The agency's relationship with the Government's health goals stretches back to 2008, when it was appointed to anti-obesity campaign Change4Life at the height of the previous Government's willingness to spend big on communications.
Freuds' monthly fees for its Change4Life work in 2008 were understood to be between £40,000 and £45,000.
But then the arrival of the new austerity Government saw Department of Health marcoms budgets slashed, with PR spending dropping from £4.3m in 2009-10 to £0.5m in 2010-11.
Freuds had first made it on to the government PR roster in 2004, when the Central Office of Information unveiled a list of 31 agencies, and in 2006 it won a place on the DH's broadcast PR roster.
Today, under the Government Procurement Service framework that replaced the COI, there are only six agencies on the roster for PR work with a contract value greater than £100,000.
However, Freuds has thrived so far despite the changes. In December 2011 it won the contract to handle all of the DH's public health campaigns, including Change4Life and Smokefree/Tobacco Control.
The one-year contract was understood to be worth £85,000 a month and the DH took up the option to extend it into a second year.
Then last year the DH moved all comms and marketing responsibilities to Public Health England, the NHS Commissioning Board and local government. This change did not affect the overall marketing budget, which was transferred over to PHE and was £54.7m for 2013-14.
Freuds has been paid a total of £690,967.80 by PHE in recent months, according to transparency data published by the organisation covering transactions greater than £25,000 for the months from November 2013 to February 2014.
Payments marked "annual fees across all public health campaigns" total £90,000 each month (with an additional £150,000 in November).
There have also been additional payments to Freuds for work on specific campaigns. These include £151,006.80 in January for "Cancer campaigns – media engagement costs in BME".
Separate data on DH spend over £25,000 in December includes a £29,961 payment to the agency for "G8 Dementia Film Production".
However, Freuds now appears to be in a weak position to retain this work due to a statutory review combined with the changes to the Government's roster.
PHE has recast the brief as "consumer engagement" rather than PR, according to PHE marketing director Sheila Mitchell, who added that the brief is about "PR in its broadest definition".
In addition, the contest is only open to the 10 agencies on the Lot 1 roster of the Government Procurement Service's framework, for integrated marketing services. Freuds does not have a place on that roster (or the PR roster), and has been forced to partner with one or more of the agencies to compete – the smart money is probably on M&C Saatchi, which handles Change4Life advertising.
PHE's first marketing plan, for 2013-14, focused on a shift from traditional media to digital and social channels. It is now preparing to publish a new "umbrella marketing strategy" in the coming weeks.
Mitchell said the new strategy would reflect the shift to digital and the emergence of new significant health issues such as cardiovascular disease, blood pressure and dementia.
The aim of the strategy, according to Mitchell, is to bring together all PHE’s wide-ranging campaigns and approach its marketing activities as a single organisation. It will be supported by the agency or agencies appointed to the brief at the end of July.
These six did not have the opportunity to take part in the current pitch however.
Justin Wilkes, owner of Spink Health, a healthcare agency handling NHS communications, says news of a rethink is positive, although the question remains of how to demonstrate how campaigns have been successful and had an impact of behaviour.
He points to a lack of demonstrable success of the Change4Life campaign, which has taken a predominantly advertising-led approach, and suggests that an integrated approach is indeed the way forward.
"They need to take a strategic marketing focus, not just advertising or PR," he says.
However, choosing the Lot 1 roster agencies over Lot 4 for such a major PR brief could raise questions going forward, suggests Oliver Hickson, former PR director at the COI, the system preceding the GPS, and now consultant to a number of agencies involved in the government rosters.
He predicts that this could be challenged by PR and digital agencies who will feel they should have been invited to pitch. "This could set the cat among the pigeons," he says, hinting at another potential hurdle for Freuds to overcome.