Evidence map›Paper›PMID 38331750›Full record

ArticleBMC health services research2024

'A system that is struggling': understanding health protection resilience in England during the COVID-19 pandemic through the experiences of local health protection responders.

Suzanne Rotheram, Stephen Clayton, Ian Buchan, Sam Ghebrehewet, Ben Barr

Abstract read
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Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Suzanne RotheramNational Institute of Health Research, Health Protection Research Unit in Gastrointestinal Infections, The University of Liverpool, Liverpool, United Kingdom. suzanne.rotheram@liverpool.ac.uk.
Stephen ClaytonDepartment of Public Health, Policy and Systems, The University of Liverpool, Whelan Building, Liverpool, L68 3GB, United Kingdom.
Ian BuchanNational Institute of Health Research, Health Protection Research Unit in Gastrointestinal Infections, The University of Liverpool, Liverpool, United Kingdom.
Sam GhebrehewetThe UK Health Security Agency (UKHSA), UK Health Security Agency North West, Cheshire and Merseyside Health Protection Team, Suite 3B, 3rd Floor, Cunard Building, Water Street, Liverpool, L3 1DS, United Kingdom.
Ben BarrNational Institute of Health Research, Health Protection Research Unit in Gastrointestinal Infections, The University of Liverpool, Liverpool, United Kingdom.

Funding

National Institute for Health Research (NIHR) Applied Research Collaboration North West Coast (ARCNWC) NIHR200182National Institute for Health Research Unit (NIHR HPRU) in Gastrointestinal Infections NIHR200910
6 · The paper itself

Abstract

backgroundLocal health protection systems play a crucial role in infectious disease prevention and control and were critical to COVID-19 pandemic responses. Despite this vital function, few studies have explored the lived experience of health protection responders managing COVID-19. We provide new insights by examining how COVID-19 shaped infectious disease prevention and control in local health protection systems in England.

methodsSemi-structured interviews were conducted with twenty local health protection responders from three contrasting local authority areas, and Public Health England (PHE) health protection teams, in England between June 2021 - March 2022. Participants were from: PHE health protection teams (n=6); local authority public health teams (n=5); local authority Public Protection Services (n=7); and local authority commissioned Infection Prevention and Control Teams (n=2). Data were analysed using reflexive thematic analysis.

resultsFirst, participants acknowledged the pandemic caused an unprecedented workload and disruption to local health protection service delivery. There was not enough capacity within existing local health protection systems to manage the increased workload. PHE health protection teams therefore transferred some COVID-19 related health protection tasks to other staff, mainly those employed by local authorities. Second, health protection responders highlighted how COVID-19 drew attention to the weaknesses in local health protection systems already stressed by reduced funding in the years leading up to the pandemic. Injecting money into the COVID-19 response did not completely overcome former losses in specialist health protection workforce. Third, health protection responders described how pandemic management raised the profile of public health, especially infectious disease prevention and control. Managing COVID-19 strengthened collaborative working, resulting in enhanced capacity of local health protection systems at the time.

conclusionThe COVID-19 pandemic challenged the public health preparedness of all countries. Health protection responders in this study also expressed many challenges. There was insufficient resilience in these local health protection systems and an inability to scale up the specialist health protection workforce, as required in a pandemic situation. The UK needs to learn from the pandemic experience by acknowledging and addressing the challenges faced by local health protection responders so that it can more effectively respond to future threats.

Indexed as

Communicable DiseasesCOVID-19Resilience, PsychologicalEnglandHumansPandemicsCOVID-19Health protectionInfectious diseasesQualitative researchResilience

Identifiers

PMID38331750
PMCPMC10854171

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.