C19 National Foresight Group Exclusive: What did we learn?

At the start of the pandemic in early 2020, a small number of senior civil servants and gold commanders saw the need to set up a dedicated group to consider the wide-ranging impacts of Covid-19 across society, and so the C19 National Foresight Group was established.

This was a cross-government and multi-agency group set up to consider the longer-term impacts of Covid-19 so that it was informed by evidence and rooted in practical strategy. Although now decommissioned, the group’s outputs and products are highly relevant to the fire and rescue services in the UK.

The work undertaken by the group includes a series of roundtable discussions with practitioners involved in the Covid-19 response, three rapid Interim Operational Reviews conducted in March, June and September 2020 with representation from across the resilience and emergency management community and a series of standalone products.

Here we highlight the elements of our work that are of most interest to fire and rescue services.

Central Role of Fire and Rescue Services

The public narrative of the contribution of the fire and rescue services has mostly focussed on their investment in maintaining and reinforcing the UK’s critical civil protection infrastructure, while maintaining their ability to respond to fires and other emergencies. In other words, encapsulated by the NFCC’s ‘Ready, Willing and Able’ campaign, their invaluable contribution to providing mutual aid to their partner agencies such as ambulance trusts, the wider health and social care sector and local authorities.

This frontline support came in many forms, dependent on local needs, from firefighters driving ambulances, ambulance driving instruction, delivering essential food and prescriptions to vulnerable people, delivering PPE, face-fitting PPE masks for frontline NHS workers, through to the movement of bodies and the staffing of temporary mortuaries.

More recently, fire and rescue services have adapted and deployed their wide range of skills and capabilities in response to new and emerging challenges ranging from hosting and setting up new vaccination hubs, to supporting people receiving the vaccine, and, in some areas, fire and rescue services’ staff trained to administer the vaccine itself.

Always looking for ways to innovate, there are many examples of the fire and rescue services improving the safety of their communities. For example, in Bedfordshire the fire and rescue service set up a safe and well clinic in the waiting area at each of the community vaccination hubs, meaning each of the vulnerable people receiving a vaccine are engaged by community safety staff, many of whom are typically hard to reach groups.

This closer working has oiled the wheels of collaboration with many partners seeing the value of working more closely with the fire and rescue service. In Bedfordshire, the fire and rescue service now provide the complex bariatric patient rescue capability for the East of England Ambulance Service, the first fire and rescue service to do so in the UK.

The work of the C19 National Foresight Group picked this up through the reviews, and the expertise in community relationship building held by the fire and rescue service was highlighted in our intelligence briefings. There are few other public services that have invested so much in their place-based community relationships, a strength fire and rescue services rarely promotes.

Through the work of the group, we also picked up the relatively unspoken contribution to the critical infrastructure of the UK by members of fire and rescue services across the UK. Members of the fire community have been working hard in roles aligned to the local emergency management structures, the Local Resilience Forums. These are where the local strategic decision-making, planning and policy delivery are considered and implemented in line with the needs of the local communities.

The Local Resilience Forum structures for managing a major incident include the Strategic Coordination Groups, the Tactical Coordination Groups, the Multi Agency Information Cells, Command Support Cells and the Recovery Groups which are all hard at work behind the scenes managing and coordinating the local response to the pandemic. Fire and rescue services, in all geographical areas, continue to make a significant contribution to the membership and leadership of these groups in line with their statutory responsibility.

We have produced many reports and briefings as part of our work. Here we focus on four areas we think are of particular interest to the fire and rescue services.

The Common Intelligence Picture

We found across all our work that in the Covid-19 context there is a lack of data, information, intelligence and strategy to inform the decision-makers at all levels. This is not restricted to health, considering that Covid-19 has touched everything everywhere, the lack of data available to inform decision-making has been a challenge.

While government has been keen to request data, it has not been able to provide integrated data back to local teams in order to enact and deliver the local response and recovery plans. The Multi Agency Information Cells have been doing a great job at providing the local context, but national aggregation of this data to support an improved Common Operating Picture has not been actioned.

This would significantly improve understanding of not only the health-related data across the UK, but the impacts of the pandemic across the UK on economics, social relationships, wellbeing and public service degradation.

Supporting Our People

Unsurprisingly, we have found throughout all our work over the past ten months that emergency responders and the public are all being impacted. Their mental health and wellbeing have been affected in many different ways.

The public are trying to navigate variable incomes and freedoms of their liberty and plans as well as social isolation. Emergency responders are exhausted, approaching burnout and the relentlessness of Covid-19 is having a significant impact on their mental health as well as their families.

The nature of the demands placed upon emergency responders and keyworkers will not be addressed through support mechanisms such as TRiM (a trauma risk management system) or Critical Incident Debriefing, but instead need significant investment now in a comprehensive support mechanism that will be required over the next decade.

Adapting Our Structures and Systems

The emergency management structures have adapted to become long-term structures. In a typical emergency they operate for three to ten days, which has created friction and innovation. New structures set up to connect or ‘dock’ with these, such as the Health Protection Boards, Local Outbreak Engagement Boards, the Joint Biosecurity Centre and the health gold structures have not always integrated well into the existing emergency management systems, so decision and communication flows have been significantly disrupted.

Connecting National and Local Decision-making

The local strategic decision-makers found it very difficult to maintain consistent connection with the activity going on at national level across government. This is partly because of the docking challenge outlined above, but also because the communication flows do not deliver information when the local needs to hear it (preferably before the public announcement so that planning can be completed).

The announcement-led approach to communicating to all outside of government at once means local strategic leads do not have the ability to plan before policies need to be implemented.

What Does This Mean?

The net effect of these challenges means that the local strategic leadership is not only challenged by significant funding and resource issues, but also by a power drain to government who have taken decision-making power.

The responsibility for coordination (which should be their role in accordance with the Civil Contingencies Act 2004 in the description of subsidiarity) has also been restricted. The power of managing the pandemic truly lies with the public adhering to guidance. Taking these into consideration, the strategic local leadership is left with the legal responsibility of statutory obligations but fewer levers to enact change, which erodes trust and limits the power of a whole society approach to tackling large scale challenges.

Reflections

Our mandate ran for ten months and in that time, we have published 50 products in order to share learning and inform decision-making. There is value in seeking alternative perspectives and sharing our challenges. Connections, support and solutions were central to our mission to save lives, relieve suffering and protect communities and we hope models such as this are activated in future long-term emergencies. The work of colleagues continues through different avenues.

The challenge for the sector will be evidencing the impact of supporting the response to the pandemic. For example, in London alone, firefighters driving ambulances responded to over 100,000 incidents between April 2020 and January 2021 but what has been the actual impact of this support?

There is a clear opportunity for the Fire and Rescue Service to use the experience of the pandemic to strengthen its civil protection role, but it will be vital to demonstrate the ‘so what?’ impact of both the frontline response and also the crucial, if less visible, command, control and coordination roles within the environment of the Local Resilience Forum.

Nottingham Trent University, the Home Office, Bedfordshire Fire and Rescue Service and East of England Ambulance Service (EEAST) are currently working together to assess the return-on-investment analysis of five key aspects of Bedfordshire’s collaboration with EEAST: ambulance secondees, co-responding, falls team, complex bariatric patient rescue and effecting entry.

The work of responding, adapting and recovering from Covid-19 continues and we wish to thank fire and rescue services across the country for your ongoing effort.