The week in public services — 22 January 2019
This week: Lots of things that aren’t Brexit, including: school stats controversy, another hair-raising prison inspection report, and unhappy Labour councillors.
Everything
Every week, we pack WiPS with a whole host of things that aren’t Brexit. Regular readers must feel like there is a lot going on that isn’t Brexit. That is true…and also isn’t. A number of the Government’s major domestic priorities have been left to languish, and now that Brexit is becoming a serious tax on politicians’ and officials’ bandwidth, a lot more is at risk.
I’ve written about it on the Institute for Government site — and I’m keeping a running list here.
If you want to know more about the extent of Brexit distractions — and what’s going on in Government generally — you need to read the amazing Whitehall Monitor 2019 — published today.
Health and social care
The NAO’s take on financial sustainability in the NHS is reassuringly (if depressingly) unsurprising: the money will help, but with workforce and social care left to deal with, there’s a lot it won’t do. Our Chris McNulty picked out the key bits here. On the former issue — NHS Improvement has appointed a new big cheese to head up its workforce strategy.
Most of the commentary around the NHS long-term plan is coming from the big, national policy bodies — it is a national plan, after all. But, as Michael Wood from NHS Confederation points out, it’s what local external stakeholders make of it that counts — particularly local authorities.
The Nuffield Trust have pulled together, and beautifully visualised, a collection of data to assess the development of — and patient benefit from — integrated care. It’s interesting, and their conclusion (that little benefit is currently being felt) seems right. But it’s also a real demonstration of the paucity of decent indicators…There’s also a thoughtful piece on the importance of good quality data from Therese Lloyd of the Health Foundation.
In a similar vein, the King’s Fund has put together a great explainer on what community care actually is. The two think tanks together have produced some sensible advice on how to implement the “Primary Care Networks” — collaborations between GPs and other local health services. Start by focusing on a couple of clearly-defined projects, they say, and leave local discretion on governance.
The story about medicine shortages sounds like a Brexit issue — but the situation’s a lot more nuanced than that. Good explainer from the BBC.
What makes for outstanding homecare? Person-centred care — which is easier when you can pay a higher hourly rate. Possibly why a disproportionate share of care homes with a high proportion of self-funded clients are rated outstanding. At the opposite end of the spectrum, there’s a pretty grim story in the FT on effects of zero-hours contracts, illustrated with stories from the care sector.
Children and Young People
Damian Hinds appeared to accept the urging of the Education Select committee to seek a 10-year schools funding plan, à la NHS*. This will be a much tougher sell to the Treasury — who know that schools have not faced the same financial pressures over the last eight years, although their position is now getting worse.
Trying to work out how spending on schools has changed is a massive, massive pain — which makes it easy to massage the data to your own ends. The DfE are known culprits, but now the Schools Cuts website — funded by the unions — has now also been rebuked by the UK Statistics Authority. Schools policy debates tend to be so emotive, if only someone produced an independent, data-driven analysis of spending changes and their consequences….
An analysis of data from company SchoolDash found a decrease in spending on training (CPD) last year. Rebecca Allen has a neat blog teasing out reasons why teachers (from anecdote) report that so much CPD is so bad. As an ex-teacher, I 100% co-sign.
Trying to compare public service performance in different UK nations is hugely (deliberately?) faffy. But the good folks at the Education Policy Institute have overcome to faff. Overall schools performance in Wales is lower than England, they say, and the gap between advantaged and disadvantaged pupils is greater.
Ofsted is seeking feedback on the draft of its new inspection framework and guidance. Widely reported by the media using a weird false binary (‘the new framework will focus on quality of teaching instead of data’ — why do they think they were looking at data in the first place?), it has mostly been positively received. Interestingly, plans for more frequent inspections of ‘Outstanding’ schools have been scrapped, due to budget constraints.
A really good thing: the Department for Education’s free teacher vacancy advertising site is developing a-pace, with most regions now able to use it. This will take one major expense off schools’ books — a central government action which will produce tangible savings!
We on team Performance Tracker are more worried about adult social care than children’s social care (although we don’t think either are in great shape). One of the key reasons is that we don’t think the provider market in the former is sustainable. The children’s provider market is, however, also coming under some extra pressure, according to CYPNow.
Meanwhile, the FT reports that the private foster care market (where councils pay a fee to private providers to recruit carers and place children with suitable guardians) has expanded over the last four years
Demand for children’s social care is tricky to understand — and this interesting piece of research from Darlington Service Design Labs muddies the water even further. They find the number of children-in-care is strongly correlated can be self-reinforcing staff behaviours. The implication? Increasing the number of social workers may not meet demand, if part of the reason the number of children-in-care are increasing is staff behaviour. Argh!
A new Education Policy Institute report on the early years workforce (nursery nurses, playworkers, teaching and educational support assistants). TL;DR? The Government faces potential recruitment problems as the number of childcare workers is increasing slowly, and the composition of the workforce has become older each year. Perhaps most concerningly, childcare workers’ real-terms pay has decreased such that wages are converging with beautician and hairdressers’ wages — which require fewer formal qualifications. There is thus a risk that “financial incentives to [enter and stay in the childcare workforce] are practically non-existent”.
Neighbourhood Services and Local Government
What’s worse than waiting forever for proposals to reform the way government allocates money to councils? Proposals to reform the way government allocates money to councils that stich you right up. That’s how urban authorities think they’re facing right now. Proposed changes would remove deprivation as a factor from about 30% of government funding — in practice taking money away from city councils and giving it to county councils — is going down predictably poorly with Labour councillors.
Meanwhile, local authorities are expecting to generate more income from charging for services to compensate for withdrawal of Government grants, according to this LGC survey.
Law and order
Rory Stewart, the most visible prisons minister in years, wrote in the Telegraph that his department was considering banning short prison sentences for most offences. A good idea for lots of reasons — with the major caveat of the potential loss of the deterrent effect. Interestingly, though, MoJ spokespeople further clarified that the work was ‘ongoing’ with ‘no firm conclusions’.
A fascinating bit of research commissioned by the Ministry of Justice summarises the evidence on ‘procedural justice’ — that experiencing fair and just procedures leads people to view the law and authority figures as legitimate, and to greater compliance and commitment with the law. TL;DR? Prison staff’s trust, compassion, and commitment is a good predictor of how much prisoners will say they view authority as legitimate. The authors suggest the efforts to improve procedural justice would be best to target subgroups of staff and prisoners.
The latest prison inspection report from HMP Bedfordshire feels a far cry from such an atmosphere. Amongst the inexorable flood of horrifying prison statistics, this one sticks out: “a fifth said that they had developed a drug problem while in the jail”
The HMICFRS (ie. ‘the Ofsted of policing’) report into the ‘inadequate’ West Midlands police is pretty worrying — particularly on low recording rates. They’re keen to say that most crimes are recorded, but this lack of basic data is a common theme in policing overall, and is bad for victims and officers.
Unions are calling for a pause in the Government’s attempt to re-procure probation privatisation contracts, pointing out the problems that occurred with the rushed probation privatisation programme the first time.
*Technically, ‘NHS’ would be masculine in French, so I think this should say ‘au NHS’. But then it wouldn’t actually make sense to an English-speaking audience. Writing — full of compromises.
