Chris Ham: Engaging people and communities will help avoid a resurgence of covid-19

The decision to lockdown Leicester because of a resurgence of covid-19 in the community marks a significant moment in the evolution of the pandemic in England. It demonstrates a shift from national to local outbreaks and highlights the role that local authorities and public health directors are taking on. It also underlines the need for local leaders to have access to real time data on what is happening in their areas to be able to act quickly to contain these outbreaks.

As in the first wave of covid-19, controlling the impact of the pandemic depends on the actions of every citizen. Measures like hand washing, wearing face masks, and physical distancing have contributed hugely to the progress made to date and remain important. Individual actions must be joined with the engagement of communities in the next phase.

The further easing of the lockdown in England on 4 July gives added urgency to community engagement. Done well, community engagement will help avoid a resurgence of covid-19 by reinforcing support for measures known to have a positive impact on the spread of the virus. It will also limit the time people are required to restrict their movements during local lockdowns.

Local authorities across England are well placed to lead work on community engagement. Councillors possess extensive knowledge of their communities through their contact with constituents and with voluntary and community sector organisations, faith groups, businesses, and other parts of civil society. These networks have a vital part to play in keeping the incidence of covid-19 down.

The benefits of full engagement in public services pre covid-19 are demonstrated by the work of Wigan Council. Under the leadership of Lord Peter Smith, the council improved outcomes for its population at a time of deep cuts in its spending. It did so by listening to citizens, understanding their concerns, and finding more effective way of meeting their needs than those previously on offer. 

The Wigan Deal set out what the council would do and what it asked of its citizens in return. The deal focused on the assets available in the community and made a commitment to increase spending on voluntary and community sector organisations at a time when services provided by the council were being cut. Council staff were trained to have ‘different conversations’ with citizens with the help of an anthropologist.

The lesson from Wigan is that public services can be transformed when leaders embrace new ways of working. This requires a willingness to think and act differently and to focus on recognising people’s capabilities and how they can be strengthened. Particularly important in Wigan was a willingness by the council to take risks and give up power in the belief that improved services and responses to need would result.

The challenges presented by covid-19 require an equally bold approach across England. Communities have already demonstrated their willingness to contribute in the many examples of altruism and support that have helped people who have shielded and strengthened ties between households and neighbours. So what needs to happen next?

Wigan and other areas that have embraced the “community paradigm” described by the New Local Government Network have adopted a collaborative and participative way of working. This has centred on seeing people as active agents in delivering change and mobilising many resources to improve services and outcomes. Instead of old-style consultation with the public, innovative local authorities focus on listening to citizens, understanding their needs, and working with them to redesign services.

The implication is that a combination of old power and new power, to borrow from Henry Timms and Jeremy Heimans perceptive book, offers the best hope of success. Councils and public health directors must use their own resources while also channelling the commitment of people and communities to contain the impact of covid-19. The “fully engaged” scenario set out by Derek Wanless in his report on the NHS in 2002 foreshadowed this way of working, recognising the need for everyone to play a part in improving health.

Fully engaging people and communities is a way of recognising our shared responsibility to work together as the lockdown is eased to protect the public’s health. Shared responsibility means acknowledging that the choices made by each citizen are important as well as the actions of government. It rests on the understanding that with covid-19 “nobody is safe until everybody is safe” and that we have a mutual obligation to play our part in acting responsibly.

In a society uncomfortable with authoritarian measures of the kind used in China to control covid-19, it would be an admission of failure if government—national or local—had to resort to legal enforcement to control future outbreaks. It would also be folly to rely solely on each citizen to follow guidance on measures known to be effective. A blended approach is needed in which civic leadership and community followership go hand in hand to foster consent for the actions needed as we learn to live with covid-19.

Chris Ham is non-executive chair of the Coventry and Warwickshire STP and non-executive director of Royal Free Hospitals. He was chief executive of the King’s Fund from 2010 until 2018.

Competing interests: None declared