Local Innovation vs Central Control in the NHS


Government needs to set the destination, not the route


On Thursday 14th May, Prof. Hugh Montgomery, Prof. Louise Kenny and Dr Séamus O’Neill came together for a Big Tent Digital event to discuss how the crisis of The COVID-19 response has failed to take into account regional differences, and the easing of lockdown needs to be communicated locally to reflect people’s immediate surroundings and risk factors.


Professor Louise Kenny, Executive Pro Vice Chancellor of the Faculty of Health and Life Sciences at the University of Liverpool, spoke about how London-centric decision-making has impacted other regions:


“We are diverse country, and COVID-19 has heightened our diversity. London-based decisions have national consequences, and they are not always of benefit to other regions.”


Kenny also criticised the Government’s testing strategy for not being regionalised enough:


“Testing has been problematic from the get-go. Had we kept testing capacity at a regional level we would have been able to test more flexibly and taken more care.”


On top of highlighting the key work being done regionally within the NHS, she also stressed that international cooperation has been key in finding effective ways of responding to the crisis:


“My colleagues would be keen for me to share with tonight’s audience that this crisis has forged international links on a size and scale and speed we have never seen during peacetime. There is nothing like a global pandemic to highlight we’re a global village”


Professor Hugh Montgomery, Director of UCL Institute for Human Health and Performance, highlighted some of the benefits of state-level coordination in the response to the pandemic:


“For PPE, central control was a good thing; it meant there were a large amount of central stocks in the first place.”


However, Montgomery expressed that while there were benefits to the initial response being resolute and nation-wide, the easing of measures put in place to curb the spread of COVID-19 have been too London-centric, calling it “muddled”:


“The results of the national lifting of lockdown will cause a lot of problems locally. It could have been better managed in terms of national messaging, and allowing devolved change. If one has ill-informed people communicating internally to the ignorant, the result is chaos.”


“Government needs to set the destination, not the route.”



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