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The risky business of reorganising public health in the middle of a pandemic.

Response to scrapping @PHE_uk, in @Telegraph today. Plus for this particular Telegraph article there's no paywall.

Links to article references in thread below.

telegraph.co.uk/global-health/…
Gov announcement on creation of National Institute for Health Protection: gov.uk/government/new…

@MattHancock's speech at @Policy_Exchange: gov.uk/government/spe…
About @PHE_uk and its creation, from the hugely useful @HealthFdn Policy Navigator: navigator.health.org.uk/theme/public-h…

PHE's responsibilities: gov.uk/government/org…
Health Foundation response to PHE's dissolution: health.org.uk/news-and-comme…

Cuts to public health budgets: health.org.uk/news-and-comme…

NHS T&T budget: nhsconfed.org/resources/2020…
Health is an asset (@louisemarsha11 @JoBibbyTHF et al) health.org.uk/publications/t…

Gap in healthy life expectancy @davidfinchRF: health.org.uk/news-and-comme…

Whole gov approach to health and inequalities @tim_esPH : health.org.uk/news-and-comme…
Rising multimorbidity and rates of obesity:

health.org.uk/sites/default/…

gov.uk/guidance/phe-d…
COVID-19 and inequalities from @ProfKevinFenton and colleagues: gov.uk/government/pub…

and how COVID-19, lockdown, and recovery can exacerbate these inequalities: health.org.uk/publications/l…
PHE and criticism of its independence (@rob_aldridge @martinmckee and colleagues) thelancet.com/journals/lance…

PHE's International peer-review report:
gov.uk/government/pub…
Health system reorganisation and waste (from @kieran_walshe): bmj.com/bmj/section-pd…
Burden of disease in England:

publichealthmatters.blog.gov.uk/2018/10/25/how…

vizhub.healthdata.org/gbd-compare/

thelancet.com/journals/lance…
@felly500 @Jeanelleuk @chrismarriott6 @profchrisham @felixgreaves @KateAlvanley @HPIAndyCowper @JenniferTHF @nedwards_1 @davidjbuck
And for those of us in public health, here’s an example of an entirely different article in the @telegraph that neatly lays out the kind of misunderstanding/misinformation that we need to know and be prepared to counter. (This time there is a £-wall 🙄)

telegraph.co.uk/news/2020/08/1…
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More from @ADMBriggs see all

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Adam Briggs
@ADMBriggs
Week 11 NHS Test and Trace data summary. 06/8/20 to 12/08/20.

This week seems really important and raises lots of questions.

BIG increase in cases, and big drops in numbers of contacts traced.

Summary in picture, detail in thread 👇

gov.uk/government/pub…
KEY POINTS

27% INCREASE in cases compared to week 10

Includes:
34% ⬆️pillar 1 (hospital cases/care home outbreaks)
26% ⬆️pillar 2 (community cases)

AND
2% ⬇️testing (5% ⬇️pillar 1, 0.4% ⬇️pillar 2)

This may mean higher case rates in the community and in hospitals/care homes
The wk on wk ⬆️in cases last week was just 4%, potentially driven by more testing.

This doesn’t seem to be the case here. Pillar 1 %age positive⬆️from 0.41% to 0.58%, & pillar 2 from 1.55% to 1.95% (highest since wk4)

Epi curve seems back on track for a possible 2nd peak, BUT
Read 26 tweets
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Adam Briggs
@ADMBriggs
Might be of interest.

In 2017, @PHE underwent an independent international peer-review from @IANPHIhealth - the International Association of National Public Health Institutes.

An organisation that strengthens government agencies responsible for public health.

Thread/
An team of 8 international experts (including the President of the Robert Koch Institute) went through reports, documents, case studies, and conducted a four day site visit with interviews and presentations.
The team asked three questions:

1. Does PHE demonstrate the leadership, strategy and delivery required to fulfill its responsibilities, taking account of the UK Government Cabinet Office model of capability?
Read 16 tweets
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Adam Briggs
@ADMBriggs
Just to unpack today's announcement a little.

PHE has been operating for the past 7 years to provide a huge range of functions. Health protection is of course a key part (it employs 2,500 scientists and manages >10,000 disease outbreaks/yr)

(thread)
But it also
-does emergency planning & mgmt (not just infectious disease - fires/chemicals...)
-does research
-promotes health improvement
-does global health
-works with the NHS
-advises nationally & supports local gov
-collates, manages, responds to PH outcome data
This includes much quieter but hugely valuable things like evidence reviews, return on investment tools, managing disease registries, publishing the Health Matters series on what works, developing public health data tools and dashboards (i.e. fingertips)
Read 17 tweets

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