Hancock confirms replacement of Public Health England

Health and Care Secretary Matt Hancock has confirmed that Public Health England (PHE) will be replaced with a new organisation called the National Institute for Health Protection (NIHP).

The new body is to start work immediately, bringing together the pandemic response work of PHE and NHS Test and Trace as well as well as the analytical capability of the Joint Biosecurity Centre under a single leadership team.

To minimise disruption to vital work dealing with the pandemic, the organisation will be formalised and operating from spring 2021, the government noted.

The NIHP's primary focus is to control infectious disease and deal with pandemics or health protection crises.

The group will work with local government, the NHS and the devolved administrations “to ensure we have the strongest possible health protection system for the whole of the UK”.

It will report directly to the Health and Care Secretary and support the clinical leadership of the four UK Chief Medical Officers.

“To give ourselves the best chance of beating this virus once and for all – and of spotting and being ready to respond to other health threats, now and in the future, we are creating a brand new organisation to provide a new approach to public health protection and resilience,” Hancock said.

“The National Institute for Health Protection will bring together the expertise of PHE with the enormous response capabilities of NHS Test and Trace and the Joint Biosecurity Centre to put us in the best possible position for the next stage of the fight against COVID-19 and for the long-term.”

Head of NHS Test and Trace Baroness Dido Harding, who was chief executive of broadband provider TalkTalk when it was hit by a cyber attack which later saw the company fined £400,000 for failings which allowed hackers to access customers' personal information, has been appointed interim executive chair of the NIHP.

She said: “The changes announced today are designed to strengthen our response, and to radically ramp up our fight against this disease, whilst also protecting PHE’s essential work beyond COVID that is so important for the nation’s health.”

The government stressed that preventing ill-health and reducing health inequalities also remains a top priority, and that DHSC and PHE experts will engage on future options on decisions around the future of PHE’s remaining health improvement functions.

Response to the move has been mixed.

Nick Ville, director of policy at the NHS Confederation, which represents organisations across the healthcare sector, said: “Introducing structural reform of this scale during the middle of a global pandemic is a risky move and the proof will be in the pudding for whether it will lead to the urgent improvements that are needed to our national test and trace system.

“If the National Institute for Health Protection can deliver on its mission to provide a more agile, alert and joined up response to protecting our country from infectious diseases and other external health threats, both at scale while making the best use of local expertise then health leaders will welcome it with open arms. But this has to be more than shifting deckchairs.”

Christina Marriott, chief executive of Royal Society for Public Health, questioned “the timing of an announcement to scrap our national public health agency in the midst of a global pandemic and before any public inquiry any has started, let alone reported.

“Multiple lessons need to be learnt before solutions can be in place in advance of the winter. To do otherwise risks avoidable mistakes in subsequent waves of the pandemic which will only harm the public’s health further.”

“Creating a new national public health body is a huge and complex task. Making such big changes during a pandemic risks temporarily impeding public health functions and is a high risk strategy,” warned Professor Dame Anne Johnson FMedSci, VP, International at the Academy of Medical Sciences and chair of the Academy’s Improving the health of the public by 2040 report.

Professor Sir Robert Lechler PMedSci, president of The Academy of Medical Sciences, also argued: “We should resist the temptation to entirely redesign our public health system through a COVID lens. We must keep in mind that illnesses such as HIV, heart disease, cancer and diabetes remain significant causes of UK ill health and premature death. Increasing rates of obesity and an ageing population also present complex health challenges. Any changes we make to our public health system now must give benefits both throughout the pandemic and beyond.”

"Preventative healthcare should be front and centre of plans for the NHS post COVID-19,” noted Richard Torbett, chief executive of the Association of the British Pharmaceutical Industry (ABPI). “It’s important we understand how the wider work on prevention and public health will be taken forward, where responsibility and accountability will sit, and how the new organisation will work with health partners."