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Duncan Selbie's Friday message - 1 March 2019

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Dear everyone

Smoking prevalence is at an all-time low in England with fewer young people smoking and we have a fighting chance of a smokefree generation. This week we published our latest evidence on e-cigarettes with a particular focus on patterns and use, the concern being that these might be gateway into smoking, something no one wants to see.  This shows that regular vaping among young people remains low in Britain and has plateaued among adults.

The findings show that in contrast to the experience in the US, we are not seeing a surge in e-cigarette use among young people in Britain. While there has been an increase in the total number of young people that have ever tried an e-cigarette, given that e-cigarettes are now the most common quit aid for smokers, this is not unexpected. Some media coverage suggested that vaping in young people has doubled over the past five years, but in truth the rate has hardly changed in the last few years. Among 11-18 year olds, the proportion of regular vapers (weekly or more) has been steady at about 1.7% and all but a small number (0.2%) of those young people using e-cigarettes were smokers or ex-smokers. We shall remain vigilant to any change in this profile and continue to publish the evidence and act on this.

This week Professor John Newton, our Director of Health Improvement, spoke at the Health Select Committee about trends in sexual health and the challenges faced by commissioners of these services. It is good to see that new diagnoses of HIV are down by 28% since 2015 and a reduction in genital warts cases due to the HPV vaccine but the picture remains mixed, with cases of syphilis and gonorrhoea up since 2016 by 20% and 22%, respectively. Since local government took on the commissioning of sexual health services in 2013, in many cases they have become better integrated, more efficient and more accessible.

Gaps and anomalies in provision remain, although these can often be addressed through good, collaborative commissioning. The reduced funding against a rise in demand is clearly a challenge for local government who are having to do more for less and we know this is an issue for the Spending Review. PHE is leading the development of a Cross-Government Reproductive Health Action Plan and we will be publishing an evaluation of the sexual health commissioning pilots and consulting on the chlamydia screening programme later this year. You can learn more about PHE’s work on sexual health commissioning in our short blog series.

Professor Yvonne Doyle, PHE Director for London has been appointed to succeed Professor Paul Cosford as PHE Medical Director and Director of Health Protection. I am also delighted to say we retain Paul as our Emeritus Medical Director.  From the point of handover in May, his new role will include leading on global health and helping PHE prepare for the new public health science campus in Harlow. I cannot sufficiently convey the debt we owe Paul as he has superbly navigated our first six years and to Yvonne in leading from the front in helping to improve the health of Londoners.

Scarlet fever is usually a mild illness but it is highly infectious and we are encouraging parents to be on the lookout for signs and symptoms after seeing a rise in cases. PHE continues to investigate reasons for this increase by studying multiple potential causes, including the strains of bacteria causing the disease, looking at levels of antibiotic prescribing and the spread of infection in different settings and patient groups. We are keen for parents to be aware of symptoms as we move towards peak season, typically mid-March to mid-April, so they can get their child diagnosed and treated with antibiotics quickly.

And finally, next Friday is International Women’s Day and this is particularly pertinent when we acknowledge the gender gap in pay that affects many organisations, public and private, including Public Health England. The primary reason for this within PHE is the gender distribution of work rather than pay itself and in line with the ‘Balance for Better’ theme this year we are on the case with practical actions to address this.

Best wishes


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