Stories from Bristol

A coordinated community and public health COVID-19 response

We recently invited Cllr Asher Craig, Deputy Mayor & cabinet member Communities (Public Health, Public Transport, Libraries, Parks), Events and Equalities, and Christina Gray, Director for Communities and Public Health from Bristol City Council to join us for Transitions 2.0.

Claire Hazelgrove (CH): Good morning and thanks for joining us at Transitions 2021. I'm really excited to be facilitating this very exciting conversation with two brilliant speakers who I'll introduce in just a moment.

To introduce myself first, I'm Claire Hazelgrove, FutureGov’s Organising and Political Engagement Director. I lead our practice of work with public institutions, supporting them with community engagement, community participation and deliberative democracy to really ensure that people's voices are at the heart of change within their place. That's one good reason why I'm leading the session today. The other is actually I just recently moved to South Bristol. So this is the place that we'll be discussing today within this session.

The topic that we're looking at is really around Bristol's coordinated COVID-19 response. And what the council and its elected representatives are doing to build back better in a collaborative networked way that addresses not only the pandemic, but wider challenges and climate and economic uncertainty.

The two speakers who we’ll go to in a moment to introduce themselves and give initial opening remarks about five minutes each are Councillor Ashler Craig, Deputy Mayor with responsibility for communities, equalities and public health and Christina Gray, Director for Communities and Public Health at Bristol City Council. So welcome to you both.

Councillor Asher Craig (AC): Thank you so much for inviting us, both myself and Christina to present the journey that Bristol has been on, particularly over this last year. One of the things that I will say quite clearly about Bristol is that about three or four years ago, the mayor had the vision to look at how we as a city can coordinate better collectively.

Not just as the city council, because we are only one of the sum of many different parts. But to bring together a collective of partners and key organisations from across the city, in what we call that one city approach: Bristol, one city. Over the last two years, we've actually initiated and set out a plan for the future direction of the city to 2050. But it's a collective effort. It's no one organisation leading, it's a collection of those organisations.

When Christina came that day and tapped me on the shoulder, whispered in my ear that we have our first (coronavirus) case, we just set the wheels in motion. And because we already have the infrastructure of the one city plan and the one city approach, it made our response absolutely immediate.

We'll get to talk about some of the things that we did, but we had a very dormant, volunteering website. And maybe it had a couple of hundred people on there. We mobilised really quickly, working with our community development team to up the ante and use that as a means by which we could coordinate a lot of the efforts from the mutual aid support groups, that just literally sprung up overnight. I think we have maybe 30, 40 even more mutual aid support groups. It was great to see all of that volunteering effort happening. But obviously, we're also talking about vulnerable children and vulnerable people, we needed to make sure that people were not going to take advantage of that situation.

We were able, as a local authority, to use our infrastructure to wrap our arms loosely around those mutual aid support groups. So they were still able to just be free and flexible and do what they needed to do. But we used our website, our volunteering hub, to actually get people to sign in and do some training.

We could identify those who had been CRB checked as well, so we could also ensure that some of those volunteers could also form part of our city-wide efforts.

And I have to say, it was absolutely phenomenal, within 72 hours we went from a couple of hundred people on the volunteering website to about 3,000. We now actually in a year, have now got 10,000 volunteers across the whole of Bristol; 3,000 of whom are very active, working with shielded individuals and just volunteering in their neighbourhoods.

It has been a phenomenal experience here in Bristol, and we have been able to strengthen the ties that abound our city together with all of the key leaders and been able to be extremely responsive. I'm going to hand it over to Christine because I'm giving a strategic overview of where I was, from the inside looking in. But Christina has been driving the work on the ground, and she's been absolutely phenomenal.

Christina Gray (CG): Thank you, Asher. Thank you for inviting us. And I think these events are an opportunity to reflect as well. And when I was looking back on the last year, there were a number of things that just stood out that I thought I would like to share.

The first thing I think that we've learned, not just in public health, not just in the local authority, and not just in the city, but actually across the country and probably the globe, is that it is possible. Whatever it is, it is possible.

In the last year, we have achieved things that I think previously we would not have thought were possible. In public health, we've had to set up brand new services literally overnight that might have previously taken two or three years for us to think through and put in place. So testing programmes, contact tracing programmes, the volunteering programme that Asher has spoken about. So it is possible. That's my biggest takeaway from this.

Pre-COVID, the challenges that face us in public health are the big, stuck, intransient challenges. They're health inequalities or inequalities that have persisted over generations. And in Bristol, we've got areas of the city that have experienced huge inequalities that haven't shifted in some 20 years. So sometimes, it's hard to believe it is possible. But I think my takeaway from this is actually, it is possible.

Thinking through, what is it that made this possible? What is it that made this shift? I think there were a couple of things. First of all, everyone was focused on the task; we knew what we had to do. Everybody - whatever their role, wherever they were in this organisation or in the city and cross-party in Bristol - this was a cross-party alliance, got their shoulders behind this and really held together. So even when there was a challenge, when our rates were very high or whether there was dissonance in the city, actually we had that really strong coalition, focused on the task.

And the final thing is that it is absolutely about alliances and coalitions. It's about everyone. It's only by us binding together and listening, particularly deep into our communities. We could have had all the plans in the world that we wanted to reach our communities to get the message out, perhaps to get people in for vaccination programmes or to get people tested. But if we didn't have networks of communities or community activists who were trusted individuals in our very diverse communities within the city, we could not have done this.

That concept of alliances, and I know many of us are very familiar with it and we use it in public health all the time. There's nothing we do that we don't do in partnership with an alliance, but this was palpable and powerful. And actually, in terms of COVID and where we're looking forwards, that needs to be global. Because if we haven't got those alliances and that reach right across the globe so that everybody is vaccinated and everybody is protected, we will not protect ourselves.

It's been a real privilege to be part of this. As Asher has said it has taken a city, everyone. And particularly, I just want to acknowledge the cross-party leadership in this, that's not easy in a local authority. But all of our party leaders and all of our elected members were absolutely behind this. And without that, we couldn't have led it through in the way that we have.

CH: That was really insightful and a great way to start. So just to build on that a little bit, I think one thing that you're talking about there indirectly is around trusting in the community and between different stakeholders who were taking part in this response. I'd like to touch on that a little bit more.

Bristol is well known for being a very vibrant city, a very diverse city with people in it from a whole range of different backgrounds, artists community, the tech community and more. It sounds like these are long-standing relationships, most of them. How have you gone about really building up that sense of trust so that when disaster struck, you could pull on those levers and all know that you could work really effectively together?

AC: As I said before, we've built up that trust over the last four or five years, in terms of building Bristol as one city. I think that the trust element is there because we've been meeting throughout that whole time. The whole city has agreed on the priorities for the city that they're all prepared to get behind. Climate emergency, ecological emergency, child poverty, period poverty, food equality, you name it. The whole city, not just Bristol City Council. And in some regards, it's our other public sector, even the voluntary sector, leading to deliver on the many challenges that our city faces.

What we have is, as I said, a collective effort. This is our city, it doesn't belong just to Bristol City Council. Everyone has a stake. SO when disaster struck, that trust element, it was just instant. I also think it's because of our own continued investment in the city and particularly the voluntary and community sector. We established 23 community hubs, built off the back of existing community anchor organisations. And in those wards where there were no anchor organisations, we put staff in and coordinated with local councillors. Because the trust comes locally. The councillors were there and could get the information out and were working in those communities.

But I think if we didn't have that infrastructure in place already in many different quarters, it's not just around one city. There's a whole range of different initiatives that we're doing that meet that trust element. And yes, cross-party it's not easy, but no one really ever thought about it. We were just all in this together.

CG: Yes, trust. Trust is hard-won. We shouldn't be naive about it, there are differences. Bristol is known as the city of protest. If you have 100 people, you will have 100 different views. So you have to accept that. That's part of diversity and you have to find the energy in that. What I think was interesting, reflecting on the last year, was this common goal, which enabled us to bring all that diversity together.

I would just echo what Asher has said about the importance of investing in and nurturing that infrastructure of community connectedness. Not owning it. Not having to own it or be a big flat-footed local authority, but to be an enabler of people and place. In a city like Bristol, we're so fortunate in our diversity, in our talent, in our people, in the energy that is there, that actually we can allow that.

So it's not an accident, the title of Director of Communities and Public Health, because in Bristol the community is at the heart of public health. Any of our big public health challenges, whatever they may be, will be rooted in community experience, community knowledge, community assets. So that's vitally important.

We haven't said anything about faith groups, actually, but faith groups have been hugely important in this. Bristol has invested in its multi-faith forums and dialogue over many, many years. There was trust, both within the faith communities and between the faith communities and the public organisations. The faith communities were part of all the conversations, they were advising us. We met several times with multi-faith leaders, with Mosque leaders, with Christian leaders, with the Sikh community. All of those layers and layers. I think Nishita is going to talk about embroidery and think that's a very, very good analogy for the community. It's definitely woven and that was very important.

CH: You've rightly both highlighted the long-term approach that really enabled you to be able to jump on the opportunity that presented itself, and the need to coordinate so effectively and so deeply across the city. That’s something that we've heard a lot in our work with a range of different councils, a real desire to continue these new and evolved practices that they've perhaps taken up for the first time during the pandemic. But a bit of an elastic band pulls back to old ways of working or going back to their substantive roles as the phase moves on.

What in terms of the newer things that you've tried are you hoping to sustain? Have you got any advice about how to keep these long-term partnerships going?

CG: I don't think anyone will allow these partnerships that have formed to disappear. That's never going to happen. It's kind of like the magic bullet, we've now realised. As Christina said, you don't have to wait three years to get something done. In some instances, we were getting stuff done within three days. Finding the resources and getting them into those communities.

AC: What was really great for us is that we stood up a lot of COVID-19 cells around domestic violence, around food, you name it we have a cell for it. Those groups actually are continuing to meet and evolve.

Everyone is in agreement that we can't go back to how things were done before. They've been able to, with many of our other public sector partners, reach out to communities they haven't ordinarily reached. Sometimes those communities felt like lip service was being paid. But this time, they felt very much involved and engaged with what is happening. A lot of that work I think will continue.

As you know, we're talking about building back better and renewal. We have just delivered a new research report called Designing a New Social Reality: The Future Of The Bristol Voluntary, Community & Social Enterprise Sector Beyond Covid-19. It's a report that was delivered by one of our groups that are usually at the margins but came very much to the mainstream, which is Black South West Network.

That very comprehensive report is going to set a new trajectory for the direction of travel for the voluntary and community sector. It will also help us to identify where our resources also need to go, particularly as we address the disproportionate impact that COVID-19 has had on many of our communities, like injecting more resources into mental health provision for young people.

I'm constantly reminding agencies and organisations that this is not the time to just put a sticking plaster over it and think all we've done on this. Let's get on with it. It's about systemically looking at some of the issues that have actually got our communities at the disadvantage that they’re in. Looking within ourselves as a local authority, as the CCG, etc, to look at your service delivery, there's something wrong with it. It doesn't work for certain communities. Here is an opportunity now to really fix things going forward. We talk about institutional discrimination at a whole range of different levels. Now, it's an opportunity for everybody to really fix it if you really want to address inequalities that face our communities when it comes to health.

CG: Yes, absolutely. For public health, we'll be involved for some time to come yet in the response. Even when the background rates of infection reduce, public health teams will be part of that. So now, we're pivoting to make sure that we have that at the centre.

But whatever health protection response you have, it almost inevitably exposes inequality. So we're unashamedly using this as a way to address those systemic structural issues that Asher was just describing there, which for Bristol are about inequality. We have around a 10-year gap in healthy life, between our most and least affluent areas. That's huge and so we'll be refocusing our efforts on that.

CH: You've also been running a range of innovative approaches to thinking about how to come out of the recovery as well. And I noted your citizens' assembly that you had not too long ago which focused on the recovery but also on those other challenges that you've talked about and how integral they are to that climate emergency and so on.

Lots of councils are thinking about running assemblies at a range of different levels, be that across county-level or combined authority level. How did you find that assembly? And was there anything that surprised you about that? What would your message be to those who are thinking about running one themselves?

AC: My message? Do it. It was a phenomenal experience. And I have to say, when we first started the mayor wasn't too convinced. By the end, not only was he convinced, but we're now going to embed it into the democratic processes of Bristol. Year on year, we will focus on a wider citizens' assembly. But I think it is really useful, particularly at the local level, particularly when there are issues where everything is black and white, and there's no agreement. I am very proud of those citizens and what they did.

CG: I participated actually providing evidence. And what was really interesting about the citizens' assembly is because it's a purposeful sample. You had people with very different views; it was not a self-selected group. So you had a quality of debate, which really surfaced the things that I've talked about before. Let's not be naive about this, this is not all soft and cuddly. People in Bristol, different groups, different individuals have different experiences with very strong views. And it was a forum that really allowed us to really work through that, which I wasn't expecting. But that was very interesting.

CH: Thank you very much. And thank you both so much for joining us. We could talk for hours more about this, thank you for being really insightful. I think there'll be lots that other people who are listening to this can take away from that.

And hopefully, listeners and readers take up that mantle and follow some of these approaches as well. I really love that idea of diversity being a source of energy for change. Thank you again for your time, I hope everybody who's tuned in has enjoyed this session.