A new public health improvement initiative will be led by the Local Government Association (LGA) over the next three years. The Public Health Peer Review programme  will aim to maximise public health benefits from wider local authority spending.

The programme is funded by the Department of Health and Social Care and will begin in June 2026.  It will add to the LGA's existing offer of peer review programmes. These bring practical insight into the realities of delivering on outcomes in local government. The process supports reflection on practice, highlights strengths and identifies opportunities for improvement.

This initiative will be welcomed by directors of public health. The offer will give them a fresh pair of eyes on the work they are leading, from needs assessment and commissioning through to health improvement and community development. Councillors and chief executives will also benefit from feedback on how well they are delivering on their public health responsibilities.

Councils will be keen to see a broad view of public health work reflected. That is, one that acknowledges how public health teams work across local authorities, including their focus on the wider determinants of health such as education, employment, housing and economic deprivation. 

They will also hope that the process focuses beyond outputs that, while easily measured, do not necessarily have a major impact on health. The LGA has said the review will incorporate the Local Outcomes Framework which includes some fundamental health and wellbeing metrics that are crucial to population health. However, this framework also includes process measures that are arguably not fundamental to population to level health outcomes.

For example, the Local Outcomes Framework includes measures of how many people set quit dates with stop smoking services. While these services are a crucial part of reducing tobacco related harm, they are only responsible for a small proportion of the reduction in smoking each year. Local authority public health teams are aware the majority of people prefer to quit smoking without signing up to a structured support programme and so they also work to reduce smoking rates through effective behaviour change campaigns, the provision of online support tools and work to prevent smoking uptake. Therefore, it is essential changes in overall smoking prevalence are also taken into account.

Councils will also be hoping to see a focus on community development and public mental health work. While the Local Outcomes Framework incudes suicide prevalence, it does not properly address the vast amount of community focused work public health teams deliver to reduce loneliness, social isolation and support those vulnerable to poor mental wellbeing. Community development activity is difficult to ‘measure' with a simple indicator.  But it has been shown in evaluation work to be associated with reduced urgent hospital admissions and children's social care referrals.

Fortunately, the support offer from the LGA should be able to transcend simplistic numerical indicators. The peer review methodology draws on LGA's considerable experience of supporting local authorities. It will also utilise councillor and officer peer reviewers who will understand that everything, and especially some of the most impactful actions, cannot be easily captured via a simple numerical indicator. 

The involvement of experienced peer reviewers will also ensure that the broader context of public health work is considered. For example, they will bring an understanding of socioeconomic inequality is built into the reviews and that areas in the most deprived areas will not be expected to achieve the same outcomes as those in more affluent locations. In addition, peer reviewers will know to focus beyond what the ring-fenced Public Health Grant directly funds. Rather, they will also examine what public health teams are doing to improve outcomes through their partnership with other stakeholders, such as social care, NHS and the police.

In summary, the announcement of a new public health improvement and support programme is positive news. The Local Government Association already supports public health teams and has an in-depth understanding of how they work. They will be able to build on the existing Sector Led Improvement (SLI) work that already goes on within regional public health networks to deliver a process that adds genuine value. This will not only benefit public health teams, but the full range of system partners that are striving to improve our residents' health outcomes.