<b>Quantifying the unmet need that currently exists for Public Health (PH)Grant services</b>

Using a conservative "return-to-peak" (R2P) methodology comparing current spending to historic 2015/16 peak spending, the total estimated unmet public health need across England is £1.2 billion.</p><p dir="ltr">Service-area spending shortfalls: Based on R2P calculations, the largest service-specific unmet needs include children’s 0–5 services (£520m), sexual health (£447m), substance misuse (£370m), children’s 5–19 & NCMP (£223m), and obesity & physical activity (£222m).

Specific modelling approaches also estimated sexual health unmet need separately at £552m.</p><p dir="ltr">Policy implications and systemic challenges: Unmet need is exacerbated by "unfair" historical funding allocations that failed to account for population shifts, competing pressures from acute services that threaten preventive spending, and instances where Directors of Public Health lack direct influence over spending decisions.</p><p dir="ltr">Data and workforce barriers: Effectively identifying and targeting population groups with high unmet need is severely hindered by inconsistent, non-granular local data as well as workforce shortages, particularly in specialized data analysis roles.</p><p dir="ltr">Key recommendations: Reversing unmet need requires restoring funding to 2015/16 peak levels alongside systemic reforms: improving local data collection quality, investing in workforce capacity development, and establishing local prioritisation and commissioning processes to target health inequalities and underserved groups.</p>