The week in public services — 4th December 2018
This week: More money for police, schools vanishing students and no NHS long-term plan.
This is a weekly round-up of research and happenings from the team at the Institute for Government that put together Performance Tracker — a data-driven analysis of the performance of public services.
Public spending
ICYMI last week, the NAO published a report that argued HMT sometimes prioritises short-term spending control over long-term value for money. Over-optimistic, unrealistic budgets are “kept within the spending envelope by unplanned short-term cuts, which can damage long-term programmes”. The IfG’s recent report on how to run the 2019 Spending Review covered similar ground, and made recommendations on how to avoid these problems; tl;dr look at performance!
Health and Social Care
NHS Improvement released the quarterly performance report for NHS providers, and it’s not happy reading. The projected deficit for providers is £558m, but Nuffield’s Sally Gainsbury writes that this includes £2.45bn of emergency funding from the Provider Sustainability Fund, £850m of non-recurrent savings and some very optimistic assumptions baked in. NHS Providers CEO Chris Hopson is equally as sceptical, and has promised to eat his hat if the provider deficit is less than -£900m at year end (this blog will hold him to account when the figures are released).
Matt Hancock was supposed to say the NHS should learn from the leadership support given to army personnel, but instead heaped praise on the professional development infrastructure at McDonald’s. The comparison was juxtaposed with NHS England’s announcement of a revamped Diabetes Prevention Programme, through which patients will be prescribed very low-calorie diets (800 calories a day, less than a Big Mac and fries). Simon Stevens urged the food industry to cut junk calories to help the NHS pound go further.
The Health Secretary is also in a bit of bother this week after giving an interview to a Babylon-sponsored health supplement in the Evening Standard; a piece which sang the praises of several health apps including, er, Baylon’s. Shadow health minister Justin Madders wrote to the Prime Minister suggesting this broke the Ministerial Code. The HSJ highlighted the dangers such behaviour posed to NHS innovation, and Andy Cowper produced a survey of the Health Secretary’s previous in this area.
Helen Salisbury has made the case for GPs to retain their minor illness work, rather than delegate it to an independently-practising physician’s assistant. She proposes GPs work with an administrative assistant to allow the doctor to focus on the patient; GPs have the autonomy to institute this, but not the resources.
The NHS long-term plan was expected to be launched yesterday, but has been delayed. This could be because it’s not finished (we think it is), it could be because it’s going to be partnered with the social care Green Paper (we think it could be), but most likely it’s because of Brexit mess, since Matt Hancock has confirmed that both will be released before the end of the year. Merry Christmas?
QualityWatch has reviewed and updated its safety indicators and situated them in a shiny new website.
On to social care, and a good piece on the impact of cuts and rising demand for social care in East Sussex and Somerset. In the former, “the council has already cut all bus subsidies, scrapped school bus services and reduced support for the elderly, disabled and troubled families [and now] proposes shutting most of its remaining libraries and waste sites, closing its school improvement service and reducing road spending”.
Maybe this will help make adult social care part of a national conversation. A new BBC drama about care will air on Sunday night. A good alternative to I’m A Celebrity (or the TV debate on the Brexit withdrawal agreement), in any case.
A feel-good social care news story: Middlesbrough Football Club is sending boxes of memorabilia to care homes in the area to help residents with dementia reminisce about their memories of the club (the story is adamant this is an exercise in compassion, not punishment). For those residents that aren’t football fans, there is cake.
Children and young people
Over 2000 children with special needs on an Education, Health and Care plan receive no support at all, and up to 10,000 pupils cannot be accounted for and may have been “off-rolled” — moved off the school roll illegally because they are seen as difficult to teach — according to the head of Ofsted Amanda Spielman.
Ms Spielman received a letter from schools minister Nick Gibb this week, asking Ofsted to inspect more “outstanding” schools, but maintaining the Government’s commitment to exemption from routine inspection for those schools.
The new Ofsted annual report was published today; we’ve had a quick skim, but the headlines are here.
New teacher training numbers are out, and show a slight overall increase in primary and secondary trainees, paired with continued decline in STEM subjects (good thread here). Teacher recruitment targets are increasing as the number of pupils is projected to go up; NFER has a good blog explaining the drivers of these pressures.
NFER has another good blog, exploring the idea that teachers in other countries benefit from teaching larger class sizes (hear me out), because it increases non-contact time to allow for more time to be spent on CPD. Are UK teachers receptive to this idea? Well, not really, because classes are already large enough and existing CPD is ineffective.
And finally, here’s an interesting piece on what children’s social workers do day-to-day.
Neighbourhood services and local government
Northamptonshire County Council is still making headlines, albeit slightly misleading ones. Rather than “bailing out” the council, the Government has made an exception to the accounting rule that prohibits local authorities from using capital receipts to fund its day-to-day services. As a result, the council will be allowed to use the £60m it received from the sale of its HQ to plug the £35m deficit from last year and to top up reserves.
As if that weren’t enough for the council — set to be restructured in 2020 — a third government-appointed commissioner has been sent in to take over children’s services. Next May’s elections have been postponed, while a consultation on the restructuring is carried out.
Not just counties, city councils are now writing to the Government to cancel planned cuts to the “revenue support grant” — central government’s main grant to local authorities — in 2019/20.
“Tying the future of their public services to the uncertainty of the property market”. A nice piece of investigative journalism from Gareth Davies at the Bureau, looking at how much councils have invested in commercial property since 2013/14, and the risks this entails.
The head of the Local Government Ombudsman — the body that investigates complaints about local councils and social care providers — has suggested that the rise in adult social care complaints which are upheld is due to systemic process and policy errors, rather than one-off errors. A. Warning. Sign.
An interesting blog from Donna Hall (chief executive of Wigan Metropolitan Borough Council) outlines how Manchester’s integrated public service delivery model works.
Law and order
It seems police in England and Wales might be in line to receive a funding boost. Sajid Javid has reportedly won the argument to allow police and crime commissioners to double the policing precept on council tax bills to pay for the extra money from £1 a month to £2 a month from April 2019, which could raise £450m. Council tax: is there anything it can’t fund? Like lots of parliamentary business these days, it’s reported as an attempt by the Prime Minister to keep rebellious colleagues onside in the days leading up to the Meaningful Vote, rather than a festive gesture of generosity.
Clinks has published its annual State of the Sector report, assessing the trends of charity organisations working in the criminal justice system. The full report is here, but one of the key findings is that costs are being shifted onto providers, which are not fully subsidised by the statutory organisations referring people to them.
Finally, The Police Foundation have published a report on improving police response to fraud, recommending national and policing fraud strategies and investigations conducted by dedicated fraud units.
