© Institute of Health and Social Care Management
HORST RITTEL AND MELVIN WEBBER
TOP CYBER SECURITY TRENDS
YOU NEED TO KNOW IN 2025
“YOU DON’T HAVE TO DO IT ALONE.”
Horst Rittel and Melvin Webber
Professional and personal reflections from the Covid 19 pandemic and lessons for Health and Social Care Management
Top Cyber Security Trends You Need to Know in 2025
Welcome to our new issue of the Loop magazine, dedicated to our IHSCM members and full of articles and ideas for helping you to do what you do.
I am always struck by the huge diversity of our nearly 10,000 members in respect of your roles and the organisations that you all work for.
It is certainly a public misconception, used periodically by political representatives of all hues, that if money to support the work of health and social care isn’t for ‘front line’ use then it is, somehow, a waste. Everything that you do, I know, is calibrated to support the delivery of essential services and it makes me very frustrated (you too, I know) when the impression is opined that the NHS and social care support functions are bloated.
Here in the UK, administrative spending is around 1.9% as a percentage of total healthcare spending, compared to 4.4% (Germany) and 5.5% (Germany). The US admin spend as a percentage is around 8.9% (all these figures are from OECD report 2022). E
D I T O R I A L
The next time that someone talks to you about what they might perceive as the NHS and social care’s ‘bloated bureaucracy’ you might like to put them right! Ditto if they start talking up the merits of alternative health systems abroad.
I acknowledge that we are far from perfect in the way that we deliver health and social care, but, to my mind, it is at best unfair to label what nonclinical staff do as ‘bureaucracy’, particularly when the phrase is used to demean the value that so many of you provide.
Allow me to move on though, because, for this issue of ‘The Loop’ I want to focus on the merits of that breadth of diversity and effort. Whilst the Department of Health & Social Care wrestles with its decision to abolish NHS England, and your political leaders in Wales, Scotland and Northern Ireland struggle to close the circle of public expectation matched with system capability, it might be easy to feel distracted, even downbeat, about the value that you all bring across the health and social care landscape.
For any of you, constantly having your organisations addressed as ‘broken’ or ‘failing’ is demotivating. You can only control your own controllables and that means doing the best that you can do to encourage, inspire, support, and recognise the efforts that your teams are making.
Adopting a metaphorical noise cancelling mindset is at the foundation of this, focusing simply on what you and your teams are doing and making certain that it is done to the very best of your collective abilities.
Leave it up to others to judge the health and social care system and the relative merits, as they see it, of what value is being delivered. We have enough critics who have never done what you do and could never understand the stress and strain of doing so. Leave them to express their glib social media opinions and, instead, look yourself in the mirror and know that you are valued by those that matter – and absolutely by your Institute.
Enjoy the new edition and thank you for the brilliant work you are all doing.
Jon Wilks CEO
Roy Lilley Health Policy Analyst, Writer, Broadcaster and Commentator on the NHS and social issues.
Let me introduce you to a couple of people who may be playing a role in your life that you might be unaware of.
If you have a job, had a job or been involved with the health and care sector you cannot be unaware of a question that’s been haunting it for the last twenty, maybe thirty years.
It has certainly haunted successive governments… and in the case of one of them, probably ruined their electoral chances.
Horst Rittel and Melvin Webber.
In 1973 they first described a ‘wicked problem’. A complex, multifaceted issue that lacks clear solutions and are difficult to define.
The characteristics?
There is no definitive problem statement, there is no obvious solution.Every time there is an attempt to resolve it, the problem changes.
Stakeholders have differing views on what a solution might look like, never mind differing views on what the problem actually is. To make it worse, the wicked problem is connected to a raft of other problems.
Our wicked problem? What are we going to do about social care?
The Labour government has set up an inquiry into the future of social care… another one. How that will bring us closer to a solution is anyone’s guess. Lurking in the shadows is Labour’s promise to create a National Care Service, along the lines of the NHS, presumably free at the point of use, to complete Bevan’s promise of ‘cradle to grave care’.
We know the problems with that as a solution. Workforce and money and the time it would take for the scaffolding to be built and a Bill to wend it say through Westminister. We are probably ten years away from anyone cutting the ribbon at an opening ceremony.
In the meantime, what are we really dealing with? What is the problem we are trying to solve? Maybe it’s not what you think.
Most people will tell you the principle issue with productivity in the NHS is the fact that flow through hospitals gets clogged up by people who are medically fit for discharge but too frail to go home safely, without support.They are unable to do this because ‘social care’ is unable to oblige.
What they really mean is local government, responsible for social care, doesn’t have the resources to carry out the assessments and provide a care package in anything like a reasonable timeframe.
Actually, it’s more complex than that. The real issue is, local authorities have been underfunded for so long they have pared back contracting fees to the providers of, principally domiciliary care and the sector is on the verge of collapse. There isn’t enough money to make it pay.
This hides another problem.
Providing adult social care is a statutory obligation placed on local authorities. They must do it. The only wriggle-room they have is the power to flex their eligibility criteria. Most local authorities have their eligibility bar set high and at the top rung of what is allowed.
In consequence, it is estimated there are now, close on a million (some say more), people who once relied on local authority care, who no longer receive it.As a result, more elderly, frail people struggle to getby and guess what… yes, they end up in the back of an ambulance, on the way to A&E.
A wicked problem connected to a raft of other problems… for the ambulance service and hospitals.
Plus, there is a further complication. These patients mainly need a few days in a medical bed. In bad weather, it’s not long before the medical beds are full. This creates another problem for the hospital. When medical beds are full, and the trolleys in the corridors and cupboards are full, the only option is to overflow into surgical beds.
A frail elderly person in a bed costs about £350 a night. They often eat sparingly and their medications are usually generic. However, a surgical bed with a hip replacement patient or a new knee, can earn the hospital a tariff-rate in the thousands. Trusts lose money when surgical beds are full of medical patients and by the way, elective waiting lists don’t come down.
It gets more wicked. This is an evil problem.
Last year over 200,000 A&E admissions came from residents in care homes. Yes, care homes!
It happens because care homes are generally staffed by well-intentioned, kind staff, at the very lowest level of clinical experience and training and are run by owners who are risk averse.
At the first sign of trouble with a resident, they ring NHS111, who can’t do much other than send an ambulance.
That is why the most frequent users of A&E are the over 65s… and, by the way, the second group are the under 9yrs.
That is why, tonight, across the NHS, there will be 13,000 beds occupied by people waiting for support to help them get home safely. In terms of the opportunity cost, it’s an absolute fortune the NHS… in addition to the fact an over 75yrs will decondition in hospital at the rate of 1% a day. If they are in hospital for three weeks, by the time they get home they’ll have trouble lifting a kettle to make a cup of tea. As well as being unsteady on their feet.
If this is a wicked problem, anything approaching a solution, has to be not about getting people home safely… it is all about stopping them being admitted in the first place!
Wicked problems don’t have to stay wicked.
There are approaches and strategies to try to ameliorate or fix them.
Wicked problems are interconnected problems so the answers usually can be found in system thinking, involving multiple stakeholders. There will be no right solution, and a lot will depend on local circumstances, so managers will have to be innovative and agile.
There will be data. Something as simple as an admissions postcode search will reveal the care homes with the highest record of ringing 999. It would pay the local Trust to offer free training for care home staff and perhaps even provide an experienced prescribing nurse, to make regular visits.
Rather than rely on a single-source solution, wicked problems require collaborative governance.
For instance, community teams made up of a lead GP, community nurses, healthcare assistants, OTs, physiotherapists and pharmacists, with a social worker on secondment would provide the basis for an admissions avoidance team.
Working from frailty data held by GPs, it is possible to target the people most likely to end up in A&E. From there it’s all about falls prevention, nutrition, aids and adaptations, medication compliance, a visit from an optician, a friendly word and a sit down with a cuppa.
It’s important. We know that an over 70yrs patient who falls is likely to fall twice more and if they do they will end in an avoidable tragedy.
The signs, the red flags will be there. Sleeping in a chair instead of in bed, or an unmade bed. Wearing the same clothes, washing-up left in the sink, the contents of the fridge. Neglected toenails, hairdressing. Ask a district nurse… they’ll tell you.
How to end the ’wickedness’? There is no silver bullet, but there is silver buckshot. Wicked problems aren’t solved, they are managed. The key is not new organisations, big changes, upheaval and palaver.
It’s all about adaptability and collaboration, another name for management.
Think it can’t be done? You’re wrong it can. Ask Richard Kirby, who leads the specialist community trust Birmingham Community Healthcare Foundation Trust. He has just been appointed a part-time advisor to the NHSE board. In a recent interview with the HSJ, he said;
“At the core of it, I think, is that integrated neighbourhood teams focus on proactive, personalised care for people with longterm conditions, complex needs, and a range of vulnerabilities. They are supported by integrated locality hubs in specific neighbourhoods modelled around PCNs which help us to coordinate care at the point of crisis, keep people out of acute care…”
Now that is really wicked!
The IHSCM supports health and social care managers by helping them to meet the challenges of the unusual as well as everyday operations through understanding, developing, sharing and celebrating good practice for the benefit of people that need advocacy or assistance.
In a myriad of ways this makes the discipline complicated by definition. The IHSCM’s aim was heightened during the CoViD 19 crisis between 2020 and 2022, made worse in the UK by poor strategic leadership, currently under investigation through the Hallett Inquiry.
A conversation with Richard Shircore towards the end of 2022 opining the lack of lessons learnt during the course of the pandemic. This led to the idea of the ‘CoViD Reader’.
Hallett’s work remains welcome. But it was assessed to be too focused on strategic issues and not enough on professionalism, community contexts, risk management and for those public services, such as the police for whom knowledge of pandemics is minimal.
The first part of the Hallet Report was published in August 2024 and focuses on strategic resilience and preparedness but does not consider the excellent response and recovery work that individuals and teams delivered within a health and care system who’s resilience has been eroded concomitant with fighting health inequalities in communities that are significantly more vulnerable to these dangers, as articulated by Dame Jennifer Dixon CE of the Health Foundation in response to the first part of the Hallet report.
This chimes with our own experiences during the crisis, witnessing good public health practices and the recommendations of the Ottawa Charter and its manifestations since 1987 being observed and implemented on a day-to-day basis despite the chaos being created at government level.
This was a major driver that prompted the ‘CoViD Reader’ alongside the time that it would take for Hallett and her team to complete their work.
David Bates ARRC MPH FIHSCM FRSPH Senior Lecturer in Disaster Response and Humanitarian Action, University of Cumbria
Richard Shircore MSc FRSPH Independent Consultant, Community and Public Health
Creating the ‘Reader’ would give individual practitioners a voice to demonstrate how they and their teams responded to the initial disaster and what they learnt from the experience.
Richard posted a callout on social media for expressions of interest in mid-2023 which resulted in an eclectic mix of public health practitioners and academics from across a wide professional base responding.
Individuals worked on their own papers and were given freedom to write in whatever style they wished but emphasising that ‘reflection on’ their own practise and experience was the key criterion.
This led to a rich data set that generated profound themes: collaborative mitigation and preparation for disasters to create resilience, accurate messaging to reduce population confusion and unnecessary fear, intelligent management of residual risk all bound by ethical practice.
This ‘Reader’ is intended to encourage the reader in “reflective practice”. Focusing on the moral and ethical challenges that CoVid generated.
A strong sense of disconnect between government and public resonates throughout the ‘Reader’ as does the professionalism and purpose demonstrated by the front line staff.
Download your FREE e-copy of the CoViD Reader, here: The-Covid-Reader-Reflections.pdf
© Institute of Health and Social Care Management
As we step into 2025, the landscape of cyber security continues to evolve at a rapid pace.
With the increasing sophistication of cyber threats and the growing reliance on digital infrastructure, it is crucial for businesses and individuals to stay ahead of the curve.
Here are some of the top cyber security trends to watch out for in 2025.
Cybercriminals are leveraging Artificial Intelligence (AI) to orchestrate more advanced and targeted attacks.
AI enables the creation of highly personalised phishing campaigns and realistic deepfake content, making it harder than ever to distinguish between legitimate and malicious communications.
To counter this, organisations should invest in advanced threat detection systems and provide ongoing training to help users recognise and mitigate AI-driven threats.
AI and machine learning are revolutionising cybersecurity by enhancing threat detection and response.
These technologies analyse vast data to identify anomalies and predict incidents, allowing proactive measures against threats.
AI-driven systems can detect unusual network behaviour and respond in real-time, while automating routine tasks to improve efficiency.
AI is also used for continuous monitoring, adaptive security, and user behaviour analytics, which helps detect insider threats and prevent breaches.
Overall, integrating AI and machine learning significantly advances the fight against cyber threats, ensuring the security of digital infrastructures worldwide.
As the world continues to migrate to cloud environments, securing these platforms is becoming increasingly critical.
Misconfigurations, inadequate access controls, and lack of visibility can lead to data breaches and unauthorised access.
Adopting comprehensive cloud security strategies, including continuous monitoring, encryption, and adherence to best practices, is essential to safeguard data in the cloud.
As we move further into 2025, the concept of Zero Trust Cyber Security continues to gain traction as a fundamental approach to safeguarding digital environments.
The Zero Trust model operates on the principle of "never trust, always verify," meaning that no user or device, whether inside or outside the network, is trusted by default.
This model focuses on identity verification and continuous monitoring to ensure security.
This approach is crucial as cyber threats become more sophisticated and widespread.
By adopting a zero-trust framework, you can enhance your security measures and significantly reduce the risk of unauthorised access.
The proliferation of IoT devices expands the attack surface for cyber threats.
Many IoT devices lack robust security features, making them attractive targets for attackers seeking to exploit vulnerabilities.
Ensuring the security of IoT ecosystems requires implementing strong authentication mechanisms, regular firmware updates, and network segmentation to prevent unauthorised access.
In July 2024, the UK government announced plans to introduce the Cyber Security and Resilience Bill, aiming to strengthen the nation's defences against escalating cyber threats.
This legislation seeks to update the existing Network and Information Security (NIS) Regulations 2018, enhancing the security and resilience of critical national infrastructure and essential digital services.
Quantum computing is an emerging technology that, in the future, could impact how businesses secure their data. Whilst it is not an immediate concern for SMEs in 2025, its ability to break traditional encryption methods may become relevant in the coming years.
Larger organisations are already exploring quantum-resistant encryption, but for SMEs this is something to be aware of rather than a top security priority right now.
Keeping up to date with developments in post-quantum cryptography and ensuring strong cybersecurity fundamentals – such as MFA and secure cloud storage solutions – will help SMEs stay prepared as the technology evolves.
Ransomware attacks have been an ongoing issue for a number of years, and they are anticipated to keep evolving in 2025. Cybercriminals are likely to use multiple extortion techniques, combining data encryption with threats to disclose sensitive information. This method raises the urgency for victims to pay ransoms, complicating efforts to address these attacks.
With the shift towards hybrid work environments, the risk of compromised identities has increased.
Cybercriminals will exploit vulnerabilities in remote work setups to gain unauthorised access to sensitive information.
To mitigate this threat, it is essential to implement robust identity and access management solutions to safeguard your data.
The cyber security landscape in 2025 will be shaped by advancements in technology and the evolving tactics of cybercriminals. By staying informed about these trends and adopting proactive security measures, businesses and individuals can better protect themselves against emerging threats. As always, vigilance and continuous improvement in cyber security practices will be key to staying ahead in this ever-changing digital world.
For any of your cyber security business needs, don't hesitate to get in touch with CyberScale.
Our team of experts is ready to help you navigate the complexities of cyber security and ensure your organisation's safety in 2025!
Email info@cyberscale.co.uk and a member of the team will get in touch.
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is
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