Member blog: Lincoln Sargeant

I was a reluctant Director of Public Health (DPH). The job seemed to be about endless emails, long meetings, Gantt charts, budget spreadsheets, HR, governance structures and the like – not the things that get me out of bed in the morning. However, after 12 years in the job, it turns out to be so much more! I still anticipate each day knowing it will bring new opportunities to learn and use the skills I’ve gained over the years.

Two factors prompted me to apply for my first post. Work colleagues I trusted and respected thought I had the necessary qualities to do the job. Their endorsement gave me confidence. The second was the move of public health functions in England from the NHS to local authorities following reforms of the Health and Care Act 2012. This was an opportunity to shape the role in its new context and I wanted to play my part to make the move a success.

Local authorities deliver hundreds of services that affect the day-to-day lives of residents. They are responsible for policies and strategies that shape local places and support local communities. Only national Government is more influential in affecting the context in which we live our daily lives. The factors that have the greatest impact on population health such as employment opportunities, housing, transport and the physical environment are heavily influenced by local authority decisions. Services that support the most vulnerable such as social care are also functions of local government as is the local responsibility to plan for and respond to emergencies. In England, DsPH and our teams are therefore well placed in local authorities to directly influence a range of functions and services that promote the health and wellbeing of residents and reduce, delay or defer the need to health and care interventions.

Moreover, Elected Members have a direct connection with their constituents and the voice of local residents can have an immediate effect on how business is conducted. The political nature of local authorities adds a dimension to the work of senior officers, like DsPH, that differs to similar roles in the NHS, for example. We have to think about the technical merits of a proposal as well as its political acceptability. I have worked in a two-tier (where functions are split between a county council and district councils) and in a unitary authority (that covers all functions) and I have also worked in authorities with different political balance from strong political majorities to no overall control – each situation changes the nature of the job.

This is where the Association of Director of Public Health (ADPH) and the constituency networks are so important in supporting our work. ADPH helps us navigate the complex nature of the job; leading in political environments, being senior managers with budget, HR, and programme and project management responsibilities, as well as being up to date with public health practice across the domains of health improvement, health protection and population health management.

One of the practical offers for Directors new to the job or changing locations is the ADPH mentoring programme. I have benefited both as a mentee and a mentor. Peer support through challenging periods of transitions helps us remain resilient and focused on what matters. We have access to decision makers and need to be connected to the people whose interests we serve to help them make connections themselves, or faithfully represent their perspectives. Getting that right and making a difference to our local residents’ lives is both the hardest and the most fulfilling part of the job and, unlike Gantt charts, is what gets me out of bed in the morning!