Member blog: Siobhan Farmer

People often ask me what being a Director of Public Health (DPH) actually means. Some of my friends still joke that I’m the food police or that I spend my days telling people to wash their hands for 20 seconds. The truth is far broader, messier, and much more human. Public health is about creating the conditions that help people live well. It’s about fairness, evidence, relationships, and understanding how all the small and large parts of society shape our chances of living healthy, long lives. 

My route into public health wasn’t planned. I studied physiology at university because I was fascinated by how the body works, especially neuroscience and the nature versus nurture debate. I realise now that I was always drawn to the bigger questions about how individual behaviour sits within wider communities, populations, and politics. Learning that some communities have far fewer chances to live well felt profoundly unfair, and I wanted to do something about it. After university, I worked on large scientific studies, but I found myself drawn more to the stories of the people behind the data and the wider forces shaping their health. 

I ended up in public health almost accidentally, but it made sense to me straight away. In 1988, Donald Acheson described it as ‘the science and art of preventing disease, prolonging life, and promoting health through the organised efforts of society’, and that definition has always resonated. The science tells you what is happening; the art is how you respond, how you interpret the evidence, work with communities, and make judgments in complex, realworld situations. 

My early roles were in health development: delivering sex education programmes in schools to reduce teenage pregnancy, supporting drug services, and developing school food policies around the time Jamie Oliver took on the Turkey Twizzler. Those experiences shaped how I think about trust and listening. Interventions only work when you understand the pressures, fears, and practical barriers people face, and I saw how national policy (and occasionally a determined celebrity chef!) can influence local practice. I went on to complete a Masters degree and joined the national public health training scheme in 2014. 

A standout moment from training was working through a large measles outbreak in the North West. It was fast-moving and demanding, and it taught me how vital calm communication and compassion are in a crisis. Those lessons were invaluable in my early consultant roles in Salford and Greater Manchester but particularly when I arrived in Gloucestershire as Deputy DPH in January 2020, just before Covid-19 hit. Our teams showed such resilience, adaptability and care for our communities, and we tried to lead with humanity and humility throughout. 

Equity continues to run through all my work, and I know it cannot be achieved through data alone. The Podsmead pharmacy work illustrated this well. The data suggested residents could access a pharmacy nearby, but their lived experience told us there was no safe way to cross a busy road with a buggy. Listening revealed a genuine gap in provision, and acting on that improved access for the community. 

As DPH, I have learned that leadership can mean being open about my own experiences, including the impact of alcohol misuse in my family. My 2023 annual report focused on this. While difficult to talk about, it created space for honest conversations and helped challenge stigma. 

Working with partners locally, regionally and nationally is a real privilege and every day brings new challenge and reward but public health is longterm work and only if we can stay curious and always remember there are people behind the numbers, can we genuinely narrow the inequality gap.