The week in public services — 19th March 2019
This week: Cancer unit staff shortages, schools achieving ‘emergency service’ status, new money for the National Citizen Service and the MoJ sitting on evidence.
Health and Social Care
The Royal College of Radiologists has found that 7.5% of consultant posts in major UK cancer centres are vacant. Other staff are plugging the gaps by working overtime, but the stress this induces, the number of doctors retiring in the near future and increasing demand mean this is unsustainable, and the RCR does not think current recruitment plans will be sufficient. This does not bode well for the long-term plan’s cancer commitments.
Nick Carding had some interesting insight on NHS capital funding this week. There is still a Waiting-for-Godot amount of uncertainty around what role the private sector might play in the NHS estate’s future, but a Treasury spokesperson reportedly thinks that NHS trusts are more likely to be successful in their bids for capital if they show they’ve “thought as hard as possible” about it.
The HSJ reports this week that the Treasury is “concerned” about some “maverick” accounting practices at some NHS trusts. The ‘re-lifing’ of trusts’ assets allows them to set less money aside to maintain or replace them. This doesn’t seem to be discordant with the Treasury allowing trusts to make transfers from their capital budgets to their day-to-day budgets, so we won’t judge them too harshly.
This piece in the Huffington Post reporting the experiences of patients in one hospital bed on an acute medical unit ward in Blackburn offers a great cross-section of the NHS, and a different perspective on the capacity challenges it faces.
Wired’s deep-dive into the costs of Babylon’s success to NHS commissioning is well worth a read. The popularity of the GP at Hand surgery in Fulham has burdened the local CCG with an enormous influx of new patients, even though they’re often based elsewhere in London. An Ipsos MORI report on Babylon’s impact on the NHS as a whole is due out next month.
Health Secretary Matt Hancock made a speech last week entitled “I believe in the power of technology to make lives better”. In the speech he quoted “ice skater” Wayne Gretzky, who is the NHL’s all-time leading scorer. Perhaps the power of Googledotcom might have made this speech better.
His speech also suggested that the practice of nurses standing when a doctor entered the room still went on in “archaic corners of the NHS”, a point which was received… poorly. There’s no evidence this happens anywhere in the NHS, and the point offended doctors who do not expect it, nurses who don’t get a chance to sit down, and everyone who thinks the workforce numbers that are the problem, not respect between different clinical professions.
Children and Young People
The Association of Schools and College Leaders have labelled schools the “unofficial fourth emergency service”. Schools and teachers are increasingly providing clothing and food to poor and vulnerable children and their families, even as they receive less support from councils.
Former education secretary Estelle Morris expressed some strong opinions to the Guardian about schools being forced to close early and parents being asked for donations to prop up school budgets: “It is an end-of-tether moment.”
A new report from the Resolution Foundation shows that the pace of growth in young people’s educational attainment has more than halved in the last 20 years, leading to skill shortages that affect, among other things, Brexit.
Chris Hatton has written an interesting blog on what NHS Digital stats tell us about the experiences of young people with learning disabilities in inpatient services. It’s important but not very happy reading.
Neighbourhood Services
Stoke-on-Trent City Council’s children’s services have been rated inadequate by Ofsted. The regulator’s report said that vulnerable children were “not being protected”, and that social workers’ caseloads were too high, averaging more than 25 children each (Performance Tracker found the national average is 17.8).
An MHCLG evaluation of the Troubled Families Programme shows… good news. Some signs of net overall and fiscal benefits, and clear evidence it stopped some children from going into care. The Government has still not made a decision on whether to continue funding it after 2020, but one suspects James Brokenshire will use this evidence to make the case at the Spending Review.
The LGC reports that councils have been given until the end of the financial year to spend their share of the £9.75m allocated to cleaning up high streets. The funding was announced last week and comes before the first High Street Perfect Day (a real thing!) in May.
A council in Wales has announced that, since moving to monthly bin collections last year, it has recycled 11% more and sent 12% less waste to landfill. It’s hoping that the move will save £390,000 annually in landfill fees, but there has been a commensurate increase in fly-tipping. Spending on waste collection in England is about 20% below where it was in 2009/10.
David Cameron’s flagship youth programme — not hoodie-hugging, the National Citizen Service — is due to receive a rebrand. The LGA thinks that the £10m-odd allocated to revitalise the NCS would be better spent on council-run youth services, which have seen funding cut by 52% since 2010.
Law and Order
The Ministry of Justice has been accused of sitting on data that shows users of the criminal justice system thought they benefitted from appearing physically in court, rather than via a video or phone link. Those whose cases were dealt with outside of a physical courtroom were much less likely to report that they felt confident they had been listened to or that they felt the process was accessible.
This piece in the Guardian outlines some of the domestic circumstances that can contribute to youth violence. Overcrowded housing, compounded by cuts to youth services budgets (62% since 2010), limits the choices available to some young people.
Russell Webster has dug into the knife and offensive weapon sentencing statistics released last week, and has a good summary on his blog.
Self-harm in Scottish prisons has reportedly shot up by 43% in the last year. In England and Wales, the number of self-harm incidents in prisons has increased by 88% since 2009/10. Scottish prisons face similar pressures as those in England and Wales: funding cuts, staff shortages and people entering the criminal justice system with complex needs.
