Recommendation 20

Senior ICB leaders reported to the National Audit Office a continued lack of progress with the government’s long-standing aim to move towards preventing ill health rather than treating it. One of the most important reasons cited by ICBs has been the focus on other pressing national priorities, particularly elective care backlogs and acute services, which has meant they have had little additional headroom to grow preventative services as they would have wanted to.34 The public health grant used by local authorities to commission preventative measures such as health visiting and drug and alcohol services is expected to fall by £193 million (5%) between 2022–23 and 2024–25 (at 2022–23 prices), despite government’s commitment in the 2021 spending review to maintain it in real terms.35