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Duncan Selbie's Friday message – 16 June

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Dear everyone

First, I would like to warmly congratulate the Right Honourable Jeremy Hunt MP on his reappointment as Health Secretary.

Lest we forget, tobacco remains the number one killer in England and for every early avoidable death from tobacco, 20 other people suffer long-term poor health. So the publication yesterday of the latest smoking prevalence rates could not be more important or a better example of public health policy and practice coming together to make a positive difference to people’s lives and reduce demand on the NHS.

Prevalence rates are at an all-time low at 15.5%, down from 16.9% in 2015 – that’s half a million fewer people who are smoking. But even better, this steep decline is greater among younger adults with smoking at an all-time low in those aged 18-24 years, a huge step forward in our aim to have the first tobacco-free generation. Congratulations to those involved in this achievement, in government, in local government, in PHE, in the third and voluntary sector and in the NHS. There is certainly more to do, especially for the less affluent and people who have poor mental health, but this is a great foundation on which to further improve and a moment to say thank you to everyone.

Our ambition is to be the most local of national organisations and to be as relevant as we can be to local priorities, and this matters as much to our work with the NHS as with local government. And this notably comes together through NHS sustainability and transformation partnerships (STPs). STPs are a golden opportunity for the NHS to get serious about prevention, working with local government to make sure health services are integrated at local level, meet specific local needs and offer opportunities to tackle preventable diseases such as cardiovascular disease at source, both treating disease but also addressing the causes of disease.

A very practical step for the NHS is to go truly tobacco-free, where tackling tobacco dependence, particularly when people are actually in a hospital bed, is fully integrated into clinical pathways. With one in four hospital beds occupied by a smoker, the opportunity, at almost zero cost, to direct people to where they can get help is an easy win.

I would also like to welcome the six new mayors directly elected last month in Cambridgeshire and Peterborough, Greater Manchester, Liverpool City Region, the Tees Valley, the West of England and the West Midlands. They now account for 9.5 million people – almost 20% of the population in England. Their primary duty is to improve the economic circumstances for their people, which is fundamentally a health agenda, with health and wealth being two sides of the same coin.

Essentially, having a job is good for your health and creating more jobs that local people can get is the best way of closing the health gap by improving their economic circumstances, and when you are in employment and become unwell, that every effort is extended to help you to get back into work as soon as can be. This is where we believe that local government as place leaders can make the greatest difference and where we want to put the burden of our effort in supporting them in the years to come.

A quarter of five-year-olds in England have tooth decay when they start school. On Wednesday we published our latest edition of Health Matters, focusing on child dental health. Children who have toothache or who need dental treatment may have difficulties with eating, sleeping and socialising, and may have to be absent from school in order to go to the dentist or to hospital. This edition focuses specifically on what can be done to improve child dental health and outlines how local authorities and the NHS can help prevent tooth decay in children under five as part of ensuring every child has the best start in life. Do share the infographics, slide set, case studies, video and blogs with colleagues.

On average, a person diagnosed with cancer will spend 20 days in hospital during the first year, according to new data presented at the Cancer Data and Outcomes Conference in Manchester on Tuesday. The findings, based on analysis from PHE’s National Cancer Registration and Analysis Service (NCRAS) and Macmillan Cancer Support, highlight the impact of cancer on an individual’s daily life and the importance of making sure that people who have been diagnosed have the information and support they need to prepare for the changes they are likely to face. Further work from NCRAS presented at the conference revealed wide variation in the use of dual-regimen chemotherapy for treating ovarian cancer, and showed that older people with advanced cancer are less likely to receive treatment, even when comorbidity and deprivation is accounted for.

And finally, PHE supported the UK’s first National Clean Air Day on Thursday, organised by Global Action Plan to encourage people to reduce, talk about and avoid air pollution, with advice on practical things that people can do to cut local pollution levels. Tackling air pollution is where tobacco control was 30 years ago and, along with improving mental health, likely to dominate the public health agenda going forward.

With best wishes,

Friday messages from 2012-2016 are available on GOV.UK

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  1. Comment by Dr. Éamonn O'Moore posted on

    Great to see reduction in tobacco smoking prevalence in the general population in England, especially among the young. The contrast with the prison population is even more stark now- around 80% of people in prisons smoke. Many of these men and women are parents and this influences a future generation as well as affecting the health and wellbeing of offenders. PHE are working in partnership with NHS England and HM Prison & Probation Service to implement a smoke-free prisons programme. Already, 21 prisons are now smoke-free and we are implementing the programme in a phased approach across the rest of the prison estate in England learning from experience as we go. This ensure that no one is left behind from this important health improvement programme- even those often described as 'hard to reach' but more apprpopriately described as 'under-served' as health services frequently do not engage with them effectively. PHE Health & Justice is driving this programme forward and our progress is of interest internationally. For further information contact Health&