The new health promotion arrangements in general medical practice in England: Results from a national evaluation

Abstract

The new health promotion arrangements were introduced in October 1996. This study, commissioned by the Department of Health, aimed to assess the extent of health promotion activity under the new arrangements, and to explore views about their implementation. The study was conducted in two parts. The first stage consisted of a telephone survey with a nominated person from each health authority in England. The second phase, reported here, consisted of semi-structured face-to- face interviews in six health authority case study sites. Sixty-nine interviews were conducted with a range of key health promotion informants. The most common focus of health promotion activity related to coronary heart disease and stroke with less emphasis on other Health of the Nation target areas. Monitoring of health promotion was generally low-key and informal which led to concerns about effectiveness and accountability. There was little evidence of evaluation of health promotion activities by practices, although most routinely carried out audit. The regulatory role of HPCs appeared to be lessening, and they were being overshadowed by HimPs and PCGs. These findings raise issues which will have important implications for the future development of health promotion services.