Pandemic preparedness: Listen to local leaders

As the first module of the UK Covid-19 Inquiry draws to a close, I have been reflecting on our involvement as a Core Participant, and how this opportunity has enabled us to share our members’ insights on how to better prepare for a future pandemic.

In view of the prominent role Directors of Public Health (DsPH) played during the pandemic, and the contribution ADPH made to national policy discussions, it was important that as an organisation we ensured our members’ evidence and experiences were formally recorded.

By becoming a Core Participant we were able to present this evidence, gathered from DsPH across all four nations, as one, collective, voice. Importantly, not only did this mean that DsPH (and/or their employing organisations) did not have to become individual witnesses which would have been both a burden financially and in terms of resources, it also meant that we were able to present evidence that might otherwise have been overlooked. By making clear, evidence-based points, we demonstrated the critical role that strong, consistent and enduring leadership of DsPH plays in preparing for, and responding to, a pandemic.

Being a Core Participant in the Inquiry also enabled us to raise awareness of the DPH role during the pandemic with key stakeholders, partners and the public, advancing our policy positions and recommendations, and helping to safeguard the reputation of DsPH and ADPH.

Key messages about resilience and preparedness for the pandemic at a local level were delivered by our KC through a short opening statement which I was able to expand on when I gave oral evidence. We then offered our conclusions after all the evidence had been heard in our closing oral and written submissions.

Throughout our testimony, we emphasised that there had been insufficient understanding of the role, capabilities and responsibilities of DsPH at a national level and that, as a consequence, they were largely omitted from the systems, processes and plans that were put in place at the beginning of the pandemic.

DsPH are trained in containing infectious diseases, understanding and interpreting data, recognising risk factors, understanding the evidence base and what motivates behaviour change, and helping develop local policy interventions. Crucially, DsPH also have a great deal of knowledge about their local populations and community organisations.

After conducting a detailed survey of DsPH to present to the Inquiry, it was clear that although they were working in close partnership with colleagues at a local level at the start of the pandemic, they were repeatedly excluded from key communications and guidance developed at a national level.

That DsPH should have been consulted more comprehensively by national bodies with responsibility for health protection from the outset is one of the key messages that was picked up by media coverage of the Inquiry and one that I sincerely hope is taken on board in the future.

There needs to be greater recognition of the role of local public health and local government in planning for future pandemics. Therefore, much greater local involvement is needed in formulating national policy. This means bringing in bodies such as ourselves, the Local Government Association, the Associations of Directors of Adult and Children’s Social Services (and devolved equivalents) to collaborate and inform national decisions.

One of the many lessons I hope our evidence can demonstrate is that locally driven processes and responses are both faster and more effective than those prescribed centrally through ‘top-down’ approaches. They also enable improved co-ordination and collaboration between agencies and it is important that the UK Government understands the distinct role of DsPH in this collaboration when engaging locally.

Finally, it is important to recognise that responding to the Inquiry as a Core Participant was a big undertaking and would not have been possible without the support of our members who took the time to document and discuss their experiences. I am immensely proud of how we – as a collective – were able to deliver specific, high quality and actionable recommendations, which reflect our members’ commitment to improving and protecting health throughout the UK.

As we all know, another pandemic is inevitable. However, through collaboration and learning we can take the necessary steps to protect our society and I am confident that the Inquiry team will be able to draw solid conclusions about how to improve the UK’s resilience and preparedness from the evidence presented by us, and the other Core Participants, in Module One.

For the latest information on ADPH’s contribution to the Covid-19 Public Inquiry, visit our website.