A survey of people in the UK from last week revealed that only 7% wanted to return to ‘normal’ after lockdown. Many folk across the world have put up signs on buildings and on twitter saying ‘we can’t go back to normal because normal wasn’t working’. There seems to be an emerging consensus that we need to reform the norm.
But how exactly? It isn’t sufficient to say we need to change and leave it at that; because the danger is we will forget how everything feels so different now and revert to the comfort blanket of the old way because it’s what we know. We need to spend the remaining time we have designing in great detail our collective future normal.
We are inhabiting the liminal space at the moment: the critically important space between one form of existence and the next. Liminal phases can’t be rushed through. We need to dedicate every ounce of our energy, imagination and creativity to the system redesign - the paradigm shift, in readiness for the longed-for renaissance we will experience at the end of the precious liminal space we have been given. It’s really difficult to do this in reality when local government and other public service leaders are working so hard around the clock to save lives and protect the most vulnerable residents from long-term serious harm or even worse. The reason they are having to do this is the now more obvious broken state of the welfare state; no longer the safety net it was designed to be.
Drawing on what we have learned already about what works from brilliant radical thinkers and system designers like Hilary Cottam, Adam Lent, Jessica Studdert, Julia Unwin, Chris Ham, Kate Raworth, Anna Randle, Victor Adebowale, Helen Bevan, Neil McIlroy, Vidhaya Alakeson, Andy Knox and others we know that the system needs to be more like this:
- Democracy needs to be more localised. Devolution of powers to local councils and combined authorities to enable them to work more closely with local people to shape the future based on the specific needs of the locality.
- Communities have never been more important than now, as has been demonstrated by the pandemic response. They need more power so they can decide things for themselves based on local needs. They need to be trusted, supported, funded and empowered to get on with it.
- Frontline teams have also never been more important. They need to be also funded, supported and trusted to innovate on the front line and freed from the unnecessary bureaucracy we often put in their way when they are trying to do their best for families and individuals in crisis.
- ‘Spark plug’ innovators - the brilliant 3% of teams who make stuff happen should be cherished and valued and listened to harder. Whatever their role within a team they are invaluable and we have so much to learn from them.
- Local economies need a fresh start through community wealth building as the old economy collapses globally.
- Digital by default works - so why didn’t we do it before?
- We need a new welfare state which prioritises and supports people in crisis rather than punishing them and pushing them deeper into crisis.
- The climate crisis is real and unless we build a donut model to prevent further collapse and invest in a new alternative we will be unable to feed ourselves.
- We need a new social contract - a bit like the Wigan Deal between citizen and state. In my NHS Trust Accident and Emergency attendance has fallen by two thirds, bringing into question how we use our public services in the future.
- We need to get rid of the market paradigm model in health and care and collapse commissioning and provision into one. Traditional Clinical Commissioning Group (CCG) models are shown to be largely redundant in a crisis.
- Integrated multi-agency place-based teams as community hubs with public servants working as one including police, social workers, housing officers, doctors, district nurses, health visitors, schools, mental health support teams and community groups have proven themselves to be invaluable during a pandemic. Sharing hard and soft intelligence about people who live in the area who need wrap around support and developing a single multi-agency action plan for the person or the family. Why don’t we learn from this and just make this the way we work all the time?
- Inspection needs to be about places, how people work together to support and protect communities not about individual services and the temperature of a fridge.
If we use this time to capture everything we have learned during this crisis we could well and truly reform normal forever and live a better and richer life.
Professor Donna Hall CBE is chair of the New Local Government Network and chair of Bolton NHS Foundation Trust