Select Committee on Health Appendices to the Minutes of Evidence


Memorandum by Health Promotion England (PH 82A)


  1.1  Health Promotion England (HPE) was established in April 2000 upon the closure of the Health Education Authority (HEA) by the Health Education Authority (Abolition) Order 2000 (Statutory Instrument 2000 No. 604 attached). Under the abolition order certain staff, property rights and liabilities were transferred to the Lambeth, Southwark and Lewisham Health Authority (LSL) to continue, as the new HPE, elements of the public education work previously undertaken by the HEA. Thus HPE carries out a defined programme of health promotion campaigns on behalf of the Department of Health which includes work previously undertaken by the HEA.

  1.2  A Service Level Agreement (SLA) between the Health Authority and the Department of Health (DH) sets out the outputs and outcomes expected from HPE in return for an agreed level of funding.


  2.1  The HEA was established in 1987—as a special health authority to replace the Health Education Council. The HEA's functions included undertaking health education activity, planning and carrying out campaigns; sponsoring research, publishing material and providing a national centre of information and advice on health and education in England. Funding was provided by DH and the work programme was agreed jointly.

  2.2  The DH contracted or commissioned the HEA to undertake activity on public health education campaigns, this included:—tobacco education, AIDS/HIV prevention, drugs, nutrition, skin cancer prevention, mental health and immunisation.

  2.3  The concept of evidence-based health care and practice grew in the public health movement and government. In July 1999, the Government published its white paper Saving Lives: Our Healthier Nation. This signalled the replacement of the HEA with the Health Development Agency (HDA) charged with the study and dissemination of the evidence base for public health interventions. This, combined with the publication of consolidated ministerial priorities by the newly appointed Secretary of State Alan Milburn in December, gave a clear message that the provision of public health campaigns would be a central task for the Department of Health, working closely with other government departments, agencies such as the COPI, the newly created HPE and the voluntary sector. The DH Communications Directorate is charged with developing and managing national Communications Strategies for priority and "must do" areas.


  In establishing the work programme for HPE, discussions have taken place with DH policy and communications leads. The resulting programmes of work vary widely from fully integrated campaigns including advertising, press and PR, new media, publishing, research and professional support (eg Immunisation) through to basic level maintenance work, such as the reprinting and distribution of existing print materials (eg Alcohol). These discussions have occurred in a challenging arena, with multiple changes taking place within DH and the NHS nationally and locally in the context of the development and the implementation of the NHS Plan.

  3.2  In all HPE's programmes of work there is a common link. Whether complex or simple, all our proposed work programmes require liaison with those working in Health Promotion and other relevant local professionals and the management of their expectations. Former HEA programmes often involved sophisticated formulae for field liaison which included: briefing days (roadshows), database mailings, regular catalogues, flyers, newsletters, small grants schemes, attendance at conferences and exhibitions, the facilitation of reference or user groups, media training, telephone support and other technical assistance. HPE are continuing to adopt comprehensive field support strategies.


  HPE has been initially contracted to work on the following areas:

    —  Alcohol;

    —  Children and Families;

    —  Drugs;

    —  Immunisation;

    —  Sexual health;

    —  Older People (Department of Trade & Industry) falls campaign;

    —  And to provide and update a range of other published health promotion resources produced by the former HEA.


  Alcohol consumption generally has fallen very slightly, it continues to rise among the young. Drinking brings with it many problems, not least 3,000 alcohol-related deaths per year.

  HPE promotes sensible drinking, especially targeting young people and parents. Pending the launch of the National Alcohol Strategy later in the year the work programme currently includes:

    —  The promotion of Drinkline (0800 917 8282), the free (except from some mobiles) alcohol helpline, which provides support, advice and information.

    —  Provision of a portfolio of resources for health specialists and the public.

    —  Support to the press and media on alcohol issues.

    —  Provision of expert advice through conferences and seminars including the British Nutrition Foundation in September and a second paper on teenagers and alcohol to the Drugs Education Forum in October 2000.

    —  Work with other key organisations in the alcohol field including Alcohol Concern, The Portman Group, WHO Phase IV Primary Care Project and the National Family and Parenting Institute.

    —  Management of a site aimed at young people aged 14-16 years highlighting the dangers of binge drinking and intoxication.

4.2  Children and Families

  Having a baby is probably the major event in any woman's life. Yet many women, particularly those from disadvantaged groups, lack the knowledge to make this an enjoyable and as painless an experience as possible and one that ensures the baby grows up fit and healthy. Natal and peri-natal deaths are still at unacceptable levels.

  HPE aims to provide all new parents with authoritative and independent information in forms that are acceptable to them on all aspects of pregnancy and early years development.

    —  Since HPE was established, two reprints of the flagship publications The Pregnancy Book Birth to Five have been produced. A proposal, based on previous HEA research, to merge the two books has been submitted to the DH and will be considered at the Children's Programme Board shortly. The proposal looks specifically at how to meet the needs of disadvantaged groups.

    —  Developing the new resource as a website as well as in hard copy has been discussed with DH.

    —  HPE has also contributed to the Having a baby life episode of UK online and is continuing to make available a number of other specific titles in this area of child health.

4.3  Drugs

  11 per cent of 11-15 year olds (ONS, 1998) and 31 per cent of 16-19 year olds (BCS, 1998) had used drugs in the last year.

  Within this context, HPE works to support the Government's ten-year strategy for tackling drugs misuse, Tackling Drugs to Build a Better Britain (1998), specifically "to support young people to resist drug misuse in order to achieve their full potential in society".

  The work programmes includes:

    —  The provision of information through printed and new media resources for young people and parents including a new site aimed at 14-16 year olds at

    —  Press releases and feature/editorial coverage of the issues in media outlets to promote the National Drugs Helpline (0800 776600 and as a sourse of free, confidential information and advice and to encourage responsible reporting of drugs issues

    —  Regular contact and the supply of accurate information to provide support for professionals in the field, to extend and enhance other government activity where appropriate with a range of government and non-government agencies at national, regional and local levels.

4.4  Immunisation

  Cases of Meningococcal C have fallen by 90 per cent among 15-17 year olds in England and Wales and by 82 per cent in babies under a year old, from 32 in 1999 to 6 in 2000.

  For more than ten years the Immunisation public education campaign has been an integral part of the UK National Childhood Immunisation Programme. This work is continuing within HPE through the provision of resources and support for health professionals. The work programme includes:

    —  A range of print and new media resources containing up to date information on all childhood immunisations including

    —  Research to assess the impact of the public education campaign

    —  Expert advice to Immunisation Co-ordinators and other health professionals through factsheets and locally organised seminars for professionals

    —  Promotions including Babies TV advertising encouraging uptake of childhood immunisations

    —  Continuation of the successful Meningitis C campaign aimed at under 18s and new freshers.

    —  Work with a number of local, national and international organisations including Primary Care 2000, Advanced Vaccinology Course (Annecy), and the Millennium conference in Liege.

4.5  Sexual Health

  Latest figures from the Public Health Laboratory Service (Dec 2000) on sexually transmitted infections (STIs) show a rapid increase in acute infections since 1995, with genital chlamydia diagnoses rising by 76 per cent, gonorrhoea by 55 per cent, syphilis by 54 per cent and genital warts by 20 per cent. This suggests an increasing complacency over safer sex and lack of awareness of the seriousness of many STIs including long-term effects such as pelvic inflammatory disease, infertility or ectopic pregnancy.

  Pending the launch of the national sexual health strategy later in the year, HPE will continue to:

    —  Run a safer sex TV campaign featuring two cartoon characters called `Clem' and `Lydia'. The ad aims to build awareness of safer sex including the dangers of chlamydia amongst young men and women, emphasising that practising safer sex makes sense.

    —  Run a TV filler about chlamydia broadcast on ITV and BBC on a free-to-air basis. Both films offer further information or advice, free and in confidence by calling the National AIDS Helpline (0800 567123) or viewers can visit

    —  Provide information about HIV, other sexually transmitted infections, and unintended pregnancy through resources and a range of media

    —  Support various agencies and professionals that work with young people to enable them to promote safer sex

    —  Promote the National AIDS Helpline (0800 567123) which is a freephone service providing advice and information about HIV, AIDS and sexual health/local services.

4.6  Older People (Department of Trade & Industry) falls campaign

  Every five hours an older person is killed as a result of falling in the home and about 1,000 older people are killed each year falling on their own stairs. Yet many accidents can be prevented by simple, practical actions.

  Avoiding slips, trips and broken hips is a campaign to raise public and professional awareness of the risk of falls in the home to older people. The work programme includes:

    —  The provision of free resources on falls prevention and stair safety in the home including leaflets (new Step up to Safety leaflet), posters, audiocassettes and videos.

    —  Research into the needs of health professionals working with older people.

    —  Building alliances with a broad range of professionals who work closely with older people: pharmacists, chiropodists, the ambulance service, community transport and housing as well as health professionals from many different disciplines. All have an interest in promoting independence in older people and recognise that preventing falls in the home is one important way.

    —  Developing a register for local activists and anyone interested in learning about best practice and networking with others working in falls prevention.

    —  Promoting the campaign website

    —  Providing expert advice through conferences and publications including Practice Nurse, British Geriatrics Society, Health Advisory Services, Help the Aged, Community Transport Association, Age Concern, Research into Ageing, Disabled Living Foundation and Basic Skills Agency.

4.7  Marketing and Communications

  4.7.1  In addition to the advertising, press & PR, new media and alliance work already highlighted under topic areas a number of corporate activities have also been undertaken. These include: establishing an HPE website at including an on-line catalogue, developing marketing materials, regular mailings and newsletters to Health Promotion Units and a contact database and contributing to a range of exhibitions, conferences and events nationally and locally.

4.8  Publishing

  4.8.1  A key focus in April 2000 was to transfer the HEA publications list comprising nearly 500 titles into three categories—HDA, HPE and DH. A fourth category—the Food Standards Agency (FSA)—was added later in the year. This necessitated a comprehensive review of all titles and a re-structuring of the stock management system at the warehouse.

  4.8.2  A seamless transition of service was essential, as the prime concern of customers is continuity of service and sufficient supply of stock. Without confidence in these it is difficult to plan work at local level which relies on nationally produced resources. Many Health Promotion Units provide resources to a range of local health and other professionals.

  4.8.3  Audits and reviews

  HPE is currently auditing it's resource portfolio (and selected DH titles) for appropriateness for people with learning difficulties and other disadvantaged groups, with a view to ensuring that all current and future titles meet DDA requirements and conform to best practice standards with regard to meeting the needs of vulnerable communities. Current distribution services are also being reviewed to ensure effective and efficient delivery in the future to all audiences, such as voluntary agencies, the police, local authorities, HAZs and other organisations who now have a stake in health promotion activity.


  5.1  HPE works under a service level agreement (SLA) with the Department of Health (DH) and other Government departments. The work of the unit is approved through a management steering group consisting of:

    —  DH Communication Director (Helen McCallum—Chair).

    —  Senior Public Health Policy Team (Professor Donald Nutbeam).

    —  DH Public Health branch leads.

    —  DH Communications Deputy Director and SLA Manager (Wyn Roberts and David Horton).

    —  LSL Deputy Director of Public Health (Dr Alan Maryon Davis).

    —  HPE General Manager (Geof Webb).

  5.2  HPE is managed through Lambeth, Southwark & Lewisham Health Authority (LSL).


  6.1  HPE was initially contracted to 31 March 2001. Business planning discussions are currently taking place within DH regarding HPE's future role in delivering government health promotion activities.

  6.2  A number of options are being considered to assess how HPE can best add value to: the health related work of government and particularly to cross government initiatives; the work of other national agencies and; meeting local needs and priorities in order to strengthen the delivery of national programmes.

15 January 2001

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