The Wider Public Health Workforce

Improving public health is essential for reducing healthcare costs and is a primary focus of the National Health Service (NHS) Five Year Forward View. A significant aspect of achieving this goal involves integrating healthy lifestyles into communities, thereby making public health a collective responsibility. At The Royal Society for Public Health (RSPH), our emphasis is on enhancing the skills and knowledge of the wider public health workforce. Both RSPH and Public Health England (PHE) recognize the necessity of engaging this workforce to support a "radical upgrade in prevention," enabling broader access to essential health support and advice, particularly for 'hard-to-reach' populations.

Defining the Wider Public Health Workforce

The wider public health workforce includes individuals who are not specialized public health practitioners but have the potential to positively influence health and well-being through their work, whether paid or voluntary. According to the Centre for Workforce Intelligence (CfWI) and RSPH, this workforce is estimated to comprise approximately 20.2 million individuals, including those providing unpaid care and support. The workforce is categorized into 57 occupational groups, which encompass 185 different roles. Engagement levels within the wider workforce are classified as Active, Interested, or Unengaged, based on participants' experiences and insights during workshops.

Estimating the Workforce Impact

Utilizing national data from the Office for National Statistics (ONS) Labour Force Survey, the CfWI estimates that around 15 million people in England are employed in roles that can positively impact health and well-being. This estimate is corroborated by workshops that confirmed the inclusion of specific occupations in the wider public health workforce. Additionally, the UK Census indicates that approximately 5 million individuals provide unpaid care and support due to disability, illness, or mental health issues. Thus, the wider public health workforce is estimated to range between 15 to 20 million individuals.

Key Contributors to Public Health

Research indicates that early adopters within the wider workforce making significant contributions to public health include:

• Fire Services
• Health Trainers
• Pharmacists
• Allied Health Professionals
• Social Housing Sector

While these groups are not exhaustive, they represent a strong starting point for expanding the wider workforce's role in public health. Many of the identified occupations maintain direct and regular contact with the public, creating opportunities for health promotion and education. Our preliminary assessments suggest that nearly half (48%) of the wider workforce has the potential to establish trusted relationships through ongoing interactions with community members. This could occur through established client lists, such as hairdressers and midwives, or through strong community ties, such as elected officials and police officers.

Potential and Challenges of the Wider Workforce

It is clear that millions of individuals work in roles that can positively influence health and well-being. Approximately 5 million people provide unpaid care to family and friends, alleviating some of the burdens on the healthcare system. Despite efforts to identify occupations actively involved in public health, the sheer size of the wider workforce underscores the vast potential for innovative approaches to public health service delivery.

Capacity for Change

The wider workforce is uniquely positioned to enhance preventive health measures due to their extensive reach within communities and their enthusiasm for developing asset-based and personalized approaches. This workforce spans various sectors, including health, social care, education, and community services, and engages individuals across all life stages. Key contributors such as fire services, allied health professionals, social housing workers, health trainers, teachers, and community pharmacists are already making significant strides in improving health outcomes.

Integrating the Wider Workforce into Public Health Strategy

The growing body of evidence highlights the crucial connection between health outcomes and the broader workforce. In light of current economic challenges, it is imperative that the public health system collaborates with this workforce to address health inequalities. The wider workforce plays a vital role in integration, early intervention, and fostering independence. However, the full value of this workforce is often overlooked due to their limited representation in strategic planning at both local and national levels.

Development and Training Initiatives

To enhance the effectiveness of the wider workforce, it is essential to implement development and training interventions that recognize their contributions and improve the quality of public health initiatives. Key strategies include:

1. Establishing a public health skills framework for the wider workforce.
2. Incorporating public health principles into pre- and post-registration education across health and social care sectors.
3. Creating collaborative training programs that equip the workforce with necessary public health knowledge and skills.

Conclusion

The wider public health workforce is a vital component in the quest for improved health outcomes. By recognizing and empowering this diverse group, we can leverage their unique positions within communities to foster healthier lifestyles and reduce health inequalities. As we move forward, it is crucial to integrate their voices and contributions into public health strategies to ensure a comprehensive approach to health promotion and disease prevention.

References:

• Centre for Workforce Intelligence (CfWI) and Royal Society for Public Health (RSPH), 2014.
• Office for National Statistics (ONS), Labour Force Survey, 2014.
• Office for National Statistics (ONS), UK Census, 2011.