The document discusses the role of public health leadership during the COVID-19 pandemic, highlighting the effectiveness of local systems in health protection compared to national systems. It outlines the challenges faced, such as fragmentation in the English health protection system and the need for clear roles for Directors of Public Health (DPH) in local systems. Additionally, it lists critical success factors for public health leadership, emphasizing the importance of local governance, adequate funding, and collaboration.

1. The Future of Public Health
Leadership
The Devolution APPG
16 November 2022
Prof. Jim McManus , D.Sc, FFPH, Cpsychol,
President, Association of Directors of Public Health UK
www.adph.org.uk

2. DPH Leadership during Covid – evidence
Knitted together health protection expertise with local capabilities to
create systems which delivered for place
• Local systems performed better at test and trace than national systems (Sandwell)
• Local systems performed better at self-isolation support than national systems
(Hertfordshire)
• Local vaccine uptake systems saw an acceleration in vaccine uptake
• Local vaccine tracing systems saw an improvement in uptake in least vaccinated
populations
• Est cost for 1 year local test and trace system £350m
www.adph.org.uk

3. Local Systems, Local Leadership
• DsPH worked with their systems to create local leadership
• Shire Counties – created multi-tier local health protection boards
• Greater Manchester and Combined Authorities , London – combined DPH
leadership
• Scotland, Wales, NI – created national systems
• We shared our learning to create multiple sets of “what good looks
like” learning and standards for DsPH
• In England we want strongly to remain in local government.
• Disciplines and opportunities in local govt the NHS doesn’t have
www.adph.org.uk

4. Challenges
• The English Health Protection system is now fragmented
• The role of the DPH needs to be understood very clearly in their local
system
• That leadership is not just there for health protection, it needs to be
used on health improvement
• ICS – the DPH has a job for the local system, not just the ICS
• Further cuts to public health will be counter productive
www.adph.org.uk

5. Six to fix - Critical Success factors for Public
Health Leadership
1. The NHS is not the main producer of health, policy needs to stop
privileging it as if it were
2. Locus in local systems as system leader
3. Funding – both LA and Public Health
4. Environmental health systematically undervalued in national policy
5. Behaviour and mindset - National –local system design and
collaboration
6. A new Public Health Act suited to the 21st century
www.adph.org.uk

6. "True statecraft is manifest when, in
difficult times, we uphold high principles
and think of the long-term common good"
Pope Francis.
Laudato Si. 2015. Para 178
www.adph.org.uk
president@adph.org.uk
policy@adph.org.uk
Jim.mcmanus@hertfordshire.gov.uk