Directors of public health as ‘a protected species’: qualitative study of the changing role of public health professionals in England following the 2013 reforms

Llinos Mary Jehu, Shelina Visram, Linda Marks, David J Hunter, Howard Davis, Anne Mason, Dan Liu, Joanne Smithson

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    Abstract


    Background

    The Health and Social Care Act 2012 gave councils in England responsibility for improving the health of their populations. Public health teams were transferred from the National Health Service (NHS), accompanied by a ring-fenced public health grant. This study examines the changing role of these teams within local government.


    Methods

    In-depth case study research was conducted within 10 heterogeneous councils. Initial interviews (n = 90) were carried out between October 2015 and March 2016, with follow-up interviews (n = 21) 12 months later. Interviewees included elected members, directors of public health (DsPH) and other local authority officers, plus representatives from NHS commissioners, the voluntary sector and Healthwatch.


    Results

    Councils welcomed the contribution of public health professionals, but this was balanced against competing demands for financial resources and democratic leverage. DsPH—seen by some as a ‘protected species’—were relying increasingly on negotiating and networking skills to fulfil their role. Both the development of the existing specialist public health workforce and recruitment to, and development of, the future workforce were uncertain. This poses both threats and opportunities.


    Conclusions

    Currently the need for staff to retain specialist skills and maintain UKPH registration is respected. However, action is needed to address how future public health professionals operating within local government will be recruited and developed.
    Original languageEnglish
    Pages (from-to)e203–e210
    JournalJournal of Public Health
    Volume40
    Issue number3
    Early online date7 Nov 2017
    DOIs
    Publication statusPublished - 3 Sep 2018

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