The past year has been like no other. The COVID-19 virus has taken a huge toll on our communities, with each death a terrible loss.
In the longer term, the experience of the coronavirus pandemic and its impact, particularly on the most vulnerable in society, will long be with us.
Local councils have been at the centre of measures to tackle the spread and impact of COVID-19.
Directors of public health and their teams have worked with partners across local government, the NHS, the voluntary and community sectors, and beyond, to co-produce a magnificent team response.
They have worked quickly, efficiently, and creatively. At times of crisis, people rise to the challenge, and nowhere is this seen more clearly than in the local response to COVID-19.
Public health in local authorities has a central role in tackling the virus in local places.
It provides the leadership, expertise, partnership working, and access to local resources that are fundamental to effective place-based coordination of health protection interventions.
It also helps local areas to understand and address the economic, social and psychological impacts of the pandemic, and the serious health inequalities that have been highlighted and deepened.
Partners from other organisations who have worked with public health on COVID-19 now have a much clearer understanding and appreciation of their pivotal role, as does wider society.
Awareness and understanding of public health among the public and organisational partners and colleagues increased markedly throughout the pandemic.
Local government leaders report that their role has been an irreversible game-changer for how directors of public health and their teams are viewed in local authorities and across wider partnerships, and their influence will continue into the future.
But for the public, just as social care became equated with care homes, public health is associated with tackling disease.
This raised profile is very positive and should be built on going forward, but it will be important to emphasise that public health is a multifaceted discipline with a large range of functions.
Its basis is in scientific understanding, and its methods include epidemiology and understanding the social determinants of health, but it also involves skills such as working at the frontline with individuals and communities.
This span of functions gives public health its huge potential to make a real difference to people’s lives.
Tackling a pandemic is a rapidly evolving situation, in which everyone involved has had to learn, adapt, persist, take risks, and innovate, while operating under huge challenges and pressures.
Everyone is focused on the same goal, and there are some clear imperatives, but there are also areas about which there are different views on the best way forward, so judgements have had to be made.
Sometimes, this involves balancing needs and risks to find the least-worst outcome. Throughout the pandemic, there have been tensions between the benefits of keeping people virus-free and the negative impacts on individuals and the economy – between individual freedoms, prosperity, and collective safety.
This year’s public health annual report is an important document. It looks back through the events of the past year and focuses on what public health has helped achieve. It also looks at what could have been done better.
“The virus, in different forms, will be with us for years to come”
COVID-19 was an unprecedented challenge for all organisations – national, regional and local – and, often, there were dilemmas about the best path to take.
Although the rollout of vaccines means that risks posed by COVID-19 will gradually reduce, the virus, in different forms, will be with us for years to come.
Continuing to tackle this, and reduce its impact on people facing health inequalities, will be a key task for public health long into the future.
Nor will this be the last major infectious outbreak we face, although we sincerely hope it will be the last global pandemic for many years.
We need to understand the lessons from this pandemic and apply them, so we can achieve a seamless response to future challenges.
The end of Public Health England, the new UK Health Security Agency, and the Health and Care White Paper mean we are, yet again, facing significant organisational change. The long-standing problems of health inequalities and regional inequality have become ever clearer during 2020, and the pandemic’s repercussions will exacerbate these at a time when resources are limited and unclear.
At this crucial time, we must not misstep. We must come together and work at scale wherever this is most effective, but always keep the focus on local places – where people feel a sense of belonging and community, and where the direct work of health improvement and health protection take place.