To approve a shared service with Shropshire council for the provision of professional services, which include those of the director of public health. 

To meet the requirements regarding a nominated director of public health for Herefordshire in the most cost effective way.

To continue with the secondment arrangement for the director of public health from Shropshire. This is not recommended, as the current arrangement does not provide sufficient certainty for either council or for the director of public health himself, would not address the wider issues around joint working in public health to secure best value for money and sustainability of those services, and would be unlikely to be acceptable to Public Health England, which on behalf of the secretary of state for health appoints directors of public health jointly with councils.

To commence the recruitment of a director of public health for Herefordshire alone. This is not recommended, as this would involve both significant extra cost and there have been considerable difficulties in attracting appropriate candidates to Herefordshire in the past.

To seek an alternative shared arrangement with Worcestershire. This is not recommended, as the synergies between public health teams are significantly stronger between Herefordshire and Shropshire than between Herefordshire and Worcestershire.

To delete the post of director of public health. This is not recommended, as the role is a statutory requirement for all upper tier councils.