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“Building back better”: easy to say, harder to achieve
Agata Miśkowiec and Alissa Davies reflect on how local authorities can recover from the COVID-19 crisis and what is means to ‘build back better’.
The COVID-19 pandemic has turned the world as we know it upside down. The whole nation is facing enormous social and economic challenges. But as we recover, we also have an unprecedented opportunity to build a fairer and more resilient society, to ‘build back better’.
So far, the response to Covid-19 has shown that local authorities are well placed to lead us through the crisis, but it’s not an easy task.
How can local authorities navigate the multiple pressures and uncertainties, driving change at pace across the whole system?
This is a million pound question. Or, to be more precise, a 7.8 billion pound question based on the LGA’s estimate of the funding gap for local services by 2025. Bear in mind that these figures predate COVID-19. It’s difficult to predict the overall financial impact of the COVID emergency, especially in the midst of the second wave with vast swathes of the country dealing with increased restrictions.
Even before COVID, local authorities and their partner agencies were operating in a challenging environment of rising demand, reduced resources and growing complexity. People are living longer (but not necessarily healthier) lives. Their needs and expectations are changing significantly. This often leaves a patchwork of local services provided along traditional organizational lines that struggle to offer the joined-up support needed for better outcomes.
Navigating these challenges is inherently complex. It requires a 360 degree view of the local issues, which looks at the underlying dynamics and not individual symptoms or services. It requires a coherent response across the whole system which is based on a shared long-term vision. Most importantly, it requires genuine collaboration with partners and communities.
This is fully recognised in the rhetoric of public service reform. For years, the mantra of public sector leaders has been a whole system approach, with a special focus on integrating health and social care. It’s something that everyone talks about but very few actually achieve in any meaningful way.
Moving towards whole system thinking and working has proven difficult in practice. Even though the NHS Long Term Plan established a target for every area in the country to be covered by an Integrated Care System (ICS) by 2021, developing ICS’ has presented multiple challenges. In many places vulnerable people in difficult situations still have to navigate complex and fragmented services. For example, a person with dementia may access up to 19 services at different times. No wonder that the overall understanding of public services is low: nearly 2/3 of the population think that social care services are provided by the NHS.
In conversations with local leaders, we often hear that COVID-19 is providing a much-needed impetus for change. Local authorities and their partners have responded to the pandemic by accelerating integration, working together to draw in local partners and communities in a spirit of cooperation and togetherness.
This change is happening at all levels. Local leaders of ‘Gold command teams’ across public services are meeting daily to discuss the key challenges and coordinate action. Frontline teams are cooperating more closely together, building mutual trust as they rally around the common goal of keeping people safe. In spite of some local tensions, we’ve seen the rise of community spirit. There has been a big push towards using innovative digital solutions, and some of the previous barriers to sharing health and care records are dissolving.
But we can’t take these changes for granted. Many places and organisations have really come together during the crisis. But things will slip back to how they were before unless more sustainable structures are put in place. Now is the right time to think about how to ‘lock in’ the positive changes.
There is no single way for public services to come together and support their local people and places through COVID-19. But one thing is certain: only places and organisations that have clarity about their long-term strategic priorities will emerge from the crisis stronger.
A necessary (but not sufficient) first step is for local authorities and their partners to develop a shared vision and strategy for the local area – a ‘people and place strategy’. Only then can they build a clear roadmap for how change will be delivered and create sustainable structures for cooperation that everyone can sign up to.
It’s no longer (and never was) a mere £7.8bn at stake, it’s about building thriving places, resilient communities and ensuring that all people enjoy a healthy, safe and fulfilling life.