Ruth Hussey on improvement through inspection

Inspection and regulation are powerful levers for change and can make a significant contribution to improving public health.

It is often assumed that public health means health improvement or health promotion and that this is about individual choice, which is not normally regulated.

However, there are three components to public health practice that carry with them public expectations regarding inspection and regulation.

Several inspectorates, covering many different sectors, are responsible for carrying out this work. Directors of public health, as joint appointments, are now inspected by the NHS and local authorities.

Examples of how inspection and regulation are used to improve public health include:

To ensure effective health protection

This covers a range of issues including infection control, emergency planning, health and safety, pollution, smoke-free public places and wider environmental issues.

To prevent ill health and promote good health

Inspection and regulation can ensure that all health and social care providers pay due attention to health promotion for their staff, patients and visitors, as well as delivering appropriate preventive health and social care along the patient pathway.

This area is increasingly recognised as crucial to health improvement because of the number of health and social care staff employed and the amount of contact these staff have with patients and clients.

It is also important that other agencies play their full role in prevention and in tackling the wider social determinants of poor health, and that the NHS plays its role in that partnership.

Equitable access to high-quality health and social care

The regulator can ensure that minimum standards are met for all population groups, and that they have fair access, regardless of social characteristics, so that health inequalities are addressed effectively.

Organisations sometimes view inspection and regulation as a burden. Good managers, however, should view inspection and regulation as an opportunity to provide external reassurance and to ensure that minimum standards are met.

The beneficial role that regulation can play in improving the public's health is already evident.

Regulation must continue to be developed with public health goals in mind so that all providers deliver an acceptable standard of prevention and health protection for their staff and patients.

Furthermore, commissioners should ensure that the expected standards. are met.

The current population health challenges mean it is essential that regulation be used to its full benefit.

This is especially relevant where other system levers fail to improve health or have a limited effect on promoting good health, and therefore fail to safeguard the public.

Dr Ruth Hussey is NHS North West regional director for public health.