[CITED FROM LGA website: http://tiny.cc/qf5acx]
The return of public health to local government has been widely welcomed. It affords an opportunity to provide leadership for health that was largely missing from the NHS between 1974 and April 2013.
The new arrangements could enable a more joined up approach across sectors and greater collaboration with citizens and communities. Local authorities could make a shift from a medical to a social model of health, providing a real opportunity to refresh what we mean by public health.
But the wider environment is tough both financially and politically. Mental and physical health and wellbeing are suffering because of widening health inequalities, and government policies are threatening to reinforce these trends. It all amounts to a perfect storm.
Given the enormous system changes and pressures affecting local government, it needs to be very clear about its priorities and where it should invest resources. Local policymakers and practitioners urgently need credible and robust sources of information to determine local priorities.
Knowing which interventions might give the best value requires access to evidence. But given the sheer volume of evidence that exists, and the number of research studies that are stock-piled, navigating a way through the maze can be daunting – especially if staff resources for are limited.
A review published by the Local Government Association through the Economic and Social Research Council’s local government knowledge navigator initiative, provides a digest of what social science research is currently available, identifies major themes, and provides a critical commentary on how these can help investment decisions.
The research reviewed may be used to inform health and wellbeing strategies and action plans to tackle the health gap between social groups, adapting it to local contexts.
Various themes are selected for particular attention: governance for health – what does research say about the role of local government; planning for public health locally – what models are available; and evidence and public health – what are the difficult issues in using evidence in complex settings.
Because of the complex and often “wicked issues” with which public health wrestles, there is much debate over what counts as evidence and how it can best be applied in different contexts. Evidence doesn’t exist in a vacuum – how it is presented and by whom are key issues which can determine its value and uptake. Even where respected evidence resources exist, such as the National Institute for Health and Care Excellence, awareness of them remains poor in many local authorities. And getting their findings into practice locally can be problematic.
Finally, evidence will only ever be one among many factors influencing decisions, especially in a local government context where elected members draw on multiple sources of knowledge to reach decisions. The review encourages local authorities to become system leaders for public health at this critical time. Helpful knowledge exists but it is overlooked or ignored.
This review will act as a guide to make existing research more accessible for those wanting to develop local government’s role in public health.
Contacts
Jane South is a professor at Leeds Metropolitan University, David Hunter is a professor at Durham University and Mark Gamsu is a visiting professor at Leeds Metropolitan University.
Please note a full version of this article appears in The Guardian.
– See more at: http://www.local.gov.uk/health/-/journal_content/56/10180/5945025?_56_INSTANCE_0000_templateId=ARTICLE#sthash.HLJWHHUg.dpuf