The Government White Paper, Healthy lives, Healthy People: Our Strategy for Public Health in England (The Department of Health, November 2010) and the Health and Social Care Act 2012 (formerly the Health and Social Care Bill (The Department of Health, January 2011)) have changed how the NHS and local authorities in England commission and deliver health protection and health improvement services.
As a result of the Health and Social Care Act, local authorities now lead on public health, using a ring-fenced budget and health premium, which reward areas that make the most progress.
Healthy lives, healthy people: Our strategy for public health in England
The White Paper, Healthy Lives, Healthy People moved local public health responsibilities from the NHS to local authorities and established a new national body, Public Health England.
The public health budget, estimated at more than £4 billion, is ring fenced from the overall NHS budget. The majority of public health services are commissioned by Local Authorities from their share of this ring-fenced budget, or by the NHS, all funded from Public Health England’s new public health budget.
In bringing public health functions together at a national level, abolishing the Health Protection Agency and increasing the powers of the Secretary of State, the White Paper represents an attempt to strengthen government involvement in public health on one hand while trying to increase the role of localities and communities on the other.
Public Health England
At a national level, a new core public health service - Public Health England – combines experts from public health bodies such as the Health Protection Agency and the National Treatment Agency as part of the Department of Health. This integrates leading expertise, advice and influence into one organisation.
Public Health England focuses on national resilience against things like flu pandemics and other health threats, as well as being a ‘knowledge bank’ for the best and most up-to-date evidence on behaviour change techniques and monitoring data.
The Health and Social Care Act
Key developments outlined in the Health and Social Care Act are:
Health and Wellbeing Boards
These are intended to improve the strategic coordination of commissioning services across NHS, social care, related children’s and public health services.
The Health and Social Care Act required the establishment of a Health and Wellbeing Board in every upper tier local authority by April 2013. They bring together Elected Members and the key NHS, public health, social leaders and patient representatives to work in partnership. They have some flexibility and may work at whatever geographical level “makes sense locally” – e.g. covering more than one local authority area, or focusing on the needs of a specific neighbourhood.
Enhanced Joint Strategic Needs Assessment and the new Joint Health and Wellbeing Strategy
The core purpose of health and wellbeing boards (HWB) is to join-up commissioning across NHS, social care, public health, children’s services and other services so that the Board can have an impact on the wider determinants of health eg. Housing, planning, environment, education or leisure. Through the boards, these organisations will be brought together to understand local needs through a joint strategic need assessment (JSNA). They will also create a joint health and wellbeing strategy (JHWS) to address these needs.
The Act places legal obligation on NHS and local authority commissioners to refer to the JSNA and JHWS in exercising their commissioning functions.
Increased joint commissioning and pooled budgets
Health and wellbeing boards are able to look at the totality of resources available to support local people’s health and wellbeing, across the budgets the NHS, council and other partners. The Health and Social Care Act and Health and Wellbeing boards are intended to encourage local authorities and their NHS partners to have greater flexibility to pool budgets or have lead commissioning arrangements when drawing up the joint health and wellbeing strategy and to provide more integrated commissioning across health and social care.
On 16 December 2010, the Department of Health published a factsheet summarising the main points of the Health and Social Care Bill. Factsheets summarising the Health and Social Care Act may be found here.
The Department for Communities and Local Government
The Government’s Localism Bill sees a fundamental shift of power away from Westminster to councils, communities and homes across the country.
The Department for Communities and Local Government sets policy on supporting local government; communities and neighbourhoods; regeneration; housing; planning, building and the environment; and fire. The Department is reducing top-down government by giving new powers to councils, communities, neighbours and individuals.
More information about the work of this department is available at the website of the Department for Communities and Local Government.
Local Government and Public Health
Since April 2013, local authorities have taken on the major responsibility of improving the health and life-chances of the local populations they serve and lead others to work together to improve health and wellbeing.
Local authorities have always had a role in public health. Most of the ‘proactive’ health services are already in councils: housing, sport, parks, environmental health, the youth service and fitness centres for example. There have been services and roles which have been funded and appointed jointly by Health and local authorities for many years.
About local government
Local councils are run by elected councillors who are voted for by local people. They make the major decisions on the services the council provides, oversee how those services are run and represent the interests of people in their division or ward (the area they are elected to represent). They are elected every four years in local elections. This element of democracy is key to the way the council is run, ensures public accountability and scrutiny and distinguishes it from some other public bodies such as the NHS.
Powers and duties
Local authorities have a wide range of powers and duties. National policy is set by central government, but local councils are responsible for all day-to-day services and local matters. They are mainly funded by the government’s revenue support grant, Council Tax and redistributed business rates.
Local authorities work within the powers laid down under various Acts of Parliament. Their functions are far-reaching. Some are statutory, which means that the authority must do what is required by law. Others are discretionary, allowing an authority to provide services if it wishes.
In certain cases, ministers have powers to ensure consistent standards to safeguard public health or to protect the rights of individual citizens. Where local authorities exceed their statutory powers, they are regarded as acting outside the law and can be challenged in court.
In Scotland, Wales and Northern Ireland, local authorities now work mainly with the devolved governments.
Local government spending is about a quarter of all public spending in the UK. In Northern Ireland, district councils still raise money through a domestic rate and a business rate.
Council services are provided through departments or directorates. The Chief Executive is in overall charge. Each directorate has a director and a number of senior managers or heads of service responsible for particular areas of that directorate’s work. The way departments are organised varies between councils, but an example would be:
- Education and Learning – adult education, childcare and pre-school, schools,youth and community education
- Environment – countryside, conservation, planning, sustainability, waste and recycling
- Leisure and culture – sports, arts, libraries, museums, tourism & travel
- Regulatory Services – Environmental Health, Trading Standards, licensing, planning and some enforcement activities
- Roads and Transport – parking, public transport, road safety, roads & pavements, transport plans
- Social Care and Health – Adults, Children & families, carers, disabilities, health, mental health, older people, child and adult safeguarding
- Community Safety – crime prevention, anti-social behaviour, street wardens, CCTV and security
- Registrars - births, deaths & marriages
- Business – advice & guidance, property, regeneration
- Corporate core – strategy & change, legal services, human resources, ICT, finance & procurement, Policy, performance & communications
Local councils are run by elected councillors who are voted for by local people. They make the major decisions on the services the council provides, oversee how those services are run and represent the interests of people in their division or ward (the area they are elected to represent). They are elected every four years in local elections.
Councillors also hold surgeries to meet the people who live in their ward and deal with the issues they raise. They spend time supporting local organisations and services, campaigning on local issues and developing links with all parts of the community.
Councillors are not council employees. They are not paid a salary or wages but are entitled to allowances and expenses to cover some of the costs of carrying out their public duties. The elected councillors provide the policies, and then paid employees (council officers) put them into practice. The Council is managed on councillors’ behalf by a Chief Executive and a senior management team.
Most councillors are identified with a political party, though there are also independent councillors. A council is controlled by the party with a majority of seats on the Council. Quite a few councils have no party with an overall majority and are controlled by coalitions – usually of two parties who then have a majority. The council’s decision-making body is called the Cabinet and is a small group of executive councillors who meet regularly.
Some councillors who are not members of the cabinet take part in scrutinising the work of the council, providing a balance to the cabinet function. Scrutiny committees provide advice to the Cabinet on major policy and service delivery issues and may review its decisions.
Full council meetings (all councillors) are usually held once a month in public. Councillors generally also sit on a range of committees and at other meetings.
The council is founded on a democratic structure and as such they are publicly accountable. Members of the public have access to information about the various committees and individuals who represent them on their local council, any decisions or declarations they have made. Any member of the public can examine agendas and minutes of council meetings and find out how to contact any member of the local council. Most of the meetings are open to members of the public. Every council must publish a ‘forward work plan’ listing the decisions that will be taken over the coming months. They also publish meeting papers at least five working days in advance, and afterwards they publish the minutes of the meeting, summarising the decisions made.
Decision making and scrutiny
Councils have different ways of making decisions. Most councils in England have a small executive group that is responsible for the overall business of the council. Its decisions are subject to scrutiny by a different group of councillors who meet in overview and scrutiny panels, to check and monitor what the council does.
Smaller councils often have a committee structure dealing with separate aspects of the council's business, rather than having executive and scrutiny panels.
While the full council (a meeting of all elected members of the council) is theoretically responsible for all the decisions made, in practice most of the work is delegated to smaller groups of councillors or council officers (employees).
The arrangements are designed to ensure that people know who in the council is responsible for taking decisions, how they can have an input into decision making, and how they can hold decision makers to account.
In recent years, the role and responsibilities of scrutiny have expanded significantly. Starting with the health service, scrutiny now has responsibility for investigating the delivery of services provided by a wide range of public, private and third-sector partners.
Local government structure
Across the country, local governmental bodies are organised into a mixture of one-tier and two-tier systems. How your local system is arranged will depend upon where you live.
The information provided here follows that on the Gov.UK website page on Local government, where more information can be found. For more information about government and administration in England, see the Office for National Statistics website.
County and district councils
In many areas of England, there are two levels: a county council and a district council. County councils cover large areas and provide most public services, including schools, social services strategic planning and highways.
Each county is divided into several districts. District councils cover smaller areas and provide more local services, including council housing, gyms and leisure facilities, parks, local planning and environmental health. District councils with borough or city status may be called borough councils or city councils instead of district council, but their role is exactly the same.
In most large towns and cities, and in some small counties, there will be just one level of local government responsible for all local services. These are called a 'unitary authority'. Depending where they are in the country, these may be called metropolitan borough councils, borough councils, city councils, or unitary councils.
In London, each London Borough is a unitary authority, but the Greater London Authority (the Mayor and Assembly) provides London-wide government with responsibility for certain services like transport and police.
There are currently 56 unitary authorities in England, and 27 shire counties split into 201 (non-metropolitan) districts. Counties, districts and unitary authorities are subdivided into electoral wards/ divisions.
Town and Parish Councils
In some parts of England there are also town and parish councils, covering a smaller area. They are responsible for services like allotments, public toilets, parks and ponds, war memorials, and local halls and community centres. They are sometimes described as the third tier of local government.
Some local authorities share services covering a wider area, like police, fire services and public transport. This may be done to avoid splitting up services when council structures are changed, or because some councils are too small to run an effective service on their own.
Every part of the UK is covered by a local authority fire and rescue service. Each of the 59 fire authorities must by law provide a firefighting service and must maintain a brigade to meet all normal requirements. Each fire authority appoints a Chief Fire Officer, or Firemaster in Scotland, who has day-to-day control of operations.
Scotland is subject to the administration of both the UK Government in Westminster and also the Scottish Executive in Edinburgh. The UK Government has responsibility for issues such as constitutional matters, foreign policy and defence, whereas the remit of the Scottish Executive includes matters such as health, education and law.
Scotland is subdivided into 32 council areas. All are unitary administrations with responsibility for all areas of local government, which in turn are divided into electoral wards and communities or community councils.
For more information about government and administration in Scotland, see the Office for National Statistics website.
Wales is subject to the administration of both the UK Government in Westminster and also the National Assembly for Wales in Cardiff. The UK Government retains responsibility for all primary legislation but the National Assembly has powers to make secondary legislation in a range of policy areas such as health, education, industry, agriculture, local government, environment, and culture.
Wales is subdivided into 22 unitary authorities with responsibilities for all aspects of local government, which in turn are divided into electoral divisions and communities.
8 of the unitary authorities (Bridgend; Cardiff; Merthyr Tydfil; Neath Port Talbot; Newport; Rhondda, Cynon, Taff; Torfaen; and Wrexham) have county borough status (reflecting their existence as large population centres), whilst the other 14 have county status (reflecting at least some aspect of rurality). These definitions do not however affect authority structures.
Unitary authorities are built from electoral divisions. They are also divided into communities or community councils.
For more information about government and administration in Wales, see:
Links to all 22 unitary authorities
Pictures of Health for local authorities in Wales are produced by the Public Health Wales Observatory.
Northern Ireland is subject to the administration of both the UK Government in Westminster and also the Northern Ireland Executive in Belfast. The UK Government retains responsibility for a number of issues such as international relations, policing and justice. The Northern Ireland Executive however has powers in a number of areas such as health, education, industry, agriculture, environment, and culture.
Northern Ireland is subdivided into 26 district council areas (although within Northern Ireland they are also known as 'local government districts' (LGDs)). The district councils are unitary administrations responsible for all areas of local government, but their remit is more limited than that of local authorities in the rest of the UK. These in turn are divided into electoral wards. Many of the local government functions are still the responsibility of the Northern Ireland government, a legacy of the history of the province. However there were proposals to change this in 2011 and form eleven ‘Unitary Councils’ for Northern Ireland, although this has not been agreed to date and there is still work ongoing on local government reform in Northern Ireland.
More information about the future of local government in Northern Ireland can be found here:
Local Government Improvement and Development
A glossary of definitions and terms used in local government.
This newspaper website also features a glossary of terms used in the public and voluntary sectors.
Roles in Local Government
There is a huge range of careers in local government including opportunities in housing, health and care, education, leisure, environmental conservation, environmental health, trading standards, planning and licensing. There are also roles in finance, policy and planning, administration, information technology to name but a few.
Related career stories:
- Gareth Dix
- Kate Ardern
- Jim McManus
- David Regan
- John Britt
- Jayne Norwood
- Lynsey McNair
- Evonne Tennant
- James Devlin
- Huw Brunt
- Hazel Ainsworth
- Sarah Copeland-Lowe
- Shelley Colby
Working in Local Government
Local Government Employers
For information on pay and conditions, pensions, workforce issues & advice.
LG jobs is the official government site which advertises council vacancies.
DirectGov: Apply for a job at your local council
If you're interested in working in local government services, you can find out about jobs at your local council and neighbouring councils here.
LARIA: Local Area Research and Intelligence Association
Established in 1974, its formal remit is to promote the role and practice of research within the field of local government and provide a supportive network for those conducting or commissioning research.
Find your local council:
Gov.UK: Local Councils
Find principal local councils throughout the UK. Includes county, city, borough and district councils and unitary authorities.
The Essential List
This is Tagish's directory of UK public sector information sources covering UK central and local government (including parish and town councils), UK healthcare providers, and UK universities.
- LG Group Quick Guide to local Government
Adobe PDF document, 641 KB
- Public Health Transition to Local Authorities: Training and Development Resource Directory
Adobe PDF document, 2 MB