The challenges facing public health professionals in local government, at Public Health England and the NHS were already huge for 2020.
Inequalities and ‘the health gap', prevention and mental health were all top priorities at the beginning of the year, but sweeping aside all this is an emergency the UN has called ‘the worst crisis since World War Two'. One thing is certain, COVID-19 will have implications for many years to come.
Public health colleagues have responded amazingly to the outbreak, putting into practice skills they were trained for, but never expected to be called upon to use at this scale. Penna's networks tell us they are working around the clock to provide advice, guidance, support and practical assistance on the frontline. They're also prioritising community-based support to limit and control the spread of the outbreak.
No-one knows if and when the outbreak will be contained, but far-sighted public health colleagues are already beginning to plan for life post-COVID-19. Public health leaders and their teams are recognising and taking mitigating steps against the potentially massive impact on public health outcomes that the virus will have.
In particular, they have begun to identify the mental health challenges that are likely to have an impact across the whole life course.
Starting at the pre-birth stage of life they have identified anxieties around the impact of the coronavirus on unborn children, increased financial worries for parents at an already stressful time and worries about access to clinical care and support once their baby arrives. For children in the 0-5 age bracket, mental health challenges arise with significant changes to childcare and education routines, isolation from friends and the impact of parental stress and anxiety.
For older children many of the impacts will be the same, with the added complications of academic pressures, boredom, anxiety, depression and other mental health problems. For working age adults balancing work and home, carer responsibilities and the prospect of worklessness are huge concerns.
Finally, for senior citizens there is increased isolation, potential inability to source vital supplies, the fear of contracting the virus and the emotional impact of loneliness. This mixture of pressures and concerns across societal age profiles blends into a potent cocktail which could have an enormous ongoing impact on the wellbeing of citizens and communities.
The longer-term impacts of COVID-19 will come when public health staff and wider local government, the NHS, voluntary and private social care providers will be coping with the same issues in their own lives, while picking up this increased workload and carrying on.
On top of everything they will be wary of a return of the virus, ensuring containment processes and procedures are in place.
Dealing with mental health challenges and resilience will surely be key factors in how the country emerges from this crisis. Directors of public health and their teams will be front and centre in the efforts to help communities to move forward and recover.
With the public health challenges even more demanding than ever, close collaboration with colleagues in the full range of council services will be needed – in particular adult's and children's services, housing and across the whole health and social care system to help communities to cope with life in a post-coronavirus age.
I've observed directors of public health becoming true ‘system leaders', co-ordinating and engaging the efforts across their authorities, as well as leading across the whole health and social care system, influencing organisations including the NHS, housing associations and third sector providers. As post-coronavirus challenges emerge it will be even more important for public health practitioners to continue this vital system-leadership role, using their well-established evidence-based approach to help local authorities and partners cope.
It will be important for public health to have real presence at the forefront of efforts to help communities to rebuild and individuals to cope with their personal challenges.
The next few months will be uniquely challenging. Public health leaders will need to support each other and their teams with their mental and physical wellbeing. My advice is to spend time sharing, guiding, mentoring, providing mutual aid, and supporting staff. ‘Softer' leadership skills and coaching, mentoring and supportive approaches will be important attributes across public health teams.
It is also vital that the rest of us assist our colleagues in whatever way we can to fulfil their role and look after their own wellbeing. Showing kindness and respect for colleagues across the health and care sector, all of local government and civil society is imperative.
Nick Raper is lead public health recruiter at Penna
