Public health commissioning

NHS England and NHS Improvement works closely with Public Health England and the Department of Health and Social Care to provide and commission a range of public health services.

Public health functions agreement (Section 7A)

The public health functions agreement (S7A) is an agreement between the Secretary of State for Health and NHS England.

Public health commissioning intentions

NHS England Public Health Commissioning Intentions for 2020/2021 have now been published. They set out to healthcare providers notice of NHS England’s Commissioning Intentions for Public Health Services under the public health functions agreement (S7A) .

NHS seasonal flu vaccination programme

NHS seasonal flu vaccine programme – advice and reimbursement guidance for the 2021/22 season

The Joint Committee on Vaccination and Immunisation (JCVI) has published its scientific advice and recommendations on the use of influenza vaccines in the UK for the 2021/22 season. Based on these recommendations, NHS England and NHS Improvement (NHS E&I) has published a letter, setting out the vaccines that should be offered to eligible people and the reimbursement guidance for 2021/22.

NHS Breast Screening Programme (NHS BSP)

In England, breast screening is currently offered to women aged 50 up to their 71st birthday, every 3 years. Women invited for a breast screening have an X-rays (mammograms) at a clinic or mobile breast screening unit.

The major aim of the NHS breast screening programme is to reduce mortality from breast cancer by diagnosing cancer at an early stage when treatment is more successful.

The key objectives of the NHSBSP include:

  • identifying the eligible population and ensure efficient delivery with optimal coverage
  • delivering and supporting the programme with suitably trained, competent, and qualified, clinical and non-clinical staff who, where relevant, participate in recognised ongoing Continuing Medical Education, Continuous Professional Development, professional revalidation and External Quality Assurance schemes in fit for purpose facilities
  • having audit and service evaluation embedded in the service to maximise safety and accessibility of the service for all groups in the eligible population
  • maximising screening sensitivity and specificity by detecting early stage cancers with the least possible radiation dose and minimising the biopsy and referral of women who do not have breast disease to minimise the adverse impact (physical/ psychological/clinical) of unnecessary investigations
  • having a seamless pathway at the interface between screening and diagnosis and the treatment pathway to ensure women are referred promptly and safely to treatment services

Links to useful documents


NHS England and NHS Improvement Diabetic Eye Screening Programme (DESP)

Diabetic eye screening is a test to check for eye problems caused by diabetes.  The test can identify problems before sight is affected.

The aim of DESP is to reduce the risk of sight loss amongst people with diabetes by the prompt identification and effective treatment if necessary of sight threatening diabetic retinopathy, at the appropriate stage during the disease process.

This will be achieved by delivering evidence-based, population-based screening programmes that:

  • identify the eligible population and ensure effective delivery with maximum coverage
  • are safe, effective, of a high quality, externally and independently monitored, and quality assured
  • lead to earlier detection, appropriate referral, effective treatment and improved outcomes
  • are delivered and supported by suitably trained, competent, and qualified, clinical and non-clinical staff who, where relevant, participate in recognised ongoing continuing medical education (CME), Continuous Professional Development (CPD), and Quality Assurance (QA) schemes
  • have audit embedded in the service

Links to useful documents


NHS England and NHS Improvement Abdominal aortic aneurysm (AAA) screening programme

AAA screening is a way of checking if there’s a bulge or swelling in the aorta, the main blood vessel that rums from the heart to the stomach.  The swelling in an AAA. In England, screening for AAA is offered to men from aged 65.

Key objectives include:

  • Inviting eligible men to the AAA screening programme using standard information provided by PHE
  • Providing clear, high quality information that is accessible to all
  • Carrying out high quality abdominal ultrasound on those men attending for initial or follow-up screening according to national protocol

Links to useful documents


NHS Cervical Screening Programme

Cervical screening is a test to help prevent cervical cancer. All women and people with a cervix aged 25 to 64 should be invited by letter. During the screening appointment, a small sample of cells will be taken from your cervix. The sample is checked for certain types of human papillomavirus (HPV) that can cause changes to the cells of your cervix. These are called “high risk” types of HPV. If these types of HPV are not found, you do not need any further tests. If these types of HPV are found, the sample is then checked for any changes in the cells of your cervix. These can then be treated before they get a chance to turn into cervical cancer. You’ll get your results by letter, usually in about 2 weeks. It will explain what happens next.

The aim of the NHS Cervical Screening Programme is to reduce the number of people who develop invasive cervical cancer and the number of people who die from it.

Links to useful documents


NHS Bowel Screening Programme

NHS bowel cancer screening checks if you could have bowel cancer. It’s available to everyone aged 60 or over. The programme is expanding to include 56-year olds in 2021. Regular NHS bowel cancer screening reduces the risk of dying from bowel cancer.

Bowel cancer is the fourth most common type of cancer. Screening can help find it at an early stage, when it’s easier to treat. To test for bowel cancer you use a home test kit, called a faecal immunochemical test (FIT), to collect a small sample of poo and send it to a lab. This is checked for tiny amounts of blood. Blood can be a sign of polyps or bowel cancer. Polyps are growths in the bowel. They are not cancer but may turn into cancer over time. If the test finds anything unusual, you might be asked to have further tests to confirm or rule out cancer.

Link to useful information


NHS Antenatal Newborn Screening (ANNB)

You’ll be offered some screening tests during pregnancy to try to find any health conditions that could affect you or your baby. The tests can help you make choices about further tests and care or treatment during your pregnancy or after your baby’s born. All screening tests offered by the NHS are free.

The screening tests offered during pregnancy in England are either ultrasound scans or blood tests, or a combination of both. Ultrasound scans may detect conditions such as spina bifida. Blood tests can show whether you have a higher chance of inherited conditions such as sickle cell anaemia and thalassaemia, and whether you have infections like HIV, hepatitis B or syphilis.

Blood tests combined with scans can help find out how likely it is that the baby has Down’s syndrome, Edwards’ syndrome or Patau’s syndrome.

Public Health England have published revised newborn blood spot (NBS) screening standards, with an implementation date of 1 April 2020.  Details of the revision can be found on the PHE website at the following link: NBS New Standard

Link to useful information