Health systems are changing rapidly in response to new threats to population health from lifestyle diseases, long-term conditions and the global effects of climate change and sustainable development. Public health as a set of skills to improve health and with its focus on the health of communities rather than individuals is at the forefront of current health and health care policy and practice. In England, public health is going through a major reorganisation with local public health functions now returned to local authorities after nearly 40 years of being part of the National Health Service (NHS) and a new national public health service – Public Health England. The new organisational architecture introduced by the Health and Social Care Act 2012 has given rise to substantial uncertainty about roles and responsibilities in the new system and created a new context for developing working relationships and partnerships. While the changes have been broadly welcomed, developing the new public health system places enormous challenges on those who will lead it and also those people working within it.

This series of books on public health policy and practice aims to strengthen and add to the knowledge base for UK public health and address gaps in evidence and existing practice skills. The series has its roots in the publication of the Wanless Report (Wanless, 2004), the Cooksey Report (Cooksey, 2006) and a programme of research funded through the National Institute of Health Research (NIHR) Service Delivery and Organisation (SDO) Programme – now called the Health Services and Delivery Research programme. Cooksey identified the SDO Programme as filling an ‘R&D market gap’ and, therefore, of fundamental importance to the NHS (Cooksey, 2006). Following publication of the Cooksey Report, the Department of Health published Best Research for Best Health (DH, 2006) and the government specifically highlighted the need for the SDO Programme to commission research on public health service delivery and organisation. The SDO Programme initially commissioned Professor David Hunter to undertake a review of the state of the public health system in England in terms of its structure, capacity and skills, and the likely impact of the current changes in policy in health and local government on the public health system and their implications for its future design and effectiveness (Hunter et al, 2010).