When it came into power, the Labour Party promised a much-needed prevention revolution in England. There were bold ambitions that public health specialists were enthusiastic about delivering: eradicating HIV transmission by 2030; halving the healthy life-expectancy gap between the richest and poorest; and transforming the NHS from a sickness service into a modern health system that supports people to prevent illness and disease.

However, as public health doctors made clear at the recent BMA special representative meeting, the 10-year plan disappoints regarding the shift to prevention.

While the NHS cannot prevent illness and reduce health inequalities alone, it has an important role to play. Healthcare public health is one of the three domains of specialist public health practice. Consultants working in healthcare public health help ensure the NHS maximises population health through data, intelligence, service redesign and workforce planning. With the NHS facing some of the greatest challenges in its history, now more than ever it needs to harness the expertise of consultants trained in healthcare public health.

But for too long the NHS has had inconsistent access to the public health expertise necessary to contribute to the prevention agenda.In 2013, the Lansley reforms moved large sections of the public health workforce out of the NHS in England. Now, the abolition of NHS England and cuts to ICB (integrated care board) budgets further compromises what fragile public health capacity remains in the NHS in England. At the last count, there were only 36 public health consultants working in ICBs, fewer than one consultant post per ICB.

More worryingly, many ICBs are appointing non-specialists to ‘population health’ roles that clearly require public health training to undertake. This undermines the profession, compromises standards, and risks public safety. In the longer term, it compromises the training of the next generation of public health consultants and risks limiting their exposure to healthcare public health.

On the NHS ‘front line’ few provider trusts and primary care networks employ or utilise public health consultants. There is no requirement for any local NHS bodies in England to appoint public health consultants. The BMA has long argued for this to change as have the Faculty of Public Health, the Royal College of General Practitioners, the Royal College of Physicians and others.

Over the last year BMA public health doctors and the PHMC and PHMRS have continued to lobby for a stronger public health system. At the Public Health Medicine Conference our members overwhelmingly backed motions on expanding healthcare public health. And at the BMA annual representative meeting we passed policy directing the BMA to support members affected by the abolition of NHS England and to continue to lobby to increase public health consultant and registrar posts. Professor Philip Banfield, previous BMA council chair, provided evidence to the Health and Social Care Select Committee, while PHMC chair Heather Grimbaldeston has written jointly with the Faculty of Public Health to all ICB chief executives and has also written to the minister for public health and prevention.

Meanwhile, PHMRS deputy chair Chad Byworth has written in the BMJ alongside fellow public health registrars and past-BMA president Professor Martin McKee on the vital need to strengthen public health in the NHS. Earlier this year we released our Rebuilding Public Health Report which outlines recommendations for how UK governments can rebuild public health. This was endorsed unanimously at the SRM.

PHMC and PHMRS continue this work. We have launched our position statement on public health medicine and healthcare public health. This sets out our vision of an expanding public health workforce and an NHS that has access to the public health consultant talent it needs to succeed. Key to this includes a requirement that all ICBs, large provider trusts and health boards appoint registered public health consultants to ensure their clinical colleagues have access to their expertise. We also recommend that all public health registrars undertake at least one dedicated healthcare public health placement within the NHS or HSCNI. We are clear that public health consultants cannot be replaced by non-specialist population health workers.

We will also be writing to the secretary of state for health and social care to request a discussion on our concerns around the 10-year plan, public health in the NHS, and the long-standing problem of pay disparities in public health.

We remain determined to support and rebuild the profession inside and outside the NHS. This will take action by our committees, our public health doctor members, the wider BMA and our colleagues elsewhere. We urge you to get involved – we must remain committed as a specialty if we are to make progress. We know that without public health consultants leading evidence-based public health programmes, this prevention revolution will fail.

Chad Byworth is the deputy chair for workforce and regulation and chair of the public health medicine registrars subcommittee