Public health capacity in the new primary care organizations: defining a workforce that is fit for the purpose

Abstract

Recent UK government policy calls for a strong public health function within health and local authority services. The recent restructuring of the National Health Service has drastically changed the organizational structure of Public Health, and has resulted in concerns over the capacity and capabilities of the specialist public health workforce. This paper presents findings from the first phase of a study assessing the capacity and development needs of specialists in public health. Face-to-face semi-structured interviews were conducted with a purposive sample of key public health informants. Four key themes were identified. First, interviewees noted the lack of clarity encompassing the term ‘specialist in public health’ and the consequent confusion regarding the role of a specialist and the public health function. Second, concern was expressed over the recent fragmentation of the workforce, the loss of critical mass and the potential for professional isolation. This was seen as particularly worrisome in light of a growing public heath agenda. Third, respondents identified key skills gaps within the workforce such as health protection, partnership working and leadership. Last, inadequacies and regional inequities in training and continuing professional development were identified, with interviewees calling for these issues to be addressed immediately. Capacity and skills gaps in the specialist public health workforce are evident and exacerbated by the confusion surrounding the definition of a specialist and, hence, individual roles and responsibilities. The ability of the public health workforce to meet the growing public heath agenda will be dependent on the success of various new mechanisms for joint working, capacity building, and skill enhancement.

Acknowledgements

This study was funded by the Department of Health. The views expressed are those of the authors and should not be taken to represent the opinions of the funding body. The participation of interviewees and their organizations is gratefully acknowledged. The authors wish to acknowledge the role of the wider management team in progressing all phases of the study.