Detailed criteria were used to select indicators for inclusion in PHOF. These are set out in the table below.
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Essential [required for all indicators] |
|
|---|---|
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Clarity |
it is clear what it measures, outcomes or activities |
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Rationale |
it addresses a specific policy issue or draws attention to a particular outcome |
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Relevance |
it is relevant to the policy and there is action available to improve |
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Attributable |
it measures progress attributable to the interventions or activities |
|
Interpretation |
it is meaningful to the intended audience(s) |
|
Validity |
it has an unambiguous definition, is methodologically and technically sound from a reliable data source which is available at an appropriate level (for example local authority or integrated care board (ICB)) to make it meaningful and sustainable |
|
Construction |
the methods used support the stated purpose of the indicator and there is transparency about how they have been tested |
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Risks |
any limitations, risks or perverse incentives are identified and stated with any mitigating actions |
|
Availability |
it is collected at sufficient level of geographical or organisational split |
|
Affordability and value for money |
it benefits without disproportionate costs and where new burdens are created these will be estimated, as well as sustainable funding identified |
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Desirable [wherever possible] |
|
|---|---|
|
Timeliness |
it is possible to update with sufficient frequency (ideally quarterly) and data time lag (ideally less than one year but may vary for surveys) |
|
Comparable |
suitable UK or international metrics are available for making meaningful direct or proxy comparisons |
|
Disaggregates |
there is potential to break down by equality and inequality characteristics to measure impacts on different groups |
|
Supports alignment |
it is used across the health and care system via the other outcome frameworks. |
All indicators require context in order to understand them. In general, the indicator values are somewhat abstract, and don’t mean much to anyone unless they are presented in comparison to other values of the same indicator. The Fingertips platform that is used to present PHOF indicators shows:
OHID has produced a range of technical guidance to aid the interpretation of indicators and comparators.
Indicators in the PHOF use existing data sources wherever possible. The data source for each indicator is set out in the definitions tab.
Indicators are only shown in the tool where there are data available for them. All indicator data that is contained in the webtool is available to download from the download tab and metadata for the data download is available.
The fingertipsR package allows you to download public health data using R and the Fingertips API (Chrome only) allows public health data to be retrieved in either JSON or CSV formats.
Most indicators in the PHOF have the potential to impact on inequalities. We aspire to make it possible for all indicators to be disaggregated by equality characteristics and by socioeconomic analysis wherever possible. This is intended to support work locally to reduce in-area health inequalities where these persist. There is a list of inequalities data for each indicator and the data can be accessed from the Inequalities data view.
Where possible, indicators in the PHOF are presented at the following levels:
Details of which geography level is presented for each indicator is available.
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 in the Area Profiles view. The reason for this is that for many indicators, these values can artificially skew the distribution of values in England. They are therefore excluded to give a more representative range of values.
The England best and worst values are not displayed (and the spine chart is absent) in the Area Profiles view if more than 25% of local indicator values are not presented.
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 value in question. For some indicators, there is a set goal (for example, 90% for many of the immunisation indicators). If a local value meets this goal or not determines their colour.
When not using the RAG rating, the colour of the indicators are:
At this stage we have only implemented a simple chi squared test for trend. For this to be a valid test for a statistically significant trend in an indicator, it needs to meet the following:
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. For more information, visit the Trend markers - technical specification for users.
The box plot is a standardised way of displaying the distribution of data. In the Fingertips 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.
Documents showing all indicators for a selected area can be found in the Reports section.
For general viewing, keep your browser up to date (particularly Internet Explorer).
For printing, users might need to enable background images if the colours are not showing up, depending on their browser settings. To do this:
If you use Internet Explorer:
If you use Google Chrome:
To fit more content onto each page, reduce the scaling percentage from 'Print Preview'.
Life expectancy at birth and Healthy life expectancy at birth for each deprivation decile in England is available in the data download.
Also available is a guide to the slope index of inequality method for PHOF overarching indicators and a link to the ONS data and briefing for A02c (local level healthy life expectancy slope index of inequality).
Slope index of inequality data for 2016 to 2018 onwards have been calculated using the Index of Multiple Deprivation 2019. A summary report and set of charts have been produced to assess the impact of using the Index of Multiple Deprivation 2019 rather than the Index of Multiple Deprivation 2015 for this time period:
Summary: impact of the change to IMD on slope index of inequality (HTML)
Charts: impact of the change to IMD on slope index of inequality (pdf)
Supporting indicators for the excess weight in adults (aged 18 and over) data in the PHOF are available. Breakdowns of local authority prevalence data by BMI category (underweight, healthy weight, overweight, obese, severe obesity and excess weight) are presented in an Excel spreadsheet: .
Trend data is available for small areas and health geographies on the prevalence of excess weight (overweight including obesity) in children from 2010 to 2011 to 2017 to 2018 and obesity from 2008 to 2009 to 2017 to 2018. Data from the National Child Measurement Programme (NCMP) is presented for Middle Super Output Areas, Electoral Wards, and Clinical Commissioning Groups (CCG).
The following links may be helpful for further information about the health of the population in your local area.
Public Health England data and analysis tools
This page provides links to all PHE data and analysis tools, including specific tools around child and maternal health, alcohol, tobacco, sexual and reproductive health, child obesity and end of life care.
Public Health Dashboard
The purpose of the dashboard is to support local decision making by bringing existing comparative data into one place and making it accessible and meaningful to a wide audience.
Local authority health profiles
The Local Authority Health Profiles provide an overview of health for each local authority in England. They pull together existing information in one place and contain data on a range of indicators for local populations, highlighting issues that can affect health in each locality.
Local Health
Local Health provides quality assured health information at small area level.
National General Practice Profiles
These profiles are designed to support GPs, clinical commissioning groups (CCGs) and local authorities to ensure that they are providing and commissioning effective and appropriate healthcare services for their local population.
Marmot indicators for Local Authorities in England
Fair Society, Healthy Lives: The Marmot Review report was published in February 2010, presenting the recommendations of the Strategic Review of Health Inequalities in England post 2010. The Marmot Indicators for local authorities were released, providing information to support monitoring of the overall strategic direction in reducing health inequalities.
NICE guidance summary for public health outcome domain
A summary of NICE guidance on nursing and midwifery, to underpin practice that will improve population health and wellbeing.
NHS Digital Indicator Portal
NHS Digital has responsibility for standardising, collecting and publishing data and information from across the health and social care system in England.
Ministry of Housing, Communities and Local Government Open Data
Linked Open Data from MHCLG
The LGBT Public Health Outcomes Framework Companion Document
The Lesbian, Gay, Bisexual and Trans Public Health Outcomes Framework Companion Document is a resource for all those commissioning and delivering healthcare services in order to support the delivery of an equitable public health system.
