The chief executive of NHS Providers Chris Hopson spoke out last month about the UK Government's poor approach to communicating important changes to its policies without consultation with those who have to deliver them. Findings from our research, being conducted by a partnership between the Universities of Keele, Sussex and UCL, suggests this experience is not an isolated case, but a central problem being experienced by those delivering the COVID-19 crisis response across the UK.
Based on weekly interviews and observations of meetings with more than a dozen partnerships, the research has tracked the experiences of several local resilience forums (LRFs) dealing with the crisis. Through this approach data has emerged that suggests local capacity has been consistently undermined by government's heavy ‘top-down' approach.
From the onset of the crisis onward the Government's centralised directives have not always easily integrated with the emerging ‘place-based governance' being constructed by LRFs to address local community needs. For example, a key policy early in the crisis was the delivery of food to the vulnerable. Some LRFs worked rapidly to set up the networks and infrastructure, all in a matter of days. Yet, when food did arrive, it was not in neatly made up packages as they had been led to expect but in large containers that needed repackaging into parcels, something they had not been told by the Government to prepare for.
LRFs reported that these kinds of difficulties related to poor government communication, with many finding out about COVID-19 developments via the media or ministerial briefings, with no advanced consultation. This meant they often had little if any opportunity for planning and implementation. Over time, some LRFs even suggested that important information was being deliberately held back by central government through fear of policy leaks.
In April, some LRFs experienced issues with ‘national' testing sites being underutilised. These centralised ‘super test' centres under government control were not needed because LRFs already had unused capacity in the testing centres under their control. Some found their new sites could not even be registered on the national systems, so they remained woefully underutilised. This left some LRFs feeling as though they were working to meet self-imposed government targets rather than earnestly addressing the crisis.
Another issue concerned data to and from the Government. For example, as LRFs prepared for excess deaths they struggled to make complex decisions about how many units to build in the absence of modelling data from the Government. Opportunities to make local level decisions were then further undermined as the Care Quality Commission (CQC) stepped into the fray when high mortality in care homes became the next ‘high-profile' issue. From an LRF perspective the CQC often swept up local capability and LRF working practices were overwritten.
This tension has become particularly acute over tracking, tracing and isolating (TTI). Here several LRFs expressed frustration that no infrastructure for such a complex process was in place locally and wouldn't be for several months. Yet according to government announcements the new system was expected to be operational just a few days later.
Regardless of the underlying motivations, what is evident is a systematic pattern indicating an attitude that has been undermining effectiveness and trust in government at the local level. What our research suggests is that the Government's ‘top-down' approach has left some LRFs feeling frustrated and undervalued. Moreover, despite LRFs not being legal entities, they have been left making life and death decisions in a context of shortfalls not of their own making. Perhaps no surprise then that concerns have emerged within LRFs around accountability and a focus on recording of decision making in preparation for subsequent inquiries.
At the theoretical level our findings can be understood through a combination of an organisational psychology framework of trust (Kramer & Tyler, 1995) and a social psychological level in terms of the dynamics and relationships in the management of mass emergencies and disasters (Carter, Drury, & Amlot, 2018). Our research suggests that many of the issues raised can be addressed via a better focus on building trust and introducing open and two-way dialogue between central and local government. Adapting Carter and colleagues' (2020) recommendations, our research adds to understanding of interoperability dynamics – in this case between local and national responses.
Drawing on this empirical and theoretical background we offer the following advice ahead of the next emergency and – or for further iterations of this one:
1) Communicate openly and honestly
Openness from government is a key dimension of fairness in interactions with local delivery partners. Conversely, being seen to withhold information can destroy any sense of togetherness and create suspicion.
2) Negotiate with LRFs about policy announcements
Regular updates should be provided to LRFs prior to public announcements and better consultation is needed about the practicalities of delivery.
3) Build from the bottom up
Central government should seek to support and ‘scaffold' local activity rather than to control what gets done and how exclusively from above. Central government should seek to optimise LRF strengths by allowing them to manage policies locally to help ensure that they are implemented more efficiently.
Dr Arabella Kyprianides is research fellow in policing at UCL
Additional authors: Prof Clifford Stott – professor of social psychology at Keele University; Marcus Beale – practitioner academic at Keele University; Dr Leanne Savigar-Shaw – lecturer of policing at Staffordshire University; Dr Matt Radburn – research fellow in policing at Keele University; Ian Wiggett – former ACC in Greater Manchester Police, and Owen West MSt (Cantab) – former chief superintendent with West Yorkshire Police
