Shortly after the restructuring of Public Health envisaged in the Health Social Care Act 2012, the Public Health Medicine Committee (PMC) undertook a survey of public health specialists and trainees on their experiences in the new structures in Public Health England and local government. The PMC resolved at the end of 2016 to undertake a follow-up to the initial survey.
The key themes that emerged were the level of morale amongst respondents, the impact that workload was having on their health, and the sense of there being restrictions on being about to speak out on public health issues and directly to councillors.
- Almost 30% of respondents reported that that their morale was low or very low
- Workload for nearly 20% of respondents was consistently unmanageable, notably up on a year ago
- Nearly 40% had felt unwell with work-related stress
- Too few respondents agreed that they had the professional independence to speak out.
This latter perception, coupled with the concerns about budget cuts and the long-term sustainability of public health services is likely to reinforce professionals' sense of low morale and of not being fulfilled professionally which in turn is likely to affect their health.
These figures no doubt contribute to the responses on career plans which indicate that:
- Less than 60% intend to remain with their current employer (though this may be affected by the responses of trainees).
- 18.3% of respondents intending either to retire or to stop working in public health.
- A further 9.2% intend to reduce their hours.
This could herald a future staffing crisis in public health.
Read our recent public health briefing papers, which show the potential contribution of public health is being undermined by funding constraints and an inconsistent use of evidence in developing policies, despite clear evidence of the cost effectiveness of ill health prevention and early intervention activities in improving public health.
Key survey headlines
This survey was sent to Public Health professionals, both medical and non-medical. The survey was sent to BMA members as well as non-members, via third party organisations. Public health professionals were emailed a link to an online survey between 22 March 2017 and 12 May 2017. The total number of survey responses is 246.
Morale and workload
Taking everything into account, how would you describe your current level of morale?
30% of respondents described their morale as either Low or Very Low, although this was a slight improvement on a year earlier, this still represents a substantial number of staff in the sector.
How would you describe your current workload?
Nearly 20% of respondents described their workload as consistently unmanageable, which may be one of the contributors to low morale identified in the previous question. This also tallies with questions on resourcing where respondents have noticed cuts in resourcing over the past year.
The amount of respondents describing their workload as consistently unmanageable has increased over the past 12 months.
In the last 12 months, have you felt unwell as a result of work related stress?
Almost 40% of respondents said that they had felt unwell due to work-related stress over the previous 12 months.
Leaving public health
What are your career plans for the next 12 months?
72% of respondents planned to either stay in their current role, retire at a normal retirement age or were trainees planning to work in Public Health - that leaves about 28% of respondents that are planning on leaving their current public health roles over the next 12 months.
Why have you planned on leaving or reducing your current work / training?
Respondents who said that they were planning on leaving their roles were asked to provide their main reasons for wanting to leave. The top three reasons given as to why these respondents wanted to leave were:
- I don’t feel fulfilled professionally
- My work environment is not sufficiently supportive
- I would like to improve my work-life balance
I am able to make a positive contribution to the health and wellbeing of the population I serve
Respondents felt that, in general, they are able to make a positive contribution to the wellbeing of the population that they serve. The question was asked on a 1 to 10 scale with ten meaning strongly agree. The average score from respondents was just over 7, with roughly 80% of respondents giving positive scores (scores above 5).
I have the professional independence I need to speak out on public health issues
Despite the sense the respondents could make a positive contribution to their local populations, the picture was less clear-cut in terms of professional independence. This question has an average score of 5.9, which puts it close to the neutral point.
While the average score is positive, there was a substantial minority (26%) who answered negatively regarding professional independence. These answers were compounded by respondents not being very positive about others in their organisation understanding their role or their skills being valued by senior management.