The public health system in England

Hunter, David J.; Marks, Linda; Smith, Katherine E.

doi:10.2307/j.ctt9qgt6f

Cited by 26 publications

(37 citation statements)

References 46 publications

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“…At the time this study was undertaken, the primary functions of the public health system (health improvement, health protection and improving health services) were officially the responsibility of the National Health Service (NHS), 11 although they are now transferred to local Authorities. 12 However, the wider determinants of health inequalities such as education, transport and housing lie outside of the scope of NHS activities, necessitating partnership working.…”

Section: Introductionmentioning

confidence: 99%

Who runs public health? A mixed-methods study combining qualitative and network analyses

Oliver

Vocht

Money

et al. 2013

Journal of Public Health

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Section: Introductionmentioning

confidence: 99%

Who runs public health? A mixed-methods study combining qualitative and network analyses

Oliver

Vocht

Money

et al. 2013

Journal of Public Health

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“…These variables would represent the attributes of the healthcare system on the local or national context. Access, clinical categories, characteristics of patients, performance or efficiency, quality of life, coverage, knowledge, facilities, equity, technical practice and public satisfaction are some elements used to assess the quality of services in public healthcare, understand it as a system (Donabedian, 1988;Hunter et al, 2010;Maxwell, 1992;Papanicolas, 2013;Schoen, 2004;Turnock, 2015;Wilson et al, 1995).…”

Section: Literature Reviewmentioning

confidence: 99%

Structural Equation Models Applied for Evaluating Service Quality and Satisfaction in the Healthcare System of Cartagena de Indias D. T. y C. (Colombia)

Schmalbach

Ávila

2018

Economics &Amp; Sociology

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This research attempts to answer which is the most recommended structural equation model (SEM) technique while evaluating healthcare services' quality in Cartagena de Indias city (Colombia). CB-SEM and PLS-SEM techniques were used in this paper for comparing the results in the local context. For assessment, robust weighted least squares with mean and variance adjustments (WLS) for CB-SEM technique and PLS-SEM with centroid scheme were utilized. Data were collected with a final valid sample of 582 adults aged over 18 years, residents of Cartagena city. Also used was a questionnaire designed in three parts: demographic profiles, quality perceptions (overall quality services, infrastructure, coverage, and access), and satisfaction levels. In terms of quality, the findings reveal that infrastructure and access have a significant effect on service quality levels and this variable has a strong effect on satisfaction for both techniques. In term of structural equation model (SEM) techniques, the results indicate that coverage does not present a significant effect on service quality only in CB-SEM technique. In this case, the positive association between coverage and overall services quality was rejected. Both techniques were validated with different results, concluding the applicability of CB-SEM and PLS-SEM in this context.

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“…Meticulous epidemiological research, followed by simple and direct action, saved lives. However, since that time, and most particularly since the Second World War, public health has had a history characterised by uncertainty of purpose, locus of control, and workforce identity [ 1 ]. In the UK, repeated reforms of the National Health Service (NHS) and local government since 1974 have been particularly unsettling for the field [ 2 ], but similar difficulties are present in other jurisdictions.…”

Section: Introductionmentioning

confidence: 99%

“…The 1974 reforms saw many public health functions transferred into the NHS, with public health redefined as the speciality of ‘community medicine’, and MOsH become NHS ‘community physicians’ [ 1 ]. The Faculty of Community Medicine, formed in 1972, mandated medical qualification as a membership criterion [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Beyond the parish pump: what next for public health?

et al. 2018

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BackgroundPublic health has had a history characterised by uncertainty of purpose, locus of control, and workforce identity. In many health systems, the public health function is fragmented, isolated and under-resourced. We use the most recent major reforms to the English National Health Service and local government, the Health and Social Care Act 2012 (HSCA12), as a lens through which to explore the changing nature of public health professionalism.MethodsThis paper is based upon a 3-year longitudinal study into the impacts of the HSCA12 upon the commissioning system in England, in which we conducted 141 interviews with 118 commissioners and senior staff from a variety of health service commissioner and provider organisations, local government, and the third sector. For the present paper, we developed a subset of data relevant to public health, and analysed it using a framework derived from the literature on public health professionalism, exploring themes identified from relevant policy documents and research.ResultsThe move of public health responsibilities into local government introduced an element of politicisation which challenged public health professional autonomy. There were mixed feelings about the status of public health as a specialist profession. The creation of a national public health organisation helped raise the profile of profession, but there were concerns about clarity of responsibilities, accountability, and upholding ‘pure’ public health professional values. There was confusion about the remit of other organisations in relation to public health.ConclusionsWhere public health professionals sit in a health system in absolute terms is less important than their ability to develop relationships, negotiate their roles, and provide expert public health influence across that system. A conflation between ‘population health’ and ‘public health’ fosters unrealistic expectations of the profession. Public health may be best placed to provide leadership for other stakeholders and professional groups working towards improving health outcomes of their defined populations, but there remains a need to clarify the role(s) that public health as a specialist profession has to play in helping to fulfil population health goals.

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The public health system in England

Cited by 26 publications

References 46 publications

Who runs public health? A mixed-methods study combining qualitative and network analyses

Who runs public health? A mixed-methods study combining qualitative and network analyses

Structural Equation Models Applied for Evaluating Service Quality and Satisfaction in the Healthcare System of Cartagena de Indias D. T. y C. (Colombia)

Beyond the parish pump: what next for public health?

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