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The University of Southampton
Southampton Law School

Building Ethics and Law Capacity within the UK Public Health Workforce

Research conducted in the Health Ethics and Law Centre at Southampton Law School has benefited the UK public health workforce by building and supporting professional capacity in public health ethics and law. This ensures public health policy and practice is conducted lawfully, and is ethically informed and justifiable.

Context

Decision-making by public health bodies must be undertaken in ways that are lawful and ethical, and which reduce the incidence of moral distress and uncertainty faced by practitioners. This can be achieved through the embedding of public health ethics and law (PHEL), which is historically perceived as being the most underexplored and underdeveloped of all workforce competencies.

Research conducted in the Health Ethics and Law Centre has pioneered the training, assessment and embedding of PHEL into the UK public health workforce.

Research challenge

Dr Adrian Viens and Professor John Coggon undertook the key research driving the adoption of PHEL by public health bodies. They explored the relationship between criminal law and public health in terms of their philosophical underpinnings, aims and practical effects, and laid the foundations for subsequent collaborations with public health bodies to promote greater awareness of the importance of law for public health.

Their research culminated in a 2017 book, Public Health Law: Ethics, Governance, and Regulation considered by senior PH leaders to be an authoritative resource from which PH trainees and practitioners “benefit significantly”.

Shaping knowledge and skills training for the public health workforce

Due to their leading body of research in PHEL, in 2017 Public Health England (PHE) commissioned Viens and Coggon to write guidance setting out how PHEL underpins the various professional skills set out in the Public Health Skills and Knowledge Framework.

Department of Health building, Richmond House, London

In their resultant guidance paper, Public Health Ethics in Practice, they emphasised that the ethical mandate of public health, namely its commitment to health outcomes and social justice, means that PHEL values are ‘an integral component of public health decision-making that should be incorporated into all aspects of policy and practice.’

The guidance paper is widely used by public health workers in the NHS, universities, councils and other public bodies in their decision-making, professional registration and training curricula.

Informing examination and assessment of PHEL skills

Drawing on Viens and Coggon’s research, the Faculty of Public Health (FPH) added ethics content to its ‘Part A’ examination used by the profession to test candidates' understanding of the scientific basis of public health, and their ability to apply their knowledge and skills to its practice.

FPH confirmed that the Southampton research “provided a seminal and necessary basis for devising and designing rigorous new questions relating to ethics and law”, and that these have been become “a core competency of public health training and assessment”. 

Embedding PHEL into the activities and practices of professional public health bodies

The “crucial contribution to public health ethics” of the Southampton research has led key UK public health bodies to change their activity and practices in order to embed PHEL culture and values more deeply.

PHE amended its Public Health Skills and Knowledge Framework – the key reference platform for public health professionals – to state that the standards and guidance related to personal conduct and legal and ethical practice form the basis of the Framework, and that they are “relevant to all workers, paid and voluntary, regardless of sector”.

This signifies an important change of emphasis in the organisations representing public health, placing PHEL at the foundation of their mission.

Additionally, the research provided the basis for the creation of the FPH’s internal ethics committee, which enables the FPH to drive focus on ethical development in educational, policy and practice aspects of the profession.

This has led to the formation of local public health ethics committees elsewhere in the UK, including in Scotland and Northern Ireland.

Key Publications

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