Biosecurity and national security Contents

4Resilience on the ‘frontlines’

Strategic Defence & Security Review 2015—

The UK’s resilience depends on all of us–the emergency services, local and central government, businesses, communities and individual members of the public.156

64.We discussed in Chapter 3 how the covid-19 pandemic has tested central Government’s systems for emergency preparedness. But it has also affected the resilience of frontline responders, at the local and regional levels. This Chapter considers how they have been supported ahead of time, and during the pandemic.

Devolved administrations

65.The responsibility for the preparations for, and response to, an emergency in Scotland, Wales or Northern Ireland depends on whether or not the emergency relates to a devolved or reserved matter.157 In areas of reserved responsibility, the UK Government’s relevant lead department will lead the response, working closely with the devolved administrations. Each devolved administration has arrangements to coordinate the response to aspects of emergencies for which it is responsible. In the case of the “most challenging emergencies”—especially those that affect the UK as a whole—there are “established arrangements for linking the UK Government’s emergency coordination structures with those of the devolved administrations, to ensure that we have a coordinated response.”158 A tension arises where the UK Government’s ‘retained’ responsibility for national security impinges on Departments’ managing remits that are devolved—health, business regulation, transport, local authorities, and so on.

66.Since the covid-19 pandemic began, there have been different approaches by the different administrations to some aspects of its management, including most notably on social restrictions and lockdowns. There has been a continuing dialogue between the response bodies across the administrations, as Lord Sedwill explained to us in July.159 There have been some tensions, nevertheless, about where the demarcations lie, with claims for example of the Scottish government not having been consulted by the UK government on decisions and a failure of some public announcements early in the crisis to make clear which applied to the UK as a whole and which only to England. There will inevitably be a continuing debate about the merits of the different approaches and the importance of maintaining national responsibilities and accountabilities—which is as much about constitutional considerations as about national security effectiveness.

Local and frontline resilience

67.The Government described local government’s legal responsibility for emergency planning:

The Civil Contingencies Act provides a common framework for preparedness activity, putting a duty on emergency planners and responders to identify and assess the risks of emergencies affecting the area in which they operate. The National Security Risk Assessment provides the basis for the work the local tier conducts to identify potential risks and prepare plans for either preventing or mitigating their impact of incidents locally.160

Local/regional work to plan for emergencies is coordinated via Local Resilience Forums (LRFs) in England and Wales, Regional Resilience Partnerships in Scotland, and Emergency Preparedness Groups in Northern Ireland (we refer to ‘local resilience forums’ throughout). These serve as multi-agency partnerships with representatives from a range of local public services, including the emergency services, local authorities, the NHS and Environment Agency local teams. Both the Civil Contingencies Secretariat in the Cabinet Office and the Ministry of Housing, Communities and Local Government offer local partners guidance with their planning and preparations work.161

68.The 2015 Strategic Defence and Security Review gave particular prominence to the role of LRFs, highlighting that the response to, and recovery from, an emergency is carried out “first and foremost at the local level”. It committed to better coordination between the local and national levels of response and greater support for organisations involved in response planning “to share and apply learning from exercises and real-life events”.162

69.The report on the 2016 Exercise Cygnus in 2016 (see Chapter 5), found uneven levels of resilience and limited capacity in some areas to surge resources into excess death management, and health and social care. The report called for more national-level operational guidance to ‘scale up’ the local response. It also proposed that regional-level planning in key areas may support multi-agency working locally. Given what happened in the early stages of the covid-19 pandemic, the Cygnus report also presciently noted that:

Local responders raised concerns about the expectation that the social care system would be able to provide the level of support needed if the NHS implemented its proposed reverse-triage plans, which would entail the movement of patients from hospitals into social care facilities. [ … ] Because of the complexity and potential impact of a pandemic influenza response [ … ], consideration should be given to developing support to the local response in the following areas: excess death planning, social care and health.163

70.In the 2018 National Security Capability Review, the Government again committed to improving local resilience, identifying further ways of understanding and assuring local resilience and readiness. It stated that the Cabinet Office was collaborating with LRFs to identify good practice, and would continue to develop a set of Resilience Standards to:

set expectations, help Local Resilience Forums assess themselves, and act as a basis for assurance and continuous improvement.164

Lord Sedwill told our predecessor Committee in 2019 that the Government had set up a resilience standard for LRFs following a major flu exercise (presumably, Exercise Cygnus – see Chapter 5) and no-deal Brexit planning had served as a test of their capabilities.165 Subsequently, in July 2020, he told us that these preparations allowed LRFs “to respond, for example reprioritising hospital beds and so on, to ensure that they had sufficient capacity to deal with covid”.166 He told us how LRFs had improved and had become more consistent:

It would not be unfair to characterise the LRFs as having been quite uneven a few years ago. Some were well constituted. [ … ] In other places, they barely ever met. People did not know each other and they did not have those relationships of trust and confidence, which are so important [ … ] However, partly as a result of Cygnus and other exercises—which involved a lot of effort, including a lot of training, by the Civil Contingencies Secretariat, [ … ]—the LRFs were already improving over several years. [ … ] Generally, I think that they have worked pretty well but [ … ] of course we must ask ourselves whether there are lessons that we can learn.167

71.The Cabinet Office minister Michael Gove told the Commons Public Administration and Constitutional Affairs Committee in April that the role of LRFs had become “even more important in dealing with this crisis” and foresaw a future need to consider the “architecture” of LRFs.168

72.Some of our witnesses highlighted problems arising from the protracted nature of the ongoing covid-19 pandemic. The C19 National Foresight Group at Nottingham Trent University highlighted a problem of fatigue, with local responders having had

little respite for nearly a year. Large sections of teams have not had leave as there are limited people who can cover absences. This also means they have not had time to grieve, rest, or spend time with their families.169

They recommended that the Government should undertake a public sector skills audit to identify capability needs and capacity gaps, in order to “help mitigate the adverse impacts of extended working for responders and support staff and their families”.170 They warned that LRFs

have run out of people, resources and spare capacity as they are now managing so many elongated demands. For example, the SCG Chair role, or the LRF Chair role are now discussed as being full time roles. This also relates to health, the health service is not pausing scheduled demand during the second wave. This means that capacity of people and NHS service will be reduced as there is likely to be no reduction in demand. There is no extra capacity across the whole system to release to increase capacity.171

More positively, the C19 National Foresight Group’s discussions with local responders in September showed an improving situation on information-sharing between the local and national levels (previously a challenge). Regional and local responders reported that interactions with the Joint Biosecurity Centre had:

facilitated sharing of local knowledge and information at a sub-national/regional level across the Local Authority and Local Resilience Forum structures. It was felt that the JBC had access to significantly better and relevant data and information, which was a clear advantage. The JBC was endorsed as bringing a broader perspective to discussions including aspects of wider societal response.172

73.Dr Jennifer Cole raised a concern about the capacity of some personnel in LRFs who when faced with a protracted crisis like covid-19 were “likely to be completely overworked and over-burdened during their day job, just at the time that their surge capacity is needed”. She highlighted the model of Israel where emergency services had a cadre of volunteer staff (supplementing professional staff) who were able to provide some surge capacity.173

74.The LSE IDEAS Centre were concerned about the effects of “significant reductions in funding and capabilities” at local government level which could have hindered the implementation of plans.174

75.Some witnesses highlighted friction in the interaction of central and local structures, in part a result of unclear demarcations. The LSE IDEAS Centre highlighted “gaps between the national strategic approach and the local operational approach”, due partly to a failure to consider how outcomes and priorities might differ across nations, regions and local communities. The UK response to covid-19 reflected “over-centralised and improvised decision-making”.175 They believed that some local structures (in local government, PHE and the social care system) lacked sufficient institutional capacity and decision-making authority to carry out functions linked to procurement, testing and contact-tracing, which they judged undermined the UK’s resilience. They also criticised the Government for not making sufficient use of existing institutions and capabilities:

In preference to utilising existing institutions, the UK Government set up large new organisations for testing and contact tracing, involving the hiring and training of thousands of people. The same principle was applied for technological solutions, with the Government choosing to develop its own app for contact tracing. In light of this experience, an important principle of resilience should be to make better use of the people, organisations and capabilities already in place–a lesson that was already apparent from the Ebola crisis.176

The C19 National Foresight Group recommended in September that, to provide clarity for all stakeholders, the Government should “commission an independent body to work with local decision-makers to produce ‘wiring diagrams’ of the local, regional and national structures, clearly showing the information and decision-making flows between key stakeholders”.177

76.LSE IDEAS complained that the Biological Security Strategy had little detail about implementation, or the continuous follow-up required at all organisational levels, including in local government and between devolved administrations, for ensuring that strategic objectives are carried out. They urged that exercises in resilience should pay closer attention to establishing and sustaining working relations and coordination between Government departments and agencies and between national, regional and local levels.178 Professor Sophie Harman told us that the role of local authorities did not receive enough attention in relation to biosecurity emergencies, given their responsibility for social care, food networks and provisions of supplies.179

77.We put these issues to our witnesses from Government. Clara Swinson, from the Department of Health and Social Care, explained that it was the responsibility of each Government department to plan against the scenarios in the National Security Risk Assessment, in terms of the tasks needed at national, regional and local levels, for those risks.180 The Cabinet Office is responsible for notifying LRFs about the risk assessment’s ‘tiers’ analysis, along with “any guidance about which ones to focus on”. The Government highlighted, however, that the UK’s resilience model is based on “subsidiarity” and the NSRA and National Risk Register “support LRFs to develop their own local understanding of risk, prioritise resources and plan effectively for critical risks”.181 Roger Hargreaves from the Civil Contingencies Secretariat explained that:

We do not chase things down to the nth degree. Ultimately, local authorities are responsible in law for their own emergency areas. We can be certain that we have given them access to lessons from Exercise Cygnus [ … ]. Whether they take that, and then translate it into planning for an individual care home, is a matter for them. [ … ] We carried out surveys to understand the extent to which local authorities had absorbed these lessons. We had a group with local authorities and local resilience forums that explored, between 2018 and 2019, how they were taking the lessons on board. We are not in the business at the moment of looking for those absolute guarantees. We look to build a system that gives people access to the information, but the accountability in law and the local democratic accountability sits with them.182

78.The Government recognised that in the current pandemic “local authorities and local resilience forum partners are under an awful lot of pressure”.183 Penny Mordaunt told us:

We have very good feedback loops in place with local authorities and local resilience forums. We have embedded liaison officers and, particularly at moments of peak activity, we very quickly stood up liaison officers in all the LRFs, so that we had a very good picture of what the additional strains were and where we felt there were areas that might be under particular strain.184

The Cabinet Office explained that it had published a National Resilience Standard for LRFs in December 2019.185 Early in the pandemic, the Government had also set up an ‘LRF covid-19 Task Force’ to assess LRFs’ preparedness for covid-19 and to identify the support they needed.186

79.Organisations at the local level—in particular local authorities, Local Resilience Forums and community organisations—form the ‘frontline’ of planning for, and response to, emergencies. We recognise the work done by the Government to improve consistency and good practice locally, including the 2019 National Resilience Standard. However, LRFs are under significant pressure due to the protracted nature of the covid-19 emergency (rather than the short-term emergencies that LRFs are intended to deal with). During the current pandemic, they have sometimes lacked the necessary intelligence, data and support from central government to carry out their role effectively.

80.Building on the National Resilience Standard, the Government should establish a long-term plan for investment in and support for organisations in local and community resilience, particularly Local Resilience Forums. This plan should focus on:

a)formalising intelligence- and data-sharing arrangements, both between central government and LRFs and between the four nations;

b)incentivising regular local exercises (see paragraph 106) to test the strength of multi-agency relationships and responses, and monitoring the progress and outcomes of these exercises;

c)providing adequate resources over the long term to local authorities for LRF emergency response preparation work and for undertaking exercises, through ring-fenced funding;

d)working with local authorities and other emergency-response bodies, considering how to strengthen career pathways and retention of emergency managers and others in resilience; and

e)exploring the scope for establishing a ‘reservist’ cadre of previously deployed LRF staff, along the lines of military reservists and (now under discussion) ‘NHS reservists’.

The public health connection

81.Some witnesses underlined that domestic resilience against a range of biological risks directly relates to the strength of the UK’s healthcare system and the health of its population. For instance, Dr Patricia Lewis, Director of the International Security Programme at Chatham House, told us that:

The best defence and deterrence against [biological weapons] is a high-functioning public health system—a healthy community and a responsive, highly vaccinated and prepared public health system. Then, if you get attacked, you are able to cope with it, but mostly you will not get attacked because there will be no point. That is the huge lesson [ … ] from the Biological Weapons Convention, and I never felt that it was fully understood in government circles as much as it could have been.187

Dr Jennifer Cole made a similar point, noting that prevention is better than cure and reflecting, in the context of the covid-19 pandemic, that the people who have been hit the hardest are those with health conditions.188 Promoting greater public health was seen generally to reduce the impact of biological risks when they materialise.

82.Most public health spending is undertaken by local authorities. Analysis undertaken by the House of Commons Scrutiny Unit shows that there have been nominal and real-terms reductions in local authority public health budgets between financial years 2015–16 and 2018–19. The Figure and Table below show the real terms changes in central government spending on Public Health (PHE and ring-fenced local authority grants) and total DHSC spending (England only). Whilst DHSC spending has been increasing, this has been primarily focused on the NHS, whilst public health spending has been squeezed; there was a £118 million reduction in spending between 2015–16 and 2018–19, driven by reductions to local authority grants (see the Table below for further information). Similarly, the House of Commons Library estimates that between 2016–17 and 2018–19 there was effectively a 9.3% reduction in public health grants per capita, contributing to a 2.3% reduction in local authority spending on public health from 2013–14 to 2017–18.189

Figure: Central government spending on public health in England has fallen since 2015–16

Real terms percentage change in DHSC expenditure

Source: DHSC Annual Report and Accounts 2018–2019, HMT GDP deflators at market prices (September 2020)

Table: DHSC Annual Report and Accounts 2018–2019 core table data

Source: DHSC Annual Report and Accounts 2018–2019, HMT GDP deflators at market prices (September 2020)

Note: Figure and Table show combined Resource and Capital Departmental Expenditure Limits (DEL). Resource DEL includes depreciation and therefore DHSC Total will not equal official Total DEL, which excludes depreciation. 2019–20 figures show planned expenditure only; outturn figures will be published in the DHSC Annual Report and Accounts 2019–20, but publication has been delayed due to covid-19.

83.In August 2020, the Government announced that it would abolish Public Health England, and replace it with a National Institute for Health Protection. This new body is expected to bring together national capabilities to protect individuals from a range of external health threats and bring together the operational capabilities for the response to covid-19.190 In future, there would be new separate governance arrangements for some of the health improvement and prevention responsibilities of PHE.191

84.Health promotion and health protection go hand in hand. Ongoing actions to improve the health of the UK population and to strengthen the national health and social care system will decrease the impact of biological risks that materialise. Safeguarding the UK’s high-quality domestic systems will also enable a more confident and credible role in leading the global health security agenda.

85.As the structures of the new National Institute for Health Protection are finalised in the coming months, following the abolition of Public Health England, the Government must ensure that the creation of the new body does not weaken wider health promotion activities, which themselves further biological security objectives. The Government should undertake exercises which test the NIHP’s role in future potential emergencies as soon as the current pandemic has abated.

160 Cabinet Office (BNS0033)

161 Cabinet Office (BNS0033)

164 Her Majesty’s Government, National Security Capability Review (March 2018), p 28

165 Oral evidence taken on 28 January 2019, HC (2017–19) 625, Q54; Written evidence, HC (2017–19) 625, (NSA0003), March 2019

168 Oral evidence taken before the Public Administration and Constitutional Affairs Committee on 29 April 2020, HC (2017–19) 118, Qq198, 206

170 C19 National Foresight Group, Nottingham Trent University Covid-19 Pandemic: Third Interim Operational Review (September 2020)

171 C19 National Foresight Group, Nottingham Trent University, Communications and the Covid-19 Pandemic: Rapid insights from practitioners and research (September 2020)

172 C19 National Foresight Group, Nottingham Trent University Covid-19 Pandemic: Third Interim Operational Review (September 2020)

173 Oral evidence taken before the Defence Committee on 14 July 2020, HC (2019–21) 357, Q8 [Dr Cole]

174 LSE IDEAS (BNS0004) para D2

175 LSE IDEAS (BNS0004) paras D4, D9

176 LSE IDEAS (BNS0004) paras D6–9

177 C19 National Foresight Group, Nottingham Trent University Covid-19 Pandemic: Third Interim Operational Review (September 2020)

178 LSE IDEAS (BNS0004) paras A4, B1, D17, C1

181 Her Majesty’s Government (BNS0013)

183 Q68 [Roger Hargreaves]

185 Cabinet Office (BNS0033)

186 Cabinet Office (BNS0033

188 Dr Jennifer Cole (BNS0021)

189 House of Commons Library Debate Pack, Opposition Day Debate: Health and local public health cuts, 13 May 2019 CDP 2019/0121

190 Health and Social Care Secretary, The future of public health, speech (18 August 2020)

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