Learning the lessons for public health from the COVID-19 pandemic across British island communities: findings of a peer support group based on action learning.

INTRODUCTION: The COVID-19 pandemic was a major public health challenge for island communities. Consequently, a peer support group was set up across British islands, led by Directors of Public Health, with the aim of using an action research approach to identify and share learning to inform aspects of the management of COVID-19 that were unique to island communities. METHODS: Qualitative analysis of nine group discussions over 13 months was undertaken. Key themes were identified based on two sets of independent records of the meetings. The findings were shared with representatives of the group and refined on the basis of that feedback. RESULTS: Key learning points were around the importance of border control to minimise the importation of new cases, a rapid coordinated response to clusters of disease when these occurred, close cooperation with organisations that provide transport on and off the island, and effective communication and engagement with both local and visiting populations. CONCLUSION: A peer support group was effective in providing mutual support and shared learning across quite varied island contexts. There was a sense that this had helped in the management of the COVID-19 pandemic and facilitated in maintaining a low prevalence of infection.

Alcohol dependence and driving: knowledge of DVLA regulations.

Aims and Methods The UK's Driver Vehicle Licensing Authority (DVLA) requires individuals to report if they have a medical condition such as alcohol dependence. General Medical Council guidance indicates that medical practitioners should ensure patients are aware of their impairment and requirement to notify the DVLA. Results In a survey of 246 people with known alcohol dependence, none were aware of advice on driving given by medical practitioners and none had self-reported. In addition, 362 doctors, either attending a college symposium or visiting a college website, were asked about their knowledge of DVLA regulations regarding alcohol dependence: 73% of those attending the symposium and 63% of those visiting the website answered incorrectly. In Scotland, over 20 000 people have alcohol dependence (over 1 million people with alcohol abuse), yet only 2548 people with alcohol problems self-reported to the DVLA in 2011. Clinical implications If the DVLA regulations were implemented, it could make an enormous difference to the behaviours of the driving public.