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March 23, 2020
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A day in the life of…

Dr Jeanelle de Gruchy talks about her role as ADPH President during the response to COVID-19 and thanks Directors of Public Health for their energy, experience and calm leadership. 

This Thursday, I was due to go to South Africa for a holiday with my parents. From looking forward to family fun, I’m now worrying about their health and trying to advise from afar on how they can shield themselves while maintaining their physical fitness, social interaction and sense of purpose. My partner is worried about her daughter Beth, a junior doctor on an infectious diseases ward in Glasgow’s main hospital – and we can’t even redirect our holiday plans to go to visit her.

The fact is that all of us have our own particular circumstances and worries to deal with in this universal crisis. COVID-19 is demonstrating how interconnected we’ve become in our global and yet increasingly unequal world. 

For many of us too, the COVID-19 pandemic is also blurring our personal and professional lives in a major way. Every day I am struck by the energy, experience and – perhaps above all – calm leadership being provided by public health professionals in the UK. Directors of Public Health have been in the thick of leading the local response to the virus from the very start. In the early containment phase, our already strong relationships with PHE and other partners were critical in enabling us to perform a key local system leadership role and ensure joined-up action.

As a membership organisation, the ADPH is always focussed on facilitating connections and providing support. DsPH have been able to connect quickly – formally and informally – sharing intelligence, resources and encouragement. From local system leadership to the shaping of national guidance (or just getting on and producing critical materials ourselves) we’ve been committed, measured, agile and decisive in getting stuck in to do what needs doing.

We – the ADPH team, Jim McManus our Vice-President and myself, our Board and many of our DPH members – have ensured that intelligence has flowed between national and local; through regular telecons between members and the Chief Medical Officer, a host of interactions with officials and advisors at DHSC, NHSE, MHCLG and others, and Jim and myself attending a roundtable chaired by the Prime Minister where we discussed the local government response.

We’ve had a clear national and local public leadership presence too. Twitter has been electric with our advice, commentary and innovative approaches to getting across key messages. Many DsPH have made assured and reassuring media appearances across the country; we’ve shone a spotlight on the DPH role on the ground, through a comment piece in the Municipal Journal, coverage in The Times and appearances on BBC Radio 4’s the World at One and PM programmes. For Radio 4, I had 3 hours on a Saturday afternoon from contact to interview and I, in that short space of time, had productive interactions with the Chief Medical Officer, Chief Executive of PHE, LGA Senior Adviser for Public Health, and our ADPH Chief Executive, Vice-President and Head of Policy. This epitomised for me the strength of our public health leadership where we bring our unique viewpoints, understand the positions of others, and combine them to provide much needed system strength for the immense task we face.

People everywhere have questions about different aspects of the situation; some are expressing what they strongly feel are the answers. This is a rapidly evolving situation – and managing the communications across so many parts of our society has clearly been difficult. But we know that people look for credibility, reliable advice and leadership. We have confidence in the considerable scientific public health endeavour that is supporting national decision-making. A bad course of action is for us to challenge, undermine or generate uncertainty around the approach for the sake of it. That will further increase confusion and anxiety. Our view is that where people with legitimate expertise consider that there are areas of concern, they have a responsibility to make these known through constructive professional communication, rather than via mass media. Consistent messaging and credible leadership remain core elements of an effective public health emergency response.

I pay tribute to the dedication of Directors of Public Health and our amazing teams – many senior public sector leaders recognise the incredible, expert, hard work being done by our members, and know that we’re a key ‘go to’ local expert and leader.

Unfortunately, this hasn’t always been the case. What has upset some of our members the most, despite leading so much of this work, is being left time and time again off key communications or guidance development by NHS England and some government departments. It’s not good enough – and it slows down our response at a time when we can least afford it.

While the focus on the NHS is understandable, the critical role of local government – and other sectors (such as schools and the voluntary and community sectors) – in all they have to step up to do for our communities during this crisis, is seldom mentioned. Collaboration is our greatest asset. We need to boost the morale of all key workers, and we should be doing more to recognise them.

The next few months will be uniquely challenging – from the immediate saving of lives to managing and mitigating the fall out on our residents’ mental health, debt, relationships, loss and loneliness, exhaustion, inequalities. This is a marathon, not a sprint and we’ll need to ensure that we – and those we work with – are able to pace ourselves. I am confident that we, as DsPH collectively, will do everything we can to support each other with our mental and physical wellbeing. I’ve been totally bowled over by how DsPH across the UK are spending time sharing, guiding, mentoring, providing mutual aid, and allowing each other to simply ‘wobble’ in safe spaces. 

One thing that some DsPH have shared on Twitter is what a day in their life is currently like – cathartic, entertaining, illuminating… I’d like more of you to share your highs and lows by using the hashtag #adayinthelifeofaDPH and including @adphuk

I’m immensely proud of all that DsPH, their teams and all those we work with have done so far, and wish you all strength and support to continue to meet the challenge as best as we possibly can.   

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