Health systems are changing rapidly in response to significant pressures on public finances and to neoliberal support for strengthening markets and competition, in addition to new threats to population health from lifestyle diseases, long-term conditions and the global effects of climate change. Public health as a set of skills to improve health, with its focus on the health of communities rather than individuals, is at the forefront of health policy and practice. In England, public health is going through a major transformation with local public health functions being returned to local government after nearly 40 years of being part of the NHS, and a new national public health service – Public Health England – being created. The coalition government's proposals for reorganisation, set out in the Health and Social Care Act 2012, introduce substantial uncertainty about roles and responsibilities in the new system and establish a different and challenging context for developing working relationships and partnerships. While the public health changes have been broadly welcomed by many, there remain reservations about how the new system will operate in a context of fiscal stringency. There are risks combined with anxiety and insecurity among many working in public health who are required to transfer from the NHS to local authorities. Whatever transpires, developing the new public health system places enormous challenges on those who will lead it and also those working within it.

This series of books on public health policy and practice aims to illuminate and inform thinking about many of the core issues to which the changes are directed, to add to the knowledge base for UK public health, and to 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, as being of fundamental importance to the National Health Service (Cooksey, 2006).