The Week in Public Services: 17th July 2019

This week: questions to ask about school funding boosts; the deluge of drugs in prisons; and the new ‘third way’?

General

The community paradigm. No, not the ‘Big Society’ (remember that?) having an existential crisis — this idea, proposed in a report by the New Local Government Network, would be based on ‘community commissioning’ in order to shift control of local public services from a centralised, state and market-led approach to one that encourages communities to take responsibility for the public services they use, they argue that this approach — dubbed ‘communitisation’, in contrast to nationalisation or privatisation — would also lead to a shift in management from ‘acute’ responses to a more preventative approach.

Health and Social Care

I, carer: in an interesting blog championing how data needs to be evaluated, and not just collected, technology think tank Doteveryone argues that data on social care is not providing enough value to justify the effort in collecting it. Pointing out that more data does not always equate to greater understanding, they say that care workers spend on average one and a half hours per shift on paperwork — which is spent mostly tracking, not evaluating data — and so little time is spent analysing what is actually working. Singling out proposals on care that seem to be suggested simply for the sake of it — e.g. involving robotics in social care, despite lack of evidence for the outcomes of this — Doteveryone argue that we need to invest instead in interoperability (the ability of computer systems to exchange and make use of information) and incentivise the shift towards early intervention, person-centred care by measuring wellbeing outcomes for individuals and the community.

Though these are interesting and valid points to raise, the following context should be considered:

· What is the average shift length of a care worker?

· What is defined as ‘paperwork’ and the proportion of this that is dedicated to recording care?

Meanwhile, the double-whammy of Brexit and the Conservative leadership contest have created a policy vacuum that, as ever, leaves domestic policy in the cold. This BBC report looks at the impact on the NHS and social care, and finds that underlying stresses in the system, including shortcomings in community care for the elderly, means that more patients are driven into A&E. They also criticise continuing delays to the social care Green Paper. Having been repeatedly postponed for two years now, it’s probably the only thing in England to have worse delays than Southern Rail.

The tensions surrounding the postponement of health policy decisions are growing, with the Financial Times reporting on how health leaders are describing Treasury curbs on NHS capital spending to be at ‘crisis point’. With claims that delays to ‘vital’ upgrades are happening despite funds being available, it seems that one of the first issues the new government will have to deal with — Brexit notwithstanding — shall be a standoff between the NHS and the Treasury.

Speaking at the Local Government Association Annual Conference in Bournemouth the Health Secretary, Matt Hancock, talked about how local and national government can work together to improve health and care. While acknowledging that local people are best placed to know what is required for local services and that local services should be delivered in partnership with local authorities, he — unsurprisingly — blamed the lack of progress of the Government’s Green Paper on Social Care on the Parliamentary logjam created by the Hung Parliament.

Children and Young People

Publishing important new research, the group What Works for Children’s Social Care have published a review of the Intensive Family Preservation Services (IFPS), which provides short term, community-based care. The review found that the risk of being placed in care by the children using the service was reduced by 49%, and that — unsurprisingly — contextual factors influenced the quality of the service, e.g. the relationships between families and caseworkers. Though most of the data came from the USA, the review provides a useful evaluation of how a similar service might be offered in the UK.

Will schools get a £3bn funding boost? As my colleague Graham points out, the questions we need to be asking are whether this increase in spending is earmarked for day-to-day costs or for investment and whether it changes real-terms funding per pupil. It’s also yet to be established whether spending on children with Special Educational Needs or Disabilities (SEND) will be ringfenced. As ever, get your essential context provided from the schools analysis in Performance Tracker.

Is teacher workload sustainable? This article in Schools Week (based on a report by the Sutton Trust) suggests it is not. They find that roughly half of teachers would consider moving to a tougher school if it offered a promotion or a timetable reduction. It’s estimated that a 25% timetable reduction would cost £10,000 per teacher. However, the survey result that 54% of teachers would be willing to move to a tougher school should be caveated by the fact that this is based on the school they would move to having a ‘clearly enforced and effective behaviour policy’ in place before they transferred.

In a speech for the Association of Directors of Children’s Services (ADCS), the Minister for Children and Families, Nadhim Zahawi, pointed out that 46% of local authorities were now rated a good or outstanding, up from 36% at the end of 2017. However, he acknowledged remaining challenges, including:

· 1.6 million, or 1 in 10, children have needed a social worker at some point over the last 6 years;

· Children in need of social care services were 50% less likely to achieve a strong pass in English and maths GCSE; and

· Children in Need at the end of Key Stage 4 were around 3 times less likely to go on to study A levels.

In a blog on a report by the Howard League for Penal Reform, Ofsted outlines the distinctions between unregulated and unregistered provision of children’s care homes. In a nutshell:

· Unregulated provision is where children need support to live independently. This is legal but not regulated by Ofsted.

· Unregistered provision is where a child being provided with some form of care is living somewhere that is not registered with Ofsted — which is illegal. It is a myth that, if you only provide care (in addition to accommodation) for 28 days, you do not have to register.

Write down the date! On the 16th of July, there shall be a Westminster debate entitled ‘Children and Mental Health Services’ led by Andrew Griffiths MP. The House of Commons Library has updated the existing briefing paper, ‘Children and young people’s mental health — policy, CAMHS services, funding and education’, ahead of the debate. Start swatting up!

In a fascinating report, the London Assembly looks at taking a public health approach to serious youth violence by using data from many sources to create an epidemiological analysis — of who are the victims and perpetrators of violence, the timing of violence, and lots of other fascinating analysis.

Law and Order

In the annual report on prisons, the Chief Inspector of Prisons, Peter Clarke, has highlighted the soaring levels of violence, a ‘deluge’ of drugs and unprecedented levels of inactivity. He argues that the introduction of the new technologies to counter drugs has been patchy. In addition, the report highlights significant prisoner vulnerability, with self-inflicted deaths up by a fifth on the previous year.

It’s against this sombre context that the Prison Reform Trust issue a report saying that, above the basic needs of cleanliness, hygiene and well-trained staff — sadly already looking like a tall order — prisoners want ‘education that stretches the mind and delves deep [combined with] training that bestows industry recognised qualifications’. It’s hard to fault their ambition…

Meanwhile, the Prison Inspectorate published a report on HMP Berwyn, the first of the new ‘super prisons’ — and found quite a few problems for a prison that is only at 60% capacity…

The Ministry of Justice and HMPPS have also launched their Incentives Policy Framework, aiming to provide ‘overall consistency’ while still giving Governors greater flexibility to tailor programmes that address the specific situations their prisons face.

The new prime minister shall face several challenges, but prisons minister Robert Buckland has warned that one of the consequences of funding more police officers will be more work for CPS, prisons and probation.