boxer MBA, said: “Having worked across the spectrum of healthcare for almost 40 years we have first-hand experience of how the NHS operates, from primary care to management of services within a specialist teaching hospital environment through to research & development and clinical trials.

“We welcome this opportunity to use our unique perspective to consider what reforms might revolutionise the NHS and address the challenge of delivering increasingly complex and expensive therapies to an ageing population within a tightly constrained budget.

“Amongst the reforms that we believe have such potential is the encouragement of consumer-led healthcare and empowerment of local practitioners to generate solutions to specific regional healthcare and wellbeing issues.”


Press enquiries:

Jonathan Werran, chief executive, Localis
(Telephone) 0870 448 1530 / (Mobile) 07967 100328 / (Email) jonathan.werran@localis.org.uk

Notes to Editors:

  1. A full copy of the report can be downloaded here:


  1. The top ten places for preventative care demand are:

1 Blackpool

2 Kingston upon Hull, City of

3 North East Lincolnshire

4 Middlesbrough

5 South Tyneside

6 Hartlepool

7 Sunderland

8 Wolverhampton

9 Medway

10 Knowsley

  1. Report recommendations:

1. We reiterate our call for local authorities to be given a coherent and comprehensive finance settlement that is fit for purpose. One that is set on longer cycles of ten years, which would facilitate long term planning of the prevention agenda.

2. In addition to the public health grant, upper tier local authorities should be provided with a Prevention Premium, modelled after the Pupil Premium grant for school funding, to help support the transition to public health delivery interlinked across all council functions and wider civil society actors and institutions. The premium would be calculated based on demographic factors, reflecting two pinch points for public health. On the one hand, the rate at which the population is ageing and on the other the prevalence of child poverty.

3. The new government should work toward releasing the Social Care Funding Green Paper at the earliest convenience, the paper should contain guidance on the joining-up of services to create holistic public health strategies as a form of preventative care.

4. The beneficial role Local Economic Anchors can play in tackling emerging public health challenges should be recognised by giving them a seat at the table on Health and Wellbeing Boards. This would lead to further collaboration between all local stakeholders including the local health and social care sector, local authorities and business.

5. Integrated Care Systems should be funded to employ health economists, to evaluate public health initiatives within a place and their effect on local NHS demand.

6. Roles should be created within Integrated Care Systems for marketing specialists, to work with local authorities within the ICS area to develop links between the NHS, the local community and the commercial healthcare and fitness sectors.

7. Constituent local authorities should be given a formalised role to act as conveners for Integrated Care Systems to actively engage with local educational institutions, to ensure a holistic, joined-up health education system, sensitive to local context, is in place.

8. CCG mergers should be halted and rolled back, with the aim of achieving parity with local government to ensure the legitimacy of locally-delivered healthcare.

9. Government, the NHS and local authorities must commit to greater collaborative working. Central to this, these partners must also sensitively and securely unlock greater potential from locally-derived patient data ‘the jewel in the health service crown’. This will mean funding to build robust systems for the effective storing, mining and analysis of larger databases including clinical and public health outcomes at appropriate sub-regional level. From this point forward, joint funding arrangements involving NHS England should be put in place, with the goal of analysing the success of health interventions across local public services.

10. In line with existing reforms to public property assets, efforts should be made by managers of the NHS estate to collocate different healthcare professionals from across the health service – e.g. GPs, nurses, pharmacists – in modern working environments within the community that support best patient care.

11. A joint nursing role that combines health and social care responsibilities should be created. This would accelerate steps toward delivering integrated care, give nurses a practical understanding of what this means, and offer concrete career prospects. For example, by employing individuals on a rotational basis whereby they work part time in the community, and part time in the acute setting, one would develop a range of skill sets, which would allow people more scope and opportunity regarding their career prospects.

12. A comprehensive immigration system that puts place-based needs first is essential post-Brexit. We propose a deal whereby visa quotas per sector are devolved to local government as they are best suited to know the needs for growth in their area. Local authorities in partnership with local NHS trusts are in a better position to identify their and recruit for themselves. Even outside of healthcare, local authorities can identify key sectors where immigration is needed and can fill gaps whilst creating incentives for people to take opportunities to train and work in their areas.

13. Efforts should be doubled to reverse the fall in numbers of nurses, GPs, and other health and social care professionals through a focus on increased homebased training. A start should be reversing the abolition of bursaries for nursing students. More institutions and places to study should be made available, with clear incentives laid out for training in specialities where there are current shortages. This should involve having clearly laid out opportunities for an upward career trajectory to boost morale.

14. Efforts should also be made to attract more young British people to work in social care, especially in areas which have experienced a brain drain and thus have a higher median age. This involves a necessary boost of investment into the social care budget, which would allow for raising wages, and creating new opportunities and prospects for social workers.

About Localis

Who we are

We are an independent, cross-party, leading not-for-profit think tank that was established in 2001. Our work promotes neo-localist ideas through research, events and commentary, covering a range of local and national domestic policy issues.


Our research and policy programme is guided by the concept of neo-localism. Neo-localism is about giving places and people more control over the effects of globalisation. It is positive about promoting economic prosperity, but also enhancing other aspects of people’s lives such as family and culture. It is not anti-globalisation, but wants to bend the mainstream of social and economic policy so that place is put at the centre of political thinking.

In particular our work is focused on the following areas:

• Reshaping our economy. How places can take control of their economies and drive local growth.

• Culture, tradition and beauty. Crafting policy to help our heritage, physical environment and cultural life continue to enrich our lives.

• Reforming public services. Ideas to help save the public services and institutions upon which many in society depend.

What we do

We publish research throughout the year, from extensive reports to shorter pamphlets, on a diverse range of policy areas.

We run a broad events programme, including roundtable discussions, panel events and an extensive party conference programme.

We also run a membership network of local authorities and corporate fellows.


Press release distributed by Pressat on behalf of Localis, on Friday 6 September, 2019. For more information subscribe and follow https://pressat.co.uk/

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Put prevention at a premium for place-based health dividend, Localis urges