1/11 @NHSProviders response to reports on future of PHE. Quick thread summarising the argument below - we all need to learn lessons from covid-19 in a spirit of learning, not blame apportionment. Government included. Much that we can do better, together, in public health. 
2/11 Five obvious issues on public health that NHS trust leaders think COVID-19 has highlighted. We look forward to seeing whether the Government's plans for the future of @PHE_uk reflect these lessons.
3/11 Lesson 1: Years of underfunding for Public Health England, and public health more widely, resulted in UK not being properly prepared to tackle pandemic like COVID-19. E.G. local authority public health grant has been cut by 25% in real terms over the last five years.
4/11 Lesson 2: @PHE_uk always had a very wide range of roles including public health hazards/emergencies, reducing health inequalities, screening/immunisation programmes, and actions to improve health e.g. increasing exercise and reducing smoking and sugar in foods.....
5/11 ...Some argued that this scope could be too wide. COVID-19 looks to have proved them right. Essential that all public health responsibilities are correctly allocated to the right bodies, and they are given sufficient resource and have the right focus to do what's needed.
6/11 Lesson 3: Unlike other health bodies such as NHS England, NHS Improvement and the Care Quality Commission, Public Health England has always been an executive agency of the Department. This gives Ministers direct control of its activities.......
7/11 .....So whilst it might be convenient to seek to blame PHE’s leadership team, it is important that the Government reflect on its responsibilities as well. It needs to show that, in any new arrangements, it will be exercising its responsibilities more effectively.....
8/11 ....Government reflection might also include whether it has been appropriate, fair or reasonable to subject the @PHE_uk leadership team to the relentless negative background media briefing of last few weeks. Everyone in the NHS has genuinely been trying to do their best.
9/11 Lesson 4: The government’s strategy in the early stages of the pandemic in key areas of PHE’s responsibility, such as testing, was flawed and confusing. Ministers, not PHE officials, were driving that strategy, directing the response and allocating resource accordingly...
10/11 ...We all need to understand how any new arragements would prevent this from happening again and how the interface between expert advisers and Ministers will work in future. Just creating a new body with new responsibilities and a new name isn't enough.
11/11 Lesson 5: The pandemic has shown that we have the balance between national and local level activity wrong here. Creating a new organisation provides a much needed opportunity to devolve more leadership, more control and more resource to local level.
@threadreaderapp Unroll please.
