Is co-location key for effective multi-agency response? 

Louise Davidson presents research evidence from the experience of multi-agency response teams in the UK during the Covid-19 pandemic

Our team has recently conducted research looking at interoperability within the pandemic multi-agency response teams (PMARTs) in the UK. Specifically, we investigated the psychological factors that might affect interoperability, particularly in relation to co-location.

Between May 1 and August 18, we conducted semi-structured interviews with 14 responders from the Police Service and FRS who were involved in PMART from two areas in the UK. The results and implications of our analysis are summarised here.

PMARTs are new specialist teams that were introduced to some areas of the UK to respond to suspected COVID-19 deaths in the community during the initial months of the pandemic (London Fire Brigade, 2020). They are teams made up of police officers, firefighters and health service staff, whose aim is to ensure a safe response to Covid-19 deaths in the community and to help reduce the demand on the ambulance service.

In any multi-agency response, including PMART, responders are expected to follow the Joint Emergency Services Interoperability Principles (JESIP) to work together, save lives and reduce harm (JESIP, 2013). The five key principles of JESIP are: co-locate; communicate; coordinate; jointly understand risk; and shared situational awareness. 

However, despite the introduction of JESIP, recurring problems are still reported in multi-agency response (Pollock & Coles, 2015; Pollock, 2017; Kerslake, 2018; see also evidence from the ongoing inquiry into the Manchester Arena Attack). This suggests that lessons are not being learned and the need for a greater understanding of the way in which multi-agency teams work together in order to improve the effectiveness of future responses. To achieve this, it is important to understand psychological factors that might affect interoperability.

The social identity approach offers an understanding of how shared identity – ie a sense of ‘us-ness’ within the group – underpins group behaviour (Tajfel & Turner, 1979; Turner et al, 1987). A shared identity can facilitate co-ordination and co-operation between group members, as well as collective behaviour through providing group members with shared definitions of situations, as well as common norms for behaving in those situations (Haslam et al., 2009). As a result, this shared identity can improve the way in which that group works together (Drury et al., 2009). 

This approach has recently been applied to understand factors affecting interoperability at the strategic and tactical level in the Covid-19 response, with findings showing that a shared social identity  facilitated an effective multi-agency response at these levels (Davidson et al. 2020a; 2020b; 2020c). In the current study, we applied the social identity approach to understand behaviour at an operational level (within PMART). 

In our interviews with PMART responders, we found that responders placed a strong emphasis on the importance of co-location for enabling the teams to work together effectively. Whilst responders also highlighted several other factors affecting interoperability (see Davidson et al., in prep), we focus here on the role of co-location specifically. Responders described three ways in which co-location facilitated an effective multi-agency response:  

• Co-location provided an opportunity for physical support: Having a physical space where responders were able to come together was beneficial because it allowed them to provide practical support to each other. For example, they were able to help make sure each other’s kit and PPE was ready, and physically check each other’s equipment in a ‘buddy-buddy’ system to ensure they were safe and fully protected before entering a premises;
• Co-location provided an opportunity for emotional support: Responders had a space where they could talk about their shared difficult experiences, debrief each other and support one another. In this sense, co-location provided the responders with a psychological mechanism that helped them enact a sense of ‘us-ness’ in the form of mutual emotional support; and
• Co-location also highlighted some organisational and cultural differences between the Police and Fire and Rescue Service, which created a few challenges in the multi-agency response.  For example, in many areas the PMART teams were based in old police stations. However, owing to security restrictions in some areas, FRS personnel were not allowed unescorted access to the building. This meant that the firefighters involved in PMART teams had to be with a police officer at all times (they needed to be escorted to the changing room, to the toilet, and to get lunch, for example).

The practical implications are as follows: 

• Responders should be encouraged to support one another in practical ways, for example ensuring that equipment and PPE is safely applied;
• Time and space should be provided for responders to discuss their shared experience following an incident in order to debrief and provide emotional support to one another; and
• When working in a multi-agency team, operational barriers such as building access and shift patterns, should be identified promptly and minimised where possible.
• This research will be discussed in more detail in the next edition of the Crisis Response Journal, which will be published in September. 

 
Research Team

• Louise Davidson, University of Sussex & Public Health England
• Dr Holly Carter, Public Health England
• Professor John Drury, University of Sussex
• Professor Richard Amlôt, Public Health England
• Professor S. Alexander Haslam, University of Queensland

 
Acknowledgements
John Drury and Holly Carter were supported by a grant from UKRI, reference ES/V005383/1. Holly Carter and Richard Amlôt are funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response (EPR) at King’s College London in partnership with Public Health England (PHE), in collaboration with the University of East Anglia and Newcastle University and the NIHR HPRU in Behavioural Science and Evaluation at the University of Bristol. Louise Davidson is also affiliated to the EPR HPRU and her PhD research is jointly funded by the Fire Service Research and Training Trust and the University of Sussex. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or Public Health England.