As we approach the end of 2022 our Chief Executive Angela Leitch reflects on the year's public health challenges, and the achievements of PHS and partners in tackling them. 


For the first time since Public Health Scotland (PHS) came into being in April 2020, it is not COVID that dominates my thoughts as we come to the end of the year. With a temperature of minus four outside at time of writing, it is the cost of fuel, food, and other basic necessities that’s the greatest concern for the health of the population. We are managing to "live with COVID" but no population can manage to live with poverty without dire long-term consequences. These are consequences felt most acutely by individuals, families, and communities. 

Together with our partners, we are working to support communities to retain and build their resilience to the challenges wrought by the cost crisis. This includes working with local authorities on a cash-first approach to supporting people in financial crisis, and providing people with income maximisation support rather than emergency food or in-kind support. Stakeholders involved in our recent health impact assessment (HIA) of the cost crisis agreed that this is an effective and dignified form of support that avoids stigma and empowers individuals and the community.

The HIA adds to the evidence that the rising cost of living has a negative impact on mental health. This will further compound and exacerbate the inequalities in mental health outcomes that the country was already seeing as a result of the pandemic. Mental health has been a strategic priority for us since our inception, but it is clear to me that our work with partners in this areas is more important than ever. We are working with partners to support early interventions that help people stay well, such as the 'Ask, Tell - Save a Life' work with NHS Education for Scotland. This year has also seen the further development of our innovative approach with partners to use data from a range of sources to help prevent suicide. This is a powerful example of how data and evidence can be used in to prevent harm in real time. We are undertaking similar work with Police Scotland, sharing data and intelligence to take timely action to prevent drug-related deaths.

It's one of the founding principles of PHS that to make a difference to population health we need to do things differently. Last month we published evidence that demonstrates just how stark the need for change is. The latest findings from the Scottish Burden of Disease (SBoD) study looks at the impact of demographic changes on annual disease burden over the next 20 years. The findings suggest that despite an overall projected decline in the population in Scotland by 2043, annual disease burden could increase by 21%. The projections therefore suggest that the sustainability of the health and social care system depends on all of us doing things differently. A focus on prevention and rethinking how we meet the needs of an ageing population is needed to reduce demands on the system. 

Our vision of a Scotland where everybody thrives, which has been reiterated and reinforced in our three-year strategic plan 2022-25, is a vision that we share with partners across the system. The building blocks of health are laid in our schools and nurseries, in our workplaces, our homes, and our communities. It is the work of our partners both locally and nationally that creates the conditions for health, and for a thriving population. I’d like to take this opportunity therefore to say thank you. Thank you to our partners and stakeholders who have committed to working with us to make a difference this year. Thank you also to our staff who continue to do all they can to tackle the challenges facing the public’s health.

The public health system has achieved a lot this year, and must continue to innovate and do things differently in the years ahead. You may have seen last week that Paul Johnston will be taking up post as the organisation’s new Chief Executive in the spring. I am confident that PHS will go from strength to strength under Paul’s leadership, and wish our stakeholders, staff and partners the very best for 2023. 

Angela Leitch


Last updated: 20 December 2022