The week in public services: 21st April 2020
This week: what did and didn’t happen in February; more coronavirus money for councils; and what we can learn going forward
General
Not a quiet week in public services it’s fair to say…
This much-talked-about (£) insight piece in The Sunday Times goes over what it calls the ‘lost five weeks’ between the end of January and the beginning of March leaving no stone unturned about what did or didn’t happen in that time. It’s well worth a read in its entirety. The government then issued a lengthy rebuttal to some of the claims made in it. Together, the two pieces might take more than one cup of tea to get through.
The Ada Lovelace Institute has published a rapid evidence review of potential technological solutions to transition from the coronavirus crisis. Interestingly, it finds that at this stage, the technical limitations and deep social risks of digital contact tracing could end up doing more harm than good.
Outgoing director of the Royal Statistical Society Hetan Shah (soon to be the chief executive of the British Academy) has written that the hard sciences alone will not be enough to solve the biggest upcoming problems. Experience shows that tackling health challenges benefits from non-medical expertise from fields such as anthropology, psychology and sociology.
Health and Social Care
Karol Sikora discusses what lessons Britain can learn from Italy and China when it comes to (£) providing cancer treatment during the pandemic. For some, delaying treatment might be the right answer but others could receive treatment with the help of private sector resources elsewhere.
Meanwhile, the new Nightingale hospital is London is up and running but with few patients. In a leaked letter to NHS leaders in London, NHS England regional director Sir David Sloman calls on them to send doctors and nurses to treat more patients there, which would help restore more routine services such as elective surgery at hospitals.
The Royal College of GPs has revealed a coronavirus revolution: only one in four GP appointments were conducted in person in the four weeks to April 12th, with over 70% of consultations happening over the phone. This was almost an exact reversal from last year.
Professor Sir Chris Ham, chair of the Coventry and Warwickshire Health and Care Partnership, has written a forward-looking piece on the necessity of adaptability and agility for the recovery phase of the pandemic, in light of the way much of the healthcare system has already adapted to the pandemic.
Official coronavirus death figures now include a breakdown by ethnicity following concerns that BME people are disproportionately affected by the virus.
Andy Cowper does not mince his words in this comment piece on media coverage of the virus and the healthcare system.
Helen Gilburt’s piece for the King’s Fund recognises the huge contribution of volunteers to the pandemic effort. But her piece is a reminder that the response is ultimately a marathon, not a sprint and a lasting legacy needs to see volunteers as more than just a resource.
On a less happy note, lawyers have warned the NHS to expect a ‘huge number’ of legal challenges over decisions make during the pandemic. Some challenges will always be inevitable, and the lawyers urge healthcare professionals to maintain accurate records and keep a clear audit trail of decisions.
John Appleby’s piece on the costs and benefits of different decisions is also worth reading, in which he argues that the weak evidence base about the costs, benefits, and opportunity costs of different options in responding to Covid-19 are too uncertain to base decisions on them…maybe Toby Young should take a read.
David Oliver, splitting his time between the NHS frontline and Kings Fund wonkery, has written an interesting article on what Covid-19 is changing on the frontline — and how much of it is being led by clinicians.
This also led me to this very helpful explainer on critical care services from top NHS data wizard, Siva Anandaciva.
Children and Young People
This piece by Will Hazell considers the lasting impact of the virus on education. Changes to exams and the increased use of technology are both potential opportunities for lasting change.
But there is concern that disadvantaged school children, including those at risk of harm, might fall through the cracks. Lib Dem education spokesperson Layla Moran has called on the government to create a network of volunteers to identify and reach out to such kids, along with some other measures.
Labour’s Tulip Siddiq has warned that government restrictions on the furlough scheme for early years providers could see key workers left without childcare. The government had previously said they could access the furlough scheme while continuing to receive local authority funding for the free childcare they usually provided but then rowed back on Friday.
Meanwhile, here’s a quick summary of Children’s minister Vicky Ford’s evidence to the Commons Education Committee this week.
Law and Order
The latest police and crime research review from the Mayor of London’s Police and Crime team (MOPAC) contains some interesting nuggets. For example, a randomised test of hot-spot police patrols on high-crime platforms across London Underground resulted in lasting deterrence and (remarkably!) little evidence of those crimes being displaced elsewhere
Local Government
The government pledged an extra £1.6bn for councils at the weekend as coronavirus causes cashflow problems for councils in England. Some had warned the government that the cost of their emergency response would tip them into insolvency if the government did not step up with more money.
The day before the announcement, Judith Blake, leader of Leeds City Council, had written to the prime minister expressing her concern that local authorities will not be fully compensated for their coronavirus response as originally thought.
Charlotte Morgan at the New Local Government Network writes about how being confined to our homes and local areas is seeing a resurgence in community spirit, which could provide for longer-lasting arrangements of communities and public bodies working together to deliver services.
Similarly, Eddie Copeland, Director of London Office of Technology & Innovation, has written up his thoughts on how some of the changes to working that coronavirus has sparked could have a longer-lasting legacy. For example, this could be the start of a sustained shift towards a more ambitious digital democracy methods.
Ending on somewhat of a rubbish note, a combination of a surge in domestic waste and virus-related staff absences has led to councils incinerating household recycling. A survey has found that one in four local waste teams have reported losing up to 40% of staff through illness or self-isolation.
