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From the National Health Service to local government: perceptions of public health transition in England

Atkins, L; Kelly, MP; Littleford, C; Leng, G; Michie, S; (2019) From the National Health Service to local government: perceptions of public health transition in England. Public Health , 174 pp. 11-17. 10.1016/j.puhe.2019.05.016.

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Abstract

OBJECTIVES: In England, in 2013, responsibility for some public health (PH) functions transferred from the National Health Service (NHS) to local government. This moved PH from a health-focussed into a broader and more politically oriented context. This article reports on the perceptions of those involved in this transition about how the PH function was changing as it transited to local government. // STUDY DESIGN: This is a cross-sectional interview study. // METHODS: The study included semi-structured interviews with 31 local government councillors, directors and deputy directors of PH, PH team members and members of clinical commissioning groups. Interviews and data analysis were informed by a theoretical framework, COM-B and an inductive and deductive approach was taken to identify relevant themes. // RESULTS: There was a mixed picture of perceived gains and losses for PH. The transition from NHS to local government was seen by some as a 'homecoming', providing the opportunity for PH to have further reach through influence and collaboration with departments like housing, transport and planning. The opportunity to promote evidence-based practice across local government was also seen as a positive aspect of the transition. However, professional roles of PH and individual PH practitioners were perceived to have less influence and autonomy than in the NHS, with some uncertainty about roles within local government. PH practitioners perceived the need to develop other skills to fulfil their roles in local government. Shorter timescales for action and pressure for faster responses were reported to be the reason for less emphasis on using PH evidence to inform policy and decision-making than hitherto in the NHS. // CONCLUSION: This study illustrates a variety of consequences of transitioning from NHS to local government. There were perceived benefits afforded by proximity to related local government departments but at the costs of reduction in status for PH practitioners and working to a timescale which in some cases reduced drawing on scientific evidence.

Type: Article
Title: From the National Health Service to local government: perceptions of public health transition in England
DOI: 10.1016/j.puhe.2019.05.016
Publisher version: https://doi.org/10.1016/j.puhe.2019.05.016
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Evidence-based practice, Guidelines, Local government, Reorganisation
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: http://discovery.ucl.ac.uk/id/eprint/10079797
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