Abstracts: November 19th, 2015

District councils are the sleeping giants of public health and it is time to wake them. This is main finding from an editorially independent report commissioned by the District Councils’ Network.

The functions of District councils that directly influence our health are housing, leisure and green spaces as well as a wide range of activities covering environmental health.

District councils are part of two-tier local government. They cover two-thirds of England’s land mass and close to 40 per cent of its population. They deliver nearly 90 essential services – many of which are important for public health – for around 25 million people. The report sets out their role in delivering these services, the health economics of this and includes some case studies.

Although district councils have their hands on many of the wider determinants of health, public health reform seems to have passed them by. Despite being so well placed, they have no statutory seat on health and wellbeing boards and no direct public health grant. Some district councils are working closely with other tiers of local government. However, there is still the sense that district councils are not fully engaged partners in population health.

The report argues that it is high time to wake these sleeping giants and the opportunity to do so may be devolution in England. District councils have a strong case that they are critical to two of the twin focuses of devolution: the move towards place-based, integrated public services; and the development of a more enabling and local state. By stepping up in these roles, district councils that choose to do so can deliver health benefits by taking a health-promoting role across their housing, leisure and environmental services and their wider role in economic development, planning and community development.

The report sets out 10 recommendations for district councils and their partners which focus on key aspects of partnership and alignment including health and wider economics of districts’ roles and innovating for outcomes.