Leading for Health and Wellbeing


Vicki Taylor

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    Foreword from the Series Editor

    The publication of the Public Health Skills and Career Framework in April 2008 provided, for the first time, an overall framework for career development in public health in the United Kingdom. Prior to this, the focus had been primarily on the public health specialist workforce. The development of the framework itself was a truly collaborative enterprise involving a large number of organisations and stakeholder groups, and was designed to enable individuals at any stage of their career to identify a pathway for skills and career progression.

    Within the framework, public health is divided into nine areas of work. There are four core areas that anyone working in public health must know about and within which they must have certain competences. There are five non-core or ‘defined’ areas, representing the contexts within which individuals principally work and develop.

    Core areasNon-core (defined) areas
    Surveillance and assessment of the population's health and wellbeingHealth improvement
    Health protection
    Assessing the evidence of effectiveness of interventions, programmes and servicesPublic health intelligence
    Policy and strategy development and implementationAcademic public health
    Leadership and collaborative workingHealth and social care quality

    This new series, ‘Transforming Public Health Practice’, has been developed as a direct response to development of the framework, and has a book dedicated to each of the four core areas of public health: Measuring Health and Wellbeing, Assessing Evidence to Improve Population Health and Wellbeing, Policy and Strategy for Improving Health and Wellbeing, and Leading for Health and Wellbeing are all featured.

    The framework defines nine levels of competence and knowledge: level 1 will have little previous knowledge, skills or experience in public health, while those at level 9 will be setting strategic priorities and direction and providing leadership to improve population health and wellbeing. This series is aimed at those who want to develop their skills and knowledge in public health at levels 7–9 (which broadly equates to Master's level), although the series will be relevant to a wider group with the publication of the Public Health Practitioner standards and opening of the Public Health Practitioner Register. This will include those interested in acquiring or developing their public health competences and knowledge and, in particular, those who are seeking to demonstrate their public health skills and knowledge (and may be considering putting together a portfolio to demonstrate this at specialist or practitioner level).

    This series will also be useful for anyone whose work involves improving people's health and wellbeing, or has a direct impact on the health and wellbeing of communities and populations – this encompasses a wide range of work areas, organisations and agencies.

    Individual books in the series outline the key knowledge and skills in the core area and take further through case studies and scenarios how these competences can be used in practice. Activities and self-assessment tools are provided throughout the book, which will help the reader to hone their critical thinking and reflection skills.

    Chapters in each of the books follow a standard format. At the beginning a box highlights links to relevant competences. This sets the scene and enables the reader to see exactly what will be covered. This is extended by a chapter overview, which sets out the key topics and what the reader should expect to have learnt by the end of the chapter.

    There is usually at least one case study in each chapter, which considers public health skills and knowledge in practice. Activities such as practical tasks with learning points, critical thinking and reflective practice are included. Each activity is followed by a brief commentary on the issues raised. At the end of each chapter, a summary provides a reminder of what has been covered.

    All the chapters are evidence-based in that they set out the theory or evidence that underpins practice. In most chapters, one or more ‘What's the evidence?’ boxes provide further information. A list of additional readings is set out under the ‘Going further’ section, with all references collated at the end of the book.

    In summary, this series will provide invaluable support to anyone studying or practising in the field of public health, in a range of different settings.

    Vicki TaylorIndependent Public Health Consultant and Director, The Roundhouse Consultancy, MK Ltd Associate Lecturer, The Open University Previously Senior Lecturer, London Southbank University, Senior Lecturer, Kings College, London

    Author Information

    John Harvey is a director of a limited company providing public health consultancy. He trained as a public health consultant after working for nine years in Yemen, doing mainly maternal and child health programmes. He has experience as a director of public health in three different settings – Newcastle, Jersey, and the London Borough of Havering – where he was a visiting professor of public health at London South Bank University. He is an honorary Fellow of the Royal College of Paediatrics and Child Health, and the co-chair of the Child Public Health Interest Group for the Faculty of Public Health.

    Vivien Martin's current post is at the University of Brighton Business School. Her background is in adult learning, training and development: she was an Area Principal in Adult Education, a Principal Lecturer in Management Development in the University of Brighton, and became Director of Management Education in the South Thames NHS Region through the 1990s. She joined the Open University to lead a project with the Department of Health to revise open learning materials for management development, and then moved into the NHS Leadership Centre.

    Susie Sykes is a senior lecturer at London South Bank University, where she teaches on the MSc programme in Public Health and Health Promotion. With a background in health promotion and public health, Susie has experience of working in both the voluntary and public sectors. Her areas of particular interest are community development, policymaking and health literacy. She is currently research active on her PhD, exploring the concept of critical health literacy.

    Vicki Taylor has worked in public health since 1985 in a range of different roles at local, regional and national levels, and is now Director of the Roundhouse Consultancy MK Ltd. She has a strong interest in public health development and, in particular, the development of public health leadership and management. She has substantive experience of public health and public health practitioner development in a number of geographical areas, spanning a period of more than 25 years. Vicki is an assessor for the UK Public Health Register and has experience of assessing public health portfolios at consultant and practitioner level. Currently she is providing Learning Sets and support for the West Midlands Public Health Practitioner's Pilot Assessment Scheme and the Kent and Medway Public Health Practitioner's Pilot Assessment Scheme, and will be providing Learning Sets for a new scheme in Surrey and Sussex. Vicki was the project manager for the NHS South Central public health practitioner development scheme from March 2007 until November 2009. In these roles Vicki has influenced the development of public health practitioner schemes.

    Rhonda Ware is a registered nurse who has worked at a senior level in the commercial, charity, local authority and health sectors, including private and the NHS. Rhonda was a senior manager in public health, having previous expertise in children's health and education, learning disabilities and care of the elderly. She is now Co-Director of Tiger Health Limited, which offers consultancy in healthcare and public health. Rhonda has a particular interest in leadership and change management, governance and quality improvement.

    Steve Whiteman is the Deputy Director of Public Health for Greenwich, and has worked in the NHS in south-east London for 17 years. Throughout this time he has worked closely with Greenwich Council and other strategic partners to develop and implement programmes of cross-agency work to improve health and wellbeing in the borough. He has been a principal author of the borough's health and wellbeing strategy, and is the chair of a number of strategic partnership groups, such as the Greenwich Men's Health Forum and the Learning Disability Health Partnership Group. He has held management and leadership roles for public health since 1997. Building sustainable cross-agency partnerships and developing joint strategies to address complex public health challenges has always been central to his approach.


    Public health and health promotion are essentially about leadership and achieving change, changes that will improve health. Leadership to improve public health is a complex process requiring leadership across organisations and an ability to engage with a wide range of people and organisations.

    Leadership for health and health improvement is complex on a number of levels. The need to work with multiple stakeholders, and to lead effectively across organisations in order to promote health requires an increasing understanding of complexity and leadership skills. Over the last decade there has been a growing awareness of the importance of leadership in promoting health.

    The development of a national strategy for Public Health leadership in the UK demonstrates recognition of the importance of leadership skills in achieving public health outcomes. This strategy (for public health leadership) was based on the development of a ‘network of individuals across the NHS and partner organisations, skilled in the areas of health improvement’.

    Building on the core competences for public health, this book focuses on leadership and collaborative working to improve health and wellbeing and adds to the existing literature. Key themes identified within this book relate to the paucity of leadership theory within the health promotion and public health literature and the necessity to draw on wider leadership and management theory. Writing about leadership development in 1997, Catford notes that, there is an absolute paucity of research on what makes good public health leaders and how leadership can be strengthened (Catford, 1997, p2). Hannaway et al. (2009, p206) note the limited literature on public health leadership and leadership development.

    Activities are included throughout the book to encourage the reader to stop, to reflect on and to critically examine their own leadership practice.

    Is This Book for me?

    This book is one of a series of four books aimed at addressing the core standards for public health practice as set out in the UK Public Health Skills and Career Framework (2004). It covers the second core area in the Public Health Skills and Career Framework: ‘Leadership and collaborative working to improve population health and wellbeing’.

    Bringing together key leadership and theory, models and frameworks, this book provides a practical resource that can be applied to public health and health promotion practice. It aims to make accessible from the vast leadership and management literature some key concepts that may have relevance to public health leadership. Through the use of case studies and activities, this book seeks to support the achievement of health improvement and health promotion goals. It is hoped that approach taken gives the reader an opportunity to consider ways of contributing to leadership for health improvement.

    The primary aim of the authors is to create a practical resource to support anyone preparing a portfolio for submission for registration as a defined specialist (at level 8), or registration as a public health practitioner (at level 5) and for those who are interested in the standards for leadership for health.

    How the Book Works

    This book is organised into nine chapters. A consideration of ‘Leadership’ and theory about leadership is at the heart of Chapters 1 and 2. In Chapter 1 the focus is on more traditional models of leadership. Chapter 2 introduces leadership as a dynamic social process and proposes that it might offer a greater understanding of public health leadership. Chapter 3 seeks to develop a wider understanding of organisations and the different organisational stuctures and cultures that can exist. It is suggested that an understanding of organisations and how they work helps public health professionals to be more effective participants in, and leaders of, organisations. In Chapter 4 the emphasis shifts to the challenge of leading partnerships and working across organisational boundaries effectively. Leadership skills such as negotiation, persuasion and influencing and the nature of power are considered in Chapter 5. The importance of understanding one's self and the communication process in order to increase effectiveness in promoting and securing health improvement are also emphasised.

    Chapter 6 considers what the term leadership means when working in a community context. A range of different models for working in and with communities to improve health and wellbeing are presented. Identifying the potential challenges that may exist in this kind of work and enabling the reader to identify strategies for overcoming these challenges are integral to the activities in this chapter.

    Chapter 7 utilises a health improvement leadership framework as a template for understanding the skills needed to lead public health at a local level. The arguments are structured around three dimensions: professional, political and people.

    The final two chapters are intended to help the reader to develop their thinking about managing projects and leading and managing change to improve health. In both chapters theory is used to generate practical frameworks and models that can assist the reader to implement change and to manage public health projects.

    How to Use this Book

    You may be using this book to help prepare a portfolio for registration as a defined specialist (at level 8), registration as a public health practitioner (at level 5) or you may be using this book as part of your studies. Once you are clear about the focus or standard you wish to consider, whether (for example) it is knowledge of various leadership styles, look at the table below which gives you a quick guide to the chapter titles and the standards (UK Public Health Skills and Career Framework (PHSCF), National Occupational Standards (NOS) and Public Health Practitioner Standards (PHPS)) covered within the chapter. A chapter overview, at the beginning of each chapter, augments this information and sets you in the right direction.

    Chapters, UK Public Health Skills and Career Framework (PHSCF), National Occupational Standards (NOS) and Public Health Practitioner Standards (PHPS)

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