EHJ March 2003 pages 72-73 Recent work by the Health Development Agency and the CIEH envisages a greater role for environmental health practitioners in improving the health and wellbeing of communities. Ian Gray reports

That environmental health practitioners have a major role to play in improving the nation’s health and reducing health inequalities, alongside NHS professionals, is a fact recognised by chief medical officer Liam Donaldson. He has acknowledged that they are the only local government workers considered to be full-time public health practitioners. Environmental health officers, says Professor Donaldson, are “practitioners who spend a major part, or all of their time, in public health practice”.¹

But recent work undertaken by the Health Development Agency (HDA), in partnership with the Chartered Institute of Environmental Health found that the mainstream practice of environmental health had become “stuck” in the delivery of a narrow agenda.²

The project report, published in September, concluded that the sector needed a new goal, to take services forward and enable practitioners to fulfil their role in improving public health and reducing health inequalities. This goal would not only need to be rooted in the modern health development agenda, best practice and a solid evidence base, but also be “owned” by field workers and managers, representative bodies and champions who would support its adoption and achievement.

The vision statement in the report emphasises the direct relationship between the general public and local authority environmental health services, which deal with people’s concerns and provide advice on food, housing standards, health and safety, air quality, noise and other environmental issues.

Environmental health practitioners, the report stresses, have a wealth of public health knowledge and skills, and a unique contribution to make through their prime focus of maintaining the health and wellbeing of communities. So the strategic vision envisages that environmental health practitioners will:

• play lead roles in local authority community health and wellbeing strategies and actively contribute to the public health agenda of NHS primary care trusts;
• be key partners in protecting and improving the health and quality of life of individuals and communities, and reduce health inequalities; and
• tackle the wider determinants of population health by identifying, controlling and preventing current and future risks.

The document sets out recommendations for action, such as urging national bodies that have leadership roles in environmental and public health to support the strategy. And it makes the case for continuing to support the development of the environmental health evidence base and building the health development capacity of environmental health practitioners.

The descriptions and definitions encompassed in the report are broad and intended to be inclusive of environmental health officers and others engaged in environmental health practice in local authorities. They are also targeted at the increasing number of environmental health practitioners working in the NHS, government departments and elsewhere.

The consultation is aimed at exploring the expected growth over the next 10 years of the environmental health practitioner’s role in improving public health and reducing health inequalities, and in working effectively with new central government structures such as the Health Protection Agency.

“This has been a very powerful piece of work,” says the HDA. “More than 150 people have taken part in a ‘think tank’ and regional workshops, which have captured the challenges, constraints and ideas for the future of environmental health practice and the contributions which it can make to community strategies and the work of primary care trusts.”

The HDA and CIEH are continuing to support the project by jointly funding a post concerned with carrying out widespread consultation to achieve consensus and influence stakeholders and decision-makers who determine the functions of environmental health practitioners, their training and professional development, work activities and performance management.

The feedback to date has been positive and the vision statement is already informing the work of CIEH task groups which are examining issues such as recruitment, training and qualification of practitioners. The CIEH is also having an impact on the thinking of other public health professionals, who are finding that environmental health officers can provide a leadership role for local authorities, with regard to their responsibilities for improving the health and wellbeing of communities.

References

1. Donaldson, L. (2001) Analysis of the public health workforce. London: Dept of Health.
2. Burke S, Gray I, Paterson K, Meyrick J. Environmental Health 2012. A key partner in delivering the public health agenda. London: Health Development Agency, 2002.

Ian Gray is specialist adviser on local and regional government at the Health Development Agency and project lead.

This article was originally published in Health Matters, issue 50, winter 2002/03. Copies of the report, Environmental Health 2012, are available from www.hda-online.org.uk/html/resources/publications.html or from the Health Development Agency on tel: 0870 121 4194. Comments are invited on the vision and recommendations for action. E-mail: ian.gray@hda-online.org.uk