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Covid-19: Recommendations to improve effective multi-agency response, Part I 

This is the first in a series of ongoing reports that aim to understand the current challenges faced by Local Resilience Forums (LRFs) in the Covid-19 pandemic, with the aim of supporting the ongoing development of good working practice. An introductory report, which includes some background information, an introduction to relevant theory and an overview of

Through ongoing interviews with responders at strategic and tactical response levels, the research summarised in this briefing report addresses interoperability dynamics at both local and national level, and assesses how the evolving situation affects strategies, practices and outcomes over time.

The findings from the interviews are presented alongside relevant theory to generate evidence and theory-based recommendations. Three key findings have been identified so far, and these will be discussed in order, alongside the associated recommendation:

Importance of understanding top-down and bottom-up communication processes
Importance of understanding the purpose of the LRF
Importance of effective communication within organisations

Method

Interviews included in this report (n = 21) were conducted between April 13, 2020 – May 14, 2020. Responders were from England, Wales and Northern Ireland. During this period, response activities included: The management of PPE; mortality planning; planning for any potential relaxations in lockdown; and testing key and critical staff.

On March 23, 2020 the UK Government implemented partial, nationwide lockdown, allowing people to leave the house only for essential travel, such as shopping, travelling to work when absolutely necessary and one form of exercise.

On May 10, 2020, the Government updated the message from: “Stay at home, protect the NHS, save lives,” to: “Stay alert, control the virus, save lives.” The devolved Governments in Scotland, Wales and Northern Ireland chose to keep the original slogan.

On May 13, 2020 lockdown measures were eased in England, allowing people to spend more time outside and meet one person from another household while adhering to social distancing rules.

Importance of understanding top-down and bottom-up communication processes

Results from interviews

A key challenge consistently highlighted by responders centred on communication between national and local level. In particular, responders reported that they received key announcements at the same time as the public, leaving them with limited time to understand any new information. One responder described how: “It feels like the Government are only talking to the press and don’t talk to us in any meaningful format.” Another commented that they felt they were: “Constantly playing catch-up.”

This challenge was also reported in the devolved states of Northern Ireland and Wales where respondents noted: “An additional layer of bureaucracy.” Responders from Wales described a further delay in information being available to local areas, owing to the need to amend legislation to incorporate specific details for this country, and for translation into Welsh. This has been described as leaving responders: “Constantly behind the curve,” in the response.

Although this challenge seemed to be consistent across responders, there were mixed views about why this occurs. Some reflected that they perceived a lack of trust and understanding of the purpose of LRFs from those at national level, resulting in the perception that some information was being withheld to prevent it from being leaked. For example, one responder stated: “I can understand why they do it because of leaks,” but described the difficulty this caused when planning for the bank holiday weekend: “We will increase our staff for the weekend just in case they decide to release lockdown.”

Others suggested that they thought it was likely that those in central roles might also be receiving delayed information, which affects the speed at which they are able to make decisions and share this with LRFs. One responder explained that although frustrating, this is demonstrative of the fast-paced situation: “I don’t think the Government are being purposefully secretive, but from a virus [management] point of view, they are still at a very dynamic stage.” 

Theoretical application

Applying previous research to this problem would suggest that the perceived communication challenges between central government and local areas risks creating a perception of government illegitimacy among local responders, fostering a dynamic of ‘us’ (local responders) versus ‘them’ (central government), whereby the two groups do not appear to identify with each other.

Withholding information from the public in mass emergencies has been shown to be ineffective in promoting effective incident management. Thus, the positive aspects of shared identity (including development of shared norms, co-operative working and increased trust) do not develop. Where legitimacy and identification seem to be reduced, additional challenges in communication and working effectively together emerge, which could result in local areas acting independently of central government. Despite this, it is important that responders at a local level keep two-way communication channels open with central government and continue providing information to it, so as to facilitate the development of shared norms and values, and to build trust between the national and local levels of response.

Recommendation 1:
1
Importance of understanding the purpose of the LRF

Results from interviews

Responders have described a key strength of the response so far as: “How well everyone has come together in such uncertain terms and put a response in place.” Pre-existing relationships with other partners has been described as being beneficial because: “Everyone knows each other and trusts each other,” and: “It allows you to get straight on with the job, rather than establishing who is running the job.”

However, some responders discussed difficulties in the range of partners that are involved in this response: “There are a lot more guest agencies and partners involved in this incident, so had people in meetings that wouldn’t usually sit there,” and these individuals: “Are not familiar with the LRF.” Some problems and delays were described in resolving certain issues as: “They [new partners] were a little reserved to begin with and took a couple of meetings to have confidence to bring problems to the table to ask for help.” Despite this, one responder described how: “This pandemic has reinforced the need for multi-agency working, because we cannot work in silos, we need to ask for support and share information based on the skills we have got between organisations.”

Theoretical application

Research suggests that a shared identity can facilitate a sense of collective agency among group members, promoting co-operative behaviour and increasing the ability of the group to work effectively together to achieve a shared goal. Based on this, when responders have pre-existing relationships with each other (through previous joint working/training, for example), they are more likely to work effectively.

When such pre-existing relationships are not in place, this can act as a barrier to effective joint working. To address this, new partners who do not have a pre-existing relationship with the LRF they are joining should be provided with the information they need to integrate into the group quickly.

Recommendation 2:
2

Importance of effective communication within organisations

Results from interviews

A concern highlighted by some responders revolved around communicating with members of their own organisation in the face of rapidly changing advice. An example of this can be seen in changing advice around personal protective equipment (PPE). One responder described that, initially, a few tensions arose among different members of staff because information emerging about PPE was: “Changing on an almost daily basis and at times that was contradictory.” This was reported to create: “Confidence and reputational issues with staff, as one day they are being told to do one thing and the next day something completely opposite.”

Similar concerns were reported in Wales, whereby there seemed to be a disconnect in the advice provided by Welsh Government regarding PPE and that which was given by organisations at a local level. Interviewees reported concern that this apparent conflicting advice on PPE would create confidence and trust issues with staff members. However, in some areas this tension seems to have eased with: “More information available locally that reinforces the decision-making that was made early on and reinforces the advice they give moving forwards.”

Theoretical application

To maintain organisational resilience, it is important that emergency responders identify with their own organisation. When people identify with their organisation and members of the teams they work with, they are less susceptible to stress and are more resilient, as well as more willing and able to work together to achieve shared goals.

To enhance identification, organisations must communicate effectively with their staff, at both an organisational and local level. Communication must be open and timely, and in changing circumstances, clear reasons should be provided for any decisions, particularly those that affect staff safety and welfare (such as the use of PPE). Inability to communicate effectively about changing circumstances and advice, or failing to respect staff needs, can undermine legitimacy, thereby preventing identification and reducing resilience. 

Recommendation 3:
3
Authors

Louise Davidson, Behavioural Science Team, Emergency Response Department Science & Technology, Health Protection Directorate, Public Health England, UK and School of Psychology, University of Sussex, Brighton, United Kingdom
Holly Carter, Behavioural Science Team, Emergency Response Department Science & Technology, Health Protection Directorate, Public Health England
John Drury, School of Psychology, University of Sussex, Brighton, UK
Richard Amlôt, Behavioural Science Team, Emergency Response Department Science & Technology, Health Protection Directorate, Public Health England, UK
Alexander Haslam, School of Psychology, University of Queensland, St Lucia, Queensland, Australia
Clifford Stott, School of Psychology, University of Keele, Staffordshire, United Kingdom

References

Stott, C, Hutchison, P & Drury, J. (2001): “Hooligans” abroad? Inter-group dynamics, social identity and participation in collective “disorder” at the 1998 world cup finals. British Journal of Social Psychology, 40(3), 359-384. doi: 10.1348/014466601164876
Carter, H, Drury, J, Rubin, G J, Williams, R, & Amlôt, R (2015): Applying crowd psychology to develop recommendations for the management of mass decontamination. Health Security, 13(1), 45 – 53.
Carter, H, & Amlôt, R (2016): Mass casualty decontamination guidance and psychosocial aspects of CBRN incident management: a review and synthesis. PLOS Currents, 8.
Drury, J, Novelli, D, & Stott, C (2013): Psychological disaster myths in the perception and management of mass emergencies. Journal of Applied Social Psychology, 43, 2259-2270.
Drury, J, Cocking, C, & Reicher, S (2009): The nature of collective resilience: survivor reactions to the 2005 London bombings. International Journal of Mass Emergencies and Disasters, 27(1), 66 – 95.
Haslam, S A, Jetten, J, & Waghorn, C (2009): Social identification, stress and citizenship in teams: a five-phase longitudinal study. Stress and Health, 25(1). doi: 10.1002/smi.1221
Haslam, S A, O’Brien, Jetten, J, Vormedal, K, & Penna, S (2005): Taking the strain: social identity, social support, and the experience of stress. British Journal of Social Psychology, 44(3), 355 – 370. doi: 10.1348/014466605x37468 

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