The Week in Public Services: 24th November 2020
This week: all eyes on the spending review; the impact of lockdowns on school attendance; and more vaccine news.
General
A shorter edition this week, but still plenty of interesting news and research to cover. All eyes on tomorrow’s spending review, which according to early coverage will include extra funding to help public services address backlogs. This blog will have a full round up of reactions next week for what the spending review means for public services, so look out for that.
Vaccine news continues to offer us all much needed hope amid the darkness of winter, continuing Covid restrictions and the prospects of a disrupted Christmas. This week it was the turn of the Oxford/AstraZeneca vaccine to announce positive Phase III trial results. As Max Roser covered on Twitter, the success of multiple vaccines in such a short timescale really is unprecedented. Crucially, the Oxford/AstraZeneca vaccine is easier to distribute than the other vaccines, since it only requires fridge temperatures for storage. It is also cheaper (at about £3), and there is a not-for-profit agreement to distribute it to low- and middle-income countries. Though some questions still remain, this is clearly very good news.
With three effective vaccines likely to become available for use, attention now turns to the logistics of a mass vaccination programme. Although plans are still being developed, we already know that healthcare workers and care home residents and staff are the top priority. The HSJ reports a possible timeline in which everyone over 18 in England who wants to will be vaccinated by early April. That sounds a bit optimistic to me, but gives an indication of the massive scale and speed of the vaccination programme being prepared from December onwards.
Lots of commentary has been written about the departure of Dominic Cummings. One piece which I’d recommend is by Sam Freedman for PoliticsHome. Freedman worked with Cummings at the Department for Education, and what really caught my eye was this line: “For all [Cummings’] demands for a scientific approach to government not a single policy either of us worked on at the DfE had been properly evaluated through, for example, a randomised control trial, because they were rolled out nationally without any piloting.” Not the most encouraging news for researchers, but certainly leaves room for improvement in the government’s approach to evidence-based policy making…
Health and Social Care
Looking ahead to the spending review, the Health Foundation has published a long read on health and social care funding over the short, medium and long term. The numbers are daunting. A further £27bn may be needed in 2020/21 for vaccines, Test and Trace, and other pandemic-related spending. Addressing backlogs is also a huge challenge. Due to constraining factors such as staff shortages, the authors suggest that a realistic target for clearing backlogs and restoring waiting times is six years — which gives a sense of the scale of the pandemic’s impact on health services.
The government published its COVID-19 Winter Plan yesterday, which announced an extra £7bn for the Test and Trace system — taking overall funding for the financial year to £22bn, an enormous amount of money even in these extraordinary times. As has been well publicised, various aspects of this system have not worked well. In particular, the final step of the process — isolation — has not received the attention it deserves (not even making it into the system’s name). A BBC long read provides a good summary of the development of the ‘world-beating’ system, and the problems it has faced. One of those problems, however, may have accidentally provided some evidence for its importance. On 3 October, Public Health England announced that 15,841 positive Covid-19 cases had not been referred to contact tracing due to running out of rows on an Excel spreadsheet. Thiemo Fetzer and Thomas Graeber’s analysis of those missing cases suggests that “the failure of timely contact tracing due to the data glitch is associated with more than 125,000 additional infections and over 1,500 additional Covid-19-related deaths.” The analysis is inevitably open to challenge due to the complexity of the problem, but it does provide tentative evidence for the system’s effectiveness despite all the challenges.
The Centre for Ageing Better released a new online report The State of Ageing in 2020. The report argues that Covid-19 has “laid bare the urgency of improving the state of ageing”. The number of people over 50 claiming unemployment-related benefits doubled from March to September this year. That is especially concerning since people over 50 have lower re-employment rates compared to other age groups. This comes on top of existing economic and regional inequalities: the wealthiest people have almost twice as many years of disability-free life ahead of them at age 65 as the poorest. The whole report is worth reading for the excellent analysis and interactive graphs.
There has been some interesting data analysis this week. The ONS have started publishing a new weekly insights article for Covid-19. Sarah Scobie (Nuffield Trust) takes a look at the data on Covid-19 cases acquired in hospital. The data shows that hospital-acquired Covid is rising concomitantly with cases. The overall share of cases acquired in hospitals is now similar to the estimated share during the first wave. This is concerning, although one major difference is that hospitals are rightly continuing to treat non-Covid patients during the second wave. In the New Statesman, Anoosh Chakelian assesses what we know, and what we don’t know, about the impact of the pandemic on suicide rates. Despite social media posts to the contrary, the current evidence overall suggests that the pandemic did not trigger a rise in suicides — although better data would be helpful so that we could be more certain.
The latest survey from the Association of Directors of Adult Social Services (ADASS) has some worrying findings. There has been an increase in adults with care needs presenting to local authorities since June; more providers of adult social care have closed during the pandemic; and budgets continue to be a major concern, with 23% of directors reporting that “they have no confidence in their budgets being sufficient to meet all of their statutory duties in 2020/21.”
Children and Young People
A new Education Policy Institute report shows that the ‘circuit breaker’ restrictions in Northern Ireland and Wales had positive impacts on school attendance. That is good news for England as hopefully attendance figures will improve as cases slowly fall. Covid absences in England in the second week of November (the latest data) represented about 6–7% of all pupils. As covered before on this blog, that is a real concern since it is likely to disproportionately impact disadvantaged pupils. See Luke Sibieta’s Twitter thread for a summary of the EPI report.
A Teach First survey also highlights inequality in education. 73% of schools do not have enough devices or internet access to ensure all students who are self-isolating can keep learning — and this rises to 84% for schools with the poorest pupils. 27% of state schools are using their reserves, and 47% plan to reduce spending in other areas. The continuing impact on disadvantaged pupils is a serious challenge for policymakers, especially as emerging evidence suggests that remote teaching is ineffective even when technology is in place.
The Early Intervention Foundation have published a report on children’s centres and family hubs. Conducted on behalf of the DfE, it explores current practices in 14 local areas across England. The aim is “to support local authorities in their strategic decision-making about the use of children’s centres in early intervention.”
The House of Commons Library has released a helpful briefing on SEN support in England, exploring the impact of the reforms brought in under the Children and Families Act 2014.
Law and Order
Attention will be on the spending review, to see if the government announces extra funding to help the courts deal with the significant backlogs caused by the pandemic. A blog on the Transform Justice website argues that more out-of-court disposals could be used to reduce the courts backlog.
Local Government
Everyone’s minds are on money this week. Croydon council, which effectively went bankrupt by issuing a Section 114 a few weeks ago, has announced a ‘bare legal minimum’ approach in order to save money. This means severe cuts to non-statutory services, such as libraries and children’s centres. Statutory services, such as social care and bin collections, will remain — as happened in Northamptonshire County Council in 2018, when it also issued a Section 114.
An informative video from the IFS looks at the funding of local councils in the run up to tomorrow’s spending review. Their analysis suggests there is a £1.1bn gap between what government has provided to councils during the pandemic, and the combined effect of councils’ extra spending and lower income. In the context of council funding cuts since 2010, this poses major challenges to many local councils. Croydon and Northamptonshire may be outliers, but unless the government announces extra funding it seems likely that many more councils will be forced to reduce spending even further in 2021. It is in that context that the chairman of the Local Government Association (LGA) has written to the Treasury asking for £8.7bn in the spending review: “Different areas of the country will need their own unique response in the coming months and years and councils must be central to efforts to level up the stark inequalities the pandemic has exposed, develop a green recovery, address skills gaps and level up the economy so that it benefits everyone.” Come back next week to find out how the Treasury responds…
That’s it for this week, but in the meantime, and on a lighter note, the latest vaccine announcement also generated some excellent Oxford-related jokes: my favourites being this one, and this one for its subtlety.
