الأربعاء، 26 فبراير 2020

Public Health England

Public Health England (PHE) is an executive agency of the Department of Health and Social Care in the United Kingdom that began operating on 1 April 2013. Its formation came as a result of reorganisation of the National Health Service (NHS) in England outlined in the Health and Social Care Act 2012. It took on the role of the Health Protection Agency, the National Treatment Agency for Substance Misuse and a number of other health bodies
Mission and resources
PHE's mission is "to protect and improve the nation’s health and to address inequalities". It employs approximately 5,000 staff (full-time equivalent), who are mostly scientists, researchers and public health professionals.[3] It announced plans to move its headquarters and 2,750 staff to Harlow on a former GlaxoSmithKline site in 2017.[4]

Structure
Initially, aside from back office functions such as personnel and finance or management functions such as strategy and programme management, PHE has the following divisions:

Health protection:
Chemical, radioactive, and environmental hazards
Research
National poisons database
Services for those working with hazardous materials
Harm reduction in relation to polluted environments
Operations
Field epidemiology
Contagious disease surveillance and control
Major incident response
Health improvement:
Substance misuse treatment programmes
Health promotion (such as healthy diet or anti-smoking marketing)
Health screening programmes (such as cancer screening, STD checks, cardiovascular disease screening, etc.)
Reducing health inequalities
Specialist healthcare commissioning (in relation to major incidents, etc.)
National Cancer Intelligence Network (and other networks)
Knowledge and Information
Substance misuse treatment monitoring
Disease registration
Research and development
Operations:
Microbiology unit
Microbe production
Research
References
Specialist services
Regional units (South / Midlands / North / London)
Preparation and response against major incidents
Local centres (several centres per regional unit, except London)
Local health protection
Substance misuse treatment services (over more than one centre)
Local specialist commissioning (in relation to major incidents, etc.) and advice
Duncan Selbie is the Chief Executive.

Campaigns
PHE took over the responsibility for Be Clear on Cancer campaigns after it was created in the Health and Social Care Act 2012.[5] Campaigns have been run on Lung Cancer, Bowel Cancer, Oesophago-gastric and Kidney & Bladder Cancer.[6]

PHE is also responsible for Change4Life and ACT FAST.[7]

In January 2014 it launched a new campaign against smoking called Smokefree Health Harms on television and billboards across England.[8]

Criticism and other published comment
Public Health England has been criticised for its underweighting of mental health within its overall resourcing and agenda; in 2011 the Royal College of Psychiatrists stated its concern that there appeared to be "few, or no, commitments or resources within either the Department of Health or Public Health England to take the public mental health agenda forward."[9]

The agency was criticised by Professor Martin McKee, in January 2014, who said that continuing health inequalities among London boroughs was a scandal and claimed coalition reforms had left it unclear who was supposed to analyse health data and tackle the problems highlighted.[10]

The agency was criticised by The Lancet for allegedly using weak evidence in a review of electronic cigarettes to endorse an estimate that e-cigarette use is 95% less hazardous than smoking. Lancet wrote "it is on this extraordinarily flimsy foundation that PHE based the major conclusion and message of its report". Lancet found this "raises serious questions not only about the conclusions of the PHE report, but also about the quality of the agency's peer review process."[11]

Authors of the PHE report subsequently published a document clarifying that their endorsement of the 95% claim did not stand on the single study criticised in the Lancet, but on their broad review of toxicological evidence.[12] The agency has also been criticised for "serious questions about transparency and conflicts of interest" regarding this review, that PHE's response "did not even begin to address the various relationships and funding connections" in question, and that this "adds to questions about the credibility of the organisation’s advice".[13]

The integrity of Public Health England was recently thrown into question when a question in the House of Lords revealed that a position underpinning UK Government policy, namely "that well run and regulated modern municipal waste incinerators are not a significant risk to public health remains valid" was asserted in advance of the results having been obtained from a study commissioned by Public Health England to answer the question whether municipal waste incinerators did, in fact, constitute a significant risk to public health

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