https://publichealthmatters.blog.gov.uk/2018/06/15/enabling-local-authorities-make-the-best-spending-decisions/

Enabling local authorities to make the best spending decisions

Stacks of silver coins increasing in height

This blog was updated in March 2019 to include the latest information and links to our tools.

In an increasingly complex landscape with limited local budgets, PHE is committed to provide as much support as possible to local authorities.

The main aim of our work is to enable local teams to create public health systems that have the greatest impact on improving the public’s health and to get the most out of every pound.

We have updated the Spend and Outcome Tool (SPOT) which allows users to see how much is being spent and the impact it is having on relevant outcomes, meaning they can compare across public health programmes, and compare these data against other local authorities.

The tool provides insight to the relationship between spend and outcomes by identifying areas where there is significant variation that warrants further investigation.

SPOT does not estimate value for money or return on investment (ROI) - PHE has produced several topic-specific ROI tools for this task, listed below.

By using SPOT, public health teams and commissioners can:

  • compare spend and outcome data against that of other local authorities or CCGs
  • look at spend against a selection of outcomes across public health interventions and frameworks, including the Public Health Outcomes Framework
  • identify programmes with outcomes that are significantly different to similar local authorities or CCGs, which may need further analysis
  • use the tool alongside return on investment and health economics toolsA video introduction on how to use SPOT is available on the SPOT web page.

We asked some local users for their feedback on SPOT:

“We find the SPOT tool a very useful way to explore our spend and outcomes in public health and identify where we may need to adjust our priorities. We use it in our prioritisation process both within public health and in discussions with colleagues in other parts of our local authority, helping us to argue for investment in the wider determinants of health.” - David Whiting, Consultant in Public Health, Medway

“We used the SPOT tool to present to Dorset County Council’s Forward Together Board. We used it to compare spend and outcomes by programme in Dorset in comparison to its CIPFA nearest neighbours. The impact it had was to help inform the priorities set by Cabinet Members and the Corporate Leadership Team.” - Lee Robertson, Senior Public Health Analyst, Dorset

Using SPOT with the Prioritisation Framework

Local areas can use the updated SPOT tool together with the Prioritisation Framework to enable them to put their budget to best use.

We know that decision making in local authorities is becoming increasingly complex and the Prioritisation Framework is a flexible tool which, alongside the SPOT tool, can enable local authorities to make evidence-based spending decisions.

The framework does not tell local authorities how to allocate budgets across programmes; rather it allows local public health teams to break down big decisions into smaller manageable pieces by considering:

  • which programmes could offer the greatest value in the future
  • the current state of programmes that are being delivered
  • the budget currently divided across programmes
  • how easy it is for programmes to change

By using this structured approach, local public health leaders will be able to make recommendations on whether to increase, decrease or maintain spend in each programme area.

Other tools you may be interested in include the Health Economics Evidence Review (HEER which is intended to be used alongside the Prioritisation Framework. The HEER brings together economic evidence on ROI and cost-effectiveness of interventions across a number of public health areas.

Future of SPOT

Users of SPOT have fed back that it would be beneficial for the SPOT to be in a digital format, rather than in Excel, to enable the tool to be updated more regularly and to include some additional features. We are therefore starting to scope this project and hope to be able to release a digitised version of the tool during 2019/20.

Topic-specific economic tools

The Health Economics team and other teams in PHE have produced a number of resources which can be used to estimate the value of investing in prevention and early intervention in specific areas.

These tools collate the best available evidence on costs, savings, and health benefits for specific topic areas in a single place, thus simplifying the process of commissioning cost-effective services.

The interactive tools produced by PHE are:

Public health teams in local systems are best placed to make decisions on their priorities and how best to invest and disinvest and for this reason resources such as the SPOT, the Prioritisation Framework, the HEER and various ROI tools listed here are not designed to tell local areas exactly how to spend their public health budget.

However, used together these tools can help to ensure that local decision making is informed by the best available evidence.

Interested in this topic? Read our blog on using PHE's Health Economics Evidence Resource

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1 comment

  1. Comment by foster posted on

    Good article.Thank you for providing this informative article.