The week in public services — 30th May 2018
This week: funding health and social care; new schools and school places; police spending.
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
If you weren’t able to make the State of Transformation conference, the Public Service Transformation Academy have written up their findings here.
New DCMS research suggests there are good reasons to think more public services will be delivered through ‘public service mutuals’, organisations partly owned by their staff. DCMS is rolling out a pilot programme to evaluate their sustainability.
Health and social care
The Institute for Fiscal Studies and the Health Foundation claim that British households should pay as much as £2,000 extra tax per year to make it possible for the NHS to cope with the demands of an ageing population. It says health spending will have to rise roughly 3% annually, and social care spending 4% annually, in order to maintain services. Check out their summary thread on Twitter here. For a critique of the think tanks’ ‘lack of imagination’, see Richard Murphy’s blog. The Centre for Policy Studies argued that funding changes needed to go hand in hand with structural improvements in how the NHS is run. For a lighter touch on all this, you can play with the IfS’ NHS funding tool to see how you’d fund the NHS!
A new Institute for Government — King’s Fund report from Nick Timmins concludes that the 2012 Health and Social Care Act, and the creation of NHS England were the high-watermark of NHS choice and competition, and the last five years have seen attempts at greater collaboration and integration. Whatever its consequences, we haven’t seen the end of political micromanagement — though the NHS does now have more of an independent voice. During the report launch, Jeremy Hunt said that he’d learned the importance of workforce planning, discussed the “umbilical cord” between health and social care, and noted he’s “sceptical” technology will create cashable savings. Watch the event here, or just read these handy summaries. The report was published on the same day that NHS England and NHS Improvement announced new measures to work closer together — you’ll need to read the report to understand the irony.
How to square the social care funding circle? Ideas from Guardian readers reveal a lot about the difficulty of finding a publicly acceptable solution. Richard Murray of the King’s Fund has a new report looking at hypothecation, which has risen up the political and public agenda in recent months. The conclusion? Neither partial or full hypothecation may be able to stabilise funding in the long term, and this attractive idea could backfire unless its risks are well understood. The FT has written a piece highlighting challenges with this approach. For more in this space, watch out for the Institute for Government’s own work on funding health and social care, due for publication next month!
In the context of rising demand, Full Fact and Nuffield have weighed in on whether this year’s winter was the “worst ever” for the NHS. Their data-driven joint explainer concludes that “the NHS experienced extreme and possibly unprecedented demand”.
How did delayed transfers of care (DTOCs) come down? It’s down to better collaboration, according to Rhiannon Edge from NHS Providers, who also notes that changing the DTOC target from a % to reducing the average daily number of beds occupied by delayed patients to 4000 is “a tall order” — last hit in April 2014.
GDP-argh? Harry Evans summarises the implications of GDPR for the NHS. No changes to depersonalised datasets, so research isn’t much likely to be affected; but opt-out options may make using national patient surveys (which includes confidential patient information) harder.
Over at the Nuffield Trust, John Appleby and Laura Schlepper write the first in a series of blogs about the NHS gender pay gap. The biggest median gap? Managers and senior managers — which are not covered by Agenda for Change payscales — where men are paid 13.7% more than women.
Finally, it doesn’t look like the obesity crisis is going away anytime soon. The Local Government Association’s analysis of 10–11 year-old children classed as severely obese says that childhood obesity rates are contributing to this time bomb. The Health and Social Care Committee published its report on the topic today, calling for bans on junk food TV ads after 9pm.
Law and order
Sajid Javid delivered his first speech to the Police Federation, promising to prioritise police spending in the upcoming Spending Review. The speech contained little by way of cast-iron specific pledges, as Lizzie Dearden from the Independent noted. The BBC coverage highlights that he came close to — but stopped short of — recognising that cuts to police forces have consequences.
The Secretary of State for Justice, David Gauke, has been making announcements on Government’s new ex-offender jobs strategy to reduce reoffending. He’s written about it in a Times article, in which he suggests using release on temporary licence for work, a system which enables prisoners to leave the prison during the day to go to work.
A breakthrough/U-turn on legal aid? Sort of. Barristers have agreed not to escalate strikes after the Ministry of Justice offered £15m extra funding for cases, but they are still refusing to take on new legal aid work.
Local Government & neighbourhood services
The Housing, Communities and Local Government Committee will follow up on its work on the Independent Review of Building Regulations and Fire Safety in a push to urge government to make specific, short-term changes aimed at making tower blocks safer.
New analysis from the Local Government Association finds that about 165,000 houses could be built with little say from local communities. Government’s planned changes to the National Planning Policy Framework could see developers build in areas that local communities didn’t want included in the local plans if councils fail to meet “undeliverable” housebuilding targets.
“The tiniest, most understaffed, most underfunded, most depressed group of people I have ever worked with”. Ouch. It’s not much fun being a planner, according to a Hay festival panel.
Schools, education and young people
The National Audit Office has reported on how Ofsted inspects schools, arguing that the existing inspection model raises questions on the levels of independent assurance about school effectiveness. It also finds that although Ofsted’s remit has expanded since 2000, its funding has fallen by 40% in real terms since 2005–06.
The Chair of the Education Committee, Robert Halfon MP, commented on the government’s response to the Committee’s report on the future of the Social Mobility Commission, noting that the Government had failed to seize the opportunity to bolster the Commission with more powers and resources. The Government’s preferred candidate to Chair the Commission, Dame Martina Milburn, will be quizzed by the Committee in a pre-appointment hearing.
Reforms to the technical education system mean that pupils will be able to study technical qualifications instead of A-levels from September 2020. Not all is hunky dory, though, as the Permanent Secretary for the Department for Education had to request a ministerial direction, calling into question the timetable for delivering these reforms.
The Department for Education has announced £50m to expand school places and facilities for children with special educational needs (SEN), but the money isn’t actually new. It is merely ring-fenced from a 2015 budget for creating new school places in England.
The next wave of 14 free schools will target the areas of England where performance is poorest, Ministers have announced. Meanwhile, the LGA is concerned about DfEs oversight of academies, and wants greater transparency, as well councils to be given the power to oversee “faltering” academies.
The County Councils Network warns that rural counties are struggling to fund free school transport for pupils, and that without more money, they will have to reduce services. They want the Government to take account of the ‘rural transport premium’ in the Fair Funding Review:
Was the recruitment programme Step Up to Social Work successful? An independent evaluation finds better five-year retention rates than teachers, and (it looks like) better retention rates compared to social workers not on fast-stream programmes. A separate longitudinal study of graduates of Frontline, another programme, has found that Frontline graduates are more likely to go from training into practice.
New survey data on what directors of children’s services are thinking. Top priorities for improvement are: recruiting and retaining staff, improving quality of practice, and managing demand.
Councils should invest in tech so social workers can spend more time with families, the British Association of Social Workers argue. A survey of 350 BASW-member social workers found that social workers spent, on average, 29 hours out of a 45 hour working week on a computer or doing paperwork.
