The Public Health Contribution to the Development of Policy for the Prevention of Violence and Abuse in England

Introduction: The aim was: “To document the process of policy development to prevent interpersonal violence in England, and explore the implications and potential role of public health”. Research gaps addressed include: an insider perspective of the policy process in general, and on the formulation process in particular. Violence and abuse are complex and challenging public health issues and wider lessons were drawn for public health. Methods: Qualitative research methods of documentary review, mapping and observation were used in the context of a case study of development of policy for violence prevention at regional and national levels in England from 2005- 2010. The research was based upon participatory observation methods as a public health advisor contributing to the policy process. In total 44 documents were reviewed and 157 meetings attended. Content and thematic analysis was conducted with violence, public health and policy frameworks followed by triangulation. Results: From initiation to publication, the policy process took ten years to complete (2003- 2012). Regional policy implementation contributed partially to national policy development. Networks and embedding within wider policy maintained the agenda. Evidence-based public health contributed to the policy, whilst, collaborative working, persistence and communication skills influenced uptake. Internal actors had the most power, especially the Prime-Ministers Office and the Home Office, whilst the Department of Health ensured development of the final policy. Senior leadership and champions drove the policy process and media reporting created windows of opportunity. Policy formulation revealed the importance of consensus and cyclical decision-making. Conclusions: Lessons include strengthening the art of public health: with clear leadership, communications and collaborative relationships, contributing to the uptake of evidence. Taking advantage of windows of opportunity and creating consensus is important for external actors. An integrated model of policy and the formulation process are presented to enhance understanding between policy and public health.