德莫斯研究所-人道主义思想共同体：危机时期变革的案例（英文）-2021.5-66正式版

Inpartnershipwith

Communitiesofhumanitarianthought:

Thecaseforchangeinatimeofcrisis

May2021

AbouttheBritishRedCross

Forover150years,theBritishRedCrosshashelpedpeopleincrisis,whoeverandwherevertheyare.Wearepartofaglobalvoluntarynetwork,respondingtoconflicts,naturaldisastersandindividualemergencies.WeenablepeopleintheUKandabroadtoprepareforandwithstandemergenciesintheirowncommunities.Andwhenthecrisisisover,wehelpthemrecoverandmoveonwiththeirlives. 

Aswelookaheadtothefutureimpactwecanmake,our

Strategy2030

willtransformhowtheBritishRedCrosshelpspeopleincrisis.Wewillfocusonthreeurgenthumanitarianissueswherewecanmakearealdifference:disastersandemergencies,healthinequalitiesanddisplacementandmigration.

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Aboutthisessaycollection

Thisessaycollectionbringstogetherleadingthinkersfromdifferentsectors,outliningwhattheyseeasthecurrentchallengesacrosstheseurgenthumanitarianissuesand,crucially,whattheyseeastheopportunitiesforpolicychange.

Weareextremelygratefultoallthosewhohavetakenthetimetocontributetothiscollection.Wehavesoughttoincludeadiversityofopinionandexperiencefromarangeofdisciplinesandacrossthepoliticalspectrum,bringingtogethervolunteersandstaff,peoplewithlivedexperienceandleadingsectorfigurestosharetheirviews.Awiderangeofvoicesplayapartinshapinggovernmentpolicy,andcontributetowardsconstructivedebateonthefuturewewanttosee.

Thepurposeofthiscollectionistoprovideaplatformforthought,ideasanddiscussion,andtheviewsexpressedintheseessaysaretheviewsofthecontributors,ratherthanthoseoftheBritishRedCrossorDemos.

Contents

Foreword

4

DavidBernstein:TobuildbackstrongerafterCovid-19,weneedtoputmore

trustinpeopleandcommunities

Introduction

8

SeemaAssadullah:TheworkoftheBritishRedCrosstouchesonmany

differentareasofhumanity

Chapter1:Healthinequalities

10

BlessedOkpeki:Oursupportissovaluedbythepeoplewhoreceiveit

10

RtHonPatriciaHewitt:BuildingontheunexpectedbenefitsofCovid-19:The

12

poweroflocalcommunities

KimLeadbeaterMBE:Acountrywherenoonefeelslonelyorforgotten

17

CeylonAndiHickman:Thenation’srecoveryeffortsmustincludetargeted,

20

sustainedandintensivementalhealthandemotionalsupportforyoungpeople

Chapter2:Displacementandmigration

26

GodwinAkinyele:Creatingasocietywherepeopleseekingasylumcantruly

26

saytheyhavefoundrefuge

ProfessorAlisonPhipps:WelcomingNewScotsintosocietyfromtheday

28

theyarrive

SabirZazai:Asylumisnotaproblemthatneedstobefixed:Wemust

32

acknowledgethehugecontributionthatrefugeesmaketotheUK

RtHonSirIainDuncanSmithMP:Survivorsofmodernslaveryneedrights

37

enshrinedinlaw–toensurepeoplecanbuildnewfuturesandprevent

re-trafficking

Chapter3:Disastersandemergencies

40

RobynWheeler:Ihopethecommunityspiritwe’veseenwillcontinueaswe

40

recoverfromCovid-19

RtHonTobiasEllwoodMP:ItistimetoensureGlobalBritainisaforceforgood

42

NimcoAliOBE:InvestinAfricanwomenasagentsofchangeintheglobal

45

movementtoendFGM

NisreenElsaim:Preventionisbetterthancure:Youthandcivilsocietyas

50

safeguardsanddriversofclimateaction

Afterword

54

ZoëAbrams:Callingforchangeinatimeofcrisis

54

MikeAdamson:Nowisthemomenttosecurethechangewewanttoseeinthe

57

world

Endnotes

60

Acknowledgements

64

TobuildbackstrongerafterCovid-19,weneedtoputmoretrustinpeopleandcommunities

ForewordbyDavidBernstein,ChairofTrusteesatBritishRedCross

IthasbeenmygreatprivilegetohaveservedastheChairoftheBritishRedCrossfornearlyeightyears,adeeplytrustedhumanitarianinstitutionthatcelebratedits150thanniversaryin2020.Ithasbeensaidbefore,butthispastyearhasbeenlikenoother,andtheRedCrosshasbeentheretohelpthemostvulnerableinthefaceoftheglobalpandemic,bothathomeandoverseas.

Initslifetime,theRedCrosshasrespondedtomanycataclysmiceventsthathaveshapedournation’spsyche:twoWorldWars,theAberfanminingdisaster,theLockerbiebombing,the7/7bombings,theManchesterarenaattack,theGrenfellTowerfire,andmore.TheRedCrossisapartofourhistoryandsomanyofourlives–indeed,myownuncleJoeworkedalongsideRedCrossteamsinhisroleasaninterpreterattheliberationofBergen-Belsenconcentrationcampin1945.

TheBritishRedCrossalsoworkswithothernationalRedCrosssocietiesaroundthe

worldtorespondtointernationaldisasters,includingthedevastatingBoxingDayTsunamiin2004andrecently,theAustralianbushfiresandtheBeirutportexplosionin2020.MyowntimeonthegoverningboardoftheInternationalFederationoftheRedCrossandRedCrescentSocieties(IFRC)showedmetheextraordinaryhumanitarianfeatsthisglobalmovementcanaccomplishbypullingtogetheracrossborders.

ThecentralroletheRedCrosshasplayedaroundtheworldinrespondingtotheCovid-19pandemichighlightsthattheorganisationisasessentialnowasiteverhasbeen.

Covid-19hasdominatedourthoughtsandactionsoverthepastyear.Aswestarttolookbeyondthepandemic,wehavebeenhandedanunparalleledopportunitytoreimagineourfutureandbuildbackstronger.Thisincludespullingtogethertoovercomemajorchallenges,boththosecreatedbythepandemicandthosewhichhavesadlybeenexacerbatedbyit.

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DavidBernstein

Withsuchalonghistoryofsupportingpeoplethroughcrisis,whathastheRedCrosslearnt,thatcanhelpsteerandshapeourpreparationforandresponsetofuturecrisis?

SomethingthatinspiresmeabouttheRedCrossistheenormousdifferenceitmakestopeopleastheyexperiencesomeoftheirdarkesthours.ItsvolunteersandstaffareembeddedinlocalcommunitiesallovertheUK,andbringdignity,powerandoptionsinmomentsofpersonalorsocietalcrisis.

TheRedCrosspracticeskindnessinaction.

Itsworkbeginswithanassumptionthatindividualsandcommunitiesknowbestwhattheyneedtogetthroughanycrisistheyface.Asksomeonewhattheyneed,rightnow,andgiveittothem.Whatyou’rereallygiving

istrust.Whatyou’rereallysayingis,thisistoughbutwecangetthroughthistogether.

WebelievethattobuildbackstrongeraftertheCovid-19pandemic,weneedtoputmoretrustinpeopleandcommunities.

ThinkbacktothosefirstdaysofUKlockdown,assupportsystemssprungupinneighbourhoodsacrossthecountry,deliveringincredibleactsofkindnessandconnectiontothoseinneedofhelp.Inthiscrisis,thecommunitiesofthiscountryhavenotprovedwanting.Aswemoveforwards,weshouldlooktoandworkwithlocalpeopletofindfreshanswers,trynewthingsandmakeourselvesstrongerforthefuture.

Buildinglocalresilienceiscritical.WhiletheRedCrossisperhapsbestknownforitsemergencyresponsetodisastersandextremeweatherevents,theworldwide

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movementalsosupportscommunitiesacrosstheglobetoprepareforandrecoverfrommajorshocksandknocks.Becausewhilesomecrisesareunexpected,manyareyearsinthemakingandyearsinrecovery.

Takeanissuethatisnowabsolutelycritical:tacklingclimatechange.Whilemuchofthepublicconversationonclimatechangelookstothefuture,wemusthelpcommunitiesdealwiththedevastatingimpactclimatechangeishaving,rightnow.

Fromthefamilywhocan’tputfoodonthetablebecausetheircropshavebeenwashedaway,tothefamilymadehomelessbecausetheirhousehasbeendestroyedbyamajorweatherevent,theRedCrossisthere,workingtohelpcommunitiesprotectthemselvesfromtheharshestimpactsofclimatechange,bothintheUKandaroundtheworld.

Weneedtoseerealglobalcommitmentandinvestmentinsupportingcommunitiestodealwiththeimpactsofclimatechangetoday.TheRedCrossisleadingthewayandhasplayedakeyrole,alongsideanumberofcountries,theUKgovernmentandtheMetOffice,inlaunchingamajorinitiativetomake1billionpeoplearoundtheworldsaferfromdisastersby2025.TheRisk-InformedEarlyActionPartnershipincludeshugelyinnovativeareas,includinggettingcashtopeopleinadvanceof

asignificantweathereventhittingtheircommunity.

Whereveryouareintheworld,buildingresilientcommunitieswillsavelivesandprotectcommunitiesfromharm.

6 | Foreword:DavidBernstein

Tomarkthecharity’s150thanniversary,thiscollectionofessaysbringstogetheradiverseandimpressiverangeofexpertvoiceslookingtowardstomorrow.TheyexplorehowweaddressthreeburningissuesofourtimethatarecentraltotheBritishRedCross’snew

Strategy2030:

Healthinequalities;Displacementandmigration;andDisastersandemergencies.

Individually,theseessayssuggestpracticalsolutionstoindividualchallengesacrossthesethemes:KimLeadbeateremphasisestheimportanceofaddressinglonelinessandbuildingtogethernessaswerecoverfromCovid-19;SirIainDuncanSmithstatestheimportanceofgreaterprotectionsforsurvivorsofmodernslavery

intheUK;andNimcoAlicallsformorepowerandfundingtobeputinthehandsofAfricanwomentoeradicatefemalegenitalmutationonceandforall.

Together,theseessaysprovideapowerfulvisionforwhatwewantourfuturetobe–onethatplacespeopleatitsheartandisbuiltonconnectednessandresilience.

Thecriseswearecurrentlyfacinghaven’ttakenusbysurprise,butratherarelong-building,protractedcrisesthatarehavinganongoingdetrimentalimpactonindividualsandcommunitiesandwhichwehavetheopportunitytotackleheadon.

Onethingisforsure:wemusttacklethemtogether.

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TheworkoftheBritishRedCrosstouchesonmanydifferentareasofhumanity

IntroductionbySeemaAssadullah,ServicesupportworkeratBritishRedCross

TheRedCrosshasbeenpartofmylifeforaslongasIcanremember.Itwasmychildhoodfriend,asalittlegirlgrowingupinAfghanistanatatimeofwar.IusedtoseetheRedCrossmedicalcentresandthehopetheygavetolocalcommunities.Whensomeoneinmyfamilywasunwell,theusualwaysofaccessingmedicationandhealthcarewerelimited,buttheRedCrosswasalwaysthereforus.Theirmedicalcentresmadeahugedifferencetoourlocalcommunity.

OnceIwaslivingintheUK,mychildhoodexperiencesencouragedmetostartvolunteeringfortheBritishRedCrossinthreedifferentrolesfromearly2018.

TheRedCrosshadgivenmesomuch,andIwantedtogiveback.

Mytimevolunteering,helpingandsupportingotherpeoplewasaverygoodexperienceforme,andalsoprovidedaplaceformetodevelopmyownskillsandstrengths.WhilevolunteeringattheBritishRedCrossIfoundtherewasaplaceforme.Theorganisation’spurposeistosupportpeople,andmakesuretheyareheard.Itisbuiltonpeoplewhocare,whoarepatientwithpeopleandshowempathy.Inmyroleasacommunityconnectorworkingtotackleloneliness,Ilearned

theimportanceoflisteningtopeople,ofreassuringthem,andofputtingyourselfintheirplace.Thathashelpedmealot.

8 | Introduction:SeemaAssadullah

TheBritishRedCrosscelebratesthepowerofkindness,anditsupportspeoplethatdothis,too–bothstaffandvolunteers.

Asavolunteer,myco-ordinatorsawthatIworkedhardandtrulycaredaboutthepeopleIwassupporting.Sheinturnhelpedmetogrow,andIlaterbecameanemployee,workingasaSupportWorkerintheorganisation’sIndependentLivingService.InthisroleIspendalotoftimewithdifferentpeople,helpingthemtoovercomedifficultperiodsintheirlives.Whenpeoplecomeoutofhospitaltheyreceivemedicalandpsychiatricsupport,buttoreallyrecoveroftentheyneedmorethanthat.Ihelpthemtoaccesssupportaroundtheirhousing,benefitsormentalhealth.Thesearethingsthatcanhaveaworryingeffectontheirrecoveryiftheyaren’tinplace.Myactivelisteningskillsandpatiencehavealwayshelpedmebuildastrongrapportwiththeserviceuser.Myabilitytospeakmultiplelanguageshasalsoallowedmetoconnectwithdifferentcommunities.

TheBritishRedCrossisahumanitarianorganisation.Thisshowsinthewaythatittreatspeopleashumanbeings,whatevertheirbackground.TheworkthatIdo,togetherwithmycolleaguesacrosstheorganisation,ensurespeople’svoicesareheard.Welisten,weshowempathy,andwebuildrapportwiththem.

Ourworkisaboutensuringthatpeopleindifferenttypesofcrisishaveeverythingtheyneedtorecover,andthatpeoplearen’tlefttodealwiththeirproblemsontheirown.

Ittouchesmyhearttoseehowpeopleworktogethertomakethishappen.

ButnoteveryoneknowswhattheRedCrossdoes,beyonditsworkonconflict.TheworkoftheBritishRedCrossextendsfarandwide,andtouchesonsomanydifferentareasofhumanity.Theissuesdiscussedintheseessaysaresoimportant,andtheyshowjusthowfarourworkreaches.Ihopethiscollectionhelpspeopletounderstandtheimportanceofthisamazingwork,andthechangesthatareneededtobringaboutakinderworldforeveryone.

Iwillneverforgetthehorriblefaceofwar,butwillalwaysrememberthegenerosityandkindnessoftheRedCross.

SeemaAssadullah

9 

Chapter1

Healthinequalities

Oursupportissovaluedbythepeoplewhoreceiveit

IntroductionbyBlessedOkpeki,BritishRedCrossvolunteer

IhavevolunteeredattheBritishRedCross’sMobilityAidsService–thebiggestnationalproviderofshort-termwheelchairloans–forfiveyears.Volunteerslikemehelppeoplestayindependentbyprovidingthemwithwheelchairs.ThisservicehelpstheBritishRedCrossinitsmissiontoensurepeopleintheUKreceivethecare

andsupporttheyneedwithoutfallingthroughgapsinthehealthsystem.

IstartedvolunteeringwiththeBritishRedCrossatadifficulttimeinmylife.IhadrecentlymovedtoBelfastwhereIknewnooneandwasstrugglingtofindmyfeet.WhenIsawanadvertforBritishRedCrossmobilityaidvolunteersinalibraryIappliedstraightaway.Iwantedtodosomethingtokeepmebusyandgivemepurpose.

10

TheBritishRedCrossisnowlikefamily;everyoneI’vemethasbeensogoodtome.Theexperiencehashelpedmesomuchtoo–Ihavelearntalot,bothfromhelpingpeopleandfromthepeopleIvolunteeralongsidewhohavesupportedandencouragedme.

Asvolunteers,we’reoftenthefirstpointofcontactforsomeonewhoisreachingoutforhelp.Peoplecanbeverydistressedwhentheyfirstcall;theymighthaverecentlyhadanaccidentorhealthcrisisthathasrestrictedtheirmobilityandleftthemreliantonotherpeople.Thesearealwaysemotionalcalls,soaswellasmakingsurewegettherightdetailsandunderstandwhatservicetheyneed,wewilllistentowhateverthepersonisgoingthrough.

ItmeansalotwhenIseethatwehavebroughtjoyintopeople’slives.Inouroffice,wekeepallthe‘ThankYou’cardsthatpeoplehavesentuspinnedtothewall.Lookingatthesecardsremindsmeoftheimpactvolunteershaveonpeople’slives,anditmeansalotthatoursupportissovaluedbythepeoplewhoreceiveit.TheessaysinthischapterallspeakaboutveryvitalandrelevantissuesthatIhavealsoseenthroughmyownvolunteering.PatriciaHewitt’sessaysaysthatourhealthcaresystemneedstofocusontreatingthewholepersonandprioritisekeepingpeopleoutofhospital.Frommyvolunteering,Iunderstandtheimportanceofensuringpeoplehavethesupporttheyneedtostaywellwithintheircommunities.Thesecondessay,byKimLeadbeater,isfocusedonloneliness,anissueofgreatinteresttome.MyexperiencesofmovingtoanewcitywhereIknewnooneleadsmetoagreethataddressinglonelinessandbuildingconnectionsmustbeakeypartoftheresponsetoCovid-19.Inthefinalessay,CeylonAndiHickmanwritesaboutthe

BlessedOkpeki

needtobettersupportthementalhealthandwellbeingofyoungpeopleintheUK,especiallyyounggirls.Iagreethatpeoplemustbesupportedtospeakupabouthowtheyarefeelingandshouldnotbeashamedtosaywhentheyarestruggling.

VolunteeringfortheBritishRedCrossgavemethemotivationtogetupeveryday,eveninmydarkesttimes.Beforebecomingavolunteer,I’dneverthoughtabouttheneedformobilityaidsorhowpeoplewouldstruggleiftheyweren’tabletoaccessthissupport.

Ihopethatafterthepandemic,wewillcontinuetoshowkindnesstoeachother,tobuildconnectionsandtosupportthosewhomightotherwisestruggleontheirown.

I’msoproudofthepartIhaveplayedinthiswork.I’mgratefulfortheopportunitiestheBritishRedCrosshasgivenme,andsopleasedthatIhavebeenabletohelpothersinreturn.

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BuildingontheunexpectedbenefitsofCovid-19:Thepoweroflocalcommunities

RtHonPatriciaHewitt,IndependentChairofNorfolk

WaveneyHealthandCarePartnership,andformerSecretaryofStateforHealth(2005-2007)

Onitsown,Covid-19wouldhavebeenbadenough.Buttheepidemicthathascausedsuchmiserysinceearly2020landedontopoftwootherdeeplyentrenchedepidemics:chronicillnessandhealthinequalities.

Thefirstisacombinationofnon-infectiousconditions–depression,anxiety,dementia,obesity,type2diabetes,chronicheartdiseaseandsoon–thatdisableandcanevenkill.Althoughthesenon-infectiousconditionsaffectmostdevelopedcountries(and,increasingly,poorercountriestoo),theUKstandsoutwith,forinstance,oneofthehighestobesityratesinEurope.

Theseconddeeplyentrenchedepidemicistheshockinggapintheincidenceofillness,disability,andlifeexpectancybetweendifferentgroups,dependingonaperson’sage,theirethnicity,howdeprivedtheyareorwhereinthecountrytheylive.Withinthedevelopedworld,theUKisoneoftheworstperformingcountriesintermsoflifeexpectancy,whichimprovedoverthelastdecadeforthebest-off,whileactuallyfallinginsomeofthepoorestcommunities.

WellbeforeCovid-19,thechallengefacingourcountrywashowtotransformahealthservicedesignedtotreatillnessintoonethatwasequallyskilledatprevention.

In1948,theNHSmainlysawworking-ageadultswhoseinjuryorillnessneededone-offtreatment.Today,thetypicalpatientisintheirlate70sor80s,withmultipleandofteninterconnectedlong-termhealthconditions.Toputitsimply,inthepastyoucouldtreatthebrokenleg;today,youneedtotreatthewholeperson.

EachoftheseepidemicsworsenedtheimpactofCovid-19and,inturn,eachhasbeenmadeevenworsebyit.Thepandemic’simpactonmentalhealth,forinstance,willlastyears,aswilltheeffectofundiagnosedoruntreatedcancersandotherconditions.But,inararesilverlining,thepandemichasalsoacceleratedmanyofthetransformationsneededtotacklechronicillnessandreduceinequalities.

WhenCovid-19struck,thefirstimperativewastopreventourhospitalsfrombeingoverwhelmed.Withinafewweeks,workingtogether,theNHS,localcouncils,socialcareprovidersandvoluntaryorganisationssolvedaproblemthathaddefeatedsuccessivegovernmentsfordecades:acutehospitalpatients,mostlyelderly,medicallyreadyfordischarge,trappedinhospitalforwantofsuitablecareinthecommunity.Almosteveryoneofthosepatientswasmovedtoacommunityhome–manynewlyopenedforthatpurpose–orreturned

totheirownhomewiththesupportofexpandedcommunitynursingandsocialcareteams.Peopleworkedtogethertomeettheneedsofanindividualpatient,regardlessofprofessionalororganisationalboundaries;and,crucially,thevoluntaryand

12 | Chapter1:HealthInequalities

communitysectorhadmuchcloserworkingpartnerships,witheachotheraswellaswithlocalcouncils.

Thattransformationisn’tjustaboutprotectingourhospitalsduringCovid-19.Aboveall,it’saboutkeepingpatientssafeandrestoringtheirhealthandqualityoflife.AstheNHSmedicaldirector,ProfessorStevenPowis,remindsus:“Apersonover80whospendstendaysinhospitalloses10percentofmusclemass,equivalenttotenyearsofageing.”1

LongbeforeCovid-19,theBritishRedCrosswasworkingwithhospitalstohelpthemgetpeoplehomeassafelyandquicklyaspossible.Itmightbesomethingassimpleasavolunteertowarmthehouse,makeacupofteaandpopinoverthefirstfewdays,orprovisionofawheelchairorcommode.Oritmightinvolvetalkingtothepatientandperhapsotherfamilymembersforathoroughassessmentofsomeone’sneeds,followedbythreemonths’volunteersupportasthepatientregainstheirindependence.

Buthelpingpeoplecomehomefromhospitalisonlypartofthestory.Farmore

RtHonPatriciaHewitt

couldbedonetoreducethenumberofpeopleneedingtogotohospitalinthefirstplace.That,too,needsthewidercommunitytoplayourpart.

WhenitcametoCovid-19,thegovernmentquicklyrealisedthattheNHScouldn’t

doitalone.Alloverthecountry,peoplerushedtosupporttheirfamily,friendsandneighbours.WhatsAppgroupssprangup,oftenconnectingpeoplewho’dlivedinthesamestreetforyearswithouteverreallymeeting.InEnglandalone,threequartersofamillionpeoplerespondedtothecallforNHSvolunteerswithinthefirstfourdays.2Andineachpartofthecountry,thestatutoryLocalResilienceForummobilisedallthekeyplayers:localgovernment,theNHS,emergencyservices,thewiderpublicsector,localbusinessesand,crucially,voluntaryorganisationsliketheBritishRedCrosswithdecadesofexperiencerespondingtopersonalandcommunitycrises.

ThereisabeautifulAfricanproverb:“Ittakesavillagetoraiseachild”.

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Well,ittakesavillagetosupporteachofustoremainhealthy,happyandindependentforaslongaspossible.YourGPorhospital,howeverbrilliant,can’tcurelonelinessoradamphome,low-paidworkorpollutedcityair–althoughtheeffectofallthesestressesbringsmillionsofpeopletotheirGPsurgeryorA&Eeveryyear.

Weknowwhatneedstobedone.Takesocialprescribing,forinstance.Insteadoftherepeatprescriptionforantidepressantsorpainkillers,yourGPprescribesexerciseandcompany.Insteadofsimplyofferingadvice,the‘socialconnector’linkedtotheGPsurgerytakesthetimetolisten,todiscusstheoptions–awalkinggroup,alocalgardeningclub,debtadvice,aregularsoup-and-sandwicheslunch–andperhapstakesyoualongaswell.Whileinnovationslikethishavebeenflourishingforyears,todaygovernmentfundingenableseveryGPsurgerytooffersocialprescribing.

Ortakethe‘escalationavoidanceteams’whereGPs,nurses,occupationaltherapists,socialworkersandparamedicsallworktogethertopreventolderpeopleneedingtogotohospital.Facedwithapatientwhoseconditionisdeteriorating,aGPinthepastmighthavehadnoalternativebuttoarrangeforanemergencyhospitaladmission.Now,theycanincreasinglyrelyonamulti-disciplinarycareteamrespondingwithinacoupleofhoursandarrangingthenecessarycareathome.Thisapproach,increasinglyembeddedwithintheNHS,echoestheBritishRedCross’sownworksupportingpeoplewhoarefrequentattendersofemergencyservices,andwhomightpreviouslyhavehadadozenormoreA&Evisitsinayear,manyofthemleadingtoyetanotherhospitaladmission.ThisisanotherexampleofthewayinwhichthevoluntarysectorcanpartnerwiththeNHStocreateinnovationsandspreadbestpractice.

AlthoughCovid-19hasputanappallingstrainuponeverypartofourhealthandcaresystem,includingGPs,primarycareandcommunityteams,ithasalsoacceleratedmanyofthesepre-Covidinnovations.Foryears,NHS111hasprovidedtelephoneandonlineout-of-hoursadviceandcare.Now,theNHS111Firstservicecanofferanurgentclinicalconsultationbyphoneorvideo,whilealsobookingpatientsinforanappointment

–withA&Eifnecessary,directlywithhospitaloutpatientsorwiththeirownGPsurgery.AllofthisisdesignedtoreduceunnecessaryorriskyvisitstoA&Eandensurepatientsgettherightcareattherightplace.

AswelookaheadtowhenCovid-19,likewinter

flu,becomespartofournormallives,let’sseizetheopportunitytobuildonthepandemic’sunexpectedbenefits–thefriendshipsandconnectionsinourneighbourhoods,thenewvolunteers,theteamworkingandpartnershipsbetweenpublic,privateandvoluntarysectors,andthedigitaltransformationthatdeliveredmorechangeinweeksthanmostoftheNHShadachievedinyears.

Therearethreeprioritiesifwearetodothis.

First,weneedtoreinforceandbuilduponthe44SustainabilityandTransformationPartnershipsthathavebeendevelopedinEnglandsince2016(andallofwhicharenowIntegratedCareSystems),bringingtogethertheNHS,localgovernment,thevoluntarysectorandotherstoimprove

14 | Chapter1:HealthInequalities

healthandwellbeing,reducehealthinequalitiesandintegratecarearoundtheindividual.Asimilarapproachisbeingtakenineachofthedevolvedadministrations.TheproposedNHSBillthatwillputIntegratedCareSystems(ICS)onastatutoryfootingisverywelcome,althoughitneedstorecognisethatdifferentareashavedevelopeddifferentstructurestosuittheparticularneedsoftheircommunities,localgovernmentstructuresandgeographies.AndwithineachICS,thelocalHealthandWellbeingBoard(s)willplayanimportantrole,includingprovidingdemocraticaccountabilitytolocalresidents.

Second,weurgentlyneedanationalplanforsocialcare.InhisfirstspeechasPrimeMinister,BorisJohnsonpromised“tofixsocialcareonceandforall”.ButCovid-19hasagaindelayedthelong-awaitedwhitepaper.Duringthefirstwave,whentheNHSfundednewsocialcareprovision,thousandsofhighly-skillednursesandotherNHSstaffwerereleasedfromcomplexandoftenprotractedarguments

betweenfamilies,councilsandtheNHSitselfaboutwhetherapatientqualifiedfor‘continuinghealthcare’–freeatthepointofneed–oronlyforsocialcare,dependentuponameanstest.NHS-fundedsocialcar