Detailed criteria were used to select indicators. The criteria are set out in Part 1B of the original Framework and its Impact Assessment. They were developed with expert input from stakeholders to provide a comprehensive means of assessing the suitability of each candidate indicator. These were used to assess the final set of indicators including those suggested in response to the initial consultation. Indicators that passed a sift, based on the criteria, went on to form the first publication of the Public Health Outcomes Framework.
When the PHOF was first published in 2012 there was a commitment not to make any changes for three years to allow it to become established during the transfer of public health responsibilities from the NHS to local authorities. In 2015 a consultation on the PHOF indicator set was carried out to make sure that the PHOF is still as relevant and as useful as possible. To maintain the balance of areas covered and promote continuity, it was determined that the consultation would not result in a wholesale overhaul of the existing structure of the PHOF. It would focus on reviewing existing indicators with the aim of removing ineffective indicators and replacing or revising others where improvements in data have taken place over the past few years. It would also provide an opportunity to consider adding a small number of new indicators where there are important public health gaps and information is available to fill them. The government response to the consultation on refreshing the indicators has further detail here.
Updates to the Public Health Outcomes Framework data tool are published as official statistics. They are produced in accordance with best practice set out in the Code of Practice for Official Statistics for example, to ensure that they are fit for purpose, methodologically sound, politically independent and produced in a transparent way. The phrase ‘Pre-release Access’ refers to the practice whereby Official Statistics in their final form and any written commentary are made available to an eligible person in advance of their publication. The rules and principles which govern pre-release access are featured within the Pre-release Access to Official Statistics Order 2008. Post holders who are given pre-release access 24 hours prior to release can be found in the Public Health Outcomes Framework Collection within www.gov.uk.
Public Health Outcomes Framework data will be revised and corrected in accordance with Public Health England's Official Statistics Revisions and corrections policy and the Code of Practice for Official Statistics.
Responsibility for collating and publishing indicators transferred to Public Health England on 1st April 2013. Data are published based on the definitions set out in the Public Health Outcomes Framework policy documents.
Indicators in the Public Health Outcomes Framework have been based on existing data sources wherever possible. The data source for each indicator is set out in the definitions tab, and will be included within a document of technical specifications, to be published soon.
You can use and re-use the data and charts from the Public Health Outcomes Framework data tool (not including logos) free of charge in any format or medium under the terms of the Open Government Licence. To view this licence in an offline capacity write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or e-mail: firstname.lastname@example.org. Please state that you obtained the information from the Public Health Outcomes Framework data tool in your published document.
The Public Health Outcomes Framework has recently been refreshed. It is planned to update the framework every 3 years so a further process will begin in 2018/19. If you are working on indicators for future inclusion they will need to meet the criteria by then - please discuss this with us during indicator development.
Updates and additions will be announced on the homepage at www.phoutcomes.info. If you use Twitter, you can also receive updates by following the @phoutcomes Twitter feed. The quarterly schedule for updating each PHOF indicator can be found here – however dates are provisional as updates are dependent on when data is available.
No, the Public Health Outcomes Framework is not a performance management tool for local authorities. PHOF data will enable local authorities to benchmark and compare their own outcomes with other local authorities.
Indicators are only shown in the tool where there are data available for them. We are working to obtain data for all the missing indicators.
The metadata for indicators which have been converted from Primary Care Trust to Local Authority level describe in detail how this is done. This applies to the following indicators:
When there are at least five consecutive non-overlapping data points available for a proportion or crude rate indicator, a chi-squared statistical test for trend* is carried out on the most recent five points. If a statistically significant trend is present, a red or green arrow is shown next to the indicator. If there is no significant trend in the most recent five points, the test is redone, including an additional (sixth) point, and so on, going further back until the full series has been tested. Please see the Trend markers - technical specification for users here
* Armitage P, Berry G. Statistical Methods in Medical Research (3rd rd edition). Oxford: Blackwell 1994.
In July 2015, Public Health England reorganised its Centres (the parts of the organisation that provide local advice and support to the public health system), moving from 15 Centres to 9. The new Centre areas are largely co-terminous with the former Government Office Regions; the only difference is Milton Keynes local authority being located in the East of England PHE centre (whereas it is located in the former South East Government Office Region).
The England rate and the England best and worst values are not displayed (and the spine chart is absent) if more than 25% of local indicator values are not presented.
In the data tool, it is possible to compare your local authority with others in the same region, Public Health England Centre or deprivation decile in the Overview tab. It is also possible to compare your local authority with its CIPFA nearest neighbours (for details of these, see http://www.phoutcomes.info/documents/Nearest_Neighbour_Methodology.docx). For Lower Tier Local Authorities, the ability to compare to others within the same ONS classification group is also available. Combined Authority groupings have now been added to the tool (Feburary 2017). Other comparators may be added in future. Please let us know if you have any specific requirements.
Indicators that are shaded blue rather than Red/Amber/Green are presented in this way because it is not straightforward to determine for these indicators whether a high value is good or bad. Indicators that are shaded white are presented in this way because they do not have confidence intervals with which to compare against the benchmark value, and therefore it is not possible to determine whether the local value is statistically significantly higher or lower than the benchmark.
Values for City of London and Isles of Scilly local authorities are not included when calculating the highest and lowest values for England that are used in the spine charts. The reason for this is that for many indicators, these value can artificially skew the distribution of values in England. They are therefore excluded to give a more representative range of values.
For many indicators, the way that the colour is assigned is based on statistically significant differences from the England value. This is determined within the PHOF tool by using the England or region value depending on the benchmark selected and seeing whether this lies within the confidence interval of the Local Authority in question. For some indicators within the Health Protection domain, there is a set goal (for example, 90% for many of the immunisation indicators). If a local authority meets this goal or not determines their colour.
At this stage we have only implemented a simple chi-squared test for trend, and in order for this to be a valid test for a statistically significant trend in an indicator 1) there must be at least five consecutive data points; 2) the data points must be non-overlapping, eg single years rather than three-year rolling averages and 3) the indicator must be a proportion or a crude rate. Only the indicators which meet those three criteria have a “recent trend” marker showing.
Metadata for the data download can be found here.
The boxplot is a standardised way of displaying the distribution of data.. In the Fingertips suite of profiles we have displayed the 95th percentile, 75th percentile, median, 25th percentile, and 5th percentile in chart format, as well as the minimum and maximum values in table format, for each indicator.
The boxplots can be viewed based on the distribution of data for all Counties& UAs, Districts & UAs, or Regions within England by selecting the Area Type. They can be filtered to show only the lower geographies within a Region by selecting the Region benchmark. This will show you the distribution of the values for the selected indicator regionally.
More information is available for different health related topics and for smaller geographical areas. See www.localhealth.org.uk for profiles of your electoral ward, or click here for a list of health profiling tools.