Simon BournePrincipal Consultant and Programme Lead for the Decision Support NetworkThe Strategy Unit
Decision-making by senior leaders to support recovery from COVID
This paper summarises experiences of Integrated Care System leaders in making strategic decisions to support recovery of services from the COVID-19 pandemic.
This paper is a short version of findings from a research study conducted during Q3 2021/22, drawing on interviews of eight out of the forty-two Integrated Care System (ICS) leaders in England. It summarises their experiences of strategic decision-making prior to and since the pandemic, including the process they followed and constraints they have experienced.
Before the pandemic, leaders reported strategic decision-making processes that were fragmented, bureaucratic and slow. They highlighted key challenges in navigating politics between organisations, limited management capacity and constraints such as lack of financial resources.
Since the pandemic, they report more ‘collaborative’ strategic decision-making processes, with a greater alignment of priorities between organisations and more freedom to make decisions (particularly in the early pandemic). They also reported improvements in the use of evidence & data to inform decisions.
However, there are concerns that decision quality has worsened over the pandemic period. Increased financial and workforce challenges are also greater constraints than ever, whilst a focus on recovering services may be ‘crowding out’ other important agendas such as addressing inequalities.
Recommendations are aimed at supporting more reflective, well-structured and evidence-informed decision-making within systems – through development opportunities, changes to decision-making processes and system intelligence functions supporting decision-makers to use evidence more effectively.