Guest Editorial

Abstract

Guest Editorial The recently published White Paper: Equity and Excellence: Liberating the NHS signals a commitment by the new coalition government to continue radical organisation reform. However, due in part to the severe financial situation, this White Paper proposes to take the reform of recent years to its logical conclusion and at a faster pace than previously known and this is likely to have significant impact on the wider health and social care workforce.1 In an attempt to streamline existing services, local authorities will replace Primary Care Trusts (PCTs) and they will take on responsibility for public health and health improvement. Indeed, there is a great deal of speculation as to the detail anticipated in the programme of reform from the public health White Paper due later this year. Certainly there is a move to decentralise the management of services in favour of a more local approach with patients empowered by the availability of information to make choices about the services they use, with professionals working in an increasingly regulated market which will drive service improvement and productivity. This special edition of Perspectives in Public Health examines different aspects of the public health workforce in the anticipated world of yet another reorganisation with a number of current topic papers exploring changing roles and ensuring the public health specialists are fit for purpose in the new world through appropriate training opportunities. Drawn from a number of different sectors, the public health workforce exists to help people stay healthy. Specialist public health professionals tackling specific health issues such as the reduction of smoking, childhood obesity and teenage pregnancy, are distinguished from the wider workforce who deal with broader public health issues such as poor housing, education, local transport and recreational facilities.2 Development of the public health workforce is necessary at all levels to help us understand the shifting pattern of disease and actively predict and prevent ill health.2 However, from the general public perspective, wealth and technology have given each individual lifestyle choices. In spite of an expectation of an increasingly high level of wellness, years of healthy life are lost directly as a result of the unhealthy choices made.2 To ensure the public health workforce is fit for purpose, education and training to enable and empower them to make a difference is crucial if the government are to realise their ambitions for the new public health agenda. Davison (p. 22) recognises the investment necessary to skill up the workforce to meet the government ambitions and, along with other papers (Radford and Hall, p. 19; Wright, p. 20; Hemingway et al., p. 38) offer a range of solutions. The pace of change continues, ever faster. Some recent initiatives in role redesign are now firmly embedded into workforce planning and are currently being evaluated. Ball & Nasr's paper (p. 24) on the 'added value' of the fairly recent health trainer role in two UK PCTs is testament to the close working relationship the health trainers had with their clients to improve their community's health and lifestyles. …