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The head of the NHS in England has hailed the ‘great strides’ the health service is making, as new figures show major improvements across long waits, urgent and emergency services, and cancer care...
The UK public sector could be missing out on the opportunity to provide faster and more cost-effective community based services to citizens due to slow 5G adoption amongst Britain’s vital frontline...
Recommendations: How can improvement-led delivery enhance the quality of outcomes for our patients, communities and our health and care workforce...
The one thing we can guarantee from the forthcoming spending review is that things will get tougher for local government. We will simply have less money, but still have lots to do...
Sixth form colleges are almost universally acclaimed as a success story in British education. They have outperformed other schools and have a proud record in giving adults a second chance to improve their skills and qualifications...
The head of the NHS in England has hailed the ‘great strides’ the health service is making, as new figures show major improvements across long waits, urgent and emergency services, and cancer care.
The number of patients waiting more than 18 months fell to just 10,737 by April – down by more than 90% from 124,911 in September 2021 and by more than four-fifths since the start of January when there were 54,882. Ambulance response times improved significantly with average category two response times now at 28.5 minutes and category one at 8 mins – both the lowest in almost two years.
Meanwhile, for the first time since the start of the pandemic, the 62-day cancer backlog fell year-on-year, with those waiting two months or more down from 21,823 at the end of the last financial year (March 2022) to 19,248 at the end of this March (2023). This is down almost 15,000 from a peak of 34,000 in July 2022.
The figure fell by over 900 per week on average through the first three months of 2023, despite urgent suspected cancer referrals continuing to run at record high levels for the last two years. Separate operational data showed huge progress on the NHS Elective Recovery Plan’s target to virtually eliminate those waiting 18-months or more for elective treatment by April.
Despite record winter pressures, half (49.6%) of NHS providers had no remaining waiters other than those who had chosen to wait longer or need complex surgery. More than one in five (21%) NHS providers had completely eliminated 18-month waits. Over two-fifths (41%) of those still waiting a year and a half had been offered treatment elsewhere but chose to wait or need complex
surgeries, such as corneal transplants and spinal surgery. Almost half (48%) of the remaining waiters are concentrated in 10 NHS trusts.
Since the start of February last year, more than 2 million people who would otherwise have breached 18 months have been treated. The progress on the backlog came as the NHS was hit by the most disruptive industrial action in its history, with around 500,000 hospital appointments postponed since the start of December. Almost 200,000 appointments were affected during just the four days of junior doctor strike action in April. The NHS also delivered a record number of diagnostic tests and checks in March (2.3 million) – up more than 128,000 on the previous monthly record.
NHS chief executive, Amanda Pritchard, said: “The great strides the NHS is making on long waits, urgent and emergency care, and cancer services in the face of incredible pressure is testimony to the hard work, drive and innovation of frontline colleagues.
“Since we first published the NHS Elective Recovery Plan last year, we have slashed the numbers waiting the longest for care with 18-month waits down more than 90% on their peak.
“Ambulance response times are the fastest they have been for almost two years while A&E performance has also improved.
“And thanks to record numbers of tests and checks, the cancer backlog has fallen year on year for the first time since the start of the pandemic.
“There is still much work to be done but these are remarkable achievements given all the NHS has had to contend with – including
the twindemic of flu and covid driving record demand that made for the busiest winter in our history. I am proud of each of my colleagues who has worked tirelessly to deliver for patients.”
Prime Minister Rishi Sunak said: “I promised I would cut NHS waiting lists and we are delivering. Reducing 18-month waits by over 90% is huge progress, and it is testament to the hard work of NHS staff who have achieved this despite one of the busiest winters on record.
“We still have work to do, but backed by record government investment and the ongoing efforts of the NHS, I am confident we will get patients the care they need more quickly.”
Health and Social Care Secretary Steve Barclay said: “Cutting waiting lists to ensure people get the care they need more quickly is one of the government’s five key priorities.
“Thanks to the hard work and dedication of healthcare staff backed by government support, the NHS has now cut 18-month waits by more than 91% – a significant reduction from the peak which saw almost 125,000 people waiting for treatment. Today’s significant milestone shows we’re delivering on our Elective Recovery Plan despite NHS strikes and the challenging winter.
“This comes after virtually eliminating waits of two years last summer. We are progressing with our plan including improving access to emergency care, with the latest statistics showing the quickest ambulance response times for the most urgent cases in almost two years. We will continue to work with the NHS to pull out all the stops to cut the Covid backlogs, backed by up to £14.1 billion over the next two years on top of record funding.”
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Firefighters across England are going above and beyond their fire prevention work and are now supporting vulnerable people with issues relating to dementia, mental health, domestic abuse, social isolation, childhood obesity and youth unemployment, according to a report by The Local Government Association
Following the transfer of public health duties to local government, the fire and rescue service is now working in partnership with councils to help combat a range of health and wellbeing issues including cot deaths, drug and alcohol abuse, fuel poverty and housing problems.
The report, Beyond Fighting Fires, catalogues work by a number of fire services across England, covering both rural and urban environments and with varying levels of deprivation and affluence. It highlights the impact FRAs are having in tackling health inequalities in collaboration with other public services.
In Bolton, Greater Manchester Fire and Rescue Service has helped keep babies and toddlers safe by distributing cots and Moses baskets to vulnerable families to try to reduce the risk of sudden infant death. In Norfolk and Suffolk fire crews have helped overweight teenagers become more active by taking part in eightweek activity and nutrition courses. And throughout the country more than half of the fire authorities have now signed up
The Merseyside Fire and Rescue Service has been encouraging people to keep active and healthy through its Fire Fit programme for the past five years. The scheme is for the whole community, but is particularly aimed at young people, with firefighters going into schools each week and conducting 60 to 90-minute sessions, which include activities such as football and running.
Firefighters in Bury and Salford have been given advice and training on falls are now able to identify when people are at risk and refer them on to the local falls services. An evaluation of those who were helped shows that 80 per cent reported feeling like they were less likely to fall at home.
Firefighters in Wigan have become health champions and are working with 20 different agencies. All 190 firefighters have received specialist training in public health and now offer advice during the 6,500 home fire safety checks that they make each year.
to the Dementia Friends initiative, with a view to all FRAs joining the scheme over the coming years.
Cllr Jeremy Hilton, Chair of the LGA’s Fire Services Management Committee, said:
“Fire and rescue services have proven just how effective they can be by halving the instances of fire over the last decade through both their responses to emergencies and their extensive programme of prevention work,” said Cllr Jeremy Hilton, Chair of the LGA’s Fire Services Management Committee.
“They are now exploring how they can use their expertise in further prevention work to improve the public’s health by providing critical interventions, promoting health messages and referring to appropriate services.
“Over half of all fire related deaths and injuries in the home happen to people over 60 and we know that impairment and disability increase the risk of harm from fires and other hazards too. This work means that not only can we prevent fires and other emergencies, but action can be taken to help people who may not even realise that they need extra help.”
The Local Government Association represents all 49 fire and rescue authorities (FRAs) in England and Wales and more than 370 local councils.
•
The UK public sector could be missing out on the opportunity to provide faster and more cost-effective community based services to citizens due to slow 5G adoption amongst Britain’s vital frontline.
The UK public sector could be missing out on the opportunity to provide faster and more cost-effective communitybased services to citizens due to slow 4G adoption amongst Britain’s vital frontline.
Fewer than one in 10 public sector frontline workers are currently using 5G technology, research amongst public sector decision makers by YouGov for Vodafone UK has revealed. The slow uptake of 5G technology in the public sector appears to be attributable to a lack of knowledge of the benefits it can provide and perception of overall costs involved, which was cited as one of the key obstacles to adoption by those that don’t already have 5G.
Fewer than one in 10 public sector frontline workers are currently using 4G technology, research amongst public sector decision makers by YouGov for Vodafone UK has revealed. The slow uptake of 4G technology in the public sector appears to be attributable to a lack of knowledge of the benefits it can provide and perception of overall costs involved, which was cited as one of the key obstacles to adoption by those that don’t already have 4G.
Frontline workers, such as police officers, nurses and social workers, could all benefit from 4G’s greater speed and capacity to
Frontline workers, such as police officers, nurses and social workers, could all benefit from 5G’s greater speed and capacity to
access critical information and update records electronically while out in the community. Fast mobile connectivity would improve critical decision making in the field, reduce time spent on administration and ultimately help to improve the service provided to citizens.
access critical information and update records electronically while out in the community. Fast mobile connectivity would improve critical decision making in the field, reduce time spent on administration and ultimately help to improve the service provided to citizens.
“As public sector organisations face continued budget cuts, delivering quality services to citizens is an increasing challenge,” said Mick Wayman, Head of Public Sector at Vodafone UK. “Armed with cost-effective mobile devices and 4G connectivity, frontline workers can access and update centralised records such as medical and criminal history while they are out in the field. This helps them to make better decisions in the moment, eliminates the need to go ‘back to base’ to complete paperwork and reduces time spent on
“As public sector organisations face continued budget cuts, delivering quality services to citizens is an increasing challenge,” said Mick Wayman, Head of Public Sector at Vodafone UK. “Armed with cost-effective mobile devices and 5G connectivity, frontline workers can access and update centralised records such as medical and criminal history while they are out in the field. This helps them to make better decisions in the moment, eliminates the need to go ‘back to base’ to complete paperwork and reduces time spent on administration. They can reinvest
time and resource where they’re needed most, whether that’s visiting a patient in their own home, on the beat, or elsewhere in the community. In frontline services such as the police where every second counts, 5G really can make a big difference.”
administration. They can reinvest time and resource where they’re needed most, whether that’s visiting a patient in their own home, on the beat, or elsewhere in the community. In frontline services such as the police where every second counts, 4G really can make a big difference.”
Fast, reliable access to information on the frontline is vital. With 5G, large files, applications and critical information can be uploaded and downloaded in an instant: a feature that over half (54 per cent) of public sector respondents said is very or fairly important to their organisation.
Fast, reliable access to information on the frontline is vital. With 4G, large files, applications and critical information can be uploaded and downloaded in an instant: a feature that over half (54 per cent) of public sector respondents said is very or fairly important to their organisation.
Crucially, giving those on the frontline fast, high capacity connectivity and access to information would also support public sector decision makers’ top three priorities which were cited as improving operational efficiency, improving customer experience and reducing overall business costs. However, the research found there is still some way to go for the public sector to realise 5G’s potential to help meet their top priorities, as the benefits are not widely understood and cost is still seen as barrier to adoption.
Crucially, giving those on the frontline fast, high capacity connectivity and access to information would also support public sector decision makers’ top three priorities which were cited as improving operational efficiency, improving customer experience and reducing overall business costs. However, the research found there is still some way to go for the public sector to realise 4G’s potential to help meet their top priorities, as the benefits are not widely understood and cost is still seen as barrier to adoption.
“We are working with public sector organisations to tear down the barriers standing in the way of putting 5G connectivity in the hands of more of Britain’s frontline,” said Mr Wayman. “We are helping organisations to understand how the technology can assist in driving efficiency, delivering better services to citizens and meeting their key priorities.
We want to ensure that those on the frontline are able to take advantage of the right technologies, such as 5G, that will help them to do their jobs in the most effective way possible.”
“We are working with public sector organisations to tear down the barriers standing in the way of putting 4G connectivity in the hands of more of Britain’s frontline,” said Mr Wayman. “We are helping organisations to understand how the technology can assist in driving efficiency, delivering better services to citizens and meeting their key priorities. We want to ensure that those on the frontline are able to take advantage of the right technologies, such as 4G, that will help them to do their jobs in the most effective way possible.”
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Council call centres handle more than 50 million calls each year, usually about council tax and parking, but they also receive some more bizarre queries which can leave staff baffled.
The Local Government Association, which represents more than 370 councils in England and Wales, has revealed some of the quirkier examples from the past 12 months. Asking the regulations for hosting a mouse race, getting help with a tricky crossword answer and finding out how to cook instant noodles are just a few examples of unusual enquiries received by council customer call centres in the last year.
These include Somerset County Council being asked about the rules and regulations for mouse racing and what to do in the event of eating an out-of-date pork pie. While Nottinghamshire County Council was offered a cat by a resident who claimed it was a nuisance and asked by one individual if they knew their lost holiday romance, who lived in the area.
One elderly resident contacted Stevenage Borough Council to ask where she could buy a shopping trolley and was directed to her nearest store by staff after a quick internet search.
Cllr Peter Fleming, Deputy Chairman of the LGA, said: “These light-hearted examples of calls highlight the variety of issues that councils deal with every day –from the slightly amusing to the outright bizarre.
“Even if they do feel as though they are outside their remit, council call centre staff will always try their hardest to assist where they can. But whilst councils offer more
than 800 services, some requests are simply beyond them.
“The fact that councils are so often the first port of call for residents who are seeking a solution to their problems shows just how central a role councils play in the lives of their communities.”
Do you know how much water I need to cook super noodles? (Stevenage Borough Council)
What are the rules and regulations for hosting a mouse race? (Somerset County Council)
Can I exercise my kestrel on your tip? (Nottinghamshire County Council)
A call from an elderly lady asking for help on her crossword. Seven letters, James Bond’s cat loving nemesis, begins with B? (Staffordshire County Council)
What is the daily room rate at the Holiday Inn express? (Stevenage Borough Council)
What size tin is required for the Mary Berry strawberry tart featured on the BBC’s Great British Bake Off? (Somerset County Council)
I met a boy whilst on holiday in Ibiza, but I’ve lost his number, he said he lived in Nottingham and his dad is a bin man, do you know him? (Nottinghamshire County Council)
How many geese are on the boating lake in Cleethorpes this year – caller wanted to visit but had an allergy to feathers (North East Lincolnshire Council)
What time does your website close? (Poole Borough Council)
How high is Mt Kilimanjaro? (Somerset County Council)
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Abergower’s»history»in»document» processing»can»be»traced»back»over»the» last»15»years.»In»that»time»they»have» delivered»national»projects»for»clients» such»as»The»National»Archive,»The»British» Library,»The»MOD,»The»United»Nations» and»The»Scottish»Government.»They»have» also»worked»with»many»local»authorities» throughout»the»UK»to»convert»their»fi»nancial» records»and»planning»applications»to»digital» content»in»the»most»effi»cient»way.
Their»expertise»is»in»working»with»their» clients»to»deliver»digital»information»to» improve»their»business»processes»or»make» information»available»to»a»wider»user»base»
in»a»way»where»the»user»can»quickly»and» effi»ciently»fi»nd»the»exact»information»or» image»they»want.
This»philosophy»can»be»illustrated»with» the»project»they»carried»out»for»The»City» of»Lincoln»Archives.»This»involved»the» digitisation»of»precious»probate»registers» which»were»over»200»years»old»and»large» maps»and»illustrations»of»the»county» spanning»a»similar»time»frame.»They» organised»this»work»to»be»carried»out»on-site» using»the»most»sophisticated»large»format» scanners,»specialised»book»scanners»and» hi-»resolution»paper»scanners»to»create» very»high»quality»images.»
Their»team»worked»with»the»city»archive» department»to»ensure»that»all»original» material»was»handled»with»precise»care» and»attention»and»that»all»processes» met»with»the»highest»standards»in»the» conversion»process.»
The»project»delivered»a»key»component»in» the»highly»prestigious»“Lincs»to»the»Past”» website»which»has»been»a»great»success» in»opening»up»a»treasure»trove»of»valuable» information»to»members»of»the»public»and» specialist»archive»agencies»with»regard»to» the»rich»and»comprehensive»history»of»the» county.»»
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The problem with health and social care crises is that they require a rapid response. In many areas, the only really rapid response available is hospital.
Not in Nottingham, though, where commissioners at Nottingham North and East Nottingham West CCGs have worked with the British Red Cross to develop the Crisis Intervention Community Support Service to prevent admission to hospital or respite care by providing short, targeted interventions.
This is a service that other CCGs could do well to look at
The service is known locally by its acronym, CICSS, pronounced “kicks,” and has been running since 2010. Last year, just over three quarters of the people referred to the service did not need an admission. This adds up to 748 admissions avoided, saving the two CCGs a combined total of nearly £1.5m.
“Our main theme at British Red Cross is refusing to ignore people in crisis,” says service manager Ruth Beedel. “It doesn’t matter what size that crisis is, it is what matters to the person.”
“So the idea of CICSS is to put in some support very quickly for a short period of time to help people over a difficult period and either help them return to independence or give their GP time to set up a package of ongoing support.”
The service is available to anyone over the age of 18, though in reality the client group is overwhelmingly 65-plus.
“We had one lady of 102,” says Ruth.
When any of the GPs in the two CCG areas identifies someone who is struggling and for whom a short package might prevent an admission, they call a central hub run by community provider Nottinghamshire Healthcare County Health Partnerships.
“Most of our referrals come from GPs but we do also get them from pharmacists, who are worried about medication, and from physios and OTs,” says Ruth.
The service does not take referrals for people who have been in hospital more than 24 hours, with one exception – the Ling’s Bar rehabilitation hospital – as there is a Home from Hospital service to support them.
The hub collects some basic information and refers on to CICSS where co-ordinators take the case before making contact with the potential service user.
“We call to say that the GP thinks you might want some help and ask if we can come to make an assessment. If they say yes, we go and see them in their home.” More than 90 per cent accept the offer.
The response is rapid rather than emergency, says Ruth. GPs can ask for patients to be seen within the hour and very often that is possible. Usually, though, first contact is within 12 hours.
“We find it really helps if a relative or friend can be there for the assessment visit,” says Ruth. “The service users do not know us and it is important they feel safe.”
The team doing these visits consists of 12 healthcare assistants. The minimum requirement is NVQ level 2 although in practice they are all either at, or working towards, level 3. They cover two shifts –7am to 3pm and 3pm to 10pm – 365 days a year.
“At the initial assessment we look at the whole picture to try to understand what the service user wants, what they understand about our service and what we can offer,” says Ruth.
“We ask what they want to achieve and usually that is something like they want to be independent again or to do their shopping on their own or to be how they were before they got ill. Then we have to unpack that a bit and work out how to achieve it.”
Sometimes it is daily activities, helping the service user to prepare meals or prompting them to take medication.
“I could be helping them to mobilise more effectively,” says Ruth. “It’s not rocket science but it needs very special people to do it effectively and we have some wonderful HCAs.”
These are Level 1 service users whom CICSS can support for 14 days. More and
Mr W was 84 and at home, receiving palliative care for terminal cancer. When his health deteriorated rapidly, the district nursing team called in CICSS to provide 48 hours of care while they set up a care package.
CICSS visited him three times a day, helping with personal care safely and comfortably and with dignity. The HCAs were able to alert the district nursing team to an area of soreness and prevent it getting worse. When the care package was delayed because paperwork did not arrive in time, CICSS extended its support. A week later, CICSS handed over care. Mr W stayed at home comfortably and surrounded by his family throughout.
more frequently, though, service users require help with personal care – toileting and washing. These are Level 2 service users who can receive seven days more intensive help.
The HCAs report back to the coordinators after this initial assessment and put together a schedule of visits. The service keeps GPs informed along the way.
“That means the GPs are aware and they can mobilise other services. We are a bit like the eyes and ears of the GP. We see their patients regularly.”
They also signpost service users to other organisations that might help and liaise with GPs and community and social services about ongoing support.
Like the NHS, CICSS is seeing rising levels of dependency and complexity, including early signs of dementia, people needing end of life care and those with high body mass index. Recently, commissioners have asked CICSS to accept referrals of patients assessed by GPs as high risk of admission – adding again to the complexity of work.
The CCGs have provided additional funds and CICSS is responding with training to support the HCAs. “We are trying to build some resilience into the team as well as enhanced skills,” says Ruth.
Dr Guy Mansford, who is clinical lead for Nottingham West CCG and a partner at the Oak Medical Centre in Beeston, says quite simply that CICSS is “brilliant”.
“It’s really raised our expectations of what can happen. In the past we would see someone not coping at home and we might make a referral to Social Services who might say they could see them in two weeks if we were lucky. There was no assurance and often we would end up admitting them to hospital.
“Now I can call CICSS and know that someone will be there within the hour. I
can tell the patient and be sure that it will happen. They are as responsive as we are.”
His only worry is that CICSS may end up filling rather more of the gap left by social services than it should. “We have to hold social services to account,” he says.
Candice Lau, senior service improvement manager at Nottingham North and East CCG, says the feedback from providers and service users is excellent and that CICSS fills a real gap. The fact that CICSS is CQC regulated provides an added layer of assurance about quality, she adds.
It costs the combined CCGs just under £250,000 a year to run and with just under £1.5m saved through avoided admissions on paper this is value for money. However, she would like to evaluate this more closely. “It’s always very difficult to allocate savings exactly,” she says.
Certainly CICSS is adding value not just for service users but also the NHS locally and it is, says Ms Lau, a transferable model. “The Red Cross is very experienced at running these sorts of crisis services,” she says. “This is a service that other CCGs could do well to look at.”
Mrs P was 82, in poor health and living alone with some support from her son. She was referred to CICSS by her GP after a visit to A&E for help with personal care needs.
The team visited every morning to help her wash and dress and have some breakfast. They also helped make her environment safe, for example by having a key safe fitted so she did not need to go to the door when her son was not present. They referred her to the Department for Work and Pensions for financial advice. Meanwhile, social services informed CICSS that they were not able to provide support for Mrs P. The GP and CICSS pressed the case and eventually a care package of morning and evening visits was commissioned – but not until 30 days after the initial referral. CICSS continued to support Mrs P throughout.
Of all public sector workers, NHS staff are most likely to work through their breaks and lunchtime, according to a report published last month by the Guardian newspaper. The newspaper’s Clockoff survey, which analysed the well-being of more than 3,700 public sector staff across the board, found that 85 per cent of those who took part in the online survey insisted stress was a fact of life for them.
Dr Jill Miller, Research Adviser at the CIPD and an expert on staff wellbeing, isn’t particularly surprised at the findings. She authored the 15th CIPD Absence Management Survey which provided benchmarking data for both public and private sector organisations throughout the UK.
Her figures showed that although absence as a whole had fallen by one day per employee (6.6 days) compared to the previous year (7.6), the figure was still far higher for public sector staff than in the private sector (7.0 days per employee compared to 5.5 days respectively).
With lots of public sector restructuring and job losses as a result, it’s thought one reason for higher absences in government – and voluntary sector - jobs could be presenteeism- staff turning up at work when genuinely ill.
“Our survey found that one third of organisations had seen an increase in presenteeism,” said Dr Miller. “And it was higher in the public sector where there were also higher levels of workload and stress.
“If people come to work when they are genuinely ill then it takes them far longer to recover from an illness. Instead of taking one or two days off to get over it they eventually end up having to take much more time off as their illness worsens.”
The reasons those interviewed gave for presenteeism included:
•Worries over job security and because of this not wanting to take time off
•Not wanting to shoulder colleagues with an even higher burden than they already had
•Concerned about letting their clients down if they were absent (this particularly applied to those working in the care field such as social workers and health visitors)
Despite the increase in absence rates Dr Miller is optimistic that organisations are starting to recognise the need to focus on staff well-being, with the public sector in particular faring far better in this respect than private organisations. She has been particularly impressed by housing associations she’s studied, and notes the NHS is also gearing up activity.
“There is a lot of more proactive activity going on now than, say, five years ago. Many more organisations are putting good initiatives in place such as Work Life Balance programmes, Healthy Eating initiatives and offering employees access to counselling, or at least signposting them to areas where they can find people to help them.
“However, we still have a while to go until it becomes business as usual. In an ideal world it would be great to see staff wellbeing become a key business operation. Realistically, though, it’ll be some time before we can celebrate that particular day.”
Communicating honestly and openly with staff – particularly around restructuring exercises - would be another way of reducing stress and absenteeism, insists Dr Miller. That includes allowing staff to ask questions rather than simply dictating what’s about to happen.
“Employees often get anxious about the reasons for changing the structure of an organisation and what’s going to
happen to their role within it. Management ignore these feelings to their detriment,” she said. “Where there is a vacuum of information and no communication, staff, understandably, start to hypothesise.”
Introducing flexible working is another method of which she is in favour. This is particularly relevant today with the ‘sandwich generation,’ she says, where many workers find themselves with children and caring for elderly parents while at the same time trying to hold down a full-time job.
“Asking employees to work core hours allows people time to build their working day around their other responsibilities and helps the burden of juggling of all these roles on a continual basis. People don’t just automatically switch off their caring role when they come to work.”
Home working, which happens less in the public sector than the private, is another initiative which can help with juggling responsibilities. However, this involves a different mindset for managers – who often need guidance and how to manage such a scenario.
Getting staff to work flexibly and from home doesn’t cost an organisation much more money – and in fact could lead to savings with rent and utility bills. Health and wellbeing initiatives, on the other hand, can cost money. However, as far as Dr Miller is concerned it’s definitely money well spent.
The delivery and continuous improvement (DCI) review considered how the NHS, working in partnership through integrated care systems (ICSs), delivers on its current priorities while continuously improving for the longer term. We know that focusing on improvement, as an essential component of quality, enables
us to achieve more consistent, highquality care. The review team explored how we ‘improve with purpose’, using all the assets at our disposal: data and evidence, digital transformation and the skills and experience of our health and care workforce. Having assessed the current approach to delivery-led
improvement both within NHS England and more widely, the review team made 10 recommendations which were endorsed by NHS England’s Executive Group (outlined in this report). NHS England’s Board has now consolidated these recommendations into three actions:
1. Describe a single, shared NHS improvement approach. NHS England will set an expectation that all NHS providers, working in partnership with their integrated care boards, will embed a quality improvement method aligned with the improvement approach to support increased productivity and enable improved health outcomes. This will require a commitment from NHS England itself to work differently, in line with the improvement approach and the new Operating Framework.
2. Co-design with our health and care partners a leadership for improvement programme, commissioned and supported by NHS England, enrolling all providers and systems (including primary care) in it to support a whole-system focus on improving healthcare outcomes with our workforce, patients and communities.
3. Establish a national improvement board, to agree the small number of shared national priorities on which NHS England, with providers and systems, will focus our improvement-led delivery work, with national co-ordination and regional leadership. The new board will support more consistent, high-quality delivery of services to improve performance and reduce unwarranted variation.
NHS England will set an expectation that all NHS providers, working in partnership through integrated care systems, will embed aquality improvement method aligned with the NHS improvement approach. This will inform our ways of working across services atevery level of place: primary care networks, local care networks, provider collaboratives and integrated care systems. It will require a commitment from NHS England itself to work differently, in line with the new NHS operating framework.
Improvement-led delivery involves a whole-system (or whole-organisation) focus on quality, using evidence-based quality improvement methods to increase productivity and deliver better health outcomes for patients and communities. It is underpinned by the use of data and measurement to achieve these outcomes.
Improvement-led delivery is a long term approach to delivery that facilitates stronger organisational governance, productivity and positive cultural change over time. Many parts of the NHS have a long tradition of embedding approaches focused on quality improvement:
Appendices: These DCI review’s 10 recommendations were presented to NHS England’s Executive Group in October 2022
Improvement Review at NHS England’s NHS leadership event with ICB and trust CEOs
The review team gathered evidence and insights directly from more than 1,000 people across the health and care system. Participants who have provided their insights and feedback include:
• Lived experience partners through NHS England’s experience of care team
• ICB chief executives and non-executive directors (NEDs)
• Provider chief executives and NEDs
• Clinical leaders and people working at the point of care, such as nurses, GPs, consultants, and pharmacists
• Strategic roles including operational, improvement and transformation specialists
• ALB partners and collaborators, such as AQUA, CSUs and Health Data Research UK
• Networks, think tanks and academics, such as Q community, The King’s Fund, and The Health Foundation.
• National bodies, such as CQC, local government representatives, and NHS Confederation
• Regional groups, such as local health and social care partnerships, and Academic Health Science Networks
• NHS England national and regional teams
Emerging insights were reported to the review’s fortnightly steering group chaired by Sir David Sloman and Anne Eden.
During the course of the review, we provided inputs into several concurrent work programmes, seeking to align our emergent findings where appropriate. These included:
• The operating framework programme
• The Creating the new NHS England change programme
• Finance and productivity board
• NHS England business planning and guidance
The review team did not undertake original quantitative research or analysis. It focused on collating and considering existing research and evidence to inform our recommendations.
While we have set out implementation plans to sit alongside these recommendations, we recognise that:
• our recommendations are closely interdependent with the ongoing NHS England change programme, which will shape how NHS England’soperating framework is realised.
• full implementation of our recommendations across the NHS (and, in time, health and care systems) will require ongoing co-designbetween national and regional teams with leaders in systems and providers as well as wider partners, using a collaborative approach centred on learning.
Every year the British Red Cross helps hundreds of thousands of people live more independently in their own homes.
To find out more about our integrated services visit: redcross.org.uk/commissioners
The one thing we can guarantee from the forthcoming spending review is that things will get tougher for local government. We will simply have less money, but still have lots to do. Resolving that dilemma is the challenge for the rest of this decade, says Joe Simpson.
We have five possible strategies to address the problem. One is to raise more taxes. What we know is that there is no public appetite for this. The most recent illustration of this was the referendum in Bedfordshire seeking public support for a higher police precept. Police are one of the more popular (and visible) public services but the vote against was clear.
A second option would be to reduce service provision, but as we see more economic recovery that strategy too will find little public support. Our third option is greater efficiency. We should always be vigilant and seek further efficiencies, but the low hanging fruit has already been collected. There may still be some big opportunities (could digital rework our basic services?) but it is unlikely that the scale of efficiency changes saving can be sustained to match the saving targets we need.
So if the first three options cannot deliver the solution we need to focus on the remaining two. First is behaviour changeso that the call on our services is reduced. To give an example, if weight levels returned to their 1992 average there would be one million fewer people with type 2 diabetes. Achieving that change would save money and make people healthier. Indeed there are five million people at risk of getting type 2 diabetes, so addressing this is critical. So a real focus on behaviour change/early intervention makes sense. The problem is, however, that the savings achieved are in the future. Indeed, we may even have higher short term costs as we twin track sustaining existing provision whilst also funding the strategies to deliver the behaviour change.
My fifth strategy is, therefore, to deliver services which people or organisations are prepared to pay for. Some might say this would go against the very ethos of local government. Whenever people hark back to a golden age of local government, they always reference Joe Chamberlain. But the gas and water he provided for Birmingham were not free goods.
In his book Joseph Chamberlain: Entrepreneur in Politics, Peter T Marsh writes “his main object was not municipal takeover of the local gas supply so much as a large increase in the town’s financial base for further civic undertakings...he assured (the council) ...that municipal consolidation of the gas companies would yield the town an annual profit of at least £15,000 rising to £50,000 within fourteen years- a provision which proved to be a great underestimate”.
Such enterprise was not restricted to Birmingham. As Barry Quirk, chief executive of Lewisham likes to remind us, in the 19th century the public baths of inner London all ran at a profit, (something city treasurers of today can only dream of when they consider the running costs of swimming pools). Into the 20th century we have the example of Hull and its phone company. Today consider the success of Manchester Airport, owned by its local authorities. The company now also runs Stansted Airport.
Commercialisation therefore is not a “new” idea but part of local government’s DNA. But this is not about replacing the private sector. It is about looking at opportunities where either the private sector finds
it difficult to operate, or where public investment delivers benefits both to the public and private sectors. Chamberlain’s investments in utilities delivered benefits not just to Birmingham’s citizens, but also to Birmingham’s businesses. The “city of a thousand trades” needed effective utilities.
The question we need to ask is, what sort of commercial challenges should 21st century local government consider? The whole devolution debate has been framed around questions of economic growth, schemes involving “earn back” and the like.
Commercialisation is more than effective procurement, or tough negotiation, but it does require commercial rigour. Not every place can become a world leader, so we must recognise what commercial strengths we might have. Secondly, like every old skill we have sort of forgotten, or which have become rusty, on day one we do not attempt the most difficult manoeuvre. So let’s start by being more commercial amongst ourselves, building on the practice of different authorities which already have developed expertise in certain areas and have traded that expertise. Finally, let’s share the learning and let’s do it quickly. Seize the opportunity to embrace commercialisation and then we have a chance to shape our own destiny.
Joe Simpson is Director of The Leadership Centre
Taxpayers. The media. Watchdog groups. If you’ve ever dealt with government financials, you know that all eyes are watching. But with MasterCard,® the public sector has nothing to worry about. Our cards provide you with state-of-the-art security controls, from credit limits to purchase restrictions by merchant category. Plus, flexible approval routings and pre-authorisations from our proprietary inControl platform ensure compliance and minimize risk of fraud and misuse. And with our team of payment experts behind you, you can open your books with confidence. To learn more, visit www.mastercard.co.uk/publicsector or e-mail us at ukpublicsector@mastercard.com
business intelligence.
WHEN IT COMES TO PUBLIC SPENDING, EVERYONE’S WATCHING. LET THEM.
Everyone responsible for a building, whether in the public or private sector, must be aware of the importance of adequate fire protection for their customers, staff and property.
The legislation (Regulatory Reform (Fire Safety) Order and Fire (Scotland) Act 2005) requires that the ‘responsible person’ or ‘duty holder’ for a building carries out an adequate fire risk assessment and follows the requirements in providing fire protection. There is a wide range of standards and guidance documents available, which can be complicated and therefore there is often a need in all but the smallest buildings to gain expert help.
Whilst for some premises it is perfectly possible for the responsible person (duty holder in Scottish legislation) to carry out the fire risk assessment, for larger or more complicated premises, it may be necessary to call in an expert.
In the public sector this is even more important to ensure that safety is seen as a professional priority and that every aspect of their duty of care has been considered.
There are a number of professional accreditation bodies which offer lists of assessors, but nowhere to find independently certificated companies that meet nationally accepted standards. A number of major facilities management companies who offer services to public bodies, now recognise that they need to have independent certification of the quality of their work.
BAFE, the independent quality approvals body for the fire protection industry, has a scheme for companies who provide Life Safety Fire Risk Assessment (SP205),
which has been accredited by UKAS and is delivered by a number of licensed certification bodies. This scheme was launched in May 2012 and organisations are now being certificated across the UK.
BAFE (based at the Fire Service College at Moreton in Marsh, Gloucestershire) is the independent registration body for companies that have achieved third party quality certification of their fire protection services. Users and specifiers currently gain the reassurance that over 1250 BAFE registered providers of fire alarms, portable extinguishers, and emergency lighting meet UK standards and are regularly audited.
The Government publishes guidelines for fire protection in a range of premises which state:
‘Third party certification schemes for fire protection products and related services are an effective means of providing the fullest possible assurances, offering a level of quality, reliability and safety that noncertificated products may lack. This does not mean goods and services that are not third-party approved are less reliable, but there is no obvious way in which this can be demonstrated.’
Many public bodies and commercial organisations now specify the requirement for their fire protection service providers to be third party certificated. There are a growing number of tenders now stating this as part of the pre qualification criteria. This is not a question of recommending one company over another, as there is now such a wide range of companies available who are certificated, but a matter of refining choices for end users.
What does BAFE scheme SP205 offer to specifiers and building owners/managers?
Under the legal provisions that apply in the UK, the duty holder or responsible person for a building is required to make a fire risk assessment to clarify the fire precautions necessary to ensure the safety of staff, service users and property. BAFE scheme SP205 will identify organisations that have been independently certificated to deliver this service.
For more information go to the BAFE website www.bafe.org.uk
• This scheme has been developed by a group of industry experts to help the building ‘responsible person’ meet the requirements for Fire Risk assessments under the Regulatory Reform(Fire Safety) Order 2005 and Fire (Scotland) Act 2005
• SP205 specifies that companies must have the required technical and quality management capabilities.
• Risk assessment staff need to meet appropriate standards.
• The scheme has been designed to meet the requirements of companies large and small, recognising that there are many individuals working as assessors.
• BAFE has been working closely with the Competency Council which was independently set up to monitor and develop Risk Assessor competence criteria.
• SP205 is delivered by UKAS accredited certification bodies.
If you are responsible for a business premises, the law requires that you have a fire risk assessment.
To find competent providers, you need BAFE.
Under the provisions of the Regulatory Reform (Fire Safety) Order 2005, the Duty Holder or Responsible Person for a building is required to make a Fire Risk Assessment to clarify the fire precautions necessary to ensure the safety of staff, customers and property.
At present there are no adequate means to ensure the competence and reliability of a company commissioned to carry this out.
BAFE scheme ‘Life Safety Fire Risk Assessment SP205’ has been developed specifically to address this situation, and will provide reassurance to the Responsible Person that they are doing everything possible to meet their obligations.
Don’t leave everything to chance. Make sure that your suppliers are registered with BAFE.
Public sector workers have been under immense financial pressure to find savings for a number of years now and still the challenge increases with the current government now looking for further 40% cutbacks, whilst the demand for goods and services continues to grow , says Nigel Scorey.
Traditionally, the top-down approach would have been to make the necessary budget cuts, then apply pressure on managers to find further slashing of the quality or quantity of services to meet targets. The prevalent attitude amongst beleaguered managers has therefore not surprisingly been to try and protect services and quality and defend requirements in their area, hoping other services will take the hit, rather than embracing change and working collaboratively to find solutions that reduce cost whilst maintaining service standards.
The public sector’s receptiveness to the value and advantages of professional procurement has been mixed as the process is understandably seen as cumbersome and often the buyers are seen as at odds with the needs of frontline staff. However with the pressure increasing, more and more public sector professionals are embracing more forward thinking procurement solutions, transferring lessons and tactics gleaned from the corporate world into the public sector. This is by no means a revolutionary idea, but with a change in attitude from
both the user and the buyer communities, the benefits associated with this approach are being firmly recognised.
Long before government accepted the need to look at cost cutting measures, big business had been ravaged by recession. The private sector learned early on not to cut back on the customer experience- at the risk of losing custom and the business itself. Instead it forced managers to work across functions and with procurement to find solutions that were fit for purpose, whilst enhancing the consumer experience of the brand. Local government needs to take heed from grassroots level up. Spending cuts across the public sector needn’t be at the cost of quality or service. Quality frontline services can be delivered within available resources through a simple review of a spend area’s direct impact on the consumer versus the savings achievable through an aligned procurement strategy. The programme then starts with low impact / high savings areas, quickly proving the model. Savings are delivered through a fit for purpose collaborative approach, consolidating the huge range of suppliers and specification in use, without comprising the public services that affect millions of local people.
Now is the time for widespread change to embrace a new way of resolving cuts. It has to start with changes in attitude from a defensive and protective approach to one that embraces the need for collaboration and new ways of working. Then changes
spending cuts across the public sector needn’t be at the cost of quality or service
in the approach to procurement from a process and criteria-led doctrine to one that is consumer needs-led. Finally, managers have to embrace changes to supplier and specification that sees one fit for purpose solution utilised across functions and user communities from the multitude in use within one organisation today. In short, embracing change to develop strategic improvements that will help reduce costs and improve social value.
Embracing change on this scale is tough for any organisation. Public sector managers can benefit greatly from combining their insight into their areas with hands-on procurement professionals operationally experienced in delivering such programmes on both sides of the public and private fence. Providing a 360 overview to help overcome the inevitable challenges of defensiveness and protecting services, whilst ensuring that procurement teams are seen as understanding the needs of the consumer and what genuinely constitutes fit for
purpose. Ultimately developing and delivering a truly collaborative approach to ‘change management’.
Procure4 is one of a number of small businesses that provides such professionals in both local government and the NHS. It was engaged by Solihull Metropolitan Borough Council a number of years ago to achieve cashable savings which would help with investment in a new shared services infrastructure. The Council knew it had to gain control of spending and reduce the high number of low value transactions. Procure4 analysed the spend data and current processes across a number of categories, prioritising temporary labour, telecoms, strategic highways, print, office supplies, property services, adaptation works, books and ICT as the place to start a major programme of change. Approach strategies were established for each category, including use of eProcurement tools and traditional tender. A fully auditable savings process was implemented and enabled clear
benefits tracking within the Council.
In year one, more than £1m collectable savings with significant other cashable and non-cashable efficiency gains were delivered. In the second year, a further £1m was delivered. The tangible savings enabled budgets to be re-assessed and freed up resources for use on back office systems which then supported frontline services. More importantly, through broader training and skills transfer, a refreshed attitude to change management was established which ensured that the Council could move forward independently to tackle larger and more challenging areas of budget cuts with confidence and a truly collaborative, cross functional approach.
The public sector is dealing with huge spending cuts and unwavering demand for services. Swift change is hard to come by, but change is taking place in some areas of local government where forward thinking CEOs embrace learning from other sectors and new models of service delivery are developed to address financial pressures. As the Solihull Metropolitan Borough Council contact demonstrates, through embracing change on a number of levels, local government can adopt a truly collaborative and proactive approach to reducing budgets, utilising simple procurement techniques to ensure the quality of frontline services and the consumer experience remain the priority of public service provision.
In recent years, Procure4 has taken learning from blue chip business to public sector organisations as diverse as Suffolk Council and South Staffordshire NHS, helping under pressure managers to comfortably meet budget constraints across multiple categories.
Nigel Scorey is CEO of Procure4 www.procure4.com
With public sector spending now firmly in the spotlight, the pressure for public services and healthcare providers to deliver more for less is greater than ever. Public sector managers must try to balance budgets and increase efficiency without affecting services or patient care.
Docmail is used by over 20,000 organisations across the UK as a vital communication tool and has printed and delivered over 68 million letters since its launch in 2008. Of these, a third have been sent by healthcare, local government and education institutions, including GP surgeries, schools and local councils, representing a collective saving of around £8 million on the cost of traditional print and mailing.
Docmail’s hybrid mail solution allows users to benefit from savings in administrative time and postage costs. Faster, more costeffective and secure, Docmail relieves the labour intensive task of a manual postal mailing, especially at peak times - all for just 39p per letter.
Through the secure online portal, Docmail users create personalised letters, print and deliver a high quality communication piece securely to all, or a selection of their database.
Martin’s Oak Surgery, a small practice in East Sussex, has been using Docmail for four years. Practice Manager Carey Sinclair says the difference it’s made to their practice is significant:
“We have saved weeks in staff time and hundreds of pounds using Docmail for large runs – it’s more efficient than the more traditional method. Our flu campaign alone saves us over £800. By using EMIS Web searches, we save even more. We believe that other medical practices should benefit from it, too.”
From appointment letters and clinic campaigns to result reminders, invitations for QOF indicators and invoicing, the capabilities of the innovative Docmail system offer limitless options for healthcare and medical organisations. In recognition of its benefits, CFH Docmail recently secured a new agreement with GP Systems of Choice as part of its Lot 2 Additional GP IT Services Framework, which include the Docmail hybrid mail solution.
As part of its ongoing strategy to develop innovative mail delivery mechanics which save their customers time and money as well as well as reducing the impact on the environment, CFH Docmail has recently launched Dotpost, an innovative online document delivery solution.
Dotpost is a secure online platform that allows users to store documents easily – and free of charge. Recipients simply register using a unique invitation code and they can view, save and print the documents they need on any device (PC, smartphone or tablet).
Dotpost reduces the amount of paper used
and slashes postage costs. Free Dotpost accounts can be offered to all citizens so they can benefit from free storage and delivery of documents from all public sector departments.
Dotpost was used recently by Ian Brown, Head of Revenue and Benefits at Wiltshire Council.
“The Dotpost system is slick and easy to use, and we are hopeful that this will lead to a reduction in our usual postage and stationery bill. The Dotpost system helps us to access customers in a more personal way and to take a step towards our ambition of a much more efficient communications system. It has also allowed us to manage our database more effectively, and meet customer’s expectations, in terms of electronic delivery.”
CFH Docmail Managing Director Dave Broadway believes the Dotpost solution is an ideal way to deliver documents securely in the digital age.
“Mass mailing is an expensive task and email is wholly unreliable. We believe that this way of sending letters and reports – is a great alternative to print and post, and of course much easier for citizens if they can store and view all paperwork in one secure portal.” www.docmail.co.uk
Communication is vital to government organisations but the estimated cost to the public sector is around £1.10 to send a letter, printed and delivered. One smart and efficient solution is helping to bridge the gap
After 18 months and thousands of amendments, the Health and Social Care Bill was passed in Parliament in March 2012. The writing was on the wall for NHS Providers and staff to either embrace the changes or disappear. In East Kent, GPs, Commissioners and Independent Providers embraced the changes and became the pathfinders for the development of GP-Commission-led services, delivered to Key Performance Indicators which would provide value for money, and safe and efficient, high-quality physical therapy services.
Working as the superintendent physiotherapist for the Canterbury and Coastal area gave insight into a failing NHS physiotherapy service. New to Follow Up ratios were climbing, Did Not Attend rates were as high as 20% and waiting times even reached a maximum of 53 weeks for routine, chronic conditions.
In partnership with local GPs and Practice Based Commissioners, EKTRA was established in 2007 with the prime objective of tackling the deplorable problems in East Kent NHS Physiotherapy services. An independent, contracted service was commissioned by the NHS and produced a truly efficient and seamless service for its patients. The independent management of patient referrals allowed for patient choice and expansion of service availability, delivered by a plurality of providers.
Where patients were previously being funnelled into secondary and primary care physio centres and hitting bottle necks of high waiting times, they are now allowed to choose to have their physio in their GP surgery near home or their workplace or
even in one of EKTRA’s six private clinics. NHS patients can now experience the quality, integrity and care of real private healthcare, without the worry of having to find the funds to pay. This is what is commonly referred to in the media as privatisation of the NHS.
With this phrase, media outlets and politicians have incited a belief and scared off the public, reminding them of past problems experienced from privatisation of the public sector and grossly expensive Private Finance Initiatives. Ultimately, they have demonised the private companies as fat cats creaming off the profits.
Sadly, we’re not shown the full picture. Providing a contract for companies like EKTRA is similar to finding a decorator to rejuvenate your house. You tell them what you want, they do what you want. You don’t worry about when you’re going to decorate, the materials you will need, the planning and execution of the process. This method is tried and tested in all walks of life, yet we seem more reluctant implementing this in our health service.
This aspect of NHS service is not being privatised. There is no selling off or ownership of the NHS. EKTRA and other providers must provide the service to agreed NHS standards or will fail and disappear quickly. The contracts are zerobased in value. They cost nothing to the NHS when not providing treatments or for failed appointments, down time or peaks and troughs in demand. This ultimately results in highly efficient, cost effective and VFM patient care. The private sector is only providing what the NHS failed to do and has not been able to provide within its
capacity. Therefore, demand has grossly exceeded supply!
Over 8 years of experience, EKTRA has seen its physical therapy services bring DNA rates down to 4.98% and the NFU ratio to 1 : 3.35. Waiting times are massively reduced with appointments booked within one week and urgent cases within 48 hours. This is a startling improvement on the historical average NHS wait of 12+ weeks. Numbers and statistics have become a very important element of controlling overstretched and under resourced services. However, patient care is paramount as each single patient referral is the most important asset to EKTRA, a growing healthcare company.
The local CCGs benefit from our services as it reduces their financial burden by decreasing secondary care referrals and prescribing and administrative costs. The service provides real-time records with flawless communication between GP/ physiotherapist and the patient. Both GPs and physiotherapists have a sense of ownership and control over the service. Equally, physiotherapists are empowered and supported to work autonomously with flexible working patterns, according to demand.
If you want to provide a first class community-based service that could be recommended to your friends and family then this is the business model to follow. It works.
David Pearce is Principal Physiotherapist and Company Director, EKTRA Ltd.
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Sixth form colleges are almost universally acclaimed as a success story in British education. They have outperformed other schools and have a proud record in giving adults a second chance to improve their skills and qualifications. Yet a recent report from the Sixth Form College Association (SFCA) shows that six years of cuts in 16-19 education funding is having a devastating impact on the sector and the choices available to students, says Ben Thomas.
Sixth form colleges are almost universally acclaimed as a success story in British education. They have outperformed other schools and have a proud record in giving adults a second chance to improve their skills and qualifications.
Ben ThomasYet a recent report from the Sixth Form College Association (SFCA) shows that six years of cuts in 16-19 education funding is having a devastating impact on the sector and the choices available to students.
Most colleges were established in the 1960s when a group of progressive Local Education Authorities established a more rational and efficient approach to delivering post-16 education. By size efficiencies they were able to increase the number of courses available, provide specialist teaching at both A level and in vocational training, offer better extra-curricular activities and provide a vital bridge between school and university education.
efficient and effective education, why are they being starved of funding?
Most colleges were established in the 1960s when a group of progressive Local Education Authorities established a more rational and efficient approach to delivering post-16 education. By size efficiencies they were able to increase the number of courses available, provide specialist teaching at both A level and in vocational training, offer better extra-curricular activities and provide a vital bridge between school and university education.
The sector has seen funding cuts across England of 33% since 2011, and the SFCA report found that:
The sector has seen funding cuts across England of 33% since 2011, and the SFCA report found that:
•70% of college leaders do not believe that the amount of funding they are likely to receive in 2016 will be enough provide a high-quality education
•70% of college leaders do not believe that the amount of funding they are likely to receive in 2016 will be enough provide a high-quality education
•72% of colleges have dropped courses as a result of cuts since 2011
•72% of colleges have dropped courses as a result of cuts since 2011
colleges provide such an efficient and effective education, why are they being starved of funding?
Most believe it is simply a question of fashion. Because sixth form colleges are not new and the government is so intent on demonstrating the success of the academy and free school programme, they are blind to their success and unwilling to divert any resources away from their pet projects.
Most believe it is simply a question of fashion. Because sixth form colleges are not new and the government is so intent on demonstrating the success of the academy and free school programme, they are blind to their success and unwilling to divert any resources away from their pet projects.
It has also been suggested that the experience of sixth form and further education colleges in general is so divorced from the typical ministerial background of private school and university that they simply do not understand the value and benefit that they provide for those from more disadvantaged backgrounds.
It has also been suggested that the experience of sixth form and further education colleges in general is so divorced from the typical ministerial background of private school and university that they simply do not understand the value and benefit that they provide for those from more disadvantaged backgrounds.
As sixth form colleges are being squeezed, the choices available to students in many areas are being restricted and inefficiency is increased.
As sixth form colleges are being squeezed, the choices available to students in many areas are being restricted and inefficiency is increased.
Further cuts will make it unsustainable. Colleges are already reducing vocational courses and the extra-curricular and enrichment activities that have made them special. The number of colleges in England has already reduced from over 110 to 93. Many are considering converting to academy status to benefit from more favourable VAT treatment, but this will reduce their academic freedom and ability to innovate.
Further cuts will make it unsustainable. Colleges are already reducing vocational courses and the extra-curricular and enrichment activities that have made them special. The number of colleges in England has already reduced from over 110 to 93. Many are considering converting to academy status to benefit from more favourable VAT treatment, but this will reduce their academic freedom and ability to innovate.
•76% of colleges have reduced or removed extracurricular activities for students
•76% of colleges have reduced or removed extracurricular activities for students
•81% of colleges are now teaching students in larger class sizes because of funding cuts
•81% of colleges are now teaching students in larger class sizes because of funding cuts
These cuts, along with a discriminatory funding system are placing the very future of the sector at risk. Many of the cuts have been in modern languages, science and maths - subjects ministers are purporting to encourage.
These cuts, along with a discriminatory funding system are placing the very future of the sector at risk. Many of the cuts have been in modern languages, science and maths - subjects ministers are purporting to encourage.
The unanswered question remains, if the government is committed to a compulsory education till eighteen and sixth form
The unanswered question remains, if the government is committed to a compulsory education till eighteen and sixth form colleges provide such an
Or is it simply that sixth form colleges hark back to the days of planned provision by the hated Local Education Authority and progressive educational ideas of the 1960s?
Or is it simply that sixth form colleges hark back to the days of planned provision by the hated Local Education Authority and progressive educational ideas of the 1960s?
Whatever the answer, the dogmatic insistence that academisation is the only solution for improving educational outcomes,increasing student choice and eliminating the skills and productivity gap is actually making these problems worse in the post 16 sector.
Whatever the answer, the dogmatic insistence that academisation is the only solution for improving educational outcomes,increasing student choice and eliminating the skills and productivity gap is actually making these problems worse in the post 16 sector.
The unplanned growth in academy sixth forms is having a perverse outcome in that it is actually reducing subject choice and learning opportunities.
The unplanned growth in academy sixth forms is having a perverse outcome in that it is actually reducing subject choice and learning opportunities.
The government needs to re-think its approach to post 16 education if it wants to avoid a crisis in provision. It is no longer sustainable to protect schools budgets at all costs and at the expense of the post 16 sector. Sixth form colleges are an education success story that we cannot afford to lose.
The government needs to re-think its approach to post 16 education if it wants to avoid a crisis in provision. It is no longer sustainable to protect schools budgets at all costs and at the expense of the post 16 sector. Sixth form colleges are an education success story that we cannot afford to lose.
The government needs to rethink its approach to post 16 education if it wants to avoid a crisis in provisionBen Thomas is uNISON national officer
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