# 6 Scope of public health

The activities in Sections 4 and 5 indicated the breadth of public health in the UK today. Indeed, it is usually termed ‘multidisciplinary public health’ to highlight its growing importance to all professions, whether they work in healthcare, social care, the independent or voluntary sector, local government, education or almost any other sector in the UK. Influences on health are often outside the control of the health sector and include factors such as education, housing, employment and climate. Therefore, for public health activity to be successful they require effective partnerships.

Figure 4 Elements of partnership working

How do we define partnerships in public health? The conventional definition of partnership is deemed to be a joint working arrangement where the partners:

- are otherwise independent bodies with different agendas, but run based on trust;
- agree to cooperate to achieve common goals or outcomes such as reducing inequalities or improving wellbeing;
- create a new organisational structure and governance to achieve the shared goal;
- cooperate, plan and implement a jointly agreed programme, often with joint staff and/or resources (which could come from a third party) and;
- share relevant information, and pool risks and rewards.

These arrangements tend to be formally agreed on (e.g. contracts); however, informal partnerships do exist. Once resources need to be allocated formal agreements become more important (e.g. collaboration agreement).

## Activity 6: Public health partnerships types

Allow 45 minutes

The following websites illustrate some of the current government health partnerships in the four nations of the UK (England, Wales, Scotland and Northern Ireland). Choose one and consider the extent to which the partnership meets the criteria of the conventional definition provided above. Try to identify the benefits of the partnership and then write a paragraph in the word document provided on why the partnership may or may not bring about these benefits and whether a partnership is the most appropriate way of achieving these benefits.

- NHS England partnerships and relationships
- A Fairer Healthier Scotland 2017-22
- NHS Wales Shared Services and Partnership
- Northern Ireland Department of Health

### Discussion

As has been pointed out by various public health researchers and academics, for some health and social services, partnership engagement is no longer simply an option but a requirement. The four websites you accessed as part of this activity provide evidence that supports this argument. The NHS websites for the four nations refer to various levels of partnership.

- NHS England says it partners with local, national and international organisations in order to improve health outcomes in England within its financial possibilities. However, NHS England does not mention any role for communities, community groups or local authorities in this particular partnership. You may feel that community participation is a must in order to improve people’s health.
- NHS Scotland’s ‘fairer, healthier Scotland’ strategy involves partnering with various groups in order to achieve the stated aim of providing longer and healthier lives to people and communities in Scotland. The website indicates that partners include local authorities, community groups, housing associations, the Scottish Government, universities, and health and social care providers.
- NHS Wales sets outs similar strategies to NHS Scotland aimed at reducing health inequalities. NHS Wales has also created NHS Wales Shared Services Partnership (NWSSP), an independent organisation owned by NHS Wales, to provide wide-ranging customer-focused services. This partnership includes various government bodies, with intended benefits including cost reduction, provision of high-quality services, introduction of standard processes and sharing of good practice. However, in the case of certain partners, such as the relocation group, you may be unsure how health promotion could be implemented.
- In 2016, Northern Ireland’s Health Minister set up the territory’s first ‘strategic health partnership forum’, bringing together senior leaders and trade union representatives in health and social care to discuss the strategic direction of health and social care service provision in Northern Ireland. The partnership’s stated aim was to influence policy and further assess the best health delivery options by listening to ‘ideas from grassroots’ wherever possible. The Northern Ireland partnership is very different from the partnerships you’ve seen in the other three nations, given the involvement of union representatives.

OpenLearn - Introducing public health
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