A sense of belonging is a basic human need and has been shown to have a beneficial impact on people’s health. Whether through providing support networks that help people develop new skills and face uncertainty or providing a shared sense of purpose and identity. Mutual aid stems from strong communities. It fills gaps in provision and has a long and important history in the UK. This includes the early 19th century’s friendly cooperatives through to community-led welfare, such as disabled mutual aid groups, black supplementary schools and gay counselling services in the late 1960s.

Over the last few months, people have come together within their communities to set up 4,000 mutual aid groups across the UK. People have supported each other within their communities with help picking up groceries or prescriptions, as well as offering an ear to listen or a shoulder to cry on during this exceptionally difficult time. From people with long-term health conditions or disabilities and in need of care, to those experiencing financial hardship and struggling to afford food, local communities have provided essential support to those who needed it. This is reflected in emerging data from lockdown, with the ONS reporting in early June that 79.9% of people were doing more to support others in their community. This contrasts with a Community Life survey before the pandemic suggesting only 35% of people felt they could borrow or exchange favours with their neighbours.

While the resurgence of mutual aid is something to hold onto, over 95% of respondents in the New Local Government Network’s survey of local government leaders said that the contribution of community groups to their COVID-19 response has been significant. Yet it is not a replacement for the voluntary sector, left in a precarious state over the last decade and facing ever greater demands as support previously provided by the state has declined.

The government has set out plans to deliver £750,000 in funding for the local voluntary and community sector. The Health Foundation, along with other foundations, have stepped in to provide emergency funding. However, this is not enough to meet the scale of the challenge facing the sector. Pro Bono Economics have found that the sector now faces a £10.1bn funding gap in the next 6 months due to COVID-19. Nine in ten charities surveyed anticipate a reduction in their income, with over half believing this will mean significantly reducing their activity.

The pandemic response has shown the critical role of mutual aid and voluntary action. Continuing to value and provide the necessary support to maintain this will benefit health and wellbeing. The role of small, community-based organisations is too easily overlooked and resources will be needed during recovery to support their critical work. One option is a stabilisation fund to secure the long-term financial health of the charity sector, as recommended by the Digital, Culture, Media and Sport Select Committee.

Supporting someone to live well is as much about enabling them to solve their finance or housing difficulties, as it is about managing their illness. However, siloed working by service providers reduces the opportunities to take a proactive and holistic approach to meeting people’s needs. The pandemic has seen local statutory services put collaboration at the heart of the solution to tackling COVID-19 in their local area. Better sharing of information across all local services can provide the foundation for more joined up and prevention-led approaches.

One example is Barnsley Council’s experience of developing a vulnerability index during the pandemic. Before the outbreak began, the local health and social care systems lacked the information to understand service users’ financial or social status, or what was available to them in their neighbourhood. While sharing data between local systems had always been seen as desirable, it was not until the first week of the outbreak that they were able to get this work started.

They organised a workforce of analysts from each of the organisations in the system, such as different local authority teams and NHS services, to develop the vulnerability index. Starting as a list of vulnerable people shielding due to underlying illnesses, it is now a much more sophisticated database which also identifies households experiencing financial difficulties or with safeguarding concerns. Having identified around 65,000 households with some form of vulnerability during COVID-19, this has improved the ability to anticipate and respond to people’s needs. Dr Andy Snell, Public Health Consultant at Barnsley Hospital, explains:

‘We are able to risk stratify [people], knowing their risk of health problems, social problems and financial or other problems. We can identify what kinds of needs they have and prioritise support for them based on a much more holistic understanding of health. We’ve opened the doors to people who we didn’t even know needed help. People who are depressed or experiencing hidden harm – they’ve always been there but we haven’t always known about them.’

This crisis has at times pushed local systems to work better together in order to provide more effective support. It has also demonstrated how extensively people’s health is shaped by social inequalities. Continuing to build on the collaborations formed through the crisis will increase the capacity and capability for local areas to adopt prevention-led strategies.

The founding of the modern welfare state is viewed by many as one of the great achievements of the 20^th century. While the form and structure of the welfare system has faced long-standing critique from across all sides of the political landscape, the pandemic has been an important reminder of just how important a safety net it is for everyone when they face a crisis.

One of the most prominent examples was the action taken to house rough sleepers within days of the lockdown starting. A range of other measures were also taken to increase people’s housing security with mortgage holidays and a freeze on evictions. One emergency measure that should be high on the list to maintain is the increase in the Local Housing Allowance. This makes more of the housing stock affordable to those in receipt of benefits and can provide greater housing security.

On 20 March the government announced that the Local Housing Allowance would be restored to previous levels so that housing benefit would cover rents for the bottom 30% of the rental housing stock in each local area – it had been frozen from 2015. The Local Housing Allowance is designed to ensure that people receive enough housing benefit to cover the cost of renting a cheaper home in their area. Research from Crisis and the Chartered Institute of Housing found that last year over 90% of areas in the UK are unaffordable to people supported by the Local Housing Allowance. And that by increasing the allowance to the 30^th percentile it would prevent more than 6,000 households from becoming homeless over 3 years, and lift 32,000 households out of poverty, including 35,000 children.

This measure will play an important role in providing housing security for private renters, a third of whom have experienced a hit to their earnings due to COVID-19. And while the current increase will only last for 12 months, the financial insecurity renters are likely to face will continue well beyond this. Maintaining this support will both provide a safety net for those facing financial uncertainty and mitigate the immediate and long-term impact housing insecurity has on people’s health.

A secure and rewarding job has been shown to be a contributor to good health, while unemployment has a negative impact on people’s health and wellbeing. During the 2008 financial crisis, researchers found that in the UK a 1% increase in unemployment led to a 2% increase in the prevalence of chronic illness. So, when an economic crisis hits, it is a critical time to help keep people in employment, whether through supporting them to retain their job or to find new opportunities.

The Job Retention Scheme was a bold and necessary step by government at the start of lockdown. The question of when and how this is finally phased out needs to be balanced against the impact of unemployment on people’s livelihoods and wellbeing. So far, younger people have been disproportionately disadvantaged by the crisis. Research from the Resolution Foundation found that one third of 18–24-year-old employees have lost jobs or been furloughed as a result of the crisis, compared to less than 15% of 35–44-year-olds. There are additional concerns that young people leaving education this year will be entering a challenging job market with few opportunities, which could have a scarring effect on future job and pay prospects.

Some groups of young people are likely to face an even greater disadvantage. Previous work by the Institute of Employment Studies found that black and minority ethnic young people, disabled young people, young parents and those with the lowest qualifications are less likely to be in employment compared to the average for the 18–24 age group.

Regions and local areas can play an important role in supporting employment. One such approach has been the newly created Reskilling the Recovery Fund, launched by the London Progression Collaboration and the Greater London Authority. The fund calls for large organisations to pledge their unspent apprenticeship levy, which is then given to small businesses to create apprenticeship opportunities for young people living in London. This model not only offers support for small businesses that may be struggling from the crisis, but also creates new opportunities and career pathways for young people.

Insights from Health Foundation-supported analysis of young people’s working experiences will contribute to providing better employment opportunities and improving young people’s life chances.

The roadmap out of lockdown and into recovery starts and ends with local places. Various places across the UK have been affected differently by COVID-19: whether it is new pressures on health care systems, local industries being impacted in unique ways, or even the ability of public transport to adapt to new social distancing measures. As the four UK governments decide how to build back better, local government must have a seat at the table and autonomy over decisions in their area.

Cities across the UK are already planning for a post-COVID world. Kirklees Council have redesigned their cabinet to focus on COVID-19 recovery. New roles for cabinet members include voluntary sector engagement, recovery strategy, and planning the post-pandemic inclusive economy.

Derby City Council are exploring how they can work with partners across the city in their new Coronavirus Economic Recovery Task Force. The public and private sectors are working together to identify areas that have been worst hit by the crisis and partnering together to build an economic recovery plan. For example, the task force is taking an immediate focus on supporting workers recently made redundant by Rolls-Royce, helping them to find alternative employment or launch their own business. Longer term, there are plans to decarbonise the city and deliver major regeneration schemes.

Creating inclusive places where everyone has the opportunity to thrive depends on citizens having a say in decision making. Sunderland Council are relaunching their ambitious community involvement programme, Let’s Talk Sunderland, as they look to build more resilient communities after COVID-19. Residents, and vulnerable people in particular, are being contacted by the council to find out what their needs are and what changes they would like to see to improve their neighbourhoods.

Just as each area has had to respond in different ways to COVID-19, their recovery plans will look different too. Rebuilding from local areas upwards will harness and build on existing local commitments, ensure that areas are supported to be more resilient and give citizens a voice in these plans too. The Health Foundation is supporting local governments to take system-wide action on the wider determinants of health in a new funding programme with the Local Government Association. We have also announced future funding opportunities aimed at using local economic development to improve health outcomes.