Category Archives: Public Affairs

Unpacking the government’s 2025 mandate to NHS England

At the end of January, Secretary of State for Health and Social Care Wes Streeting delivered the government’s 2025 mandate to NHS England. This is a crucial document which sets out the health secretary’s goals for the health service over the next 12 months. It also provides all-important detail about the government’s emerging views on reform of the health and social care system ahead of the much-anticipated 10-Year Health Plan, due to be published later this year – likely in June or July.

The findings of Lord Darzi’s investigation into the health service, commissioned and published in the weeks immediately following Labour’s general election victory, have unsurprisingly been hugely influential in shaping the development of Streeting’s inaugural mandate to NHS England. The health secretary has said the mandate will help address the urgent challenges identified by the Darzi investigation and includes a ‘sharp focus on improving efficiency and productivity.’ Streeting again warns that the ‘culture of routine overspending without consequences’ is over.

At the heart of the 2025 mandate are three key aims: reducing waiting times, improving access to primary care, and improving urgent and emergency care. To reduce waiting times, Streeting has said he is refocusing the NHS on making progress towards an 18-week standard, whereby 92% of patients wait no longer than 18 weeks from referral to treatment, which will work in tandem with the steps set out in the government’s Elective Reform Plan published earlier this year. Patient choice is also at the heart of this agenda. The mandate emphasises the importance of implementing a cultural shift in the NHS to prioritise the patient experience in reducing waiting times, including through the use of the private sector to enable greater patient control over their treatment.

Improving access to primary care is the second key aim of the mandate. This mirrors one of the three strategic shifts the health secretary wants to see as a result of his reform agenda: shifting more treatment from hospitals to communities. Streeting is clear that primary care services are the front door to the health service but for too many people it is not possible to get a timely appointment, if at all. The mandate requires NHS England to enable patients to access general practice more quickly and tackle ‘unwarranted’ variation in services provided by general practice.

Improving urgent and emergency care is the mandate’s third aim. The mandate labels ambulance response times and waiting times in A&E as ‘unacceptable’. While the health secretary recognises that transforming these services will take time, he does state that a start must be made ahead of the government publishing its strategy to improve urgent and emergency care later this year. The mandate therefore includes a specific focus on reducing long wait times to improve patient safety, experience and outcomes.

The ambitions set out by Streeting in his first mandate are laudable. The bleak fiscal situation means the health secretary will have a hawk-like focus on monitoring performance against budgets. This is in recognition that the uptick in funding that the Department of Health and Social Care received at the October budget is unlikely to point to further significant cash injections in the immediate future. For providers, it also underscores the importance of positioning themselves as a high-quality, value for money partner to ICBs and NHS Trusts in delivering strong outcomes for patients.

If you would like to discuss the 2025 NHS mandate in more detail and what it means for businesses in the sector, then please contact Hugo Tuckett (hugo@gkstrategy.com) or Arth Malani (arth@gkstrategy.com).

Sugar, we’re going down: is the review of the soft drinks industry levy a taste of things to come?

The health secretary has warned he will “steamroll” the food and drink industry by launching a new plan to tackle obesity. In an interview with The Guardian setting out his priorities for the year, he said the move is part of a broader focus on preventing ill health rather than simply treating it. The plan is being worked up across government departments and the sector will soon be invited to feed into a consultation process.

Is this political rhetoric indicative of a heavier-handed approach to public health than under the previous iterations of government? Our gut instinct is yes, but proof of the pudding will be in the government’s response to the Soft Drink Industry Levy (SDIL) review. Launched last October, health and treasury ministers are considering revisions to the existing sugar content thresholds, including increasing the scope to milk-based and milk substitute products, and the levy rates.

Although the SDIL is widely considered to be a successful and effective policy intervention, the UK’s sugar consumption remains significantly above recommended levels, especially among children.  By lowering the sugar thresholds and widening the scope of products, more soft drink producers will be impacted by regulations and will be forced to either reformulate products or see their production costs increase. The review will be completed in the spring with changes enacted in the 2025 Budget, so producers should be closely following policy developments throughout the course of this year. The government’s response to the review will set the mood music for the National Food Strategy so this is a crunch point for all those in the sector, not just soft drinks producers.

Beyond the health merits for cracking down on sugar content, there are political and economic factors at play. Politically, the Prime Minister insists that 2025 is a year of delivery after a slow and difficult start to his tenure. Further state intervention in food and drink markets in the name of public health would play to a large section of the labour backbenchers. Party morale is likely to be put to the test in the coming months as the nation’s economic woes continue. This is where HM Treasury comes into the picture; amid turbulent financial markets and disappointing economic growth, the Comprehensive Spending Review will be an uncomfortable experience for the Chancellor and her team. Raising revenue from the levy could ease some of the pressures that will undoubtedly fall on the schools budget, which the levy supports.

For industry there is a fine balance to strike. Full resistance to public health reform would be counterproductive and leaves a bad taste in the mouths of consumers. Developing and maintaining an open, constructive dialogue with government, including showcasing innovative reformulations, will be a far more effective approach.  Framed in this way, industry will be able to better make the case that a proportionate approach to SDIL and wider reforms will deliver positive health and economic change.

If you would like to discuss the sugar levy and the government’s public health agenda in more detail, please contact GK Associate Director David Mitchell at: david.mitchell@gkstrategy.com

Maternal Health: Where does the government go from here?

In September 2024, Secretary of State for Health and Social Care Wes Streeting labelled the state of maternity services in England a ‘cause for national shame’, describing it as one of the ’biggest issues that keeps him awake at night’.

His comments followed the publication of a damning report by the Care Quality Commission (CQC) which brought together findings from 131 inspections and found that almost half of maternity units inspected were rated as ‘requires improvement’ or ‘inadequate’. The report called for increased national action and ring-fenced investment into services, warning that poor quality NHS maternity care will become normalised if action is not taken.

In January 2024, the APPG on Birth Trauma launched an inquiry to investigate the factors in maternity care that contribute to birth trauma and develop policy recommendations. By May, the APPG’s report, Listen to Mums: Ending the Postcode Lottery on Perinatal Care, presented findings from over 1,300 submissions by women recounting harrowing stories of inadequate and traumatic care. The report identified an overwhelming narrative that women felt belittled, ignored, and neglected at a time when they were most vulnerable, and concluded that a base standard in maternity services is needed across the UK.

Streeting has inherited a bleak forecast: urgent need for reform; mounting pressures on the NHS as a whole; and a poor fiscal climate. So where does Labour go from here?

Labour’s 2024 election manifesto promised to ensure that NHS trusts failing on maternity care are ‘robustly supported into rapid improvement’, to train thousands more midwives as part of the NHS Workforce Plan, and to set an explicit target to close the black and Asian maternal mortality gap.

However, the party’s manifesto lacked any concrete policies aimed at fixing the broken maternity system. This means all eyes now turn to the government’s 10-Year Health Plan, due to be published in spring this year, as the potential roadmap for change.

While the plan will focus on prevention, the transition from hospital to community care, and the digitalisation of health services, the government has given no indication of whether it will give maternal health the attention it desperately needs.

Despite rising demand, current services are stretched and under-resourced, meaning many women face significant delays receiving the support they need, if they receive it at all. Investing in early intervention, services that understand the needs of new and expectant mothers, and workforce growth is essential to ensuring that patients can access timely and effective support.

Various campaign groups are putting pressure on Streeting to make improving maternal health services a priority. The Maternal Mental Health Alliance is calling for all parties to demonstrate their support for new and expectant mothers. The Alliance claims ‘there is a vital opportunity for the new government to create positive change for current and future generations.’

The 10-Year Health Plan provides the government with the opportunity to address the alarming findings from both the CQC and APPG on Birth Trauma, restore public confidence in NHS maternity services, and show its commitment to fixing the systemic issues within maternal care. Inadequate support has devastating effects on families and adds huge costs to the UK economy, meaning it is vital that organisations engage with the government during the development of the 10-Year-Health Plan to ensure maternity services receive the focus they need. By leveraging industry platforms and policy development support, advocacy campaigns can emphasise the importance of maternal health and the challenges faced by women.

To discuss the government’s plans for maternal health in more detail, please contact Annabelle Black at annabelle@gkstrategy.com.

The Office for Students: A higher education aid or hindrance?

Late last year, Secretary of State for Education Bridget Phillipson announced increases to university tuition fees starting in September 2025. However, this did little to quell concerns of financial sustainability in the higher education sector that has been the talk of university towns. The suspension of the Office for Students’ (OfS) ability to accept new registration applications and issue degree awarding powers has not helped to alleviate doubts over the stability and growth of the sector. These temporary changes to the OfS’ remit will though allow ministers to focus on a wider package of reforms to the body. These are set out in the OfS’ draft strategy for 2025 to 2030, which is currently out for consultation.

The draft strategy builds on priorities set out by Sir David Behan in his independent review, ‘Fit for the Future: Independent Review of the Office for Students’, which was published in July 2024. His main takeaways include a lack of engagement with students, overstretched powers, and its need to help develop financial sustainability in higher education.

Central to the OfS’ draft strategy is one of the government’s five main missions: ‘breaking down barriers to opportunity’. Equality of opportunity is an underlying theme of the strategy, and it claims to place the experience of students at the centre of higher education. There are three pillars which aim to achieve greater levels of student satisfaction: regulating higher education courses; expanding the OfS’ attention to areas that impact students’ engagement with higher education; and increasing the resilience and quality of higher education.

Although student experiences are important, there is an understanding from the OfS and stakeholders that students can’t experience all aspects of university life if their university is nearing financial collapse or bankruptcy. Financial resilience of the higher education sector is the lynch pin of high-quality provision and breaking down barriers. This is even more pertinent with the rising cost of living and students’ expectations that the fees they pay should provide them with quality experiences beyond the lecture theatre.

Despite previous uncertainty surrounding the OfS’ role in the future of higher education, the pause in its powers and the body’s focus on the consultation will allow for a reset moment.

For higher education providers, the consultation is a chance to make the case to government and the OfS about the quality of its courses and the importance of higher education to the UK’s growth ambitions. The development of a stable economic base and demonstrating how the sector can meet students’ expectations will be key for encouraging investment opportunities into the sector. Stakeholders should engage with the draft strategy to help create a clearer future for the higher education sector and increase dialogue between the OfS and providers.

Westminster in 2025: Policy Shifts and Political Risks

GK is delighted to present its ‘Westminster in 2025’ report which sets out the key policy shifts and political risks we are expecting to see over the coming 12 months.

The report can be accessed here: Westminster in 2025 – Policy Shifts and Political Risks

What does the Renters’ Rights Bill mean for the future of rented housing?

GK Associate Director, Will Blackman, explores what the government’s new Renters’ Rights Bill means for the future of rented housing in England.

The government’s Renters’ Rights Bill completed its passage in the House of Commons this week and is expected to receive Royal Assent in the coming months following the completion of its Lords’ stages. What does this significant piece of legislation mean for the private rented sector and the housing market as a whole?

The origins of this bill go back several years. The Theresa May government in 2019 first consulted on reforms to rebalance the rights and responsibilities of landlords and tenants, which included the ability of landlords to issue Section 21 notices, or so-called ‘no-fault’ evictions. This change continues to sit at the heart of the bill and is intended to give greater stability and security of tenure to tenants.  It also provides landlords with reformed and expanded grounds for seeking possession of their properties under Section 8 of the Housing Act 1988. This includes cases where the landlord wishes to sell or to move into the property themselves. Other measures include stricter requirements around rent increases, the creation of a new ombudsman, new requirements on landlords to remedy mould and damp problems and a new right for tenants to request a pet.

The last Conservative government introduced its own version of this legislation – the Renters’ Reform Bill – however this fell away following the dissolution of Parliament ahead of the General Election. The Labour government’s version of the bill – now the Renters’ Rights Bill – includes some significant differences to its predecessor, almost all to the benefit of tenants rather than landlords. For example, tenants must now be in three months of rent arrears before landlords can seek possession, rather than the two months proposed by the Conservatives; the grace period after which landlords can seek possession in order to sell the property has also been doubled from six to twelve months and the notice period extended from two to four months. Moreover, the current version of the bill gives tenants new rights to terminate a tenancy from day one with two months’ notice – something previously not allowed under the last bill until at least four months after a tenancy started. This would have effectively created a minimum six-month term.

These reforms are the most significant changes to the regulation of the private rented sector for over 35 years. The residential landlord sector has been careful not to be seen opposing the legislation outright given the unhelpful optics around this. However, many individual landlords are concerned that the balance has tipped too far away from them, potentially leaving many unable to take back possession of their properties in reasonable circumstances. Court backlogs have provided an additional layer of concern, with delays in processing evictions claims already persisting in many parts of England, with many landlords calling for significant improvements in order to allay their concerns.

Some industry leaders such as Propertymark and the National Residential Landlords Association have warned that the proposed provisions could lead to landlords withdrawing from the sector, in turn limiting supply and driving up rents. The Ministry of Housing, Communities, and Local Government’s own impact assessment does not predict an exodus of landlords from the sector. Indeed, landlords have been subject to a raft of regulatory and tax changes since 2015, but these have not resulted in significant divestment from the private rental market, which many had predicted at the time.

However these changes play out in the long term, individual and institutional investors in the private rented sector will need to grasp this new regulatory landscape quickly, especially given its wide-ranging impacts for the sector and the prospect of significant disruption to their portfolio. It is the case that home ownership remains unaffordable for many and this is unlikely to change in the near term. However, as the government looks to tip the balance in favour of tenants, it is vital that investors engage with the new regulatory landscape to ensure they are well prepared and can take steps to insulate themselves from any emerging risks.

To discuss the government’s housing policy reforms in more detail, please contact Will Blackman at will@gkstrategy.com