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Responding in a crisis: reflections of a director of public health

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    Stephen Gunther

If there is one thing the Covid-19 pandemic has shown me so far, it is the resilience and kindness of humanity. Time and time again I have seen, heard or witnessed people go ‘above and beyond’. I have seen the flexibility and agility of teams and organisations supporting communities and their staff, streamlining activity and taking swift action. I have also seen where, with hindsight, things might have been done things differently, but that’s for another place.

Global pandemics are something directors of public health plan for yet hope never happen. Here, I reflect on the leadership approach I have taken to protecting and supporting staff and local residents during this time.

Role as a leader

Throughout the Covid-19 pandemic I have constantly asked myself two questions: ‘What is my role now?’ and ‘Where can I add the most value?’

As the situation unfolded, responses – both within public health and beyond – had to adapt. For me this meant looking at the skills and talents across and beyond my team and considering who was best placed to lead responses, as myself and my team could not do this alone. This dispersed leadership approach – building on the skills and talents of others, guiding, providing reassurance or just letting them get on with it – was a conscious decision. My role, where I could add the most value, was providing clarity, direction and support.

In Walsall, we’ve worked on the principle of learning as we go and understanding that we are not going to get things perfect first time, every time. I’d say to others: look wide for learning and at varied sources of information, think laterally about how others are applying action and what could be done locally in the context in which you are leading.

What has helped?

  • Providing clarity: be clear on who is doing what and how to communicate with them; the sheer volume of new information and new actions needed can be overwhelming., Constantly review the evidence and consider the politics (locally, regionally and nationally). Have trusted sources of information and think laterally on how action based on new or emerging evidence can be optimised.

  • Being agile: responding to a constantly changing situation where things land without warning requires a different response and the ability to mobilise people and resources quickly. It is important to have an open and flexible mindset and give clarity on why you are making your recommendations.

  • Providing direction: as a leader, be clear on what is known, what actions are going to be taken and be brave in decision-making. Take what is known at the time, make informed decisions and assess their impact, both with intended and unintended consequences. This will help inform any future direction.

  • Communicating clearly: be really clear on who you need to communicate with and when. Ensure that communication is understood to minimise wasted time, energy and resources. This is a constant balance between checking in versus pace of decision-making.

  • Maximising opportunities: whether it is digital sharing, newly built relationships, or reduced travel, take advantage of the little changes that make life easier. Make them stick and role model positive behaviours. Use the momentum gained to continue to build and support other innovations.

  • Providing support: trust others to deliver and support them to take action. In times of crisis, action is not always perfect first time, so be kind, supportive and provide guidance. Reflect, learn and share together. Have conversations with different people and communities; share experiences and learning between teams and local organisations.

  • Knowing your local context: understand where there are strengths and weaknesses. Covid-19 has highlighted differences in preparedness: be aware of this in your community and channel limited resources to where they are needed to ensure the right support and mitigate impact as much as possible.

  • Valuing relationships: constantly build relationships and spend time on them. Investing in relationships will be invaluable when you need to quickly glean information or respond to issues that arise.

  • Listening to a range of perspectives: different people view the world with different times frames, eg, from immediate crisis management to 15 years in the future. Take the time and space (where possible) to convene and connect the different viewpoints to get to a shared understanding and maximise joint opportunities.

  • Finding your groove: providing support can be an emotional rollercoaster, with multiple requirements coming at you at the same time. There is a constant tension between resting and keeping going. Finding your groove/workflow is important to able to support and lead others without burnout. Let others know what your groove is so they can best support you to keep it.

As we move into the next phase of Covid-19, sharing experiences, learning and support for each other will continue to be important. Don’t be afraid to share, question, challenge and reflect on what we have had to deal with and what has been achieved so far.

Leading through Covid-19

Short resources and shared experiences to offer some help in supporting leaders working in the NHS, social care, public health, local authorities and the voluntary and independent sector.

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