Reaching out across the UK

Now we’re at the end of January and Christmas and New Year are a distant memory, it’s time to look ahead and think about what the year holds in store. 

This year we will continue to work closely with colleagues in the UK’s four countries and dependent territories so that we can accurately represent all our members’ views in discussions about public health policy, funding and workforce. 

This approach is at the heart of what we do, and, as part of an ongoing programme of visits around the country, I recently met with Directors of Public Health (DsPH) in Scotland and Wales to find out about their priorities and challenges. Although DsPH in England work for Local Authorities, as opposed to the NHS as is the case for Scotland and Wales, the role of protecting and promoting good health and wellbeing for our populations is the same. In visiting, I wanted to understand how we as ADPH can support them, as well as explore ways of working together on areas of commonality, and where other members and areas can learn from their experiences.  

Both Scotland and Wales are leading the way in many areas of public health. For example, minimum unit pricing (MUP) for alcohol is saving lives and, contrary to industry concerns, barely affects prices in pubs and clubs. Hearing the positive impact this legislation is having direct from our members strengthens our calls to the Government to introduce MUP in England. 

Scotland is also taking a groundbreaking approach to drug use with the opening of the Thistle Centre early this month. As the first safe drug consumption facility in the UK, the centre will showcase the benefits off focusing policy on prevention, treatment and recovery as opposed to supply and enforcement.  

Meanwhile, there is much we can learn from how Wales’ Wellbeing of Future Generations Act (2015), which outlines how a wide range of public bodies should work together to improve wellbeing in the country, is working. 

We also discussed Lord Darzi’s report ,and I was particularly interested to hear their perspective given the DsPH in Scotland and Wales sit within the NHS. Despite the different perspectives of NHS and LA employees, it is clear that we all believe that any ‘major surgery’ the Government plans to perform looks beyond the NHS, and gives sufficient weight to the role that DsPH and their teams have in promoting and protecting health and wellbeing at a local level. 

We discussed whether this difference in location – NHS v LA – of the DsPH matters. I think it does matter, and there are pros and cons to both, but the overall role is to be a DPH for the population, to advocate for good health practice and support positive health outcomes, stitch all this together across multiple systems, and deliver programmes so although we may come at it from a different angle, the outcomes should be the same. 

From an ADPH perspective, we have always been about the DsPH being a bridge and providing system leadership – this framing also helps to encompass the system in all four nations. However, fragmentation of the system will undoubtedly happen, although the issues might be different in individual countries.  

Funding also remains an issue for us all and needs to be addressed, not only in terms of it having been consistently cut in real terms over the last ten years, but also how it is allocated. I can’t stress enough the importance of local budgets needing to be able to meet local needs and while small ring-fenced pots can be helpful, they are not a sustainable way to provide an efficient service to local populations.  

My discussions with members in Scotland and Wales have helped me understand more about the structures in which DsPH work and to look at how ADPH can best provide support. Putting structures in place to share learning and perspectives in terms of policy, systems and practice will help to strengthen the support DsPH can provide for the health and wellbeing of their communities.    

Over the coming months I will be visiting other areas of the UK and look forward to learning from members there about their priorities, successes and challenges because only by working together, to collate and advocate for evidence-based policy that improves people’s lives, and ensuring that we strengthen the voice for public health across all areas of the UK, can we make it possible for everyone to live a healthier life for longer.