NHS Health Scotland is Scotland’s national health improvement agency and is therefore one of the country’s main public health bodies. 

Scotland’s health is improving, but we continue to face significant public health challenges. There is widespread agreement that we need to change the way we do public health in Scotland to meet these challenges.

On this page you can find information about how we fit into the wider public health work in Scotland and read the Public Health Review report.

What is public health?

Public health is often defined as ‘the science and art of promoting and protecting health and well-being, preventing ill-health and prolonging life through the organised efforts of society’. But what does that mean in practice?

In public health, we define health very broadly as a resource for everyday life which includes physical, mental, and social wellbeing and resilience, rather than just the mere absence of disease.

We take a population focus, working to understand and influence what makes communities, regions, and countries more or less healthy.  Among the most powerful of these determinants of health are the forces which shape the conditions in which we are born, grow, live, work and age. These forces include

  • political
  • cultural
  • commercial
  • environmental
  • socioeconomic.

To act on the determinants of health and health inequalities public health agencies like us work at the local, national, and global levels. We take a long-term perspective, since the health of future generations depends on the social, built, and natural environment we create for them now. We also work to understand and mitigate the negative health consequences of historic inequalities and the illnesses this causes.

Domains of public health

The main domains of public health are

  • health improvement - enabling individuals and communities to improve their health and wellbeing by addressing the wider determinants of health
  • health protection - preventing and responding to contagious or infectious diseases and environmental hazards, and promoting resilience to future risks
  • health and care services - maximising the quality of health and care services for the population.

Each of these domains is based on the collection, analysis, and interpretation of data and research evidence, known as public health intelligence.

Public health workforce

A wide variety of people in different professions work together on public health in Scotland.  This includes people who have public health as part of their job description such as Directors of Public Health in health boards. It also includes the wider workforce, such as people in the third sector, who work with individuals and communities to promote health and wellbeing and tackle barriers to the right to health.

The Scottish Government’s Public Health Skills and Knowledge Framework describes the areas in which the public health workforce operates. It also provides a benchmark for employers to understand the skills and competencies they need. Our Public health skills and knowledge framework launch event took place in March 2017. 

Public Health Review 

The Scottish Government established an expert Public Health Review group in 2015. The report of the review highlighted the need for 

  • more clarity on organisational roles
  • stronger leadership around public health
  • a public health strategy for Scotland with clear priorities
  • greater partnership work across all sectors.

Future of public health in Scotland 

The Scottish Government’s Health and Social Care Delivery Plan (external website), published in December 2016, set out the timescale for making the necessary improvements identified in the Public Health Review.    

  • In 2017 - Set national public health priorities with SOLACE and COSLA that will direct public health improvement across the whole of Scotland.
  • By 2019 - Support a new, single, national body to strengthen national leadership, visibility and critical mass to public health in Scotland.
  • By 2020 - Set up local joint public health partnerships between local authorities, NHSScotland and others to drive national public health priorities and adopt them to local contexts across the whole of Scotland. 

We welcome these improvements and the emphasis on strong public health leadership for the future. We know that we – our people and our work on fairer health improvement – will become part of the new body and are working closely with the Scottish Government and partners in the development of the new organisation.  

You can contact us to find out more about our role within the wider public health context.