England & Wales Covid-19, Health and social care

Councils not consulted, notified, alerted to guidance – yet again

Janet Sillett, LGIU’s Head of Briefings, writes on the government’s failure to clearly communicate with local government regarding Covid-19 guidance and around vaccines, as well as a lack of local involvement and accountability from central government. 

Déjà vu – the government fails to let councils know about a change of Covid-19 guidance.

The Guardian reports that public health chiefs are demanding urgent answers about why the government failed to announce new advice urging people not to travel into or out of areas with a significant increase in the Indian variant of Covid-19 and to avoid indoor gatherings. It apparently was published a few days on a government website before but local authorities hadn’t received any notification. Jamie Driscoll, the North of Tyne metro mayor, said nobody from central government had told his officials of the travel guidance. Blackburn with Darwen’s director of public health Dominic Harrison said the affected areas “were not consulted with, warned of, notified about, or alerted to this guidance”.

Is anyone in local government surprised this has happened yet again – I expect not.

This follows confusion over the last two weeks over who can get the Covid-19 vaccine, given the rise in infections of the new variant.

LGC reported early last week that more than 6,200 people were vaccinated in Bolton over the previous weekend – which health secretary Matt Hancock welcomed, but he also said that the “very strong focus is to get the vaccine to all those over 50 who have not yet taken the first jab”.

In areas that have seen a quick rise in Indian variant cases, health officials and local authorities have been doing whatever they can to get people vaccinated as quickly as possible – and that has led to some disputes about how the Joint Committee on Vaccination and Immunisation (JCVI) guidelines on vaccine eligibility have been interpreted. Bolton, with high rates of infections, claimed that they do not believe they were bending the JCVI’s rules, as factors prevalent in Bolton such as deprivation, ethnicity and living in a multi-generational household could mean that younger people are eligible. Eligibility guidelines state Covid-19 vaccines can be given to those aged 36 and over and they are also available to those aged 18 and over with any underlying health conditions, or who live, care or work with anyone with underlying health conditions.

The LGC reported on the confusion over eligibility, and the fact local areas had requested more flexibility. Clear messaging from the government would seem to be as important.

It is clear that once again there have been mixed messages from the government and that local authorities, public health teams and combined authorities in places most affected by the new variant believe that there was a lack of flexibility, at least initially, which could have hindered the fight against it spreading.

No wonder some senior public health directors have said to the government that they should be represented on the board of the JCVI – the current JCVI membership consists of four co-opted members and 16 members, two of whom are not based in the UK and none of whom are directors of public health. How could this possibly have been seen to be acceptable?

A senior public health director stressed this to the LGC. “Part of our job is to improve and maximise the uptake of the vaccine, so it would make sense for that work to be heard and to be part of those discussions,” they said. “JCVI needs to think about how they engage directly with those of us who have to implement their policy”. Public health officers have also called for public health directors to have membership of other key government Covid-19 advisory committees.

There have also been stories about problems with data – again. The Guardian claimed that a glitch in the government’s test-and-trace system could have helped fuel the spread of the Indian variant in several towns, particularly in Blackburn with Darwen, when cases went missing during a faulty IT upgrade. One local government source said it had taken at least two weeks for the problem to be resolved and resulted in some areas getting a “huge download” of hundreds of cases earlier this week, by which time the 10-day isolation period had ended for most of those people.

It’s disappointing, to put it mildly, that the sector is still having to argue its case for local involvement and for greater accountability from the centre. Local government has reiterated time and time again that bypassing local health teams and councils or bringing them in late into developments has been a fundamental failing of the management of Covid-19.

According to LGC, public health directors have voiced frustration that the government still lacks a coherent national strategy for managing Covid-19 surges at local authority level – “instead, there have been siloed sets of actions from different departments such as the Department for Business, Energy & Industrial Strategy and the Department for Education, which are disconnected from the NHS’s vaccine rollout and the National Test and Trace service”. There is concern locally about this lack of coordination. Public health directors have pointed out that emergency work is much more joined up at the local level. The announcement today about travel from local hotspots reflects starkly the lack of a strategy – nearly a year after the first local lockdown in Leicester.

We are now, hopefully, coming out of the pandemic crisis – though global developments and new variants could change that situation, but the lessons learnt from the response to Covid-19 (spelt out in a recent NAO report we will be covering) have much wider resonance – about government planning for crises; the relationship between the centre, localities and regions, the lack of coordination at the national level, and the difficulties that incoherent messaging cause. And, that despite all this, local government has continued to be innovative, quick to take action and flexible.

 

Related briefing

Vaccinating the nation: local authorities’ crucial role

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