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. 2020 Dec 3;12(1):73–109. doi: 10.1002/rhc3.12207

Table 4.

A Summary of the Pathologies Identified in the Norwegian and U.K. Total Defence Systems

Hallmarks VSM System Norway System Pathologies U.K. System Pathologies
1. Anticipation and monitoring

S4

S3*

Functional: In Norway, S4 did not work properly. Pandemic was an identified risk, but preparations were inadequate.

In Norway, the more centralized approach (Single lead ministry and coordinating agency, DSB), enabled S5 to be agile and adaptive in its response.

Functional: In the United Kingdom, S4 did not work properly. Pandemic was an identified risk, but preparations were inadequate.

Structural: U.K. inadequate integration in the vertical unfolding inhibited sporadic audit.

2. Leadership and decision making S5

Structural: In the United Kingdom S5 was not adequately defined, and there was a failure to balance S4 and S3.

Communication: In the United Kingdom, there was a lack of key communication channels, including the algedonic channels to ensure a prompt response.

3. Collaboration and joint effort S3

Structural: S3 in the United Kingdom is fragmented resulting in a lack of cohesiveness.

Communication: In the United Kingdom, S3 communication channels were inadequate or incomplete.

4. Coordination structure S2 Structural: In Norway, health crisis coordination is set in legislation. But confusion exists between State and Local responsibilities. The Home Guard deployment is constrained by regulations.

Structural: In the United Kingdom legislation, statutory guidance and protocols were not adhered to by S5. Moreover, the devolved nations have separate arrangements.

Communication: In the United Kingdom, there is fragmentation in the communication channels, many of which have inadequate capacity.

5. Crisis communication S1

Structural: In the United Kingdom health is devolved, and each home nation applies a different structure and approach.

Communication: In the United Kingdom, the complexity of the Health Service inhibits effective information flow. This contrasts with the Military which has a central command and control structure with sufficient recursive unfolding