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Public Policy and Health

Shifting the gravity of spending? Exploring methods for supporting public health commissioners in priority-setting to improve population health and address health inequalities

There is increased urgency to demonstrate return on investment in relation to public health interventions and explore methods of decision-support for public health priority-setting. The return of the responsibility for public health commissioning to local authorities means that priority-setting will take place within new organisational and cultural settings, which presents new challenges. With local authority ring-fenced public health budgets confirmed, difficult decisions about investment, and particularly in a time of economic stringency, about disinvestment, will have to be made, not just within the ring-fenced public health budget but also across different departments of the local authority.

This two year study is supporting public health priority-setting in three local authority case study sites across England, through bringing together specialist input from health economics and public health in a series of seminars and targeted decision-making support for public health commissioners. The relevance of prioritisation methods and their impact on spending patterns within and across programmes will be evaluated through a series of initial and follow up interviews with decision-makers in each site.

The project is seeking to show which priority-setting tools local authority commissioners find useful for public health investment, assessing enablers and barriers to decision-making and deliver recommendations about appropriate decision-making support for determining priorities in public health commissioning within local authorities.

This research project is funded by the National Institute for Health Research (NIHR) School for Public Health Research (SPHR).

The research team is led by Professor David Hunter (Centre for Public Policy and Health, CPPH, Durham University). Other researchers include staff from the CPPH at Durham University, FUSE, London School of Hygiene and Tropical Medicine (LSHTM) and the School of Health and Related Research (ScHARR), Sheffield University.

For further information on NIHR SPHR, please refer to their website at:

Read the latest article from Fuse providing an update on this study

Read the Blog and Full Report on our Shifting the Gravity of Spending? Workshop on 17th January 2017

The Report of the findings of the follow on study is now available


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How are priority-setting tools used in local government?

Findings will soon be published from a follow on study looking at the decision making tools used by local authorities to prioritise spending.

How local government can provide good leadership in public health

New guide sets out where local authorities can find the best research to help them tackle health inequalities

Investing in Prevention

Approaches to prioritisation in local authorities and the NHS

Making the case for investment in public health: experiences of Directors of Public Health in English local government

Contact Information

For further information regarding this study please contact:

Miss Lisa Monkhouse

Research Administrator, Durham University
Tel: 0191 3340360