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Being a public health consultant

Leading a cross-section of organisations and individuals, public health consultants strive to realise ways of making our communities and our environments healthier, and more capable of providing us with what we need for optimal health.

Where do they work?

Public health reaches far beyond the usual confines of NHS structures. It pulls together skills and people from a wide range of disciplines.

Public health consultants will therefore most often work for, and across, organisations to improve the health of a certain population group.

These include:

  • local NHS organisations
  • national and local government agencies and authorities
  • the military
  • Public Health England
  • local community organisations
  • university and academic institutions
  • NGO/voluntary organisations
  • World Health Organization.

Most of those who do specialise in public health work in the public sector.

What does their work involve?

Leaders in public health must be diverse in their capabilities: creative in their ability to visualise change, meticulous and organised in making it happen, and then monitoring the results.

They take on the challenge of extremely varied and often unpredictable workloads.

Timescales for getting projects up and running can be long and require a great deal of negotiation, but a good public health consultant will be able to handle the challenge of this, providing the leadership and management skills necessary to see projects through to completion.

They seldom, if ever, work on one project at a time, and must also be able to respond to emergencies as they arise.

What do they need to know?

To do the job, they must :

  • Have a broad understanding of all the factors that contribute to health, the structure of healthcare systems and services, current government policy, and how to effectively interpret available data.
  • Be able to evaluate evidence to devise and implement strategies to improve and protect health, and to improve health services.
  • Be both tough negotiators and simultaneously possess good powers of persuasion to get the community, other stakeholder organisations and politicians to agree and work effectively towards common goals.

Some consultants will become experts in a specific area of public health, while others will find that their job incorporates a cross-section of public health activities and/or research. However, their work usually falls within one or all of the following three domains: improving health, protecting health or improving health care and related services.

Improving health

Individual behaviour is not the only factor that contributes to a person's state of 'wellness'; a complex set of social, economic, political and environmental factors influence this. These 'wider determinants' are vitally important to health.

Improving health therefore also means reducing inequalities in society and improving access to education, housing and employment. Although these areas have traditionally been beyond the scope of the NHS, they have such a great impact on the service that they can no longer be ignored.

Public health consultants must work with the community, other relevant organisations and politicians to develop and implement local and national policies to encourage healthy lifestyle choices and reduce risk factors.

They must then monitor and evaluate how effective their strategies are through the surveillance of diseases and risk factors.

Protecting health

Infectious diseases, chemicals and radiation are among the factors that can threaten the health of a large portion of any given population. Public health consultants must understand and continually monitor these threats and plan and manage prevention strategies, and any required emergency responses.

Environmental health hazards, such as flooding and pollution, are other possible dangers that they may have to deal with, and some consultants choose to specialise in environmental health.

Improving health and social services

A public health consultant working to improve health and social care services must continually take stock of the health and social care needs of their population, as well as the efficiency and effectiveness of the services that they have access to. Managing and improving healthcare services requires excellent leadership skills and strategic decision-making to improve the systems in place.

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Key skills and knowledge

Epidemiology is the cornerstone of public health practice. It is the study of the distribution and causes of a disease or state of health, and the use of this information to act to prevent or control health problems and diseases.

However, there are a great number of other skills and areas of knowledge which are essential to public health consultants:

  • Statistics, handling and interpreting data, and managing health information
  • Demography
  • Medical sociology
  • Social policy
  • Health economics
  • Communicable diseases
  • Budgeting, leadership and people management
  • Health needs assessment, health impact assessments and health equity audits
  • Critical appraisal and research

"The great thing about a career in public health is that it can take you in a multitude of different directions. My background was in surgery and I've always had an interest in acute services. I managed the Leeds review of acute hospital, services which combined major project work with strategic thinking and intense work with clinicians and managers.

"My next job was director of public health for Leeds. The five years I spent getting to know the community and its health services well, and seeing the improvements in health and health services that can be brought about, was an immense privilege.

"It's the variety of working in an acute trust that I enjoy the most. I have a real, hands-on opportunity to improve healthcare services for some very deprived populations. No two days are ever the same – preparing for a Foundation Trust assessment, dealing with a clinical problem, resolving a difficult ethical issue, planning service development, working out how on earth we are going to cope with the impact of Modernising Medical Careers – the list and challenges are endless, but that's why I love this job."

Liz Scott, Medical Director

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