The Covid-19 pandemic has thrust the sometimes-awkward relationship between evidence and policymaking into the spotlight. While the government has claimed it has been ‘led by the science’, some of its representatives have a chequered relationship with expertise. 

This session starts with a long view about evidence in policymaking and how the views of experts have been used to inform decision making. 

The panel will then reflect on the lessons that might be drawn from the management of the pandemic and history more generally, and discuss what the future holds for the role of evidence and science in policymaking.

Despite a commitment to evidence forming a central pillar of the UK government’s Covid-19 response, our health service has nonetheless faced overwhelm; tens of thousands of lives have been lost; and the path to recovery in health care looks fraught. 

What’s more, long-standing problems like workforce shortages, a disconnect between health and social care and continued funding shortages threaten to undermine attempts to return health services to anything like ‘business as usual’. 

What lessons can we learn from the Covid-19 response to inform future health care policy? 

How has the role and status of experts been important in this process? And how big a threat to future health care engagement is the presence and spread of misinformation?

Throughout history, pivotal events like wars and epidemics have led to significant changes in the way services are delivered and societies operate. 

This session will look at how significant events can lead to major shifts in social expectations and the way public services are delivered.

Achieving change in the delivery of public services can feel tortuous. The NHS has expressed an ambition to deliver ‘integrated care’ for decades. Proposals for reorganising health care services tend to iterate through consultation after consultation; innovators regularly complain that they struggle to get new technology adopted; and outdated working practices can persist for years. Yet Covid-19 has shown us that in a crisis, change can also happen overnight. Public services may seem to achieve in a moment what would normally take months, if not years. 

This session will explore how individuals and organisations can harness opportunities to drive change, and the roles that clinicians, patients and wider civil society can play in catalysing change and removing barriers.

Many elements of the English health care system have been copied worldwide, but its highly centralised and politicised structure is not commonly replicated. Some argue these characteristics leave the UK slow to respond to crises like pandemics, with local public health knowledge left untapped for creating a vital test and trace system that arguably remains of limited effect almost a year on. Where the NHS has responded well, it appears to have been associated with greater devolution of decision-making. But this also presents its own problems – and countries with a proven track record of decentralisation have found it increasingly hard to make important policy decisions quickly and consistently. 

Can lessons be learned from the pandemic that teach us about effective governance in more normal times? 

Could new health legislation change things for the better? 

And what can the military and local government teach us about how to manage central versus local dilemmas?