Tag Archives: Local Government

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

Jehu, L.M. et al. Journal of Public Health, https://doi.org/10.1093/pubmed/fdx154

Published: 07 November 2017

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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.

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Evidence-based medicine meets democracy: the role of evidence-based public health guidelines in local government

Kelly, M.P. et al (2017) Journal of Public Health. pp. 1–7 doi:10.1093/pubmed/fdx002

In 2013, many public health functions transferred from the National Health Service to local government in England. From 2006 NICE had produced public health guidelines based on the principles of evidence-based medicine. This study explores how the guidelines were received in the new environment in local government and related issues raised relating to the use of evidence in local authoritites.

Methods

In depth, interviews with 31 elected members and officers, including Directors of Public Health, from four very different local government organizations (‘local authorities’).

Results

Participants reported that (i) there were tensions between evidence-based, and political decision-making; (ii) there were differences in views about what constituted ‘good’ evidence and (iii) that organizational life is an important mediator in the way evidence is used.

Conclusions

Democratic political decision-making does not necessarily naturally align with decision-making based on evidence from the international scientific literature, and local knowledge and local evidence are very important in the ways that public health decisions are made.

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Supporting integration through new roles and working across boundaries

By The King’s Fund (2016)

This report looks at the evidence on new roles and ways of spanning organisational workforce boundaries to deliver integrated health and social care. Commissioned by NHS Employers and the Local Government Association, it finds increasing focus on roles which facilitate co-ordination and management of care, development of existing roles to increase the skill-mix and enable the provision of more holistic care, and a limited number of truly innovative roles, the most notable being care navigators and community facilitators, enablers or link workers. Given that many of the skills required for integrated care already exist within the workforce, it suggests the central question is how to use those skills more effectively to support boundary-spanning activities.

Click here to view this report

Supporting integration through new roles and working across boundaries

By The King’s Fund (2016)

This report looks at the evidence on new roles and ways of spanning organisational workforce boundaries to deliver integrated health and social care. Commissioned by NHS Employers and the Local Government Association, it finds increasing focus on roles which facilitate co-ordination and management of care, development of existing roles to increase the skill-mix and enable the provision of more holistic care, and a limited number of truly innovative roles, the most notable being care navigators and community facilitators, enablers or link workers. Given that many of the skills required for integrated care already exist within the workforce, it suggests the central question is how to use those skills more effectively to support boundary-spanning activities.

Click here to view this report

The district council contribution to public health: a time of challenge and opportunity

By The King’s Fund (2015)

This report was commissioned by the District Councils’ Network in 2015. Its intention is to contribute to the understanding, assessment and development of the role of district councils in improving the health of their citizens and communities. It focuses on district councils’ role in promoting public health through some of their key functions and enabling roles.

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Sexual health commissioning in local government: building strong relationships, meeting local needs

By Local Government Association (2015)

These nine case studies showcase local government experience of commissioning sexual health services since taking over this responsibility in April 2013

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Health and social care priorities for the Government: 2015-2020

By The Nuffield Trust (2015)

This briefing outlines ten possible key health and social care priorities for the new government, covering funding and finance, quality of care, new models of care and workforce.

Click here to view this briefing