The week in public services — 8th May 2018

This week: School reforms; the aftermath of local elections; and Resolution Foundation’s attempts to fix social care (and more!)

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.

Health and social care

Public Health England’s failure to invite many women to their final breast cancer screen has been a major public health story. Their chief exce, Duncan Selbie, has blogged about what PHE will do in future here. Royal Statistical Society president David Spiegelhalter has an excellent read about probability, risk, and the troubles we have working out whether the benefits outweigh the risks for individuals.

And we missed something! Nuffield research from February looked at how to get the best out of general practice. Focus on timely and convenient access may come at the cost of GPs holding a ‘medical generalist’ role, Dr Rebecca Rosen argues. Later this week Nuffield will launch a case study of how Japan tackled ageing population pressures: keep an eye out.

In wonk world, the King’s Fund has evaluated how UK health resources and spending compares to other countries. TL;DR? The NHS is under-resourced compared high-performing health systems. Spending is in line with other OECD countries (though less than Germany, France and Sweden, which spend at least 11% of GDP), but the UK has a below-average number of doctors and nurses.

HSJ has written up interesting Capgemini research, which finds that A&E attendances outstripped population growth over the last five years: in other words, a large part of increases in A&E attendances are driven by a small number of people visiting emergency departments multiple times. They estimate that 5% of the population uses 40% of bed capacity.

Big report news: the Resolution Foundation have released the final report of their Intergenerational Commission. Their headline recommendation — that millennials should be given a £10k ‘citizen’s inheritance’ when they turn 25 — suggests more David Wallets than David Willets*, but the full report covers a range of areas from housing to social care to pensions. If you don’t have time to read 230 pages, you’re in luck! Resolution Foundation director Torsten Bell summarised the report’s top 10 facts and recommendations here.

On social care, the report argues that to avoid breaching the intergenerational contract (cutting support for older generations or putting more costs on younger ones), the Government needs to tax wealth to raise revenue.

They recommend: a £2.3bn ‘NHS levy’ (levied via higher National Insurance tax on the earnings of over 65s, and a slight increase in National Insurance tax on occupational pension income); and a £2bn increase in social care funding (to come from reformed property tax and an increase in property based contributions towards care).

All interesting ideas, though IfG chief economist, Gemma Tetlow, has pointed flaws with a hypothecated tax based on National Insurance.

Law and order

How can the police best tackle crime(s)? Alex Murray blogs about how the West Midlands force are taking an evidence-based approach. Turning Point contracts and more emotive speeding penalty letters: yes. Motivational prison cell graffiti: no.

Moving through the system to criminal courts, a Criminal Bar Association survey has found that workloads have increased and half of barristers feel “able to balance their home and work lives”.

And moving further through the system to probation, a new report from Clinks argues that one-third of charities providing probation are subsidising their work with their own charitable funds to improve quality, with the smallest charities least able to secure funding. Outside of the privatised community rehabilitation companies, the report argues that the public National Probation Service, which works with the highest-risk offenders, has been discouraged from commissioning services from voluntary providers.

Clinks have also recently looked at how to best co-ordinate voluntary services in prisons, making recommendations to prisons, the voluntary sector, and the Prisons Inspectorate.

Local Government & neighbourhood services

A sunny bank holiday is making local elections feel like a distant memory: here’s five questions your new councillors should be asking, from me. Also new: advice to councillors on questions to ask about, and how to learn from best practice in, youth justice, from the Local Government Association.

Politically, the spin war over who ‘won’ the expectations game has been fierce. The BBC have a good summary of what the local election results might mean, here.

And it’s not new, but people on both sides continue spilling ink: larger councils would undermine local democratic links, argues Colin Copus.

Schools, education and young people

Just what is the role of teachers, schools, Ofsted, regional schools’ commissioners, and Department for Education? DfE is trying to simplify school accountability, and they want your opinion.

Other DfE announcements: a ‘workload advisory group’ will look at how to reduce the data collection burden on schools; and an announcement of £5m for teacher sabbaticals (for teachers with over 10 years’ experience) to improve teacher retention.

Both come after a recent National Education Union poll which suggested 80% of teachers considered quitting due to heavy workload, and a SchoolsWeek story that DfE are interested in a ‘resilience tool’. Developed in Bradford, the tool evaluates teachers’ ‘resilience’ and provides support to those believed to be most at risk of leaving teaching.

The Education Endowment Foundation are looking at another pertinent question: how can schools reduce teacher workload, without adversely impacting children’s educational outcomes? Early evidence suggests: not providing written feedback on all work and implementing findings from behavioural science, such as asking 3 questions about previous lessons at the start of a lesson.

William Stewart has a fascinating TES long read about what all these changes suggest about Damian Hinds’ goals, and the longer context of Whitehall trying to drive up school standards centrally. He argues that DfE is reducing its role in improving school results to prioritise teacher recruitment and retention above all else.

Last-but-not-least, the National Foundation for Educational Research launched a report about what international education findings tell us about England’s performance. Takeaways? Signs more encouraging in primary than secondary, and England performs well in science and reading internationally; less well at maths.

Moving beyond schools to children’s services, Labours shadow minister for early years, Tracey Brabin, has called the Government’s early years spending reductions “a ticking timebomb”.

The number of annual changes amongst Directors of Children’s Services has reached its highest ever level, ticking up slightly after a five-year plateau, according to ADCS.

Therese Coffey MP is hosting a Westminster Hall debate about looked after children placements, missing children, and sexual exploitation today, following an increase in the number of looked after children placed outside of their home borough.

And are local authorities using their powers to look after children appropriately? Louise Tickle reports concerning signs that social workers may be misusing voluntary S20 agreements by pressuring parents into accepting foster or residential care.

Looking across public services

Last-but-not-least, we found some interesting articles about public service reform in general:

  • It’s too easy to forget England =/= the UK: what’s happening to tax, spending, and public services in Scotland? Peter Hetherington lays out the challenges and opportunities facing the devolved government, and the SNP’s political strategy.
  • Social impact bonds: controversial, complex, limited evidence and…good? David Ayre at Doncaster discusses using a social impact bond for a new model of alternative education, and the impact it had on the way his council worked.

*(H/T to @patrickkmaguire whose Morning Call I shamelessly stole this joke from)



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Graham Atkins

Graham Atkins

Senior Researcher @instituteforgov: public services, infrastructure, other things. Too often found running silly distances in sillier weather.