The Week, 17 February 2023
Yesterday, the Royal College of Nurses announced a big escalation in their ongoing industrial action. Unionised nurses will walk out for a full 48-hours, and, as the RCN General Secretary put it, “will leave no area of the NHS unaffected”. This means that in trusts affected by the strike action, nurses will not be providing care in crucial settings such as A&E and intensive care units. This represents a much higher risk to patients than previous action, with the RCN essentially acknowledging that previous strikes had not proven disruptive enough. Elsewhere, with Parliament on recess it has been a relatively quiet policy week.
In good news, yesterday, the Government announced an additional £421 million (through to 2025) for local authorities to improve drug and alcohol treatment and recovery. While we’re still waiting for the public health grant to be confirmed (last year’s grant had already been determined by this point), money to tackle drug addiction is welcome news and will hopefully help reverse a worrying upward trend in drug deaths.
As an independent review by Dame Carol Black noted in 2021, drug misuse is associated with enormous costs to a number of public services — whether in criminal justice (half of all homicides, thefts and burglaries are linked to drugs), meeting the complex physical and mental health needs of drug addicts, or in additional benefits and housing costs. A good example of where tackling cause, not symptom, is the correct approach.
In other public health news, today the Government launched a new pilot scheme to incentivise healthy eating and exercise in Wolverhampton. The scheme — the first of its kind in England — uses an app to reward those who log better diet and exercise habits with vouchers for shops, gym discounts and cinema tickets. The pilot shows a welcome appetite in government to think differently about how to boost health. However, with a £3 million price tag, ongoing evaluation will be vital in determining whether such a scheme is actually value for money.
Finally, yesterday, Cabinet Office shared the latest weekly occupancy data on the average number of staff working in each of the departmental headquarters. The headline? There’s still big variation, with several major delivery departments reporting below two thirds occupancy, including HMRC, the Home Office and the Department for Work and Pensions. In the week commencing the 6 February, over 80% of desks in the Ministry of Defence were occupied, compared to less than half in the Foreign, Commonwealth and Development Office. Given the complexity of the challenges facing some departments — for example a major and growing asylum backlog in Home Office (61%) — there’s a genuine question around the right balance of staff working from home and in HQ.
Onto the reads...
First up is this expert evaluation on progress made in digitising the NHS commissioned by the Health and Social Care Committee. The verdict isn’t pretty. Despite widespread recognition that digitisation is essential for transforming the NHS and the launch of dozens of strategies, roadmaps and dedicated digital agencies, progress across the board has been “inadequate”. Commitments identified as not on track include: the roll out of integrated health and care records, growing the health technology workforce, and improving data collection and access for research in primary care.
Next up is this read in the FT (£), on why regional inequalities in the UK may be more intractable than those in the US. Why? In a word, the Treasury — whose level of central control and power is “wholly atypical among advanced economies”, with local government left to “beg for funds”. By comparison, evidence from across the OECD tells us that devolving power away from the centre is “essential for fostering national growth”, and especially the growth of left behind areas.