Prime Minister Boris Johnson has unveiled his plans for tackling COVID this autumn and winter. His ‘plan A' promotes vaccines and testing, with a ‘plan B' back-up if more action is needed to protect the NHS.

But is the worst of the pandemic really over, and what are the priorities of local government chief executives and public health experts as they ponder the future? A Local Government Association webinar last week Beyond the roadmap: living with COVID explored some of the most pressing issues.

President of the Association of Directors of Public health (ADPH) Jeanelle de Grucy has  been appointed as the new Deputy Chief Medical Officer for England and will also co-lead the Office for Health Improvement and Disparities (OHID) – the new national body aiming at tackling health inequalities. She told the webinar she believes we have ‘all seen the worst of the pandemic behind us'.

But while she pointed to ‘grounds for cautious optimism', no-one underestimates the significant challenges for public health of the coming months, she added.  And, possibly one of the challenges is ‘people being overly optimistic about the current situation'.

She highlighted an unvaccinated group of adults which at six million is ‘huge' – and would continue to drive COVID [infections].

Inequalities is going to ‘continue to be a challenge and an ongoing deepening one', she continued. ‘We need to really drive up the vaccination rates, particularly in more deprived areas or from particular groups such as BAME groups who are still less likely to receive a jab.'

Shifting the focus of local places to recovery and ‘building back better' has to be set in the context of a ‘really complex' national picture, she added. This includes the NHS and public health system reforms, Brexit and the Comprehensive Spending Review, ‘and how difficult that's going to be particularly for local government'. All of that is going to test and stretch local systems and the workforce, she emphasised.

‘Everyone has taken quite a bit of strain over this…..we just going to have to dig deep and continue,' she added.

She said the Government's ‘Plan A' announcement of universal vaccination of 12 to 15 year olds would provide another tool to reduce transmission, and limit the consequences of missed education.

‘Clear and consistent' messaging to parents will be crucial to build trust and ensure informed consent, and the rollout must also limit disruption [to schools] as much as possible, she added.

Speaking on behalf of the Society of Local Authority Chief Executives and Senior Managers (Solace), chief executive of Ealing LBC Paul Najsarek also focused on the importance of protecting and supporting education.

He also highlighted the importance of making sure the vaccination programme and the testing and contact tracing programme are focused in communities and families that are most vulnerable, where deprivation is a particular factor.

Mr Najsarek also emphasised the need to support workplaces and businesses to make sure settings and safe and well supported, and to ‘begin to facilitate the economic and social recovery of our community from the pandemic'.  That would include supporting city centres and town centres, thinking about green infrastructure and ‘making sure we've got really welcoming public realm'.

He said the relationship between NHS Test & Trace and the UK Health Security Agency (UKHSA) – responsible since April for UK-wide public health protection and infectious disease capability and replacing Public Health England from the end of this month – is a ‘crucial' one for local government.

Being agile enough to devolve resources and responsibility to the right place is vital, he said. Timely data needs to flow through the system, and resources and skills need to be focused on the parts of communities that most need support in terms of tackling enduring transmission or particular outbreaks, he added.

Mr Najsarek underlined that the COVID crisis ‘has been the ultimate test this last 18 months both professionally and personally'. Ealing had lost nearly 900 residents to the virus, ‘and you know every part of the country will have a story analogous to that', he continued.

Director of Contain at NHS Test & Trace Tony McArdle's team is shortly to become the new regional and local engagement arm of UKHSA. He said that ‘as with any change in the Government's approach' the Contain framework would be reissued so that the guidance ‘remains fresh and current'. The refreshed framework should be issued early next month.

He said  test, trace and isolate, including continued access to a PCR test for anyone who believes they may have contracted COVID, support for self-isolation and the availability of lateral flow tests for anyone asymptomatic – ‘all of these things which we're so familiar with, will continue'.

But crucially he noted that local government has ‘as a sector done extremely well over the last 18 months in helping to support this country through this virus - and with every expectation that [it] will continue to do so, over the next six months'.