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Critical issues in practice development: localism and public health reforms.

This paper explores practice development and radical policy reforms found in the White Paper Healthy lives, healthy people, which place a higher priority on UK public health by integrating services under the concept of localism. As a method to improve health and reduce health inequalities, localism aims to promote public health services to be responsive, resourced, rigorous and resilient. However, issues of evidence-based practice, staff freedom to innovate against the tensions of reforms and organisational structures are significant within primary care. By promoting local and professionally driven innovation, the experiences of one community service practice development unit are discussed as an effective approach to encourage local change and innovation. Two issues of significance to innovation in nursing practice and the effectiveness of localism are the application of evidence into practice and motivating staff against the tensions of unrelenting reforms.