The ‘mass vaccination event’ at Twickenham Stadium on the Spring Bank Holiday was a proud day for the NHS and local government. The North West London NHS and Hounslow Council, supported by the Rugby Football Union, pulled off this remarkable day with less than a week to plan, following a surge in Covid cases in Hounslow.
The communications around the event included the obvious routes of national, local and social media, but also included targeted door knocking in Hounslow. During the day, as it became clear that there were likely to be some vaccines left over, the local NHS took the wise decision to open up the offer to anyone aged 18 and over and this was quickly picked up and reported by the BBC, Sky and other media outlets. The result was a huge spike in demand towards the end of the day. By the close, over 11,000 people had been vaccinated – a record for a single day at one venue in the UK. Those behind this effort are to be hugely congratulated.
There are three lessons I think we can learn from this remarkable event. First, it may be a myth that young people don’t want to get vaccinated. Most of those turning up when the offer was extended were under 30. Media reports talked of a ‘festival atmosphere’ and those who attended have confirmed to me that there was a real ‘buzz’ among the young people coming forward. A number of young people turned up with older family members, having persuaded them belatedly that they should be vaccinated. While time will tell, this does suggest that there may be more enthusiasm among younger people for getting vaccinated than had been previously suggested.
Second, and perhaps more contentiously, the quicker we open up to all age groups, the easier it will be to coordinate the vaccine effort. Had the whole day been open to anyone aged over 18, it is likely the demand would have been even higher throughout the day. While the initial targeting of older and more vulnerable people made sense, it becomes harder to justify as we move down through the age groups – and harder for the NHS to coordinate and promote vaccination. We might also want to think about vaccinating people at their convenience wherever they live – while the event was targeted at Hounslow residents and others in the NHS ‘North West London’ sector, I know people from Richmond were not turned away.
Finally, what we can learn is that if everyone pulls together and works as one team, remarkable things can be achieved, even in short space of time. This is a lesson that extends beyond Covid-19 and the vaccination programme – and bodes well for ‘integrated care systems’, in which the NHS and local authorities are expected to work in statutory partnerships in the years ahead.
Cllr Ketan Sheth is Chair of Brent Council‘s Community and Wellbeing Scrutiny Committeeand Chair of NW London Joint Health Overview & Scrutiny Committee
Local government is digging deep into its financial reserves and hiking council tax bills by double inflation, but still anticipates making further service cuts in 2021–22. The Public Accounts Committee report earlier this month shows how central government support hasn’t matched Covid-related budget reductions. More positively, at the same time, councils and partners are eyeing the improvements made to commissioning and procurement during the pandemic and asking whether these could help balance the budget. Can adding value to local government’s annual procurement spend of £100bn help improve outcomes for citizens, sustain local councils, and build a better recovery?
As NESTA’s recent report, A Catalyst for Change, evidenced, councils’ collaboration with other public sector bodies, citizens and the voluntary and private sectors was at the centre of the response to COVID-19. Local authorities ‘stepped into their role as conveners, leveraged their existing relationships and partnerships, and forged new ones to dynamically address key issues. This allowed organisations to link up volunteers with vulnerable people, support businesses, deliver food parcels or find temporary accommodation for rough sleepers’.
I’ve heard from some of the council managers on INLOGOV’s teaching programmes of the amazing agility and flexibility councils have been able to develop with partners in areas such as social care and housing. Commissioning and procurement processes that in the past were seen as inflexible, slow, risk-averse, price-obsessed and lacking innovation were transformed rapidly in response to the immediate threats of the pandemic. Data was shared in more depth and quickly, enabling better targeting of services. More flexible financial and performance management arrangements opened the door to flexible service delivery.
Now, a major research programme led by Dr. Richard Simmons at Stirling University, called Optimising Outcomes, is looking at the impact of Covid on partnering and procurement. The programme is working with key sector bodies such as CIPFA and SOLACE as well as universities and research councils, to answer key questions such as:
How, and how effectively, are local authorities deploying their commissioning and procurement functions to address the challenges posed by Covid-19? What are the successes to be celebrated? Where are the tensions that need to be managed? Where is the system at risk of breaking down?
What are the opportunities for improved procurement performance? How do local authorities optimise every aspect of procurement spend?
Can local authorities adopt more innovative, strategic, entrepreneurial and relational approaches to strengthen local resilience and avoid a weak and incapacitated system?
What role can greater data-analytic capacity play in supporting a more agile and effective response?
As part of this research, council managers have been invited to take part in a survey to capture learning from the many challenges and achievements of the sector during the last year. The survey is aimed at all UK council managers (there is a separate survey for procurement teams) and takes around 10 minutes to complete. The closing date for responses is 21st June.
If you are a UK council manager and haven’t yet taken part, please would you complete the survey here.
This is a great opportunity to ‘build back better’ by applying the lessons and innovations councils and partners have developed over the last 18 months. I’ll report back on the results later this year.
Jason Lowther is Director of the Institute for Local Government Studies (INLOGOV)
In a recent blog entitled ‘Elections in a pandemic’ Jason Lowther concluded, along with the great bulk of surveyed council Returning Officers and Chief Executives, that ‘Super Thursday’ on May 6th may not be a great idea. Over 5,000 representatives in 4,300-plus separate ballots, including councillors in 150 English councils and the London Assembly, 13 mayors, 40 Police and Crime Commissioners, plus the Scottish Parliament and Welsh Senedd, town and parish councils, and the odd local referendum – to complete what might well be our “most complex elections ever”.
On balance, and notwithstanding that well over 100 countries have managed to hold significant public votes over the past 13 months, Jason’s conclusion was that, while:
“as always, local government will rise to the challenge if the decision is to go ahead in May, … the Westminster government … might be wise to start contemplating a Plan B.”
I happen to agree, although I can’t pretend to share the “incredulity” of those council chief executives Jason had consulted “that the Government seems unwilling to seriously consider delaying until October”. Indeed, it serves as the starting point for this blog.
Postponement of ‘Super Thursday’ – including now probably the Hartlepool parliamentary by-election – would still be perfectly feasible. It would reassure at least some potential voters, and almost certainly increase turnout – as evidenced in a recent online survey by Hope Not Hate, the anti-racism charity, and the National Education Union, as part of their #MAKEVOTINGEASIER drive. Over a quarter of respondents felt the Covid-19 situation would make them less likely to go to the polling station to vote, rising to around 40% of ethnic minorities and the largely unvaccinated under-25s.
Ah, but, Government Ministers and the Electoral Commission probably responded, you didn’t describe polling stations’ additional safety measures, and how easily – if you remember and have a working printer handy – you can apply for a postal or proxy vote by April 20th or 27th respectively.
But detailed dates aren’t the real issue. Last year’s postponement came on March 13th, this year’s current deadline is March 29th, and even could be stretched. But it won’t be, because those Ministers have nil incentive to jeopardise any political ‘vaccine bounce’, or #MAKEVOTINGEASIER for more young and ethnic minority voters to turn out and support mainly other parties.
Even that vanishingly small chance, though, is a big difference from Sunday’s Census, which passed its optimal postponement date sometime last summer – when Covid’s potential impacts were already apparent, leading the canny Scots and Irish to postpone their scheduled Censuses until March and April 2022 respectively.
The Chief Executive of the Scottish Public Record Office, National Records of Scotland, described it as “the right decision”, as it has surely proved. Scottish academics, or at least some, disagreed – one labelling it “an act of scientific vandalism”, while “the country’s leading historian” (name in URL), almost incredibly, could “not understand how the incidence of coronavirus in a year’s time would affect the collection of census data in Scotland” – which even then made you wonder what he thought the purpose of the Census actually is.
Speaking as a definitely non-leading academic, and nowadays merely tax-paying UK citizen, I can honestly claim to have applauded the Scots’ July decision at the time, and, as circumstantial witnesses, would call on the undergrad students to whom I once taught ‘Research and Measurement in Public Policy’. I offered to bet the class of 2000/01 that that April’s Census would be the last traditional count-everybody-on-a-random-Sunday Census of its type, and that by 2011 we would have followed the increasing number of at least European countries who even then were switching to alternative, more efficient, flexible, and significantly cheaper methodologies.
I would have lost hands-down, of course, but I’m not completely stoopid, and knew that by then they would have long left Birmingham, forgotten the bet, or both. Rather more importantly, though, the Scots’ decision and the questionable value of significant chunks of Sunday’s data should finally end the mythology of our 200-year old decennial event being uniquely capable of providing policymakers with the comprehensive statistical data they will require over the next decade.
Yes, mythology, in several ways. First, there is no ‘UK Census’ and never has been. Nothing to do with devolution. Right back to the first official census in 1801 – of England and Wales – it has always been censusES, with Scotland then Ireland in 1821 doing their own thing. Usually that has meant the four countries using the same arbitrary Sunday, asking similar but not identical questions, and separately processing and publishing their results.
Genuine UK-wide statistical comparability – “harmonisation of outputs” is the favoured euphemism – is a real struggle. Even the Office for National Statistics rated only half the last Census’s roughly 50 questions as ‘highly comparable’ across the whole UK. A quarter were ‘broadly comparable’, the rest ‘country specific’.
Sunday’s exercise, therefore, will be a sophisticated snapshot of Scotland-less pandemic Britain at the most exceptional, unrepresentative point in most of our lives. And costing close to £1 billion – much of it going to the Zurich-based Adecco company, for expensively recruiting and training 30,000 inexperienced ‘field staff’ for door-to-door ‘completion-checking’ – a further Covid-model scandal in itself.
The Scots’ foresightful postponement obviously scuppers any genuine UK-wide comparability. It should, however, enable them to reconsider and potentially rephrase key questions and reduce obvious pitfalls: over-counting those working from home; under-counting street homelessness, the unemployed – by excluding the ‘furloughed’ – and the vulnerably housed; miscounting travel-to-work patterns, migrant workers, early availability for work, and our own university students.
Then there are potentially hugely important new questions – on vaccination perhaps, place of work, mode of travel-to-work, travel days per week. Plus the opportunity to get some existing ones aired and re-clarified – why Britain’s Jews and Sikhs aren’t treated as separate ethnic groups, for example, and the really rather basic difference between a person’s sex and their gender identity.
We know this Government doesn’t like gender self-identification, but that hardly justifies muddying its Census guidance. It was only finally sorted last week, thanks to the crowd-funded campaign group, Fair Play for Women, and a High Court judge – after an estimated 3 million of us had, albeit prematurely, completed our forms.
To clarify: ‘sex’ is one’s legal sex, as registered on birth or gender recognition certificate – but not necessarily one’s passport, which, like a driving licence, is alterable without a formal legal process, and so, contrary to the original Census guidance, NOT technically a legal document. Gender identity is an entirely separate, voluntary question for over-16 respondents. You’d think someone official over the preparatory decade might have clocked that – wouldn’t you?
All of which shambles surely means we may finally join – possibly as early as 2026 with an emergency, catch-up census – at least most other European countries in using census methodologies more appropriate to the 21st Century than the early 19th – more frequent perhaps, thus more continuously reflective of change, and significantly cheaper.
It is 50 years now since Denmark held its last ‘traditional’ census and started modelling the switch towards register-based – and in some countries five-yearly – censuses, with information on population, households and dwellings being continuously compiled in various registers, files and databases.
The UN Economic Commission for Europe, in announcing that some 15 countries have so far postponed planned censuses to some degree – just contemplate all that “scientific vandalism”! – suggests that approaching 60% of the 2020-22 round of European censuses will be at least partly register-based, leaving the UK, Ireland and mainly small and/or Eastern European countries with their ‘traditional, direct collection’ methods – plus France, forever proud in its exceptionalism, with its ‘rolling census’.
However, some Stop Press news from the Office for National Statistics: “We are investigating the feasibility of moving to a census based on administrative data after 2021.” Fingers crossed that they don’t rush things.
Chris Game is an INLOGOV Associate, and Visiting Professor at Kwansei Gakuin University, Osaka, Japan. He is joint-author (with Professor David Wilson) of the successive editions of Local Government in the United Kingdom, and a regular columnist for The Birmingham Post.
There are many lessons to be drawn from the UK government experience of responding to COVID-19 in 2020 (see Joyce 2021). But some of the most important concern the problems created by a weak surveillance system and a passive response at the start of the year and by the centralised and command-and-control approach to decision making that denied the national government the full benefits of cooperation in a multi-level system of governance.
Weak Surveillance and Passive Response Early On
The UK Government was expecting a flu pandemic: in 2019 a National Security Risk Assessment document went to the UK Cabinet that stated that a flu pandemic was the top civil risk. Its experts seemed to be suggesting that the threat posed by COVID-19 might be thought about as a threat somewhat akin to a flu pandemic: in February 2020, with the COVID-19 virus spreading outside China, a committee that formed part of the UK Government’s structure of expert advice, produced a paper in which it judged that the reasonable worst case for pandemic influenza “would be an appropriate scenario at that point” (SPI-M-O 2020). This expert judgment was based on the evidence available at the time, but the evidence was limited: the UK Government was slow to increase its testing and tracing capability and even in April, after the lockdown had begun, its testing capacity was still quite modest (see Chart).
Chart: Extent of testing for Covid-19
Chart Note: The data was obtained from Our World in Data. Available at: http://www.OurWorldInData.org [3 June 2020]. There are important national differences in the production of the data (e.g., whether tests from all labs are counted, the inclusion of pending tests).
The UK government did eventually expand its capacity to carry out testing but in the early months, when its response emphasis was on surveillance, it was handicapped by a lack of data.
Generally speaking, the initial UK Government response was quite passive by comparison with many other countries, which had often responded quickly with measures to address the threat of the virus entering the country. The UK was different. By the end of May 2020, the UK government still had no measures in place to deal with the threat posed by international travel.
We might call the initial strategy of the UK Government a “spectator” strategy, because it mainly relied on treatment rather than prevention, counting on the NHS hospitals to treat those who became seriously ill; aggressive containment was definitely not part of the initial thinking. The advice coming from the World Health Organization (WHO) in early March 2020 was quite at odds with the UK’s spectator strategy. The WHO’s Director General strongly advocated an aggressive containment response: “So activate your emergency plans through that whole government approach, […] If countries act aggressively to find, isolate, and treat cases, and to trace every contact, they can change the trajectory of this epidemic. If we take the approach that there is nothing we can do, that will quickly become a self-fulfilling prophesy. It’s in our hands.”
Centralised and command-and-control decision making
One question that came up repeatedly concerned whether exactly the same measures should be applied to all four countries of the UK in identical ways and at the same time. It appears that on the whole there was a high degree of commonality in the design and application of measures – but with some differences in detail and timing. The Prime Minister’s briefings to the public on his aspirations and proposals for future measures had sometimes seemed to refer to the whole of the UK when, in fact, his remarks were just applicable to England. The Scottish First Minister, speaking at a televised daily briefing to the people of Scotland, said: “I will, as I have done before, ask the Prime Minister when he’s talking about lockdown and lifting restrictions to make clear that he is talking about England alone”.
In the early months of 2020 London was the place where infections and deaths rapidly increased and the hospitals were put under immense pressure by the pandemic. This is not surprising given London’s importance as a centre of commerce and tourism in the UK. The mayor of London was responsible for public transport in London, amongst other things, and clearly might have been expected to want to engage with the national decision-making process about responding to Covid-19. There was a newspaper report about the 2 March 2020 COBR meeting and the non-inclusion of the mayor of London in that meeting. The report said he had not been invited and quoted someone speaking on behalf of the Prime Minister: “The prime minister’s spokesman said Mr Khan was not invited because the meeting was meant to deliver a “a national response”, while London – and other areas – were involved through local level resilience forums.”
The UK Government decisions about how to end the first lockdown were also a focus of some friction in the UK’s governance system. In particular, some prominent council leaders in local government in the North of England were unhappy about the proposals to reopen schools on 1 June 2020. The concern for them was that they judged that the pandemic had not been adequately contained and controlled and the Prime Minister was bringing forward proposals that were too risky. For one local government leader, the Mayor of Greater Manchester, the source of the problem about too much risk in how the lockdown was to be ended was the advice being given to the Prime Minister by his special adviser, Dominic Cummings. He said: “Far from a planned, safety-led approach, this looked like another exercise in Cummings chaos theory.”
The problem in multi-level governance was not just one of friction. Sinclair and Read, writing in April 2020, pointed to the failure of the UK Government to take advantage of capacity existing at local government level:
“The government has been accused of missing an opportunity after it failed to deploy 5,000 contact tracing experts employed by councils to help limit the spread of coronavirus. … PHE’s [Public Health England] contact tracing response team was boosted to just under 300 staff, deemed adequate for the containment phase of handling the Covid-19 virus up to mid-March… tracing was scaled back when the UK moved to the delay phase of tackling coronavirus in mid-March… in Germany, thousands of contact tracers are still working – with more being recruited.”
The big challenge facing the UK Government is to evaluate its experiences of COVID-19 in 2020 and to learn lessons about how future pandemics may be prepared for and handled better than this time.
Paul Joyce is an Associate at INLOGOV, University of Birmingham. He is also a Visiting Professor in Public Management at Leeds Beckett University. He has a PhD from London School of Economics and Political Science and is currently writing a book on the execution of strategy in the public sector.
His recent books include Strategic Management for Public Governance in Europe (Palgrave Macmillan, 2018, with Anne Drumaux); Strategic Leadership in the Public Sector (Routledge, 2017, 2nd edition); and Strategic Management in the Public Sector (Routledge, 2015).
In 2019 he became the Publications Director of the International Institute of Administrative Sciences, IIAS, headquartered in Brussels, Belgium.)