The future of the PH workforce

Earlier this week, the Royal Society for Public Health published a new report on the Wider Public Health Workforce. In it they raise important issues around the need to recognise and value those people who are working to improve public health now, and around the need to future-proof the public’s health by creating a strong career path and pipeline for the next generation of public health workers.

We all know that our health is improved and protected by a huge range of people, working across all sectors and at all levels and I have written before about how each and every one of these people – most of whom don’t have ‘health’ in their job titles – play a critical role in public health.

The list of these non-specialist public health workers is huge but, take for example Trading Standards officers. These professionals are responsible for enforcing the Food Safety Act which is designed to keep consumers well by protecting them from unhygienically prepared food. They are also tasked with enforcing laws around the illegal sale of goods – many of which, like the sale of vapes and cigarettes to children, are illegal because of their harmful impact on health and wellbeing.

Other examples are those working in the fitness and leisure industry, people working to improve our air quality or architects and planners who are designing the places we live and work in – all have a crucial role in supporting our health and wellbeing yet these professionals, and so many more, are not necessarily given any training in ‘public health’, or recognition for the role they play.

How far the definition of the ‘wider workforce’ should go is an important question and one that we all probably have different answers to. What is clear though is that we need to tease out this definition, in conjunction with that of the ‘specialist public health workforce’, remembering that while not everyone is a public health professional, they do have enormous potential to positively impact people’s health and wellbeing. By understanding the different types of influence and role, we can begin to understand the intersection of skills and ensure that the right training and opportunities are given to the right people.

In their report, the RSPH recommends a cross-sector national workforce strategy which includes both specialist and non-specialist public health workers, but how we achieve this is a complex question. Can it, or even should it, be UK wide?

We need to recognise that the current – and future – workforce, although operating in different systems depending on their geography, have the same skills, knowledge and experience and move from one place to another. Just as teachers use their teaching skills to teach A levels, Highers or BTECs, depending on the school system they are in, public health professionals also deploy their same skills in different systems. Instead of addressing the issues we are facing in silo, we should embrace this shared knowledge, while remembering that one size doesn’t necessarily fit all.

Scotland already have a health and social care workforce strategy, and of course there is the NHS long-term workforce plan, which although does reference public health, doesn’t go into depth about its various roles and routes. M for the UK.

All of these strategies rightly have a different emphasis but essentially all have the same aim – to make sure that the future health and wellbeing of the population is supported by the very best workforce possible. What’s needed now is to take an approach that recognises and uses the strengths of each of these strategies and reports to embed clear, effective career paths, training and development that is appropriate to the role, and set agreed standards to ensure quality and professionalism.

Crucially though, it isn’t about creating one path to the top. Instead, it is about securing knowledge and understanding relevant to people’s roles so that their jobs are made clearer and all sectors can work together, more efficiently to support the public’s health.

This is because society needs a wide variety of people working well across a huge range of professions to achieve healthier outcomes. In our manifesto for a healthier nation, we argue strongly for a health in all policies approach. This means that every department and decision made should put the consequences for people’s health at its heart, which will necessarily mean that all professions will be concerned in one way or another with supporting healthier outcomes and preventing ill-health – that is the only way we will reverse the current trend of rising levels of preventable sickness.

However, regardless of definitions and remits, the public health workforce cannot be addressed in isolation. Sadly, over the last decade, the public health system has been subject to repeated reorganisation and funding cuts. As well as adopting a health in all policies approach, the next Government must commit to funding a sustainable, cohesive and comprehensive public health system which is focussed on prevention and not reliant on one-off initiatives and new treatments.

At the same time, it would be hugely beneficial for a central body to be tasked with tackling the issues around training, recognition and recruitment of both the specialist and non-specialist public workforce. Such a body would also need to develop close ties to the other industries and businesses that support health and wellbeing, so that we have that overview and can harness the collective power of cross-sector working.

However, if our goal is to improve people’s health and wellbeing so that everyone can live healthier lives for longer, we must address these challenges in tandem. It will take collaboration and patience, but only then will everyone be able to fulfil their roles properly and be able to contribute to a society that promotes good health and wellbeing from the very start of life.