2020 was described by NHS leaders as arguably ‘the most challenging in the NHS’s 72-year history’. It saw the introduction of legislation, interventions and guidance that are affecting nearly every part of public policy and our daily lives. The scale of the pandemic response has been staggering. Our COVID-19 tracker documents national policy developments in England and is testament to this, containing more than 1,200 entries.

Keeping on top of these updates, announcements and the evolving political narrative was at times overwhelming – with guidance proving a particular challenge. First there was the sheer scale of it – one gov.uk page lists 34 pieces of guidance for adult social care alone. And then there were the regular changes, often made to the same webpage, which sometimes required a fair amount of investigative work to decipher what was new. Other pieces were withdrawn and replaced with updated guidance elsewhere.

Capturing developments in some topic areas, such as shielding, involved monitoring multiple agencies. And some areas were more opaque than others. Updates for NHS leaders, for example, were often communicated in letters later published across a series of webpages (or not published at all). This steady flow of changing guidance has surely proven most challenging for those on the receiving end – health and care providers, business owners, teachers and others – who not only have to follow but also implement it in their respective settings.

Not surprisingly, our polling work found the public also struggled to keep up with changing advice on what they could and couldn’t do during the different phases of restrictions. This may have been exacerbated by the government’s ‘whack-a-mole’ strategy – applying different restrictions to areas with higher cases of the virus, rather than reimposing national restrictions – even though most people supported a regional approach in principle.

After a year of documenting the response, we’re shifting our focus away from tracking to spend more time on our analysis of COVID-19 policies.

Assessing the impact and response

What is clear is that the UK has been one of the hardest hit countries in Europe. Back in March 2020, the NHS Medical Director said that ‘if we can keep deaths below 20,000 we will have done very well’. The latest figures show just how far away from this we now are, with the toll directly related to COVID-19 a devastating 112,798* deaths.

The full impact of the pandemic – on people’s lives, health and the economy – will become clearer over time. Work is already underway as part of the Foundation’s COVID-19 impact inquiry to explore how the pandemic, and the response to it, have affected people’s health and health inequalities. While the Prime Minister promised ‘an independent inquiry into what happened’ in July 2020, at the time of writing no further detail has been announced – including whether the government will establish a full public inquiry with the powers needed to identify wider learning for the future.

Commentary and analysis so far have raised questions about the UK’s pandemic preparedness and the resilience of our systems. There have been some successes in the response – financial support schemes, vaccine development and (tentatively) roll out come to mind.

But several elements of the government’s response have been widely criticised and mistakes clearly made. There were early issues scaling up testing capacity and getting PPE out to those on the front line, and support for social care was inadequate. Debate has also focused on the timeliness of key decisions – particularly lockdowns – and the relationship between scientific advice and policy. Several grand promises made by the government – the UK could ‘turn the tide’ in 12 weeks, the test and trace system would be ‘world beating’ and that a ‘protective ring’ had been thrown around care homes – have not aged well.

These factors, along with the ‘Cummings effect’, may also have shaped the public’s views. Our polling shows that public support for the government’s handling of the outbreak changed dramatically. As the virus started to take hold, the UK was one of several countries to see a ‘rally round the flag’ effect – a surge in public support for elected leaders at a time of great national peril.

Just after the Prime Minister declared the UK to be ‘past the peak’ of the initial wave of the virus, our polling found a majority (60%) thought the government had handled the pandemic well. However, subsequent surveys found support for the government’s response fell to 43% in July and to 39% in November. Public appetite for tougher measures to tackle COVID-19 clearly ran ahead of the government’s willingness to tighten restrictions – by November, when the second national lockdown was in force, 49% thought the measures didn’t go far enough.

Where next for our tracker?

The UK is now in its third national lockdown and, while cases appear to be falling, yet to emerge from the current wave of the virus. Policy announcements are still coming thick and fast, but fewer of these are as novel as before. And we began 2021 with a set of national restrictions and economic support schemes broadly similar to those in the first wave.

So after a year of documenting the response, we’re shifting our focus away from tracking to spend more time on our analysis of COVID-19 policies. We will be distilling insights and lessons from the rich, granular data that we have collected and taking a step back to look at different phases of the response in their entirety. We’re also turning the tracker content into a fully searchable microsite to make the information easier for others to use. Meantime, we’re always open to suggestions for ways to improve and happy to answer questions, so do get in touch if you’d like to know more.

Phoebe Dunn is a Research Fellow in the policy team, and Tim Gardner (@TimGardnerTHF) is a Senior Policy Fellow at the Health Foundation.

* Total UK deaths within 28 days of a positive COVID-19 test, updated 8 February 2021. See the latest government figures available. 

Further reading

Chart

COVID-19 policy tracker 2020

Chart

A timeline of the national policy and health system responses to COVID-19 in England in 2020.

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