Can directors of public health implement the new public health agenda in primary care? A case study of Primary Care Trusts in the North West of England

The appointment of directors of public health (DsPH) to the Primary Care Trust (PCT) boards to work jointly with the local authorities in addressing health inequalities reflects the adoption of a multidimensional perspective of public health, and a shift in policy focus from treatment to illness prevention. Neo-institutional theory of change is applied to discuss findings obtained from a postal questionnaire with all DsPH (n=40) and qualitative interviews with executive and non-executive board members in five PCTs in the North West of England, and to conclude that public health potential may not be fulfilled because of pressures outside the public health area and the lack of capacity in the PCTs. © The Policy Press, 2007.