Designing effective central-local co-operation: lessons from Liverpool’s Covid-19 response

Abstract We present empirical evidence from anonymized interviews with local leaders on governance challenges facing health and social care in England. Responding to the Covid-19 pandemic has allowed policy practitioners to see the sector’s problems with new clarity and illustrated potential solutions. We draw conclusions about central government policymaking, regional and local policymaking and some specifics of the pandemic response. Even during the Covid-19 pandemic, we found continuity with governance patterns identified in earlier scholarship. Command and control from the center, although understandably prominent as an emergency response, was not the whole story. Network governance was also visible, for instance in the ability of local organizations to shape the design of national policy on community testing. Central government was also persuaded, reluctantly, to share responsibility with subnational policy makers, for example in contact tracing and the use of individual-level health data, when local authorities demonstrated its usefulness and showed ability and responsibility in its management. The stresses of a crisis will always challenge mutual trust between local and central government, but lessons need to be learned. Central government could explain its actions more effectively, be more transparent about acknowledging uncertainty, and avoid promises which run ahead of the possibilities of delivery. We show how, during the Covid-19 pandemic, central government has neglected the potential contribution of local government even more than previously: we go beyond this to suggest practical steps which local government can take despite central resistance, drawing on sound science, insight into local conditions and community engagement.