The Week in Public Services — 19th February 2019

This week: the worst A&E performance figures ever; more than half of councils plan to dip into reserves; positive news for prisons!?

This is a weekly round-up of research and happenings from the team at the Institute for Government that put together Performance Tracker — a data-driven analysis of the performance of public services.

General

In the Week in Public Services we write mostly about public services in England, but we like to think we learn from elsewhere too. With that in mind, this story about use of data in American schools is a good read. The basic point? Obsessing too much about data — in this case, school results — ends up with excessive focus on numbers at the expense of the things you’re trying to measure and improve — in this case, student learning. One way to avoid the tendency towards overusing data, the author argues, is to simply ask: “will the data help us make better-enough decisions to be worth the cost of getting and using it?”

Health and Social Care

Back in England, the independent Topol review — analysing how new technologies can improve healthcare — was published last week. You can read the health think tanks and membership bodies responses here and here. My takeaways: making the best of new technologies requires investment in staff as well as tech, and there is still scope for better use of existing data and technology to drive improvement.

Meanwhile, the hospital performance stats for Jan are…not good.

This new figures were preceded by an emergency £600M for the Department of Health and Social Care this year, drawn from Treasury reserves. The Treasury have only said that money is for “unforeseen pressures”, but you can take it as read that it’s to bail out hospitals which would otherwise be running large deficits.

The three big health think tanks have set out their stalls on the new figures already, but I think James Illman has the most interesting take: missing targets is never good; but missing these targets has big political implications. The Government’s independent review of waiting times targets — already much-debated by health professionals — is going to be near-impossible to justify if it looks like the Government is using the review as cover to scrap targets which they aren’t currently meeting.

In social care, the Association of Directors of Adult Social Services have warned that social care “will struggle to cope unless there is an absolute guarantee from government that our colleagues from EU countries can continue to come to work here, without disruption” (which the Government’s current post-Brexit migration proposals do not provide).

Children and Young People

The What Works Centre for Social Care is trialling how to improve social worker wellbeing through “Schwartz rounds” — bringing people together, to share stories about their work and about themselves, and to listen to others doing the same. A worthwhile initiative, surely worth trying in light of rising vacancies and high turnover amongst social workers.

What’s the right standard for evidence? Whilst randomised control trials may be the gold standard in the social science community, in many cases they aren’t viable or useful for social workers on the ground. So the Centre is aiming to make sure their research is helpful despite the messy reality of the world. Sensible — and pairs well with this cautionary tale about the uncritical way we sometimes treat randomised control trials from Adrian Brown at the Centre for Public Impact.

In some rare positive news, thirteen Family and Drug Courts — organisations that give specialist support to help parents overcome their addiction, aiming to keep families together — which were at risk of closure due to government funding cuts will remain open because of a fundraising effort which raised money from private donors.

Back in the realm of controversy, would you trust an algorithm to identify children at risk of harm? Really interesting, thoughtful, article on the ethics of using algorithms in children’s social care.

A quieter week in schools, though this blog from Education DataLab — on the key points from KS4 exam results — is well worth reading. Pupils entered fewer qualifications in 2018 than in 2017, though most of that decline is explained by a change in the way science GCSEs are categorised. Still — the drop suggests some schools may be offering fewer subjects — effectively reducing the scope of education offered — owing to funding pressures. Early days, but a trend to monitor.

The Times Educational Supplement report that the Department for Education doesn’t know how much public land it has relinquished to academy trusts. The Department’s lawyers have tightened up contracts to stop this happening in future, but academies operating under old contracts may be able to claim ownership of some previously-public land.

Neighbourhood Services

The latest Local Government Information Unit survey of councils found that most councils say “Children’s Services and Education” is their biggest immediate financial pressure — above adult social care. This is now the second year in a row children’s services are at the top of the concern pile. 80% of councils say that they are “not confident” in local government’s financial sustainability, and over half of councils plan to use their reserves this year — 40% for the second year in a row. Ooh-er.

Why are councils so worried? Abdool Kara from the National Audit Office provides a great summary of the biggest challenges facing local authorities: uncertainty on budgets after March 2020; social care pressures; pressures to join-up local services; Brexit; and increasing commercial activities such as splashing the cash on retail parks and shopping centres.

Paul Johnson from the Institute for Fiscal Studies — banging the drum that if demographic trends continue and the way councils raise money doesn’t change councils will be left solely as ‘providers of social care’ — is clear and insightful (and mercifully short for an article on local government finance).

Law and order

Interesting story from HMP Durham, where the Governor is frustrated that after being promised an entrance scanner to detect drugs, it was diverted to another jail. Is it because HMP Durham isn’t one of Prisons minister Rory Stewart’s target prisons? We can only speculate…but we shouldn’t be impressed if Rory Stewart brings down violence and drug use in his 10 prisons by diverting resources from elsewhere. One to keep an eye on.

When he’s not expressing his grave concerns about a no-deal Brexit, Secretary of State for Justice David Gauke is proposing some sensible (in your humble author’s opinion) prison reforms, including replacing most prison sentences less than six months with “a robust community order regime”. Our own Emily Andrews clearly explained how reform could reduce the prison population — but the risks of relying on this alone in the Spending Review (a la Ken Clarke 2010/11) — here.

In his speech, Gauke recognised (rightly) that a well-functioning probation system is an absolute pre-requisite for this. Judges will struggle to order community sentences if they think the probation system is dysfunctional, which Danny Shaw argues is one factor in the recent decline in community sentences.

Gauke’s focus on probation is any case pretty timely, given that Working Links — a private company which runs three community rehabilitation (probation) contracts — went into administration last Friday, with Seetec — who run the probation contract for Kent, Surrey, and Sussex taking over. This comes after the Probation Inspectorate’s report into the Dorset, Devon, and Cornwall contract, which Working Links ran, found that “the professional ethos of probation [had] buckled under the strain of commercial pressures put upon it”

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Graham Atkins

Graham Atkins

Senior Researcher @instituteforgov: public services, infrastructure, other things. Too often found running silly distances in sillier weather.