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Blog by Kelly Holehouse

Kelly has been a physiotherapist for 18 years. She is employed by East Lancashire NHS Trust and works for the Integrated Musculoskeletal, Pain and Rheumatology Service and joined the Population Health Fellowship in 2020.

An image of Kelly Holehouse

I think it is fair to say that as the first cohort of national population health fellows embarked on their year-long fellowship journey in January 2020, none of us could have imagined what was about to happen!

Like most things in 2020, the fellowship was interrupted due to the pandemic and the original population health project plans between myself and my host organisation, Blackburn, and Darwen Council, were paused during the first lockdown. However, as one door temporarily closed due to the demands of clinical work, it quickly became apparent that the new world we found ourselves living in was going to pose many other challenges to the world of Population Health.

In my day job as a musculoskeletal physiotherapist in the NHS, it did not take long before we started to see an influx of patients with post-covid syndrome, or long covid, who required some sort of rehabilitation and it became apparent there was going to be a huge deficit within service capacity to serve our local population and optimise health outcomes in this new world.

Through some of the contacts I had made in the very early stages of the fellowship, with the North West Regional Training Programme Director, I was connected with an opportunity to pursue an interest in the emerging area of post-covid syndrome while continuing to work towards delivering on one of the main aims of the fellowship - to influence and lead change in our local regional systems. I connected with and began collaborating with a local Public Health Consultant and a Speciality Registrar in Public Health with a view to identifying the potential impact post-covid syndrome might have on local clinical and support services within the local ICS footprint of Lancashire and South Cumbria.

Working together with these experienced public health practitioners, as well combining efforts and sharing results of a detailed literature search with colleagues at the Midlands Partnership Foundation Trust, (who were completing similar work regarding post-covid syndrome), enabled me to gain vital insight to the process of collaborative and clinically driven research.

The collaboration over several months culminated in the writing of a paper entitled ‘Post-acute COVID-19: the physical and mental health impacts of COVID-19 on the population in South Cumbria and Lancashire’. Despite a rapidly evolving literature base and some limitations within the literature, the paper offers some guidance regarding the prevalence of COVID-19 and the subsequent likelihood of persistent post-covid symptoms specifically across Lancashire and South Cumbria. However, it is important to note that the methods used in our paper, are applicable to other areas and discharge data is available to support this.

The aim of the paper was to contribute to and aid further discussions regarding the planning of services to support this cohort of people, as well as informing our understanding of the range of persisting symptoms our local populations are likely to experience because of having experienced COVID-19.

At a local level, this paper has been presented to the Directors of Public Health, local Clinical Commissioning Group leads and is due to be discussed with Integrated Care Systems leads soon. It has also been shared with colleagues at Public Health England and as a result, it is in the process of being approved as a document that is applicable across the entire North West region.

When my Population Health Fellowship resumed, I was able to apply this in-depth subject knowledge and support my host organisation as we look to the future and plan how to support local communities in the aftermath of COVID-19. This is with the aim of improving the health of this cohort as well as the entire local population.

For further information or to get a copy of the paper email Kelly.Holehouse@hee.nhs.uk