Official Statistics

Public Health Outcomes Framework: commentary, November 2023

Published 7 November 2023

Applies to England

Background

The Public Health Outcomes Framework (PHOF) sets out a high level overview of public health outcomes, at national and local level, supported by a broad set of indicators. An interactive web tool makes the PHOF data available publicly. This allows local authorities to assess progress in comparison to national averages and their peers, and develop their work plans accordingly.

New in this update

The latest update includes data for 29 indicators. This summary provides the main messages from indicators on:

• inequalities in employment
• child development
• health visiting
• breastfeeding
• substance misuse treatment programmes

For a complete list of indicators that have been updated please see Public Health Outcomes Framework: indicator updates.

B08a: employment indicators for those with a physical or mental long-term health condition

B08a includes 2 indicators:

• gap in the employment rate between those with a physical or mental long-term health condition (aged 16 to 64) and the overall employment rate

• percentage of the population with a physical or mental long-term health condition in employment (aged 16 to 64)

The data for these indicators is from the Office for National Statistics Annual Population Survey (APS) and is based on the question ‘Do you have any physical or mental health conditions or illnesses lasting or expected to last 12 months or more?’.

Employment inequality for people with a physical or mental long term health condition is estimated by comparing the employment rate for those with a physical or mental long term health condition against the overall employment rate (PHOF indicator B08d). People in England with a physical or mental long term health condition have an estimated employment rate of 65.3% compared with the overall employment rate of 75.7%. There is an absolute difference of 10.4 percentage points in the employment rate between those with a physical or mental long term health condition and the overall employment rate (see figure 1). This gap has narrowed over time and is significantly less than in 2013 to 2014 when the gap was 13.1 percentage points.

Figure 1: employment in England overall and for people with a physical or mental long term health condition, 2022 to 2023

For people with long term conditions there is a strong inequality gradient with 57.4% of people with physical or mental long term health conditions in employment in the most deprived decile of counties and unitary authorities, compared with 72.4% in the least deprived decile (see figure 2).

Figure 2: employment rate of those with a physical or mental long term health condition by deprivation decile, England, 2022 to 2023

Health visiting (C07), breastfeeding (C05b), and child development outcomes (C08a to c)

All pregnant women and children are eligible for a schedule of 5 mandated health reviews (Universal Health Visitor Reviews). The data has been obtained through OHID’s interim reporting system for children’s public health which collects health visiting activity and related outcomes at a local authority resident level.

These indicators monitor the service coverage and related health outcomes for services funded by the local authority public health grant for children aged 0 to 5 years.

Caution should be exercised when interpreting these figures as it is a voluntary data collection and there is not full coverage. Any figures shown at a region or England level are based on an aggregate total of local authorities within those areas who supplied data items which complied with validation criteria for each indicator.

C07, new birth visits should ideally occur within 14 days; however, it is accepted that in some circumstances this is not possible. New birth visits within 14 days decreased in 2022 to 2023: 79.9% compared with 82.7% in 2021 to 2022.

C05b, breastfeeding prevalence at 6 to 8 weeks remained stable in 2022 to 2023: 49.2% compared with 49.2% in 2021 to 2022.

C08a, the proportion at or above the expected level of development in all 5 domains of development (‘good level of development’) decreased in 2022 to 2023: 79.3% compared with 81.1% in 2021 to 2022.

C08b, the proportion at or above the expected level of development in the communication skills domain, decreased in 2022 to 2023: 85.3% compared with 86.5% in 2021 to 2022.

C08c, the proportion at or above the expected level of development in the personal-social skills domain, decreased in 2022 to 2023: 90.3% compared with 91.1% in 2021 to 2022.

Successful completion of substance misuse treatment programmes, C19 a to c and C20

C19 includes 3 indicators on the successful completion of substance misuse treatment programmes for adults aged 18 and over. Successful completion is defined as individuals who successfully complete treatment and do not re-present to treatment again within 6 months. The indicators cover:

• opiate users

• non opiate users

• alcohol users

Successful completion of drug treatment for opiate users was 5.0%, for non-opiate users was 31.4% and for alcohol users was 35.1% in 2022. For non-opiate and alcohol users the percentage completing treatment successfully without re-presenting to treatment within 6 months has decreased compared with 2021 (34.3% and 36.6% respectively), for opiate users this percentage has remained stable.

Successful completion of drug treatment for opiate users shows regional variation with the percentage significantly better than the England average in the South East (6.4%), East of England (5.6%) and South West (5.4%). In the northern regions and the West Midlands the percentage was lower than the England average (figure 3).

Figure 3: successful completion of drug treatment: opiate users by England regions, 2022

C20, adults with a substance misuse treatment need, who successfully engage in community based structured treatment following release from prison. This indicator supports a shared objective, in the 2018 to 2021 National Partnership Agreement, between HM Prison and Probation Service, DHSC and NHS England, to strengthen the integration of services and continuity of care between custody and the community.

42.6% of adults with a substance misuse treatment need successfully engaged in community based structured treatment within 3 weeks of their release from prison in the financial year 2022 to 2023. This is an improvement on the percentage in 2021 to 2022 (37.4%). Engagement in treatments has been improving since 2015 (see figure 4).

Figure 4: adults with a substance misuse treatment need, who successfully engage in community based structured treatment following release from prison, England, 2015 to 2016 to 2022 to 2023

View the Public Health Outcomes Framework

For queries relating to this publication contact PHA-OHID@dhsc.gov.uk

The next planned update is February 2024.