The ingenuity, flexibility, creativity and dogged determination of council leaders, both political and managerial and their hard-working, compassionate frontline teams has come dramatically to the fore during the COVID-19 pandemic.
Like the NHS, frontline council services kept going; bins were emptied, schools continued to educate our children, businesses were supported through the toughest of times through grant distribution and advice, while children’s social care came under huge pressure with a doubling of safeguarding referrals.
'The last thing social care needs is to become part of a medicalised treatment-based model'
Many times over the years, the suggestion of moving social care into the NHS has been put forward as a solution to resolving the adult social care system. For me this would be a retrograde step. The last thing social care needs is to become part of a medicalised treatment-based model. By its very nature, it is social and needs to be connected to and part of local communities.
Integrated care systems within neighbourhoods are working together alongside social care to wrap support seamlessly around people and their families. This will be where the real change happens, rather than an exercise in deckchair rearranging. It’s the connections and the handoffs locally between social care, mental health, acute and primary care that are wasteful and complex.
Crisis in social care workforce must be owned nationally
The crisis in the social care workforce needs to be owned nationally, with investment into training, skills and career structure for carers making it a job of choice rather than a dead-end option. We also need to pay carers in line with NHS staff, so that the value of the role is judged on the vital role they play in society.
Placing local government at the heart of public policy making and delivery
Despite the essential role that councils play, there isn’t yet a compelling national vison to further deepen the creativity and potential of local government; to place it and local communities at the heart of public policy making and delivery. Policy tends to emerge in Departmental silos, without a whole, connected approach to localities.
Integrated Care Systems (ICSs) are a step in the right direction but do not connect to local economic or social reform programmes in place. A whole cross-departmental place strategy, as opposed to disparate funding pots and initiatives would be helpful.
Unlike the NHS, where there is a clear medium to long term plan from ministers, local government is left to define its own vision. Maybe that is a positive thing; however, an overarching strategic framework would help to provide more clarity for future funding, reinforcing the community leadership role and the need to work in partnership with citizens in localities.
If we had a blank sheet and the ability to reimagine the role of local government, what could we design?
Perhaps this could be the beginnings of a new and exciting vision for local government, emerging from the new Department for Levelling Up, Housing and Communities:
- Councils are passionate about their local communities. They are elected by them, they are accountable to them, they serve them, they need to listen to them even harder to be even more effective.
- Frontline teams across public services, including police, primary and secondary care, DWP, housing, ambulance and mental health, work best together when they wrap their services around people and families. Integrated neighbourhood teams developing a team around the family are the future of public services. We need to empower our frontline teams to innovate to support people to the best of their ability across the silo public service bureaucracies we have created.
- Moving from pure service provider to enabler and community leader, listening harder to citizens and building a shared vision.
- Harnessing the creativity of local partnerships in localities to focus on their health, economic and societal inequaIities is essential.
- Unlocking the power and assets in our local communities is vital.
- A shift of power to local citizens is not a replacement for well-funded and effective public services; it enhances accountability and innovation.
- Developing a funding model, based on a longer-term shared risk between NHS and social care, with a seamless caring pathway for citizens between the two, is vital.
- Investment in digital innovation in local government, citizen buy-in and inclusion will unlock opportunities.
- A new social contract between citizens and the state that serves them where there is shared accountability and responsibility would redefine the role of public services in a place.
- Anchor institutions and local businesses in a place underpin the local economy and can build community wealth. It is the role of councils to develop this approach and to work creatively with local businesses to create employment opportunities and build up the skills base of local people.
It’s not exhaustive, but it’s a start! What would your vision for local government be?
Please join the conversation @Cco.
Professor Donna Hall CBE is non-Executive Director, C.Co