The Impact of Public Health
2016 was undoubtedly another challenging year for local authorities, with continued austerity putting pressure on services while demand continues to rise, most notably within social care. With the announcement of the Autumn Statement back in November, this shows no sign of letting up, ADASS predicting a £500m overspend in Adult Social Care alone. Many solutions have been touted, STPs and the BCF, but perhaps one area that has not received many headlines yet requires more attention is the role of Public Health in local authorities.
As a core local government function, Public Health teams can make a direct impact on residents by assessing the population’s health and wellbeing to protect and improve their health, while reducing health inequalities. Good and effective prevention strategies put less pressure on other services, both within local authorities and the NHS, by reducing demand, with strong leadership necessary to drive this forward. The importance of a competent Director of Public Health (DPH) cannot be underestimated. The role they can play as a key figure in the health system by reducing demand on services and creating more traction with the NHS is crucial, which is of course one of the major objectives for local authorities at the moment.
DPHs have seen their roles chopped and changed since the transfer in 2013, and they must be able to respond to these changes. Some Directors have seen their portfolios increase beyond Public Health to include other service areas including Intelligence and Strategy, Environmental Health and Trading Standards and Community and Neighbourhood Development, while others are being asked to take on additional responsibility for two or even three Councils within a region, while others have seen their portfolios diminish in authorities that have struggled to incorporate Public health into wider council objectives. Part of the challenge is trying to get the Faculty to agree to innovation in public health structures, or streamlined recruitment processes that are still difficult and time consuming. Public Health still has a crucial role to play in the conversation about demand management, but Public Health Directors must start to demonstrate some of the wider competencies and capabilities that you would expect of any other local authority Corporate Director, but also be given the freedom to put their own stamp on the service.
Financial pressures and changes in leadership over the course of 2016 has led to consistent reorganisation in local authorities, London Boroughs alone appointing 7 new Chief Executives since the start of 2016. With new leadership comes fresh ideas, creating more demand for flexible resource and external expertise. Public Health departments have felt this as much as any other, and talent is increasingly hard to come by, particularly for experienced Directors and suitably experienced consultants who can take on effective strategic leadership roles at a corporate and wider system level. A major challenge for any DPH is to help acclimatise Consultants to the world of local government, and keep them long enough until they are ready to step up. Penna can play an important role here, offering mentoring schemes with experienced Directors in the field to provide support and guidance, and retain the talent in local authorities.
With new models being implemented and departments evolving, Directors are increasingly looking for support with short-term projects or vacant posts, although they often do not know who to contact for support or who to speak to for advice. We’re at a stage now where younger Directors are coming into post, and expectations are incredibly high with plenty to prove in a short period of time. Penna is steadily building a reputation as a partner for Public Health appointments with a strong network both permanent and interim, so please do get in touch if you’d like some support with your own career. We’ve helped to place Directors and Consultants, but also strategists, analysts and commissioners into public health teams and seen first-hand the impact good appointments at this level can have.
Senior Consultant – Local Government Executive Interim