challenges – The NEN – North Edinburgh News

Starmer: Our NHS needs ‘major surgery, not sticking plaster solutions’

PM to pledge ‘the biggest reimagining of our NHS since its birth’

PM to set out plan for long term, fundamental reform to fix broken NHS
Lord Darzi’s independent investigation concludes NHS is in ‘critical condition’
Findings provide a diagnosis of the challenges facing the health service, which will inform government’s 10 year plan to reform the NHS

The PM will pledge the ‘biggest reimagining of our NHS since its birth’ in a speech this morning [12 September 2024], following the publication today of a full and independent investigation into the state of the NHS.

Lord Ara Darzi’s probe has concluded the service is in a ‘critical condition’ amidst surging waiting lists and a deterioration in the nation’s underlying health, identifying serious and widespread problems for people accessing services.

The PM will say that the scale of the damage done to the NHS revealed by the report is “unforgivable”, recognising the tragic consequences for too many patients and their families: “People have every right to be angry. It’s not just because the NHS is so personal to all of us – it’s because some of these failings are life and death.

“Take the waiting times in A&E. That’s not just a source of fear and anxiety – it’s leading to avoidable deaths.

“People’s loved ones who could have been saved. Doctors and nurses whose whole vocation is to save them – hampered from doing so. It’s devastating.

He will also address the causes behind the state of the NHS, including the long term impacts of the 2012 Health and Social Care Act which is described in the report as “a calamity without international precedent” which “proved disastrous”, as well as the far reaching consequences of underinvestment throughout the 2010s.

The PM is expected to say: “Our NHS went into the pandemic in a much more fragile state.

“We had higher bed-occupancy rates, fewer doctors, fewer nurses and fewer beds than most other high income health systems in the world.

“And let’s be clear about what caused that…a “scorched earth” approach to health reform, the effects of which are still felt to this day.

“Lord Darzi describes [the 2010s] as “the most austere decade since the NHS was founded”. Crumbling buildings, decrepit portacabins, mental health patients accommodated in Victorian-era cells infested with vermin.

“The 2010s were a lost decade for our NHS…which left the NHS unable to be there for patients today, and totally unprepared for the challenges and opportunities of tomorrow.”

As well as recognising the cost to people’s health, the PM will also address the inextricable link between the state of the NHS and the nation’s economy: It’s not just the state of our National Health Service in crisis – it’s also the state of our national health.

“There are 2.8 million people economically inactive due to long term sickness, and more than half of those on the current waiting lists for inpatient treatment are working age adults.

“Getting people back to health and work will not only reduce the costs on the NHS, it will drive economic growth – in turn creating more tax receipts to fund public services.

In the face of these dire findings and the growing pressures on the NHS from an ageing society and preventable illnesses, the PM will set out his belief in the ‘profound responsibility’ of government to do the hard work necessary to tackle them: “What we need is the courage to deliver long-term reform – major surgery not sticking plaster solutions.

“The NHS is at a fork in the road, and we have a choice about how it should meet these rising demands.

“Raise taxes on working people to meet the ever-higher costs of aging population – or reform to secure its future.

“We know working people can’t afford to pay more, so it’s reform or die.”

Rooted in Lord Darzi’s diagnoses of the challenges facing the NHS, the Prime Minister will outline three fundamental areas of reform and the imperative to work with staff and patients throughout this process. He is expected to say: “”This government is working at pace to build a Ten-Year Plan. Something so different from anything that has come before.

“Instead of the top-down approach of the past, this plan is going to have the fingerprints of NHS staff and patients all over it.

“And as we build it together, I want to frame this plan around three big shifts – first, moving from an analogue to a digital NHS. A tomorrow service not just a today service.

“Second, we’ve got to shift more care from hospitals to communities… And third, we’ve got to be much bolder in moving from sickness to prevention.

“Only fundamental reform and a plan for the long term can turn around the NHS and build a healthy society. It won’t be easy or quick. But I know we can do it.

“The challenge is clear before us; the change could amount to the biggest reimagining of our NHS since its birth.”

Lord Darzi is an independent peer and practising surgeon with 30 years’ experience in the NHS. He examined over 600 pieces of analysis from DHSC, NHS England and external organisations during his investigation. His report will inform the government’s 10-year plan to reform the health service.

Lord Darzi said: “Although I have worked in the NHS for more than 30 years, I have been shocked by what I have found during this investigation – not just in the health service but in the state of the nation’s health.

“We want to deliver high quality care for all but far too many people are waiting for too long and in too many clinical areas, quality of care has gone backwards.

“My colleagues in the NHS are working harder than ever but our productivity has fallen.

“We get caught up frantically trying to find beds that have been axed or using IT that is outdated or trying to work out how to get things done because operational processes are overwhelmed. It sucks the joy from our work – we became clinicians to help patients get better, not to go into battle with a broken system.

“We need to rebalance the system towards care in the community rather than adding more and more staff to hospitals. And we need a more honest conversation about performance – the NHS is now an open book.

“In the last 15 years, the NHS was hit by three shocks – austerity and starvation of investment, confusion caused by top-down reorganisation, and then the pandemic which came with resilience at an all-time low. Two out of three of those shocks were choices made in Westminster.

“It took more than a decade for the NHS to fall into disrepair so it’s going to take time to fix it. But we in the NHS have turned things around before, and I’m confident we will do it again.”

Despite the damning analysis, Lord Darzi insists the NHS’s vital signs ‘remain strong’ and he praised staff for their ‘shared passion and determination to make the NHS better for our patients’.

In carrying out the review, Lord Darzi brought more than 70 organisations together in an Expert Reference Group and sought input from NHS staff and patients through focus groups and frontline visits.

Responding to the report, Secretary of State Wes Streeting said: “I asked Lord Darzi to tell hard truths about the state of the NHS. He has produced an honest, expert, comprehensive report on the appalling state our health service is in.

“Today’s findings will inform our 10-year plan to radically reform the NHS and get patients treated on time again.

“The damage done to the NHS has been more than a decade in the making. We clearly have a long road ahead. But while the NHS is broken, it’s not beaten. We will turn the NHS around so it is there for you when you need it, once again.”

Today’s report has been welcomed by NHS England and health organisations who have pledged to work closely with the government on its mission to rebuild the NHS.

Amanda Pritchard, NHS England Chief Executive, said: “As this report sets out, staff are the beating heart of the NHS with a shared passion and determination for making the NHS better for patients – but it is also clear they are facing unprecedented challenges.

“Our staff are treating record numbers of patients every day despite ageing equipment and crumbling buildings, a surge in multiple long-term illnesses, and managing the long-lasting effects of the pandemic.

“While teams are working hard to get services back on track, it is clear waiting times across many services are unacceptable and we need to address the underlying issues outlined in Lord Darzi’s report so we can deliver the care we all want for patients.

“As Lord Darzi rightly points out, many of the solutions can be found in parts of the NHS today. That is why we are fully committed to working with government to create a 10-year plan for healthcare to ensure the NHS recovers from Covid, strengthens its foundations and continues to reform so it is fit for future generations”

Key findings from Lord Darzi’s 142-page report include:

Deterioration: The health of the nation has deteriorated over the past 15 years, with a substantial increase in the number of people living with multiple long-term conditions.
Spending: Too great a share of the NHS budget is being spent in hospitals, too little in the community, and productivity is too low.
Waiting times: Waiting lists have swelled and waiting times have surged, with A&E queues more than doubling from an average of just under 40 people on a typical evening in April 2009 to over 100 in April 2024. 1 in 10 patients are now waiting for 12 hours or more.
Cancer care: The UK has appreciably higher cancer mortality rates than other countries, with no progress whatsoever made in diagnosing cancer at stage one and two between 2013 and 2021.
Lasting damage: The Health and Social Care Act of 2012 did lasting damage to the management capacity and capability of the NHS. It took 10 years to return to a sensible structure, and the effects continue to be felt to this day.
Productivity: Too many resources have been being poured into hospitals where productivity had substantially fallen, while too little has been spent in the community.

Responding to the publication of Professor Lord Darzi’s Independent Investigation of the National Health Service in England, Nuffield Trust Chief Executive Thea Stein said: “Lord Darzi’s damning report underlines the stark realities experienced across almost every corner of the health service.

“Wide-ranging problems have been growing in plain sight for years and Darzi’s impressively comprehensive assessment will be familiar to anyone who has studied or experienced the slow deterioration of health care provision in England.

“While not surprising, the report’s findings are deeply troubling. As our research work has repeatedly shown, too often the NHS is not able to provide people with the timely care they need, despite steadfast public commitment to the core principles of the health service. The impacts of this are not felt equally: people in the poorest areas are particularly struggling to access healthcare.

“The big question now is what happens next.

“The Government has an early opportunity to make good on long-argued points on dysfunctional NHS funding in its first Budget next month. The health service is staring down the barrel of a significant shortfall in funding this current year [2] and the Chancellor will need to set out clear plans to tackle this, ahead of a longer-term funding settlement.

“Rightly, the report repeatedly references the interrelated, compounding pressures of the desperate state of social care and cuts to public health provision. But by design it does not dig into those issues. In future, we hope to see serious work by the government to address those broader societal issues that determine population health and impact health care access.

“Ultimately, the Lord Darzi’s diagnostic report sets out important aspirations to be delivered in the forthcoming 10-year plan to treat – and fix – the NHS. But the improvements we all hope for – and that patients desperately need – will take time, commitment and major financial, practical and system-wide support. There will be no quick fixes.”

From austerity to crisis: Covid-19 Inquiry highlights UK’s pre-pandemic weaknesses, says TUC

Just three days short of its second anniversary, the Covid-19 Public Inquiry published the report from the Module One investigation into the resilience and preparedness of the United Kingdom (writes TUC’s NATHAN OSWIN).

The report highlights the devastating consequences of austerity in the decade that preceded the pandemic and the risk of vulnerability in the UK population.

The Impact of austerity on public services

Inquiry Chair, Baroness Hallett, states plainly that, “In short, the UK entered the pandemic with its public services depleted, health improvement stalled, health inequalities increased, and health among the poorest people in a state of decline.” This blunt assessment underscores the critical condition of the nation’s public services as they faced the unprecedented challenges of the Covid-19 pandemic.

The role of the TUC and evidence from frontline workers

As Core Participants in the Inquiry, the TUC played an integral role in the process, working with our unions to provide the evidence that ten years of under-investment and real terms funding cuts to public service in the run up to the Inquiry left key services struggling to cope.

“Public services, particularly health and social care, were running close to, if not beyond, capacity in normal times” the report states, a statement that doctors, nurses, porters and social care workers have been telling us all.

The Inquiry also heard that “there were severe staff shortages and that a significant amount of the hospital infrastructure was not fit for purpose. England’s social care sector faced similar issues. This combination of factors had a directly negative impact on infection control measures and on the ability of the NHS and the care sector to ‘surge up’ during a pandemic.”

A call to avoid past mistakes

The report is both a damning indictment and a call to never repeat the mistakes of that decade – a desperate reminder of the need to invest in our public services.

And while the report is not naive about the costs needed to make the UK more resilient ahead of the next pandemic – a matter of when not if – it reaches the conclusion that “the massive financial, economic and human cost of the Covid-19 pandemic is proof that, in the area of preparedness and resilience, money spent on systems for our protection will be vastly outweighed by the cost of not doing so”.

Addressing health inequalities

What’s more, the Inquiry is crystal clear as to the price we pay for inequality across our communities. It notes that at the outset of the pandemic, the UK had “substantial systematic health inequalities by socio-economic status, ethnicity, area-level deprivation, region, social excluded minority groups and inclusion health groups”.

And Baroness Hallett’s report correctly states that these inequalities weakened the ability of the UK to cope, stating that “resilience depends on having a resilient population. The existence and persistence of vulnerability in the population is a long-term risk to the UK.’

Recommendations for the future

The recommendations themselves speak of the need to engage with wider society for planning on how we handle a crisis and to take into account the “capacity and capabilities of the UK”.

No one knows the capacity and capabilities of our public services better than the staff that deliver them and the TUC and its affiliated unions stand ready to assist the government in this vital work.

Conclusion: Building a resilient future together

It is by working in partnership – with proper resources going into our public services – that we can truly learn the lessons this report sets out and secure the resilience and preparedness that the UK needs for a future full of challenges.

Community health and social care faces unprecedented pressures and financial uncertainty

In this Account Commission briefing about Scotland’s Integration Joint Boards (IJBs), we report that community health and social care faces rising unmet need and managing the crisis is taking priority over prevention due to the multiple pressures facing the bodies providing these services.

IJBs plan and commission many vital community-based health and care services.

People

One in 25 people in Scotland receive social care.

Expected to rise sharply due to an ageing population – 76% of people receiving health and social care are aged 65 and over.

By mid-2045, the number of people aged 65 and over is set to grow by nearly a third.

Performance

Where data is available, nationally there has been a general decline in performance of services and outcomes for people.

Data quality and availability is insufficient to fully assess the performance of IJBs and inform how to improve outcomes for people who use services with a lack of joined- up data sharing.

Care

Community health and social care faces unprecedented pressures and financial uncertainty. We have not seen significant evidence of the shift in the balance of care from hospitals to the community intended by the creation of IJBs.

Finances

IJB funding has decreased by £1.1 billion (nine per cent) in real terms to £11 billion in 2022/23. The funding gap is set to triple in 2023/24.

IJBs are making savings by not filling staff vacancies and using their financial reserves, but this is not sustainable.

Staffing

Vacancies are at a record high. Nearly half of services report vacancies. A quarter of staff leave jobs within their first three months. And there is continued turnover in senior leadership.

Action is needed now

IJBS need to share learning to identify and develop:

service redesign focused on early intervention and prevention.
approaches focused on improving the recruitment and retention of the workforce.
improvement to the data available.
commissioning approaches that improve outcomes for people.
ensure that their financial plans are up to date.

IJBs need to work together and with other stakeholders to:

ensure that the annual budgets and proposed savings are achievable and sustainable.

IJB-report Download

MEANWHILE, DOWN SOUTH …

ENGLAND’S SOCIAL CARE WATCHDOG ‘NOT FIT FOR PURPOSE

The Care Quality Commission (CQC), the body responsible for regulating adult social care services in England, is ‘not fit for purpose’, according to the health secretary Wes Streeting.

Health and Social Care Secretary Wes Streeting was responding to an independent review that identified ‘significant internal failings’ within the health and social care regulator.

The interim report, led by Dr Penny Dash, chair of the North West London Integrated Care Board, found the number of inspections being undertaken were well below pre-Covid levels.

It also revealed a lack of clinical expertise among inspectors, a lack of consistency in assessments and problems with the CQC’s IT system.

Commenting on her findings, Dr Dash said: ‘The contents of my interim report underscore the urgent need for comprehensive reform within the CQC.

‘By addressing these failings together, we can enhance the regulator’s ability to inspect and rate the safety and quality of health and social care services across England.’

Mr Streeting commented: ‘When I joined the department, it was already clear that the NHS was broken and the social care system in crisis.

‘But I have been stunned by the extent of the failings of the institution that is supposed to identify and act on failings. It’s clear to me the CQC is not fit for purpose.’ Kate Terroni, CQC’s interim chief executive, said the regulator accepts in full the findings and recommendations of the report.

‘Many of these align with areas we have prioritised as part of our work to restore trust with the public and providers by listening better, working together more collaboratively and being honest about what we’ve got wrong,’ she said.

‘We are working at pace and in consultation with our stakeholders to rebuild that trust and become the strong, credible, and effective regulator of health and care services that the public and providers need and deserve.’

The interim findings of the review of our operational effectiveness led by Dr Penelope Dash have been published this morning. In response, Kate Terroni, our interim chief executive, said: “We accept in full the findings and recommendations in this interim review, which identifies clear areas where improvement is urgently needed.

“Many of these align with areas we have prioritised as part of our work to restore trust with the public and providers by listening better, working together more collaboratively and being honest about what we’ve got wrong.

“We are working at pace and in consultation with our stakeholders to rebuild that trust and become the strong, credible, and effective regulator of health and care services that the public and providers need and deserve.

“Work is underway to improve how we’re using our new regulatory approach. We’ve committed to increasing the number of inspections we are doing so that the public have an up-to-date understanding of quality and providers are able to demonstrate improvement.

“We’re increasing the number of people working in registration so we can improve waiting times. We’re working to fix and improve our provider portal, and this time we’ll be listening to providers and to our colleagues about the improvements that are needed and how we can design solutions together.

“We’ll be working with people who use services and providers to develop a shared definition of what good care looks like. And we’re also developing a new approach to relationship management that enables a closer and more consistent contact point for providers.

“Additionally, to strengthen our senior level healthcare expertise, we have appointed Professor Sir Mike Richards to conduct a targeted review of how the single assessment framework is currently working for NHS trusts and where we can make improvements.

“Sir Mike’s career as a senior clinician, and a distinguished leader of high-profile national reviews, as well as his direct experience of driving improvement through regulation, make him uniquely placed to conduct this work.”

The interim findings of the review have been published on GOV.UK.

More progress is needed a decade on from procurement reform

Despite improved transparency, a Parliament committee has found that inconsistency, bureaucracy, and inflexibility are still creating challenges for small businesses and third sector organisations looking to participate in public procurement.

A decade on from the introduction of the Procurement Reform (Scotland) Act 2014 (the Act), Holyrood’s Economy and Fair Work Committee has explored how the Act is operating.

Intended to support economic growth with procurement systems which were transparent, fair and business friendly, the Act put in place regulation for public procurement contracts above certain financial thresholds.

During its inquiry, the Committee heard from businesses and the third sector, as well as local authorities and the Scottish Government.

The Committee found that while the Act’s improvements to transparency were welcomed, there were still challenges which made navigating public procurement difficult, with one witness giving the Act a “C+ for its performance.”

Challenges experienced by witnesses included inconsistency across contracting authorities and heavy bureaucratic load.

The Committee’s report makes a number of recommendations to improve the system including:

Ensuring that the Public Contracts Scotland website is updated to make it once again “best in class”.
The Scottish Government should work with contracting authorities to drive consistency and reduce administrative burden.
A uniform process for the provision of feedback should be developed.

Speaking as the report launched last week, Committee Convener Claire Baker MSP said: “Public procurement plays a vital role in the Scottish economy, involving small business, the third sector and public bodies.

“But with more than ten years now passed since the Act came into force, it is time to reflect on whether the ambitious aims are being met.

“There is no doubt that the Act has had a positive impact on increasing transparency of procurement processes which of course is to be welcomed. But for too many businesses, especially new or small businesses, there is still confusion and inconsistency. all of which is causing a barrier to those who may want to engage.

“Our report calls for a number of changes which would have a real impact to ensure that the bureaucracy and inflexibility can be addressed.”

During its inquiry, the Committee also found that the Act had contributed to an increase in Scottish procurement. However, the report makes clear that the Committee believes more can be done to increase local procurement.

The Committee noted the results from the community wealth building pilot areas and called for the principles and lessons learned to be fully embedded in procurement processes.

EFWS062024R08 Download

SCVO: Charities face staff and volunteer crisis

A third of organisations reported this as one of their top challenges

Third Sector organisations in Scotland are increasingly facing shortages of staff and volunteers, a new report has warned.

The Scottish Third Sector Tracker has found that issues relating to staffing and volunteers are one of the top challenges for a third of voluntary sector organisations.

Data from the tracker observes the emergence of the sector from the Covid-19 pandemic through 2021, followed by the development of the cost-of-living crisis and associated organisational concerns during 2022 and 2023.

In August 2021, 35% of organisations reported a significant concern about staff and volunteer numbers. Just two years on, that figure has now risen to 65%, with only finances currently proving a bigger challenge for the sector.

While staff and volunteer support remain a growing concern, third sector groups report an ongoing increase in demand for their core services and activities over the six waves of the tracker. In Wave 1 (Aug 2021), 56% of organisations reported an increased demand, rising to 63% by Wave 6 (Apr 2023).

These factors, on top of growing financial pressures due to the rising costs crisis and public sector funding cuts, are leading to a perfect storm for charities and voluntary groups, with strain put on already stretched teams.

Anna Fowlie, Chief Executive of the Scottish Council for Voluntary Organisations (SCVO), said: “The Scottish voluntary sector is a significant employer, providing jobs for 5% of the Scottish workforce.

“At a time where many organisations are facing recruitment challenges, the funding environment means that many voluntary organisations are struggling to keep pace with salary increases needed to attract and retain staff.

“Existing staff and volunteers have been working flat out since Covid, helping organisations and communities to weather the cost-of-living crisis. We can no longer afford to rely on their goodwill to go the extra mile.

“The invaluable services and supports provided by Scotland’s voluntary sector need sustainable investment to ensure their survival.”

Volunteer Scotland are also concerned by the staff and volunteer crisis facing the sector, highlighted by the Third Sector Tracker.

The recent release of the 2022 Scottish Household survey results reinforces the volunteer crisis, with formal volunteer participation rates falling by 4 percentage points since 2019 to 22% – this equates to less than one million Scottish adults volunteering.

In light of the current crisis, the actions that can be undertaken by volunteer involving organisations include ensuring that volunteer expense policies are clear and considering how roles can be made more flexible to fit with the decreased time volunteers have available.

Alan Stevenson, CEO of Volunteer Scotland said: “The many impacts of the cost-of-living crisis on volunteering has meant that we can no longer take for granted the contribution of our volunteers.

“While recruitment and retention issues are being felt more acutely by some, the first step for all must be the focus on good volunteering practice, appropriately supported.”

The Scottish Third Sector Tracker is a growing research community made up of representatives from third sector organisations based across the whole of Scotland, who are willing to share their experiences, views and concerns as the sector faces both new and ongoing challenges.

The Tracker is run by an independent research company called DJS Research on behalf of SCVO, the Scottish Government, the William Grant Foundation and the National Lottery Community Fund.

Those involved in the running of a third sector organisation operating in Scotland are invited to represent their organisation as a member of the Scottish Third Sector Tracker.

An Executive Summary of the Scottish Third Sector Tracker’s First Phase of research can be found here:

https://scvo.scot/policy/research/evidence-library/2023-scottish-third-sector-tracker-waves-1-to-6-executive-summary

Third-Sector-Tracker-W1-6-Executive-Summary Download

Our survival depends on people choosing local, say Edinburgh businesses

Survey by Scotland Loves Local highlights critical need for Edinburgh residents to get behind people and enterprises in the city

Nine-in-ten businesses in Edinburgh and the Lothians say the support of local people is critical to their survival as they battle continued unprecedented challenges.

The statistic has been revealed by the Scotland Loves Local campaign as it issues a rallying cry for people to choose local this summer and support enterprises – and protect jobs – in their community, unlocking millions of pounds worth of spending.

Research was carried out by Scotland’s Towns Partnership (STP), the organisation which spearheads Scotland Loves Local, among its members and stakeholders, which include the country’s Business Improvement Districts (BIDs) – with the findings reinforcing the importance of grassroots action in fuelling a fairer, stronger, more sustainable national economy.

It found:

93% of businesses in Edinburgh and the Lothians said the support of the local community was important, of which 85% said it was “extremely important”.
93% also said it was important that people “love local” and get behind businesses in their communities this summer.
And the circular impact of businesses boosting their local economy was reinforced by the survey responses, with nine-in-ten (93%) who took part saying they buy from and sell to other local enterprises across the region.

Born as the nation emerged from the first Covid-19 lockdown in summer 2020, Scotland Loves Local has evolved into a campaign for longer-term good – encouraging people to make the places they live better by supporting the people and businesses around them.

That synergy between business and community was demonstrated in STP’s survey findings, with nearly three-quarters (73%) of survey respondents involved in wider community initiatives across Edinburgh city and the Lothians – such as skills development, volunteering and charity fundraising.

Businesses and communities mutually supporting one another is a philosophy close to the heart of Fin Clarkson, Food Services Manager at Space, a community Hub in Broomhouse, that operates a community café on site and Outta Space Pizza across the city.

Fin Clarkson said: “It’s hard out there at the moment – both for local businesses and the communities they serve.

“At Space, we are working hard to support local people through regular community meals, cooking classes and food education as well as an employability pathway from our Training Academy courses to paid employment within our social enterprises. Coming up we have our Kids Go Free no-questions-asked free school holiday meal provision which is a key part of our community focus.

“Keeping money in the local community is really important, and local businesses and social enterprises play a massive part in this. Our growing working lunch event catering and Outta Space Pizza create fantastic produce in Broomhouse that has the dual benefit of raising the profile of social enterprise and enabling us to reinvest the money into our services in Edinburgh’s south west.

“We couldn’t deliver these services without the support of the community around us and, in these challenging times, that support is more important than ever before. By loving local this summer, people can discover all the amazing experiences that we have on our doorstep – while supporting local enterprises that keep millions of pounds-worth of spending in local communities.

“That support will allow us to make Edinburgh an even better place to live, work and visit.

STP Chair Professor Leigh Sparks, the leading retail academic who’s also the University of Stirling’s deputy principal, said: “Towns, villages and local places across Scotland – and the businesses that operate at their heart – are the economic and social glue of the country and our communities.

“The cost of living and the cost of doing business, though, continue to challenge both consumers and businesses.

“Local support is the common thread that helps everyone weather this and build sustainable places and communities. By choosing local – and getting behind the businesses in our communities – we will ensure the survival of shops and services. Local consumer spending generates local business spending and protects the jobs of family, friends and neighbours.

“By loving local, we will also ensure that our high streets and town centres build a fairer, more sustainable Scotland – creating even better places to live, work and visit.”

Kimberley Guthrie, STP’s Interim Chief Officer, added: “We need to begin a permanent behaviour change in thinking local first this summer, whether for shopping, days out or simply local businesses trading with each other. Choosing local is not only good for our economy and environment, but the communities these fantastic local businesses serve too.”

People across the region are also being urged to spend using the Scotland Loves Local Gift Card, ensuring the money they spend stays local for longer by directly supporting shops, attractions and jobs in the area. Businesses and charities are also being encouraged to use them as rewards.

Audit Scotland: Full transparency on NHS recovery needed

The Scottish Government needs to be clearer about how long it will take the NHS to recover from the Covid-19 pandemic and to reform services, says public spending watchdog Audit Scotland.

The government’s NHS recovery plan aims to reduce the healthcare backlog and change how services are delivered. But the plan does not contain the detailed actions that would allow progress to be accurately measured. It also lacks robust modelling to understand demand and capacity. The backlog has continued to increase in the 18 months since the plan was published as the NHS deals with a range of pressures.

Workforce capacity remains the biggest risk to the recovery of NHS services. Health boards are continuing to find it hard to recruit the doctors, nurses and other health professionals needed to make sure NHS services are sustainable in the long-term. Key recruitment targets, such as recruiting 800 GPs by 2027, are unlikely to be met. The NHS workforce remains under severe pressure and there are concerns over staffing levels, wellbeing, and retention.

The Scottish Government is moving ahead with the innovation and reform essential to NHS sustainability. But it is too early to gauge the impact of this work. In the meantime, every NHS board is facing significant financial challenges which could limit how much they can invest in recovery. And the Scottish Government also needs to make information on how long people will have to wait for treatment clear and meaningful.

Stephen Boyle, Auditor General for Scotland, said: “NHS staff remain under severe pressure and the Scottish Government is facing tough choices.

“Money is tight but investment is needed in recovery. That means ministers have to prioritise which NHS aims can realistically be delivered. And they need to be more transparent about the progress they’re making.

“The Scottish Government has set out the big challenges facing the NHS. But it also needs to clearly explain to the public what those challenges mean for the level of service they can expect, including waiting times.”

nhs-in-scotland-2022-report Download

The Edinburgh Festival Fringe Society launches its review of the year 2022

Summary of the Society’s work over the past 12 months accompanied by headline findings from surveys

This morning the Edinburgh Festival Fringe Society launches its review of the year: an in-depth look at the work it has accomplished over the past 12 months.

With unease caused by a new wave of COVID in early 2022, there was still uncertainty that a fully formed Fringe could take place this August. However, against what felt like impossible odds at times, the Fringe re-emerged in glorious technicolour, with local performers joined by artists from across the UK and 63 nations.

In June, Fringe Society President Phoebe Waller-Bridge launched the Fringe Society’s new vision – to give anyone a stage and everyone a seat. This was followed in August with the announcement of new alumni Patron, Eddie Izzard, who started her career as a street performer on the famous Royal Mile.

As the festival approached,activities to celebrate the Fringe’s 75^th anniversary took place, through memories collected from audiences and artists over the years.

The popular street events programme expanded into new areas of Edinburgh’s city centre, with over 3,200 performances taking place, and the Fringe Central participants’ hub opened its doors to over 2,100 arts industry, media, producers and visiting delegations.

Projects such as Fringe Days Out and the Children and Young People ticketing scheme returned as the Society continued with local schools and community groups. These vital initiatives supported children, young people, and those across Edinburgh who might not otherwise get to experience the Fringe.

By the end of August, over 2.2m tickets had been issued, and artists from 63 countries had performed in over 3,400 shows across Edinburgh.

Read the Fringe Society’s full review of the year 2022 at:

https://edfringe.shorthandstories.com/fringe-review-2022.

Following a year of heightened interest in the Society’s work, today the Society also announce the headline results from a mass feedback project, launched in September.

A significant part of the Society’s annual evaluation is surveying a broad group of stakeholders. This year was no different, with the largest listening drive since 2019. The Society commissioned Scotinform to facilitate surveys to registered artists, audience members, venues, workers, arts industry and media, who combine to create the Fringe ecosystem.

More than 10,000 responses across the surveys were received, with results now being used to support the development of new projects, and to target our future plans. These vital data insights also give us the evidence base we need to advocate for focused support and address some of the challenges identified by the Fringe community.

The positioning of the festival continues to be strong: 76% of audience members agreed that the Fringe is one of the most important cultural events in the world. When asked for motivations for attending the 2022 Fringe, respondents cited seeing a variety of events/performances (76%) and enjoying live performance after the pandemic (49%).

Edinburgh’s residents continue to be vital to the festival: 65% feel the Fringe makes the city a better place to live, alongside 75% who feel it makes Edinburgh a better place to visit. With the cost-of-living crisis likely to extend into 2023, 66% of audiences would like ticket offers or discounted tickets, with 91% of Edinburgh residents interested in a discount for EH postcodes.

The live experience continues to be a major motivator, with only 7% agreeing that they would like to see more online shows at the Fringe. As we look ahead to 2023, there is continued optimism from audiences, with 81% of respondents stating they are likely to come to the Fringe in 2023.

Unsurprisingly, following the intense interest in a Fringe app for 2023, 46% of audience respondents said they felt an app would have improved their Fringe experience, with 66% stating they would use an app in the future. This aligned with artist feedback, with 71% stating a Fringe app is very important to them. Work on the 2023 app is already underway and details on its functionality and launch timings will be announced in the new year.

For artists, the Fringe continues to be a core platform for artists’ careers, with 82% of those attending the Fringe for the first time doing so for professional development reasons. For returning Fringe artists, experiencing the Fringe was the biggest motivator, with 82% citing this as the main reason.

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Accommodation continues to be a concern for many performers: 87% of artists felt that affordability of accommodation and living costs will be a barrier to future participation in the Fringe; however 70% of artists said they are still likely to bring a show to the Fringe in the future. Interestingly, 17% of artists did not engage directly with the Society, and as such were not aware of the full offering of services available to them such as Fringe Connect and Fringe Marketplace.

While a small sample of workers responded to their survey, the Society continues to review how we reach and support this group more. Recognising work undertaken in support of the Real Living Wage, 77% of Fringe workers said they were paid on or above this benchmark at this year’s festival. 91% were also satisfied that they had a line manager to seek help from, if and when they needed it.

In addition to the statistical information, Scotinform evaluated free text responses across the surveys. In general, there was an appetite for more information to be shared with all respondents, at more regular points of the year.

Advance detailed information was clearly sought, and as such The Society is refining its communications strategy to ensure first time, and returning artists, have the year-round support they need to attend the Fringe in the future.

Shona McCarthy, Chief Executive of the Edinburgh Festival Fringe Society, said: “It’s easy to forget how tumultuous this year has been – between Omicron variants, the cost-of-living crisis and de-stabilising world events, it feels miraculous the Fringe happened at all.

“The fact that it did is a testament to the concerted effort and support of a cast of thousands, including artists, audiences, venues, media, staff, volunteers, crew, sponsors, elected officials and the city of Edinburgh itself.

“Improvements can always be made, and the insights and data gained from our recent listening exercise are already being taken forward.

“We recognise that there are ongoing challenges, and our team are working hard behind the scenes to continue to advocate for our artists, and to support audiences as they plan for Fringe 2023.”

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