Building back accredited public health expertise into the NHS in England
We have published a joint report in partnership with The Faculty of Public Health, titled Healthcare Public Health in England, which makes the case for input from accredited public health specialists to be urgently and significantly bolstered across the NHS in England.
This new report draws on a review of 21 core NHS, government, and professional documents and 17 interviews with senior leaders from across the system, and warns that without significantly increasing the numbers of public health specialists working within health and care settings, the NHS will continue to face difficulties in meeting its ambitions to protect and improve population health.
Whilst public health language and targets have expanded rapidly across NHS policy and functions, the specialist workforce needed to deliver this work has been shifted out of the system. Currently, just 10% of the public health specialty are working within health and care settings, despite being the group of professionals accredited with the knowledge and skills necessary to lead prevention work within the NHS.
With the NHS currently undergoing fundamental redesign, there is a rare opportunity to embed public health expertise in the future system. Consistent, well-structured, and properly resourced access to accredited public health expertise across the NHS would mean stronger decisions on pathway design, prioritisation, resource allocation, and work to tackle health inequalities.
The report sets out ten recommendations, including rebuilding specialist public health leadership into Integrated Care Boards and provider organisations, continuing to recognise Directors of Public Health as the leadership anchor at place, and strengthening professional standards in senior roles.
Professor Tracy Daszkiewicz, President of the Faculty of Public Health, said:
“Across recent years there has been growing recognition of the importance of prevention and improving population health, alongside a clear commitment to tackling health inequalities. The opportunity now is to translate these ambitions consistently into action at scale, particularly for the communities who stand to benefit most.
“At the same time, the NHS has access to a highly skilled public health workforce that can play a central role in delivering this shift. By fully utilising this expertise across healthcare settings, we can strengthen our collective focus on prevention, early intervention, and the wider determinants of health.
“As the transformation of the NHS progresses, this report highlights a timely opportunity to embed public health thinking and capability into the heart of decision-making, locally, regionally, and nationally. Doing so will be key to improving outcomes, reducing inequalities, and ensuring that everyone has the best possible chance of living a healthy life.”
Greg Fell OBE, President of the Association of Directors of Public Health, said:
“We have a real opportunity here to put prevention and reducing inequalities at the core of our health and care system, but this entirely depends on how we translate policy ambition into system redesign.
“In practice, this means creating opportunities for stronger partnership working and better coordination across the NHS, local authorities, and the specialist public health workforce, with Directors of Public Health and their teams recognised and valued for the breadth and depth of population health expertise they bring to understanding local needs and protecting community health.
“And while this is put forward in the promise of current policy and NHS reform, framed specifically within the NHS’s goals to shift from treatment to prevention, delivering care closer to home, and reducing health inequalities, actualising this change means positioning public health leaders as equal partners, with a seat at the table to shape decisions, service design, and delivery.
“Only by defining clear roles, sustaining investment, and leveraging the full expertise of Directors of Public Health and the wider public health workforce can we achieve improvements to population health.”