National Institute of Health Research, Health Protection Research Unit in Gastrointestinal Infections, The University of Liverpool, Liverpool, United Kingdom.
Department of Public Health, Policy and Systems, The University of Liverpool, Whelan Building, Liverpool, L68 3GB, United Kingdom.
BMC Health Serv Res. 2024 Feb 8;24(1):181. doi: 10.1186/s12913-024-10651-7.
Local 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.
Semi-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.
First, 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.
The 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.
地方卫生防护系统在传染病防控中发挥着至关重要的作用,对 COVID-19 大流行的应对至关重要。尽管具有这一重要功能,但很少有研究探讨管理 COVID-19 的卫生防护响应者的生活体验。我们通过检查 COVID-19 如何塑造英格兰地方卫生防护系统中的传染病防控,提供了新的见解。
2021 年 6 月至 2022 年 3 月期间,在英格兰的三个对比鲜明的地方当局地区和英国公共卫生署(PHE)卫生防护小组中,对 20 名地方卫生防护响应者进行了半结构化访谈。参与者来自:PHE 卫生防护小组(n=6);地方当局公共卫生小组(n=5);地方当局公共保护服务(n=7);和地方当局委托的感染预防和控制小组(n=2)。使用反思性主题分析对数据进行分析。
首先,参与者承认大流行造成了前所未有的工作量和对地方卫生防护服务交付的破坏。现有地方卫生防护系统的能力不足以管理增加的工作量。因此,PHE 卫生防护小组将一些与 COVID-19 相关的卫生防护任务转移给了其他工作人员,主要是那些受雇于地方当局的工作人员。其次,卫生防护响应者强调了 COVID-19 如何引起人们对地方卫生防护系统的关注,这些系统在大流行前几年由于资金减少而已经面临压力。将资金注入 COVID-19 应对措施并没有完全弥补以前在专门卫生防护劳动力方面的损失。第三,卫生防护响应者描述了大流行管理如何提高公共卫生,特别是传染病预防和控制的知名度。管理 COVID-19 加强了合作,从而增强了当时地方卫生防护系统的能力。
COVID-19 大流行挑战了所有国家的公共卫生准备。本研究中的卫生防护响应者也表达了许多挑战。这些地方卫生防护系统的弹性不足,无法按大流行情况所需的规模扩大专门的卫生防护劳动力。英国需要从大流行经验中吸取教训,承认并解决地方卫生防护响应者面临的挑战,以便更有效地应对未来的威胁。