A new public health outcomes framework will measure the work of local authorities, which will take on responsibility for public health from April 2013.

Ministers will assess efforts to reduce inequalities between regions and to improve 'healthy life expectancy' - the number of years lived in good health as well as overall length.

Local authorities will be given £5.2bn of ring-fenced funds, taking much of the responsibility for public health away from the NHS for the first time in decades. Councils will also be paid a health premium if they improve the public's health.

Marmot Review
However, the government has still yet to reveal how this will work. It follows criticism from the authors of the influential Marmot Review into health inequalities, who said there was little evidence the health premium would reduce inequalities and may even increase them.

Speaking at the Royal Society for Public Health, health secretary Andrew Lansley said: 'It is absolutely right that the budget and decision making sits with councils. They will be able to address all aspects that affect our well-being – such as school attendance, homelessness and fuel poverty – in the round.'

Mr Lansley said local professionals would be able to make 'real changes' to improve health, guided by the new framework.

The framework uses 66 indicators to track progress, similar to how GPs are judged through the QOF. These are organised into four 'domains'.

Some will be based on social determinants, the 'causes of the causes', such as the number of children in poverty. Others will be more directly health-related, such as the level of diabetes in a population, smoking prevalence and cancer screening coverage.

Mortality from cancers, hip fractures and falls, excess winter deaths and dementia prevalence will all be included among the indicators as well.

Details of the two overarching measures - for healthy life expectancy and health inequalities - have yet to be finalised. But ministers confirmed they would be based on self-reported outcomes. These may work in a similar manner to patient-reported outcome measures (PROMs) used to judge hospital outcomes.

Responsibility deal
Mr Lansley also said the government's 'responsibility deal' with industry was bearing fruit. 'The responsibility deal has led to real changes for everyone and we can now see these in our everyday life – on our high street, in our supermarkets and at work too.

'People might not realise that these changes are down to the responsibility deal but we can now see that it is helping people to live healthier lives.'