Institute for Government: Performance tracker 2022 (17 October 2022)

Summary

Ahead of the government's medium-term fiscal plan, the annual Institute for Government/Chartered Institute of Public Finance and Accountancy (CIPFA) public services stocktake reveals that public services won’t have returned to pre-pandemic performance by the next election, which in most cases was already worse than when the Conservatives came to power in 2010. 

Performance Tracker reviews the state of nine public services – general practice, hospitals, adult social care, children’s social care, neighbourhood services, schools, police, criminal courts and prisons – and their comparative and inter-connected problems.

Content

The report shows that projected 3.4% per year average budget increases set out in the 2021 spending review have fallen – due to inflation and higher than anticipated pay awards – to 1.5%, which is unlikely to be enough to meet growing demands and deal with the aftermath of Covid in most services. At the same time long-term staff shortages are set to worsen due to below-inflation pay rises and the cost-of-living crisis.

It finds that:

• Spending increases in schools is not enough to recover the pandemic-induced lost learning.
• Hospital spending is not enough to unwind Covid backlogs.
• New demand in prisons and courts is set to exceed even generous spending settlements.
• The spending settlement for local government is no longer sufficient to meet demand in adult social care, children’s social care and neighbourhood services.
• The NHS wage bill will increase by approximately £2bn in 2022/23, unfunded money which the NHS will have to find in its existing settlement - meaning cuts elsewhere in the service. 

The report also sets out the historically high backlogs in both hospitals and courts:

• A record 6.8 million people were waiting for elective treatment as of July 2022.
• In the crown court, the backlog stood at 59,700 in June 2022, slightly below the peak of over 60,000 in June 2021 but higher than at any point since at least 2000.

Recommendations

The report recommends:

• The prime minister should commit to publishing regular reports on existing and anticipated workforce shortages, with plans for how shortages will be addressed, for all of the services covered in this publication.
• The government should publish updated plans for how each service will tackle backlogs and unmet need, which include key milestones and assessments of the workforce and estate.
• The government should build on the processes used in the 2021 spending review to align spending with priority outcomes, using cross departmental outcomes to foster greater collaboration between departments and ensure that spending decisions are not siloed.
• The government should improve the range and quality of the data it collects on public services, with particular focus given to adult social care data.