Description

Sequential changes to the structure of the NHS
management systems has had direct implications for the
structure of the public health system in England. Whilst
the primary focus for change has been to improve services
their impact on public health has not been considered. This
has led to conflicting and ambivalent messages to which the
public health system has had to respond .In particular
Shifting the Balance of Power was unclear about the public
health role of Strategic Health Authorities and Getting
Ahead of the curve unclear about their role in health
protection. With the announcement of further change in
NHS management structures signalling the demise of the
DHSC tier and therefore a changing role for Regional
Directors of Public Health, the Faculty of Public Health
and the Association of Directors of Public Health
undertook a survey of public health capacity at SHA level.
The results showed that there was a strong and growing
presence at this level with responsibility for development
and performance management. The survey highlights the
changing roles and the need for greater clarity between the
leadership roles at different levels of the public health
system.