Integration, influence and change in public health: findings from a survey of Directors of Public Health in England.
Following the Health and Social Care Act in England, public health teams were formally transferred from the NHS to local authorities in April 2013.



Online survey of Directors of Public Health (DsPH) in local authorities in England (n = 152) to investigate their experience within local government 1 year on. Tests of association were used to explore relationships between the perceived integration and influence of public health, and changes in how the public health budget was being spent.



The organization of and managerial arrangements for public health within councils varied. Most DsPH felt that good relationships had been established within the council, and the move had made them more able to influence priorities for health improvement, even though most felt their influence was limited. Changes in commissioning using the public health budget were already widespread and included the de-commissioning of services.



There was a widespread feeling amongst DsPH that they had greater influence since the reforms, and that this went across the local authority and beyond. Public health's influence was most apparent when the transfer of staff to local government had gone well, when collaborative working relationships had developed, and when local partnership groups were seen as being effective.
Centre for Health Services Studies, University of Kent, Canterbury CT2 7NF, UK.
L M
LM
Jenkins
Centre for Primary Care, University of Manchester, Manchester M13 9PL, UK.
D
D
Bramwell
Centre for Primary Care, University of Manchester, Manchester M13 9PL, UK.
A
A
Coleman
Centre for Health Services Studies, University of Kent, Canterbury CT2 7NF, UK.
E W
EW
Gadsby
Centre for Health Services Studies, University of Kent, Canterbury CT2 7NF, UK.
S
S
Peckham
Centre for Primary Care, University of Manchester, Manchester M13 9PL, UK.
N
N
Perkins
Centre for Primary Care, University of Manchester, Manchester M13 9PL, UK.
J
J
Segar
D002017:Budgets / Q000458:organization & administration; D006801:Humans; D009111:Local Government; D009936:Organizational Innovation; D011635:Public Health Administration / Q000191:economics / Q000331:legislation & jurisprudence / Q000379:methods / Q000706:statistics & numerical data; D013222:State Medicine / Q000331:legislation & jurisprudence / Q000458:organization & administration / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D006113:United Kingdom
organizations; public health; relationships