Building a public health workforce for the future

Health inequalities are continuing to rise across our communities and places. This is causing enormous harm. 

We know that health inequalities worsen under economic crisis. 

The COVID-19 pandemic exacerbated health inequalities, and its impact on people's physical and mental health was not felt equally across society. Some groups were more affected – especially those who already had worse health outcomes before COVID-19 or those living within deprived households and communities. 

The surge in the cost of living in recent years has further aggravated health disparities. Rising levels of food insecurity, increased housing costs, living in cold and damp properties as a result of not being able to afford heating and escalated levels of stress and anxiety have led to a significant worsening of health inequalities. 

Local government, aware of the circumstances of so many of their residents, is focusing on reducing these inequalities, working with the wider health system to enable recovery from the pandemic and to build sustainable and healthier futures.

However, many councils face the prospect of having to decide if they need to cut valued services that communities rely on social care for adults and children, support for low-income households and preventing homelessness, along with increasing fees and charges for service users as a result of inflation and ever-tighter budgets. 

Councils have faced a 27 per cent real-terms cut in core spending power since 2010, leaving many local areas lacking the resilience they need to meet new challenges.  The ringfenced Public Health Grant received by councils has been reduced in real terms by £858 million (in 2022/23 prices) since 2015. This has resulted in a reduction in councils' ability to spend on public health commissioned services and has undermined local government efforts to improve the health and wellbeing of their communities. 

Therefore, it is vital to act now and drive forward work programmes that reduce inequalities, prevent poor health and improve people’s opportunities for better health. 

We also know that more people than ever are leaving the workforce due to ill health. 

Shaping the future of public health was the theme of last week’s public health conference and it couldn’t have been more prescient. What is abundantly clear is that no one sector is going to be able to reverse the deeply alarming trend of negative health outcomes alone.

Public health must be everyone’s responsibility and it’s going to take a whole workforce to meet the challenges of today and tomorrow to build a healthier and more productive future.

The Wider Public Health Workforce

Millions of people in the UK are already doing public health as part of their jobs and many are deeply embedded in or working closely with local government. Allied Health Professionals, sports and fitness professionals, town and country planners, environmental health officers, housing officers, cleaning and hygiene operatives and many more all positively impact the health and wellbeing of the public through their work. It is occupations like these that make up of the UK’s Wider Public Health Workforce.

Working across a vast range of settings, workplaces and communities, these groups deliver public health approaches, day in, day out - sometimes without knowing it. Although not considered part of the specialist public health workforce, the impact they have on the health of the public is huge and their expertise is vast. Like a lot of great work that happens locally, the value isn’t always recognised. 

Whether it’s helping to design healthier places, making sure the food we eat is safe or  providing opportunities and spaces for communities to keep active and much more – local governments across the country are already doing great work to promote better health and wellbeing.

The Royal Society for Public Health’s new report, ‘The Unusual Suspects: Unlocking the Potential of the Wider Public Health Workforce’ sets out four key recommendations that could help it achieve more:

1. The UK and devolved nation governments developing a cross-sector national strategy for the whole UK Public Health Workforce. 
2. The public health sector and relevant government departments thinking collectively about how to resource, upskill and empower the Wider Public Health Workforce to maximise their impact. 
3. The Wider Public Health Workforce being better recognised as contributing to public health and prevention. 
4. The Wider Public Health Workforce needing clearer routes into public health and ways to develop and be recognised for its expertise in public health.

The recommendations set out a clear, realistic and actionable route for Government and the public health sector to make the most of the huge potential in local government and across the wider workforce.

Shaping the future of public health

Getting public health right is underpinned by a number of key factors that require long-term thinking, investment and action. A restored public health grant is a positive investment in the future. Building local infrastructure, reducing levels of poverty, providing sufficient numbers of decent homes and making our places great to live in will help reduce widening health inequalities. 

It is going to take a vast collective effort to get public health right and meet the needs of local communities. It starts with a workforce equipped to do it.