Category Archives: Health

The Dash Review: the future of the CQC

Steve Brine @BrineHealth is a Strategic Adviser at GK Strategy. He was a Health Minister (2017-2019), Government Whip, and is a former chair of the Health & Social Care Select Committee. Here, he reflects on the future regulatory landscape for adult social care.

Context is everything when it comes to social care. Well, almost everything because you can’t forget the politics. On one hand, despite a grand pledge in the Labour Party manifesto to “undertake a programme of reform to create a National Care Service”, we have nothing happening at all.

On the other we have the Dash Review (and now Dash 2.0), the Ten Year Plan, the next phase of the spending review and of course, the Budget which brought a further £600m to prop up the service.

Taken on face value, a national care service is of course a very (very) big deal. This could literally mean the nationalisation of the entire social care sector – akin to how local voluntary hospitals were brought under national public ownership in the 1940s – or it could mean, well, whatever you want it to. Perhaps that’s the point. The truth is, right now, we’re none the wiser and nor I suspect are Ministers.

More immediate, not least for investors and those looking for a little certainty in the sector, is the major NHS Ten Year Plan consultation launched last week. As I understand it, everything is in scope for this programme of work led by Paul Corrigan and Sally Warren with the exception of, wait for it, adult social care. Meanwhile, the Dilnot reforms have been kicked down the road (again) which means the spending cap will now not be introduced next year as planned. Andrew Dilnot is reportedly furious and the great immovable object of NHS reform seems further away than ever before.

What we do know is Penny Dash is in the ascendancy with this government. Shortly after Lord Darzi produced his 163-page diagnosis of the NHS, Dash published her full report into the operational effectiveness of CQC. The Dash review found significant failings in the organisation which it said ’has lost credibility in the health and social care sectors’ and led Wes Streeting to say it was no longer fit for purpose. It found that the CQC’s ability to identify poor performance and support quality improvement has deteriorated and says this has undermined the health and social care sector’s capacity and capability to improve care.

Alongside Dash, a parallel review was led by Prof Sir Mike Richards (former chief inspector of hospitals) looking at CQC’s controversial single assessment framework. Sir Mike (one of the best officials I worked with while a Minister) recommends a fundamental reset of the organisation and a return to the previous organisational structure, with at least three chief inspectors leading sector-based inspection teams at all levels.

And as if that weren’t enough, Dash gets a 2.0 moment as this month we learn the way patient safety is regulated and monitored is to be completely overhauled in England. With the swoosh of a Minister’s pen; the CQC, the National Guardian’s Office, Healthwatch England and local Healthwatch services, the Health Services Safety Investigations Body, the Patient Safety Commissioner and NHS Resolution are all set to be reviewed.

Whatever the future of Henrietta Hughes (the Patient Safety Commissioner) or Helen Vernon (who leads NHS Resolution) one name here is to stay is Julian Hartley. Currently Chief Executive of NHS Providers he will take over as the head of the CQC in December. Julian is a smart appointment. A nice guy (but don’t be fooled) who exudes calm and is fiercely organised. He will find an organisation on its knees and I am sure a massive rebuild on his hands.

It is clear that Penny Dash has listened to the voices of care providers, resulting in a clear set of recommendations so Julian Hartley will benefit from that oven-ready piece of work. Equally, I suspect the Richards review findings will not meet too much resistance. Expect a re-set to a standardised approach to inspections and for line management of such to come back under the auspices of the Chief Inspector of Hospitals. I wouldn’t be surprised to see a completely re-born and re-branded CQC that focuses on safety as well as efficiency, outcomes and use of resources – you can be sure Rachel Reeves will make that a red line.

Ministers will, in my experience, find that the desire to do the Ten Year Plan minus adult social care doesn’t survive contact with political reality. And so between now and the Spring, and indeed the final throes of the comprehensive spending review to come, furious negotiations between DHSC, Angela Rayner (who is responsible for council funding) and HMT are the order of the day.

And when all is said and done, we will find out whether the work of change has great substance or everything looks and feels very familiar.

Roundtable discussion: Local authority funding and its impact on the future of social care

Images: Seb Wright Media

For a roundtable event held in July 2024, hosts Hannah Haines (Head of Healthcare Consultancy, Christie & Co), Michâela Deasy (Head of PR & Comms, Compass Carter Osborne) and Lizzie Wills (Senior Partner & Head of Private Equity, GK Strategy) were joined by some of the biggest female names in the UK social care sector.

The roundtable brought together operators, lawyers, investors and sector experts, all of whom share a passion for quality healthcare and for driving an increased awareness of the challenges faced by operators as a result of funding challenges across the country.

Below are some of the key highlights from what was discussed around local authority funding and its impact on the future of social care.

According to the Local Government Information Unit, 50% of local authorities (LAs) have reported that they are likely to be bankrupt in the next five years, with 9% predicting they would be bankrupt in the next 12 months. This is already the case for a number of LAs, including Birmingham. These struggles are not going to be resolved without fundamental reform – of how services are delivered at a local level, or how they are funded.

To address the funding challenges they are facing, most LAs have identified areas to make direct cost savings. For example, many have confirmed that they will make budget cuts relating to parks and recreational spaces. Although this may not directly impact the social care sector, it could end up affecting the mental health of the communities that rely on these facilities. Meanwhile, 16% of LAs said they are looking to reduce spending in adult social care, 12% in children’s care services, and 10% in SEND, though statutory services will be better protected from funding cuts.

… For the full article on the Christie & Co website, click here.

To find out more about the team’s next roundtable event, contact Michâela Deasy: michaela@compasscarterosborne.com

Women and Health – Why women are such an important demographic for Labour

GK Adviser Noureen Ahmed reflects on the Government’s priorities in its Women’s Health Strategy and explores the challenges Labour can expect to face in the women’s and wider health space should the party form the next government.

At the start of 2024, Health Secretary Victoria Atkins outlined her top priorities for 2024 under the Women’s Health Strategy, which came into effect two years ago. The Strategy was welcomed by the sector, due to the Government demonstrating its commitment to improving care and treatment for women. Women are routinely under-represented, particularly when it comes to clinical trials; this hinders our understanding on how a number of health problems such as cancer, endometriosis, and other gynaecological conditions impact women from a wide range of backgrounds. As women make up around 51 per cent of the population, tackling these obstacles is vital to ensuring improved outcomes for women’s health.

Under the Government’s priorities for women’s health this year, there are several initiatives expected to be implemented. These include plans to expand women’s health hubs, bolster pre- and post-natal care as well as improve support for vulnerable women. The Government has also committed to more funding for research, which would look into how women are represented in medical research.

Nevertheless, given how close we are to the next General Election (likely in October or November of this year), questions have been raised on whether such policies will actually be enacted over the coming months.

The priorities for 2024 came as a result of a Government consultation which aimed to learn more about women’s health issues, and to better understand women’s experiences of the healthcare system. The call for evidence received over 100,000 responses and demonstrated a clear consensus that health services at present fail to meet women’s day to day needs. The Women’s Health Strategy has been deemed ambitious, given it aims to “radically improve the way in which the health and care system engages and listens to all women and girls.” For the Government, the Strategy is much needed and will form “the next step on the journey to reset the dial on women’s health.”

The Labour Party has stressed its ambition to prioritise women’s health should it come into power, as well as to ensure all women – regardless of their background – have access to better quality care. In addition to its pledge to invest in women’s health services, Labour also confirmed its plans to increase access to reproductive healthcare, address gender inequalities in healthcare settings, and ensure women’s health services are equipped with the vital staff and resources needed.

As the likelihood of a Labour Government increases in the run up to the next General Election, Labour faces the challenge of demonstrating how it will ‘revive’ the NHS, with the health service having been chronically stretched and underfunded over the past decade. At present, the NHS faces a raft of issues related to recruitment, staff pay, industrial action and waiting lists which remains stubbornly high – prompting more people to take out private medical insurance. Should Labour come into power, the party will be undertaking a huge task to alleviate the crisis but will be limited in terms of how much substantial progress can be made by financial constraints.

Women make up a significant proportion of the population and so, inevitably, their choices greatly influence election outcomes. For Labour in particular, women’s votes will be essential if it wants to secure an electoral majority. It is imperative that the party works to engage effectively with women and ensure their concerns and aspirations for women’s healthcare are listened to and used to develop and implement effective policy.

GK Strategy are experts in the health policy landscape. Get in touch with noureen@gkstrategy.com if you’d like to hear more from our consultants.

GK Launches New Podcast on Trending Policy Issues

Education with Edward Timpson MP

In the inaugural episode of the GK Strategy Podcast, David Laws, GK Strategic Adviser, spoke with the former Children & Families Minister, Edward Timpson MP, about the future of special educational needs and disability policy.

The lively discussion covered everything from SEND policy to social services, with Mr Timpson offering insight into the reform to SEND services and the current policy environment across social care.

Mr Timpson spoke specifically on the 2014 Children and Families Act which he helped push through Parliament. He noted that the legislation “still stands up to scrutiny” 10 years after it was passed and serves as a blueprint for joining up and improving services across education, health and social care. However, he also described some of the challenges associated with the legislation’s implementation, which has led to many parents having vastly different experiences with the SEND system.

During the episode, Mr Laws and Mr Timpson brought to light the “tough” spending environment across the education sector, highlighting the need for increased funding from central government. However, they also touched on other issues that have impacted SEND provision, including the capacity within the workforce, the importance of educational psychologists, SEND ‘deserts’ and out of area provision, and the extent to which mainstream settings should take on more responsibility for SEND provision.

You can listen to the full episode on Spotify here.

GK Point of View: The NHS and Us

On the 75th anniversary of the National Health Service, GK Strategic Advisor and former Minister of State for Care Services, Phil Hope, reflects on the NHS in its current form and looks ahead to how the UK’s major political parties will position their offering for the health system. Find Phil’s commentary here: NHS 75th Anniversary