06 July 2007
Local government is neglecting three out of five of its health and wellbeing responsibilities, the Audit Commission has found.
The commission's report, Improving health and well-being, published on June 30, found that councils were attempting to tackle obesity and had had 'some success' in smoking cessation. But they had focused less on their responsibilities to promote sexual health and deal with mental health problems and alcohol misuse.
Recent health and local government white papers have emphasised the importance of joint working between the NHS and councils in promoting wellbeing. But the commission said that in practice 'a systematic strategic approach is the exception rather than the rule, in part due to an inability of local bodies to articulate how a strategy could be developed or who should be responsible'.
The report brings together the findings of three recent commission national reports and 77 council corporate assessments. It notes that although almost £342m had been allocated to primary care trusts to improve public health in the 88 most deprived areas for 2006/07 and 2007/08, 'not all of this will have been spent on public health because of pressures elsewhere in the service'.
The commission said: 'The most recent figures show that obesity costs the NHS directly around £1bn a year and the UK economy a further £2.3bn to £2.6bn… If this trend continues, by 2010 the annual cost to the economy could be £3.6bn.'
Failure to tackle alcohol misuse also meant rising costs for the NHS. One-third of all accident and emergency attendances are thought to be alcohol-related, costing the NHS an estimated £450m a year.
The report further highlighted 'slow progress' in designing services to improve the lives of older people and to help them remain integrated in society.
Although falls prevention services had been proven to be cost-effective by reducing A&E admissions and improving the quality of life for vulnerable people, only two out of the ten inspected authorities had introduced such services. Meanwhile, hospital admissions for broken hips increased by 35% between 1999 and 2006, the commission noted.
Although evaluation was 'essential' to developing effective initiatives, efforts so far had been 'very weak', said the report, and were often hampered by the 'short-term, ad hoc nature of projects'.
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