New operating models and COVID-19: A catalyst for change? (Part III: Inequality)

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New operating models and COVID-19: A catalyst for change? (Part III: Inequality)

COVID-19 has highlighted, and in many cases exacerbated existing inequalities across the country. In a recent report, Public Health Leeds highlight: ‘whilst much of the early commentary gave the impression that COVID-19 had no boundaries and was indiscriminate in who it affected, it has become increasingly clear that the impacts of the disease fall disproportionately on certain parts of society – Reducing this impact is a priority in Leeds’s planning and implementation as we enter the next phase’. We asked the City of York Council, Kirklees Council, Leeds City Council, London Borough of Newham, Oldham Council and Staffordshire County Council about the rising levels of inequality in the context of COVID-19 and their work addressing this pressing issue.

Which groups have been affected more than others?

Emerging evidence suggests that COVID-19 is disproportionately affecting people from BAME backgrounds. Early analysis also points to an overrepresentation of BAME health and care professionals among coronavirus fatalities. Some councils have been more badly affected than others, with London Borough of Newham experiencing the highest rate of COVID-19 deaths (per 100,000 population) in England & Wales. This reflects the fact that the borough is one of the most deprived in the country, with deep social, economic and health inequalities. The borough is also one of the most diverse with 73% of its population coming from BAME communities. COVID-19 clearly highlights the existing effect of deprivation on health outcomes and people’s lives. On 2nd June, Public Health England published a national inquiry into the “Disparities in the risk and outcomes of COVID-19.” The report confirms that “the impact of COVID-19 has replicated existing health inequalities and, in some cases, has increased them” and the risk of dying is "higher in those living in the more deprived areas [...] and BAME groups.” Locally, councils are also working to understand, monitor and mitigate the disproportionate impact the crisis is having on different communities.

Newham Council is working with health partners, including Barts NHS Trust, Newham CCG and the police to understand health inequalities in the borough and to inform the necessary action required. They have undertaken a localised ‘deep dive’ into community impacts of COVID-19 and have called on the government to provide a COVID-19 Deprivation Premium so that funding reflects needs and the disproportionate impact that the virus is having in deprived communities.

Similarly, in Leeds, the council has been working on a review of COVID-19 related inequalities, as they see this as their key priority. This will directly inform their current response, their recovery planning and implementation as well as their plans for future work as they move through the next phase of the crisis.

However, the crisis isn’t only impacting people’s health disproportionately. It is becoming increasingly clear that the economic impacts of the crisis will be most acutely felt by those with the fewest resources, people in low paid or insecure jobs or people with chronic illnesses. Councils are therefore trying to identify those in high risk groups and ensure that these pre-existing inequalities aren’t further exacerbated by the crisis to the point that they might have to access specialised services.

This reflects the experience in Oldham Council who point out that issues that existed before COVID-19, such as economic need and poverty, are now being exacerbated. “These systemic issues are coming out more strongly and for people struggling financially, they might end up hitting every service and ending up in crisis. We need to focus on the people who aren’t hitting high need just yet, but could escalate into social care if they don’t get the support they need.”

Who is falling through the cracks?

Local authorities have been working relentlessly to identify people at risk and in need of support since the beginning of the crisis. They are also aware that not everyone is able or comfortable with accessing council support and are working to identify groups of people adversely affected by the crisis who were not as visible at the beginning or who weren’t accessing support despite needing it.

In Kirklees, the council is identifying vulnerable groups by analysing who is calling the council support line, but also who isn’t. In Leeds, there are concerns for people who are not connected into organisations, such as “asylum seekers and refugees, some homeless people and those who are destitute, but also people who have disengaged from services. Work is ongoing to further engage with these groups and to ensure their particular issues and concerns are tackled”. In Newham, there has been a particular focus on residents with ‘No Recourse to Public Funds’ - a classification imposed on people due to their immigration status.

York City Council has been addressing economic inequality and inclusion by sharing existing resources in more cost effective and creative ways through their Opportunity Fund pilot. The council can directly buy necessary goods and cash can be loaded on cards for those applying for assistance. This person centered approach offers choice and control to the applicant and is often more cost effective. They are now working towards proactively contacting those who have been assessed as ineligible for financial assistance as well as exploring local, community support options.

Acknowledging and tackling inequality without creating dependency

As councils are thinking about ways to continue to support communities and address rising inequality, they are aware that nurturing a “culture of dependency” is not sustainable for communities or councils, particularly in light of future financial pressures, and does not tackle the root causes of inequality.

The first months of the crisis have shown unprecedented levels of volunteer and community mobilisation all over the country. A recent NLGN report highlighted that 95% of council chiefs believe that community volunteering has contributed significantly to their council’s efforts in responding to the crisis. To address the cycle of dependency on council-provided services, local authorities are working with community groups, civil society organisations and anchor institutions to either keep or transition some of the support into the community.

This is the case in Staffordshire, where the council, although aware that at some point they will have to stand down some of the services provided during the crisis, is working to make sure this doesn’t undermine the good work of community organisations, volunteers and partners who continue to provide vital support for communities.

In York, the council is thinking about the ways they can transition support in the community and shift focus away from ‘vulnerability’ to highlight the valuable resources already present in their communities. “We need to think of people as being valuable and contributors to society, not vulnerable. The language of ‘vulnerability’ runs the risk of creating a culture of dependency, which is not sustainable in the long term. It isn’t about ending support, but rather transitioning out of it and recognising the good, for example community led care. Some of the ways we’ve offered support, such as through food banks will evolve, through using schemes such as Fareshare and community networked food banks, rather than end.”

A similar picture has emerged in Newham, where 25% of London's food surplus (over 100 tonnes) from the London Food Alliance, has gone directly to local food distribution organisations free of charge since the beginning of the pandemic.

Kirklees Council has been talking with mutual aid organisations and anchors about continuing the support they have been providing within the community into the future. Having supported these community-led responses from the beginning is providing them with the opportunity to rely on these networks for longer term support. They are also aware that a second wave of infection could mean the support might have to be delegated back to the council rapidly if needed.

Economic recovery

Concerns around economic recovery planning are also surfacing, which is closely tied to the issue of inequality. Some of the councils we spoke to plan to rethink traditional economic models and move towards more inclusive economics, focusing on the green new deal and the levelling up agenda. Those councils who are working to embed community wealth building principles highlighted the importance of people-centred approaches to local economic development in planning for economic recovery. Organisations such as CLES have laid out some ways community wealth building approaches could help overcome “business failure, unemployment, social hardship and physical dereliction” throughout the rescue, recovery and reform stages of the crisis.

In the London Borough of Newham, Community Wealth Building is at the heart of the council’s approach to tackling poverty, inequality and injustice. This approach has been central to the council’s COVID-19 response through #HelpNewham, a programme supporting residents and the most vulnerable, as well as their business support programme. This includes establishing an Employment Rights Advice Unit by September 2020 to help those in insecure employment, low paid and front line workers, whose financial circumstances dictate a need to keep working and who are therefore more exposed to COVID-19.

A similar approach is taken by Oldham Council: they are focusing on inclusive economic strategies that ensure that economic policy benefits the many and not the few and that their poorer communities are not being hit the hardest. Whilst they are committed to do their part, by paying the living wage, spending locally, growing their own workforce, they also emphasised the importance of inclusive regional and national policy, without which inequality and economic disparity will continue to hit places like Oldham the hardest.

In our first update, we discussed how councils have found that perceptions of what is risky have shifted and they have been able to work with colleagues with traditionally lower risk appetite in new ways. As we move into the fourth sprint of this research, we want to explore this further and understand how local authorities are framing, evaluating or managing risk when responding to this crisis.

This research update is part of a series exploring changes within local government due to COVID-19 and is building on the work of the ‘Upstream Collaborative’, a collaborative network to support Local Government innovators to share, accelerate and assess new ways of working that enable citizens’ needs to be met in empowering and inclusive ways. You can read our first and second research update to better understand what this crisis has meant for local authorities in the UK.

Author

Codrina Cretu

Codrina Cretu

Codrina Cretu

Researcher, Government Innovation

Codrina is a researcher in Nesta's Government Innovation team.

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