INTEGRATED HEALTHCARE
make the service a better experience for them. You also talk to the clinical staff and local authority staff.”
The need for the prioritisation of aspects of public health is a key element of the report. Dr Hill explained that there are some pri- ority areas that will remain similar across all localities, saying: “The lifestyle areas obviously will rate very highly as they are going to impact on the future health of the population – things like smoking, alcohol, drug misuse, nutrition and physical activ- ity in terms of obesity, and sexual health – those are things likely to get very high priority, as will children’s services.
“These are long-term programmes that have to be maintained. For example, things like smoking cessation – the director of public health in local government will be commissioning smoking cessation services through the NHS or through other private
sector companies in order to ensure that that’s a free a service available, and tar- geted at those populations most in need.”
Lifestyles
Of course, many of the priority areas for public health essentially come down to personal lifestyle choices, something Dr Hill acknowledges: “Every government is aware that you can’t force people to make lifestyle changes – actually, they’ve got to know what the evidence is and they’ve got to want to make that change. But there are areas of public health where you can help people make that change. Doctors and other healthcare workers all have a con- tribution to make in raising issues around lifestyle choices.”
The report plans to make use of social marketing methods to help persuade indi- viduals to make healthy lifestyle choices.
Dr Hill also highlighted some of the other ways the new healthcare system will try to deal with issues like smoking: “There are things like trading standards, so that’s complying with regulation trying to stop underage sales, and then there’s other work going on in tobacco in relation to il- licit tobacco and trying to stop the sale of illicit tobacco through work with the UK Border Agency, for instance. Then there’s also the marketing on the packaging; no longer having branding on it, but also the other messages that reinforce that smoking is bad for health.”
New way of working
Obviously, the co-production of public health services between the individual, the healthcare provider and local govern- ment will mean change for those already employed in these areas. Dr Hill said: “The public health staff moving into local government will definitely have to learn a new way of working, a new culture. There’s a whole raft of leadership training begin- ning to be rolled out as well. A lot of it is about learning about the new culture and working with councillors and local author- ity officers.
“Quite a lot of it will be joint learning, be- cause local government has got to learn more about what public health means: the language of public health, and the impact the services in local government have on health.”
Nonetheless, Dr Hill sounded optimistic about the transition of public health staff from the NHS into local government, say- ing it was a success so far in terms of work- ing together to achieve the best possible outcomes. She said: “I’ve already heard of examples where people have come together from public health service and local gov- ernment to have joint learning sessions.”
Dr Hill said: “The report welcomes the role of local government contributing more to public health, because so many of the servic- es local government provides have an im- pact on health.”
Dr Alison Hill
FOR MORE INFORMATION The full report is at
tinyurl.com/ coproduction-for-health
national health executive Jan/Feb 12 | 33
For instance, there will be work through schools to encourage activities such as cy- cling, offering children new skills and ways into a more physically active lifestyle.
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