· Opinion piece by researchers at Warwick Medical School and the University of Birmingham argues that vital health improvement and prevention work should not be overlooked in the restructure of Public Health England (PHE)

· ‘Lessons must learnt’ from COVID-19, they argue – but PHE’s role in managing the pandemic has been misrepresented

The Government must ensure that vital work in health promotion is not lost during its restructure of Public Health England, experts from Warwick Medical School and the University of Birmingham argue.

In an opinion piece for the British Medical Journal (BMJ), they warn of the risk that the restructure poses in exacerbating the existing health inequalities that are linked to recognised risk factors for COVID-19, such as obesity and diabetes, as well as ethnicity.

The authors are public health registrars and researchers at Warwick Medical School at the University of Warwick.

Dr Paul Coleman, an Honorary Research Fellow in Warwick Medical School, said: “As Public Health Registrars involved in the UK’s COVID-19 response we have serious concerns about the future of public health in England following the Secretary of State’s announcement at the Policy Exchange on 18th August to disband Public Health England (PHE).

“We are particularly worried about the short and long-term impacts this will have on the on the future health and wellbeing of the nation. While the Secretary of State laid out new plans for the future of health protection (i.e. the ability to respond to infectious diseases such as COVID-19), there have been no announcements on the future of PHE’s vital health promotion work focusing on leading causes of illness and mortality such as diabetes, impacts of air pollution and lack of physical activity.

“This is particularly concerning as the ethnic, regional and socio-economic inequalities in Covid-19 deaths have highlighted that it is impossible to disentangle the effects of the virus from the wider impacts of health inequalities in our society.”

The authors highlight PHE’s health improvement work focused on prevention of health problems and reducing inequality, which they are concerned may suffer as a result of the planned restructure. The Government needs to think beyond just health protection during the COVID-19 pandemic, during which the organisation’s role was greatly misunderstood, they argue.

Dr Joht Singh Chandan, Academic Clinical Fellow in Public Health at the Universities of Warwick and Birmingham, added: “We are also concerned about the misleading media reports on the role of PHE, with PHE receiving criticism for mistakes outside of its remit including a lack of mass testing, problems with the supply of personal protective equipment and the decision to halt contact tracing – with the latter actually forming part of the government’s own move into the ‘delay’ phase of its coronavirus strategy on March 12.

“We also urge the government to outline plans for PHE’s vital health improvement work and to consider how the UK ensures a joined-up approach in addressing the infectious (e.g. Covid-19) and non-infectious (e.g. diabetes, air pollution) causes of disease, with a particular focus on areas with high levels of deprivation and worst health outcomes.”

Fatai Ogunlayi, an Honorary Research Fellow in Warwick Medical School adds: “While there are lessons that must be learnt, it would be prudent for the government to delay any restructure until we can better understand the mistakes that have been made – especially with the possibility of future Covid-19 surges – with the Prime Minister announcing in July that there would be ‘an independent inquiry into what happened’.”

·  ‘Restructuring Public Health England: public health is about more than being prepared for future pandemics’ is published in BMJ Open, Link: https://blogs.bmj.com/bmj/2020/08/19/restructuring-public-health-england-public-health-is-about-more-than-being-prepared-for-future-pandemics/

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