How fit were public services for coronavirus?

Failures in planning and funding cuts meant public services were not well prepared to handle the coronavirus crisis.

This report, produced in partnership with the Chartered Institute for Public Finance and Accountancy, sets out an assessment of how prepared and resilient public services, such as the NHS, schools and the police, were for the pandemic.

The report’s ‘fitness ratings’ chart shows important gaps in emergency plans, with the government failing to learn lessons from Exercise Cygnus, the last major exercise to prepare for a pandemic. Public services have also been constrained by a decade of budget pressure in which their scope and quality declined, staff became more stretched, buildings weren’t maintained, and vital equipment went unbought.

While all services benefited from the existence of emergency plans and command structures, these varied greatly in detail, focus and adaptability. The report says serious questions must be answered about whether these services could and should have been better prepared and more resilient.

It found that:

• Government plans were too focused on a flu pandemic, with not enough attention paid to the possibility of other types of pandemic.
• 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 struggled because of poor quality national plans, weak communication between Whitehall and local government, and the large number of care homes.
• Police and prison services had experience of handling emergencies, but underinvestment in buildings and ICT meant the criminal justice system, particularly in criminal courts and prisons, struggled to respond.
• However, planning for a no-deal Brexit in 2019 meant the Department of Health and Social Care had a greater understanding of how supply chains would be disrupted in a pandemic and had improved its stockpiles of some drugs.

The report recommends that:

• The government ought to conduct more regular pandemic planning exercises, with key ministers such as the prime minister and health secretary taking part within six months of taking office.
• Government departments, agencies, local authorities, police forces, NHS bodies and other providers of public services must publish their plans for dealing with emergencies and should report annually on progress implementing the key findings from planning exercises.
• Select committees scrutinise departmental plans for emergencies and hold government to account for resolving shortcomings identified in major exercises.
• The government must analyse the resilience of public services when making spending decisions, including an assessment of the ability of staffing, equipment and buildings to cope with scenarios identified in emergency plans.
• Government departments and agencies should maintain an updated list of trained reserves, recent leavers and volunteers who can be quickly deployed in an emergency.
• Government departments should identify and fill data gaps that prevent it from making real-time assessments of demand and capacity in critical public services.