Enhancing public health intelligence workforce capacity and capability: insights from English local authorities’ COVID-19 response

Introduction The COVID-19 pandemic provided a stimulus to improve emergency response capabilities in the United Kingdom. Compared to healthcare workers, there is a paucity of research examining the experiences of public health staff involved in the response. During the pandemic, English local authorities (LAs) responded to limit virus spread and mitigate its impacts by providing public health intelligence (PHI). This article reports workforce-related findings from a larger study which focused on understanding sub-national provision of PHI during an infectious disease emergency.

Methods A mixed method, sequential, exploratory study was conducted. This involved comparative case studies of LA responses and an anonymous online survey of LA PHI staff followed by data integration. The primary data collection method for the case studies was semi-structured interviews with PHI staff. A cross-case analysis of interview data using inductive thematic analysis was performed. Quantitative survey data was analyzed to produce descriptive statistics and long-form text responses supplemented the interview data. Qualitative and quantitative data were integrated by using case study findings to inform survey topics and by following an established framework to examine confirmation, complementarity, expansion, or discordance.

Results Data from 12 interviews and 120 survey responses was integrated. The pandemic saw changing demands for analytical capacity—the highest demand occurring at the outset. Inequities in allocation of keyworker status impacted those with childcare responsibilities. Staff identified knowledge gaps around health protection, data automation, information governance, and emerging data sources. PHI personnel had traumatic experience, and staff well-being was adversely affected by high workloads, limited leave, exposure to emotive data, and difficulties in disconnecting. Anticipating pandemics and emotional preparedness were valued mindsets. Peer support and effective leadership mitigated negative effects on wellbeing.

Discussion The traumatic effect of responding to the pandemic on some PHI staff might not be anticipated in a group not considered “frontline”. We propose there is a duty to prepare staff for emergencies and implement best human resource practices. Findings suggest a need to improve public health workforce planning for emergencies. Emergency response plans should include the PHI function and be tied to public health authorities’ capacity and capability to enact them.