The week in public services: 10th September 2019
This week: the fallout from last week’s Spending Round; Sir Michael Barber tackles the police; demand management vs rationing in the NHS
General
A much quieter week than last week. Now the noise has dissipated from the spending round, my colleague Martin Wheatley has written a great take on whether this is a good Spending Round. I think even I’m persuaded there are some reasons to be positive!
Health and Social Care
Interesting new bit of analysis from the Health Foundation and Nursing Standard on the nursing attrition rate — the rate of nurse trainees dropping out before finishing their degrees. They find that the average attrition rate across 59 universities was 24% — which is clearly worryingly high when the NHS has nurse vacancies — but also not higher than the year before (24.8%). A problem, definitely, but one that’s not getting worse?
Meanwhile, a clinical commissioning group in northwest London have asked GPs to look at “alternative ways” of dealing with patient needs when they are considering referring them to hospital. This has been decried as ‘NHS rationing’…I’ll leave you to read the article and make your own mind up. And a new survey commissioned by NHS Providers of 143 NHS Trust leaders found that 82% of Trust leaders though restrictions on capital funding pose a medium or high risk to patient safety.
Over in social care, the Department for Health and Social Care are asking providers to support the second phase of an advertising campaign to bolster care worker recruitment.
Children and Young People
Nice analysis from Sam Sims here. The Government hopes that an increase in teacher starting salaries to £30,000 by 2022/23 will “cut through on campus” and make teacher salaries competitive with other graduate occupations, but it represents a change from the Government’s previous policy of targeting pay rises and bonuses at shortage subjects.
Is this a problem? Well, given there are some subjects which don’t face recruitment problems, a blanket increase has high ‘deadweight’ costs — there will be some subjects which would have been able to recruit enough teachers without increasing starter teacher salaries to £30,000. Ultimately, “every pound spent incentivising recruitment to non-shortage subjects is a pound not spent on CPD, SEND or the NHS”, as Sam points out.
In children’s social care, a new report from the New Local Government Network analyses how national and local government should tackle rising demand for children’s social care. Their three key principles for reform? Encouraging community ownership; supporting early intervention; and encouraging partnership working. Lots of interesting material beyond that though — including discussion of data shortcomings, whether we are measuring (or can measure) what really matters, and whether Ofsted inspections should consider levels of spending. Worth reading.
Law and Order
Good overview of policing in the UK, including some useful analysis of whether the police will be able to recruit an additional 20,000 police officers — comparing the scale of Boris Johnson’s pledge with the last Labour recruitment drive between 2001 and 2005.
This morning, the Police Foundation have announced that Sir Michael Barber (he of New Labour new public management fame/infamy) will lead a new strategic review of policing which will consider: what the police should do; police capability; police governance, and police funding. Final report expected June 2021, so we’ve got a while yet…
In prisons, an interesting Guardian article considers the architecture of new prisons, and what (if any) evidence there is that design can improve conditions.
Local Government
Everyone still seems to be digesting the implications of last week’s funding announcements. Meanwhile, implementing business rates retention and the Fair Funding Review — changing how money is distributed — will be delayed until next 2021/22, Secretary of State for Housing, Communities, and Local Government Robert Jenrick has confirmed.
