Public Health

This section introduces the public health theme. Resources to support this theme are:

Introduction

Public health has been defined as:

'the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals' (Wanless 2004, p.3.).

Whenever we pick up a paper, listen to the radio or watch the news we seem to learn more shocking facts about unhealthy lifestyles and their consequences (BBC 2009; Guardian 2010).

The lifestyle of many young people - binge drinking, lack of physical activity, unhealthy diet is of particular concern. Increasing childhood obesity which continues into adulthood brings with it an even greater risk of developing chronic disease (British Heart Foundation 2009). It could well be that this generation will have a shorter life than their parents.

Public health issues are high on the agendas across the four UK countries. In England the Government has set out a strategy for public health in the White Paper ‘Healthy lives, healthy people‘ which involves significant changes to the funding, commissioning and delivery of public health services (Department of Health 2010a; Department of Health 2010b). A document accompanying the White Paper provides the evidence and sets the health context in more detail (Department of Health 2010c).

The new public health system, Public Health England, which is intended to be in place in April 2012, will be part of the Department of Health and will work closely with local authorities and other partners (Department of Health 2011a ). The Government proposes a less intrusive approach to public health and localism is a key feature of the new policy in England. Local authorities will take on new responsibilities for public health, with a ringfenced budget, to enable a more holistic approach across health and other related areas such as housing, leisure, transport and social care. Health and Wellbeing Boards, which are already being tested, are intended to give communities a greater say in the services required and to link with other services.

In the update to the White Paper which followed on from a ‘listening exercise’ for the Health and Social Care Bill, the Government aimed to address concerns raised about the new public health system in particular around the fragmentation of services with the transfer of responsibilities to local authorities, the impact of a transition period, and the continuation of a strong specialist public health profession and wider public health workforce (Department of Health 2011b).  For an outline of the public health developments during the period since the White Paper, and RCN activities and responses see the RCN Public Health Forum.

The NHS Scotland health care quality strategy cites as key challenges: obesity, physical inactivity, harmful use of alcohol, Hepatitis C and smoking rates. It also highlights the need to “enhance the performance of NHSScotland as a health promoting service, using every patient encounter as an opportunity to improve health” (Scottish Government 2010, p.25).

In Scotland NHS boards are required to set up Community Health Partnerships (CHPs) and there is at least one CHP in each NHS board’s area. CHPs are intended to help bridge the gap between primary and secondary healthcare and between health and social care. Audit Scotland has looked at whether CHPs are achieving what they were set up to deliver which includes improving the health and quality of life of local people. The report highlights the need for more systematic joined-up approaches to planning and resourcing and makes a series of recommendations, both for the Scottish Government and for NHS boards and local councils (Audit Scotland 2011).

Public Health Wales provides public health support to the seven Health Boards responsible for delivering all health care services across Wales. Health in Wales is worse than in many parts of Britain (Aneurin Bevan Health Board 2009). ‘Our healthy future’ sets out six action areas with the overall aim to achieve improved quality and length of life and fairer outcomes for all (Welsh Assembly Government 2009).

While our awareness of health and lifestyle issues increases so does the sense that traditional approaches to these problems are inadequate. The health of the nation cannot be improved by looking at health services alone. The challenge is to design a system that includes the NHS, but works effectively across a much broader range of partnerships.

References

The items referenced below were last accessed on 27 September 2011. The majority are in PDF format - see how to access PDF files.

Aneurin Bevan Health Board (2009) Health Challenge Wales. Aneurin Bevan Health Board website.

Audit Scotland (2011) Community Health Partnerships. Edinburgh: Audit Scotland.

BBC (2009) Lifestyle ‘doubles stroke risk’. BBC 20 February, BBC Health website. 

British Heart Foundation (2009) Couch kids – the nation’s future. London: British Heart Foundation.

Department of Health (2010a) Healthy lives, healthy people: our strategy for public health in England. London: DH.

Department of Health (2010b) Public Health England – a new service to get people healthy. DH website.

Department of Health (2010c) Our health and well-being today. London: DH.
 
Department of Health (2011a) Timeline for developing Public Health England. DH website.

Department of Health (2011b) Healthy lives, healthy people: update and way forward. London: DH.

Guardian (2010) Watching television increases risk of death from heart disease. Guardian 11 January, Guardian website. 

Scottish Government (2010) NHSScotland quality strategy - putting people at the heart of our NHS. Edinburgh: Scottish Government.

Wanless, D. (2004) Securing good health for the whole population: final report. London: Department of Health. 

Welsh Assembly Government (2009) Our healthy future: technical working paper. Cardiff Welsh Assembly Government.