Spending Review ‘must prioritise resilience’ after report finds public services were not fit for Covid crisis

Analysis by IfG and CIPFA also calls on government to plan for more outbreaks
Photo: Alberto Pezzali/NurPhoto/PA Images

By Richard Johnstone

03 Aug 2020

The government has been urged to use the forthcoming Spending Review to boost the resilience of public services after a review found planning failures and funding cuts meant they were not well prepared for the coronavirus pandemic.

The review by the Institute for Government and the Chartered Institute for Public Finance and Accountancy concluded that government had failed to learn lessons from Exercise Cygnus, the last major exercise to prepare for a pandemic.

In addition, public services have also been constrained by a decade of budget pressure during which their scope and quality declined, staff were stretched, and vital equipment went unbought.

And while there were emergency plans and command structures in place across public services, the report concluded there was “varied greatly in detail, focus and adaptability”.

There are serious questions about whether these services could and should have been better prepared, IfG programme director Nick Davies said.

“Front line staff have performed remarkably during the crisis, in extraordinarily difficult circumstances. But public services have faltered due to decisions made over the past decade.

“Greater investment in staff, buildings and equipment would have left services far better placed to respond to coronavirus. The government must learn from these mistakes, reflect on where public services are least resilient, and ensure that key services are better prepared for either a second wave of coronavirus or any future pandemic.”

Among the report's conclusions is that planning had been too focused on a flu outbreak, with not enough attention paid to the possibility of other types of pandemic. Indeed, two of the groups that feed into the Scientific Advisory Group for Emergencies advice to ministers on coronavirus still have influenza in their title: scientific pandemic influenza group on modelling and scientific pandemic influenza group on behaviours.

The report said the government must analyse the resilience of public services when making spending decisions in the forthcoming Spending Review, including an assessment of whether staff, equipment and buildings can cope with scenarios identified in emergency plans.

More planning proposed

There should also be more regular pandemic planning exercises, with key ministers such as the prime minister and health secretary taking part within six months of taking office, the report said. All public bodies, including government departments, should publish their plans for dealing with emergencies and report annually on progress implementing the findings from planning exercises.

Departments and agencies should also maintain an updated list of trained reserves, recent leavers and volunteers who can be quickly deployed in an emergency, and identify and fill any gaps in data that prevent them from making real-time assessments of demand and capacity in critical public services.

Elsewhere, the report found good planning ensured that hospitals could respond well to the first wave, but high staff vacancies and a maintenance backlog will make it far harder to restart routine services. Adult social care services meanwhile struggled because of poor quality national plans, weak communication between Whitehall and local government, and the large number of care homes.

Care homes, where the Office for National Statistics estimated last month there have been around 19,394 deaths involving Covid-19, did not have enough spare capacity to enable social distancing.

“The average care home in the UK is relatively small, and interviewees told us that many care homes were not designed for isolation – few had en-suite rooms, and many had shared rooms,” the report said.

“The head of the National Care Forum told parliament that many care homes built two or three decades ago were set up for shared space, and it was not possible to isolate patients without sacrificing the number of beds available. With care home occupancy rates ranging from 86% to 90% in mid-April to mid-May, this was difficult to do.”

CIPFA chief executive Rob Whiteman said the adult social care sector faced particular strain in the pandemic.

“A decade of austerity has resulted in over-stretched and under-resourced public services that were already facing rising demand before the pandemic struck. Covid-19 supercharged these pressures,” he said.

“In addition to meeting the additional costs resulting from the pandemic and enhancing emergency planning procedures, the government must utilise the current momentum as a catalyst for adult social care reform.”

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