The week in public services — 26th June 2018
This week: How good is the NHS?; challenges in children’s social care.
This is a non-comprehensive overview of what is going on in public services by the performance Tracker team at @instituteforgov. Did we miss something important? Let us know below.
Cross public services
David Lidington gave a speech at Reform about reforming public services, and the role of private providers. You can read highlights on this thread.
Health and social care
A big new joint report from the health and local government select committees argues that the Government should introduce a ‘social care premium’ to be paid by those over 40 in order to fund adult social care fairly and sustainably, whilst personal social care should be made free at the point of use.
The social care green paper has been delayed (again). Originally due for summer 2017, then summer 2018, now this Autumn. The sector’s response has been a surprising mix of weariness tempered with positivity that it’s better to get a delayed substantive paper than a summer rush-job.
Following the Prime Minister’s announcement on NHS funding, we have published a report outlining how government can create a sustainable long-term solution to the challenges facing health and social care funding. Meanwhile, King’s Fund chief executive Chris Ham calls on the Government to decide how to fund social care in this new context.
How good is the NHS? A team from the Health Foundation, Nuffield Trust, the Institute for Fiscal Studies and The King’s Fund published the first in a series of five reports looking at the NHS at 70. It turns out that it is NHS is good at protecting the public from the consequences of poor health, and at managing long-term conditions, but performs worse than others in treating 8 out of the 12 most common causes of death, and on perinatal mortality.
New King’s Fund report on digital change in health and social care shares practical recommendations from case studies of large-scale digital change: treat it as a clinical — not an IT — project; consider how staff work when designing the solution; and recognise that ‘information governance’ (collecting, using, and sharing patient information) is a cultural rather than a technical problem.
The latest King’s Fund NHS quarterly performance review highlights that staff morale is now top of the pile of issues that keep finance directors up at night.
The report of the Gosport Independent Panel was published, and our very own Marcus Shepheard summarised its main points here.
Fascinating paper about the impact of the National Minimum Wage from the Institute of Labor Economics. They find that the introduction of the National Living Wage in care homes did not see a spate of firing employee or company closures; but has been related to a slight deterioration in care quality (measured using CQC ratings). This throws (somewhat) cold water over those who argue that the introduction of the Living Wage would put care homes out of business.
And another King’s Fund report writes up findings from three deliberative workshops on the public’s views of the NHS. The IfG’s Lucy Campbell captured highlights of the King’s Fund launch event.
NEF have written an interesting article on social care — arguing that the key to improvement lies in structural changes, such as diversifying providers, focussing on community care, and focussing on wellbeing and prevention. It also cites Performance Tracker.
Announced last week, twelve councils chosen by NHS Digital and the LGA have received a small pot of ‘innovation funding’ to explore how tech can improve social care.
Neighbourhood services
A new report by Localis reveals that people would be willing to pay extra council tax or a one-off levy if it were to fund public health, fire services or police services — in order of preference — among others.
Onward, a Conservative think-tank, has argued that councils should be given the tools to accelerate housebuilding in a new paper.
In the face of funding gaps in local government, the LGA says that as many as half of the bus routes across the country, which are locally subsidised, are under threat.
Law and order
Not much on in this area over the last few days. A Justice select committee report on ‘Transforming Rehabilitation’ (the privatisation of the probation service) found that “it was a mistake to introduce the Transforming Rehabilitation reforms without completing thorough piloting”, and calls on the MoJ to review the long-term future and sustainability of delivering probation services, including how performance under the Transforming Rehabilitation system might compare to alternative systems, to be published by February 2019.
Another report from the Justice committee notes that a different approach to young adults is needed in the criminal system, recognising that existing approaches might be harmful to the ongoing development of young adults.
Education and young people
The Committee of Public Accounts (PAC) questioned the head of Ofsted, DfE officials and unions on the quality of school inspections in England: it transpired that data on obesity and off-rolling will be published soon, and that Ofsted has put controls in place after 43 schools were not inspected last year before the five-year statutory deadline. A useful summary is available on Twitter.
The Education Policy Institute published a report examining comparing academy chains and local authorities in terms of pupil attainment, and found that there is little difference in performance. In primary education, academy chains are over-represented in under-performing school groups, but they feature heavily in the highest-performing groups for secondary education.
A valuable new LKMCo report collates the evidence on schools and mental health: it recommends that schools play more of a role in tackling mental health issues.
A new LGA report on children’s services spending finds that variation in spending is “inevitable”, and at least partly down to inconsistent financial returns — such as how you categorise for corporate overheads, and whether central government grants are “income”. The three most significant drivers of variation were deprivation, population aged 0–25 years-old, and household disposable income.
And there is a supremely helpful (as ever) Commons Library overview of the Government’s reforms to regulate children’s social work. Meanwhile, Action for Children set out three options for increasing funding for children’s social care: a one-off grant in the budget, an increase in DfE’s budget in the Spending Review, or a children’s social care council tax precept. Any option should be earmarked, they argue. To add to the list of concerns in this area, a recent survey of frontline child and adolescent child psychotherapists saw 72% of respondents indicating that the threshold to access services has increased in the last three years, and 33% described services as “inadequate”.
Spending on the (centrally-delivered) National Citizen Service has been rising whilst council spending on youth services has declined. In Defence of Youth Work are calling for the NCS to be scrapped and the money saved to be transferred to local authorities.
Several issues with recruitment and retention. TES are starting a new campaign — getting teachers added to the Home Office’s visa shortage occupation list — to try to address teacher recruitment and retention problems. Also, a new survey finds only one in five people would consider becoming a social worker — hinting at recruitment problems.
The Education data lab highlights four reasons why female teachers are paid less than their male peers; it notes that men are more likely to reach top positions, and at an earlier stage in their career, and have a different approach to wage bargaining.
