Health of Londoners could be at risk from scarcity of public health workers, warns The King's Fund study

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Staff shortages could hamper London primary care trusts (PCTs) in their efforts to improve people's health when they take over responsibility for this from Health Authorities in April, says a King's Fund study today.

Public Health in the Balance: Getting it right for London shows that London faces huge inequalities in health with high rates of communicable diseases and fragmented local planning structures. This problem is exacerbated as some health authorities in the capital have health visitor vacancy rates of almost five times the national average.

The study also reveals that the devolution of public health responsibilities to PCTs is seen as a mixed blessing among London's public health workforce. Many interviewed as part of the study feared that individuals' specialities could be lost as practitioners take on generic functions when large teams based in health authorities are broken down into smaller PCTs.

David Woodhead, public health fellow at The King's Fund said:

'Maintaining public health standards in London is an urgent matter. Public health is only one of many competing responsibilities for London's 30 PCTs - to date they have had little opportunity to work out in detail how they will organise public health locally under new structures.

'There is now an urgent need to support London's capacity to plan its public health function strategically and ensure it is underpinned by adequate staffing and shared expertise. A historic lack of workforce planning across sectors in London means that public health staffing levels are not sufficiently linked to local needs. Strong human resource planning and management is critical if London's public health workforce is to meet the needs of local people.

'While there is a wealth of public health experience in London, we are finding there is a high turnover among public health staff and a lack of appropriate qualifications. PCTs need to ensure their workforce is the right size, has the right skills mix and is sufficiently motivated and supported.'

The study recommends PCTs work closely with local authorities and strategic health authorities to build public health networks, identify which tasks they must deliver and which can be met by other local PCTs, and map out workforce requirements against local needs.

Read the report: Public Health in the Balance: Getting it right for London

Notes to editors

Public Health in the Balance: Getting it right for London, by David Woodhead, Karen Jochelson and Ruth Tennant, will be launched at the King's Fund Open Day on Tuesday, March 26.

For a review copy or interviews with any of the authors please contact Daniel Reynolds on 020 7307 2581.

The King's Fund also publishes two further studies today, one looking at morale and motivation among staff in the NHS and the other examining the values that lie behind the NHS:

Counting the Smiles urges the Government to act now to boost morale among NHS staff. It shows that morale is low in the NHS, putting at risk the Government's plans to modernise the service. It says the two biggest causes of low morale are chronic staff shortages, which make working conditions difficult, and the strong perception among staff that their work is not valued.

Hidden Assets shows that staff, patients and citizens hold diverse views about the service. It argues that by listening to the views of patients, workers and the public, the NHS can benefit considerably as it changes to meet the demands of the new century. It adds that people should be consulted about the trade-offs between conflicting values, such as choice and equity, that are inherent in the NHS.