TUC: Austerity left UK “hugely unprepared” for the Covid pandemic

  • NEW REPORT: TUC report shows how austerity led to unsafe staffing in public services, a broken safety net, and decimated workplace safety enforcement when the pandemic began
  • Austerity cost the nation dearly. The consequences were painful and tragic. The inquiry is our chance to learn from this” says the TUC

Austerity left the UK “hugely unprepared” for the Covid pandemic, according to a new report published by the TUC yesterday.

The report looks at four pillars of the country’s pandemic preparedness:

  1. Safe staffing levels in public services
  2. Public service capacity and resources
  3. A strong safety net through the social security system
  4. Robust health and safety protections at work

It finds that in each of these key areas, funding cuts reduced the country’s capacity to respond to the pandemic.

The report was published as the TUC held a joint press conference with the Covid-19 Bereaved Families for Justice about the lessons that must be learned through the inquiry, to save lives in the future.

Safe staffing levels in health and social care

The report details how safe staffing levels in health and social care were undermined by multiple years of pay caps and pay freezes, which impeded recruitment and increased staff turnover. This left both health and social care dangerously understaffed when the pandemic began:

  • Between 2010 and 2020, the number of nurses per capita in the UK grew by less than one per cent – despite demand for care rising by one-third. This is in stark contrast to the OECD average of nurses per capita rising by 10 per cent.
  • In 2019 the average NHS worker was earning £3,000 less in real terms than in 2010, with significant impacts on both recruitment and retention. 
  • In social care, the turnover rate for staff in England increased from 22 per cent in 2012/13 to 31.8 per cent in 2019/20.
  • When the pandemic hit, a quarter (24%) of social care workers in England were employed on zero-hours contracts, with the turnover rate higher among these workers.

Public services capacity and resources

Public services capacity was damaged by steep cuts to almost every part of the public sector.

In 2020 when the pandemic hit, spending per capita was still lower than in 2010 in social care, transport, housing, childcare, schools, higher education, police, fire services, and environmental protection.

This limited the ability of public services to contribute effectively to civil contingencies, and to continue essential activities effectively such children’s education.

  • Between 2010 and 2020, school funding per pupil was cut by 8.3% in England, 6.4% in Wales, 2.4% in Scotland and 10.5% in Northern Ireland.
  • Local authority core spending power was cut by a third between 2010 and 2020. Over the same period, demographic changes increased pressures – for instance, leading to higher referrals and more complex cases in both adult and children’s social care.  And new statutory duties in public health, social care and homelessness have stretched budgets further.
  • In 2019, capital investment in the UK health sector was 10% below 2010 levels. This forced NHS providers to close hospitals and delay equipment upgrades.

A strong safety net through the social security system

The social security safety net was damaged by direct cuts through benefit freezes, and by reforms that reduced entitlement to help and narrowed eligibility to fewer people.

Most of these benefits cuts were made in the period 2010 to 2016 when David Cameron was Prime Minister and George Osborne was Chancellor – both of whom are set to give evidence at the Covid inquiry.

The benefit cuts increased poverty levels. Living in poverty was associated with greater risks of exposure to Covid-19, and greater levels of vulnerability to more serious health consequences from being ill with Covid.

  • Since 2010, £14 billion has been cut from support to households through social security.
  • A family not in work has lost on average £1,160 a year in social security support since 2010, and a family in work has lost on average £460.
  • Disabled people have lost on average £1,200 of annual support, comparing 2021 with 2010.

Robust health and safety protections at work

The pandemic had a particular impact on workplaces – especially for key workers and those who could not work from home. But the enforcement of rules to keep workers safe at work was compromised by cuts that decimated public health and workplace safety regulators, and by confusion about who had responsibility to enforce the rules.

During the pandemic, when workplace risks multiplied, workplace inspections and enforcement notices fell to an all-time low, despite vast numbers of workplace-linked transmission caused by poor health and safety practice.

  • Funding for the Health and Safety Executive (HSE – the body responsible for workplace safety) in 2021/22 was 43% lower than in 2009/10 in real terms.
  • Staff numbers at the HSE have been cut by 35% since 2010.
  • The number of workplaces investigated by a safety inspector fell by 70% from 2010 to 2020.

TUC General Secretary Paul Nowak said: “To learn lessons and save future lives, we must take an unflinching look at the choices made by our leaders in the years before the pandemic.

“In the NHS and social care, funding cuts put staff levels in the danger zone. Cuts to social security pushed many more people below the poverty line, leaving them more vulnerable to infection. And cuts to health and safety left workers exposed to rogue employers who cut corners and put their lives at risk.

“Austerity cost the nation dearly. It left us hugely unprepared for the pandemic. And it left far too many workers unprotected. The consequences were painful and tragic.

“The inquiry is our chance to learn the lessons – and to understand why we have to rebuild our public services so that they are strong enough to protect us in a future crisis.”

Pandemic paved way for more walking and connecting to nature

More people recognise the wellbeing benefits of walking are encouraged to spend more time outdoors due to their experiences during the Covid-19 pandemic according to new findings.

The research was commissioned by natural heritage body NatureScot in the aftermath of three waves of the Coronavirus crisis to better understand outdoor visit behaviour and how people engaged with nature.

The survey looked at the behaviour of more than 3,000 people who revealed details of how they spent time outdoors as coronavirus restrictions relaxed.

The survey found that people will encourage their children to spend more time outdoors, make more use of local green space, and try to walk more, have been welcomed by Scottish walking charity Paths for All who, along with other partners, supported these 3 studies.

Evidence gathered from respondents following the 2021 third wave found that 68% of people agreed they will encourage their children to spend more time outdoors, 62% will minimise non-essential travel and the same figure will make more use of local greenspace.

The survey also found almost two-thirds (64%) of people will try to walk, wheel or cycle more in favour of using a car, more than half would like to do more to look after local nature and wildlife, while more than one-third (36%) would be willing to volunteer time to help nature.

Kevin Lafferty, chief executive of Paths for All – which champions everyday walking to create happier and healthier lives – welcomed the survey and believes the impact of the pandemic has reset people’s views on how they can interact with nature and enjoy more active lifestyles.

He said: “The negative impact of the wholly necessary Covid-related restrictions on our movements and ability to get out and about cannot be underestimated and it caused great stress and anxiety for all age groups and social classes living throughout Scotland.

“But this survey is hugely encouraging and offers some very positive messages on how people are more willing to incorporate walking and getting closer to nature in their post-lockdown lives.

NatureScot has delivered an impressively comprehensive insight into what is motivating people to embrace nature more, be that on their urban doorsteps or by taking advantage of our vast array of rural landscapes.”

Seventy three percent of those questioned said spending time outdoors after Wave 3 helped them to destress, relax and unwind, while 66% stated that it made them feel energised and revitalised – an increase on both 2020 waves.

Almost three in five (58%) agreed that since the pandemic began nature had become more important to their health and wellbeing, up from 49% in the first survey – but their enjoyment was curtailed by a number of issues.

Litter was a bugbear on visits to the outdoors for almost half of respondents (48%), while nearly one-third cited a lack of public toilet facilities as a factor, followed by pavement cyclists (26%) and cars parking on pavements (25%).

Frequency of participation in outdoor visits remained high during all three waves – between 71-80% – and the survey revealed a marked decrease in the number of adults who took no outdoor visits – down from 19% in May 2020 to only 10% in the final period last September.

More than half of those surveyed said their outdoor activity after Wave 3 consisted of walking under two miles, 43% walked between two and eight miles, a healthy 15% said they walked more than eight miles, with a further 11% taking part in hillwalking.

Kevin Lafferty added: “Everyday walking is key to improving the health and wellbeing of the Scottish people so it is heartening to see such high numbers of people shaking off the restrictions of lockdown and getting out into the fresh air to walk and enjoy the abundance of nature all around us.

“The research indicates a marked drop in the number of people who latterly were not managing to get outdoors at all – probably due to vaccination uptake and rising confidence that Covid-19 is more controlled – and we hope those people have continued to enjoy all the benefits of the great outdoors.”

More than one-third (37%) of respondents reported taking more visits to the outdoors after Wave 3 than pre-pandemic. The key reasons given for the increase were a “pent up demand” following the easing of lockdown restrictions, increased levels of appreciation of the outdoors acquired during the pandemic, seeking to get fit or exercise, and having increased amounts of free time.

However, those who spent less time outdoors during this period, put it down to continued adherence to rules, general health or old age issues and/or continued nervousness about going outside due to the risks of infection or transmission.

Kevin added: “A third of us in Scotland are not active enough and walking is by far the best way for many of us to be more active.

“A brisk 30-minute walk five days a week can prevent illness, improve physical and mental health and improve our connections with our community and the environment.

“This report is important in understanding how Covid-19 impacted the daily habit of taking a walk that many of us take for granted, and hopefully one of the benefits to come out of this global health crisis is that more of us now have a stronger connection to the outdoors.”

MyTailoredTalks: new digital support for people living with Long Covid

An innovative pilot project to transform support for Long Covid patients in Scotland is underway to improve care for people living with the condition and dramatically relieve the pressure on GPs.

NHS Lothian has been working with Chest Heart & Stroke Scotland (CHSS) and Pogo Digital Healthcare to deliver a ground-breaking digital platform that brings primary care and third sector services seamlessly together for the first time.

The platform, called ‘MyTailoredTalks’, has been developed by Pogo Digital Healthcare and has been jointly funded by NHS Lothian, CHSS and the NHS Lothian Charity (formerly Edinburgh and Lothians Health Foundation) – with £120,000 invested in the platform so far.

It will allow GPs and other clinicians to refer patients automatically to the CHSS’s Long Covid support services and to provide tailored self-management information to patients.

Over 70 patients are taking part in the pilot across 26 GP practices in the region.

The team behind the project is appealing for partners to expand the ground-breaking innovation beyond Lothian so that everyone with Long Covid in Scotland can get better access to support.

Lothian-based GP Amy Small is living with Long Covid. She has been at the heart of developing the new system. She said: “As a GP and someone living with Long Covid this new digital system will be hugely beneficial to patients and primary care.

 “It’s a big breakthrough in integrated care. It gives patients direct access to support to help manage their condition.

 “GPs will also now be able to seamlessly refer their patients through to the charity’s Long Covid Support Service which provides one-to-one support and advice from experienced advisors who can provide more time to the patients than GPs can.”

Health Secretary Humza Yousaf welcomed the project. He said: “Chest Heart & Stroke Scotland’s Long Covid support service not only supports people living with Long Covid, but also helps reduce some of the pressure on NHS services. That is why we have funded and continue to support Chest Heart and Stroke Scotland to deliver a Long Covid Support Service.

“I welcome this collaboration and investment. This kind of digital innovation is just one example of the flexible way in which our NHS boards across Scotland are adapting to meet the needs of people with Long Covid. We are spending £3m this year to support NHS boards like NHS Lothian to develop and deliver the best models of care appropriate for their local population’s needs.

“I look forward to seeing the full results of the pilot exercise and we are committed to working closely with Chest Heart & Stroke Scotland to share the learning generated from it to support the sustainability of our health services.” 

Professor Tim Walsh, Director of Innovation for NHS Lothian, said: “This project shows what can be achieved by the NHS, patients, charities and digital expertise working closely together to find innovative solutions.

 “The personalised ‘MyTailoredTalks’ have been designed to provide trusted ‘bite sized’ information for patients to access whenever they need to and be able to share with family or friends.

 “We hope that these, together with the holistic support CHSS offer, will make a real difference to people living with Long Covid.”

Allan Cowie, interim chief executive at Chest Heart & Stroke Scotland, said: “For the past two years we’ve been campaigning alongside people living with Long Covid to ensure that systems are in place to help them easily access the care and support they desperately need.

“This system has the potential to transform access to wraparound care through GP services. It has been developed with clinicians and people with Long Covid and we want it to be adopted right across the country as soon as possible.

“It not only makes this process easier for people living with Long Covid, but it helps to alleviate some of the pressure that primary care is under by allowing clinicians to easily refer their patients into a service they can trust.”

Greig Brown, 44, contracted Covid-19 in January 2021 and has been hospitalised twice because of the condition. Once a keen runner and cyclist, Greig now lives with the symptoms of Long Covid, suffering from severe breathing difficulties and memory loss.

He has not been able to return to his job as a joiner at St John’s Hospital in Livingston, and he fears he will never regain the health and fitness he once had.

Greig lives in Armadale, West Lothian, with his partner, Sam. Their plans to marry are up in the air as they have had to use their savings while Greig has been off long-term sick.

He says: “This is my reality. I am so breathless and exhausted every day that simply getting downstairs and settled on the couch wipes me out.

“I used to walk miles every day around the hospital, carrying tools and anything else I needed. Now I can’t even walk to the kitchen without needing to sit down.

“My GPs kept telling me Long Covid is all new to them, too, and they don’t know how to treat it.

“I feel as if people like me have fallen through the cracks. I hope having a system in place like this NHS Lothian pilot that lets doctors refer patients directly to the CHSS support service can make a real difference to everyone living with Long Covid symptoms.”

Sanjay Singh, Head of Funding Programmes with NHS Lothian Charity, said the pilot is a “great example of partners working together during the pandemic to achieve patient care that is personalised and, crucially, in response to Long Covid, as we learn more about this awful illness as time goes on.”

 “We were delighted to be involved in this innovative project and to be able to support through funding made available to support our communities dealing with the effects of Long Covid,” he said.

Jack Francis, chief executive and founder of Pogo Digital Healthcare, added: “Working in partnership with healthcare professionals, patients and technology experts to develop this innovative new healthcare pathway has resulted in a unique way for patients to manage their Long Covid symptoms.

“I am delighted with the pilot engagement so far from both the patient groups and Chest Heart & Stroke Scotland’s advice line team, and it has been great to be part of such an innovative new healthcare solution.”

COVID: End of the Highest Risk List

List to close on 31 May

The Highest Risk List – formerly known as the Shielding List – will be formally ended on 31 May, as a result of the success of the vaccination programme and the introduction of new treatments for COVID-19.

The decision has been taken following a careful review of growing clinical evidence by a team of specialist clinicians.

It shows that, for the vast majority of those on the list, the risk of hospitalisation or death from COVID-19 has been significantly reduced and is no greater than that of the general public.

For some time now, the clinical advice has been for those on the Highest Risk List to follow the same guidance as everyone else in Scotland unless specifically advised otherwise by their own GP or clinician.

The list is not being used to identify people who are eligible for vaccine prioritisation or new treatments, and the NHS will continue to be able to contact those people when needed.

Support remains in place for those who are immunosuppressed and who may still have some reduced immunity. This group are likely to need general protection from a range of infections in addition to Covid-19.

Wellbeing support is also available for those on the List, and the Scottish Government has allocated an additional £120,000 to the British Red Cross to fund their Connecting With You service to help people reconnect with activities and friends, to rebuild their confidence in going out and to help them regain a better quality of life.

The Distance Aware Scheme is in place to provide free badges and lanyards to people who wish to show others they would welcome additional space and extra care while out in public.

The Chief Medical Officer will shortly write to everyone on the list to advise them of the change, and sign-post them to ongoing support.

Dr John Harden, Deputy National Clinical Director, said: “At the beginning of the pandemic we introduced shielding to protect the most vulnerable from a virus we knew little about. Clearly shielding did not come without impact, particularly for those who were socially isolated or feeling particularly anxious due to being labelled at ‘highest risk’.

“In March 2020, we used the information we had at that point to identify those with certain health conditions who we reasonably thought would be at higher risk of severe illness from Covid-19.

“Thankfully, we know a lot more about the virus now. Combined with our successful vaccination programme and the availability of new treatments, means the clinical evidence clearly shows that the vast majority of people who have been on the Highest Risk List no longer need to consider themselves at any significantly higher risk.

“Support is still in place for the small number of immunosuppressed people who are unable to mount a full immune response due to their condition or ongoing treatment. We will publish separate advice for this group and have put in place an identification process to be able to rapidly generate an accurate and current list of individuals to provide additional advice to, should it be needed in future.”

The Scottish Government has produced guidance for immunosuppressed people and guidance for people previously at higher risk . An  evidence review was used to support the ending of the List.

Public Health Scotland reports from January 2021 and March 2022 both highlighted the negative impact of shielding on those asked to do so.

The Distance Aware scheme was launched by Wales’ health and care think tank The Bevan Commission in August 2020. The Scottish Government invested £55,500 in developing the scheme for a Scottish audience, including procuring and distributing badges, lanyards and promoting the scheme.

The Scottish Government is asking organisations, businesses and employers to promote this to their staff, customers and members. A toolkit is available to provide further support and information.

PANDEMIC: NHS Lothian to launch COVID-19 documentary

Don’t miss the online launch of our documentary which tells the story of NHS Lothian’s response to the COVID-19 pandemic through interviews, videos and pictures of our staff.

Please join us to reflect and watch the premiere on our YouTube Channel on Thursday 28 April, 6pm. #pandemic #covid-19

Renaissance Care internal review

The leading Scottish care home group is undertaking a full review of culture across the organisation after two years of care staff fighting at the front line against the pandemic 

Leading Scottish care home group, Renaissance Care, has implemented a full review with its staff across each of its 16 homes to overhaul the traditional operations across the care home sector. 

Following interviews with staff across all levels, the group, which employs 1,200 people across the country, is reviewing the culture, working practice, and its health and wellbeing offering across the board, as it responds to rising resignations of care staff across the industry on the back of the pandemic. 

Staff across the homes will now be offered a range of new benefits including flexible working, a pay review across all roles, and a health and wellbeing package. 

In response to feedback around long shifts within the care sector, which have historically been 12 hour shifts as industry standard, Renaissance Care will now offer staff a flexible working pattern based on their individual requirements.

The move means that those who want to change shifts around childcare commitments, or want to cut down on long shift times can do so, while office staff will have the option to move to a four-day working week. 

The group will also implement a minimum 5% pay increase for all staff and has committed to becoming a Scottish Living Wage Employer.

 

In line with the review, the care group is also undergoing a project to promote inclusivity and security among its workforce.

It has committed to supplying sanitary items for female staff in all of its facilities, as well as becoming a menopause-friendly workplace with plans to roll out training for staff later this year, and is ensuring an inclusive environment for LGBTQ+ staff and residents with an understanding that identities can be complex. 

The home will also introduce a health and wellbeing package which includes free access to danceSing for all staff members – encouraging health and wellbeing through fitness classes with a saving of £400 per year for each individual. It is also to invest in upgrades to the staff rooms in each home to ensure its care teams have a space that promotes a positive culture throughout shifts. 

In addition, the care home operator is currently investing £500k on its operational management and accounting systems to improve administrative processing for all staff as it responds to feedback about time spent on paperwork throughout shifts. 

Louise Barnett, managing director at Renaissance Care, said: “It is absolutely clear that staff retention and recruitment across the care industry is a massive issue on the back of the pandemic. It comes as no shock that staff, who have had an incredibly difficult two years looking after our most vulnerable in society, would consider changing careers.  

“For most organisations, people are at the heart of the business, but within the care sector it is no exaggeration that staff play the most crucial role in ensuring that elderly residents receive care that goes above and beyond, and we see time and time again the difference that our teams make to peoples’ lives. 

“Operationally, the care sector has always functioned in a certain way but now, as we begin to recover from the pandemic, it is time to turn it on its head and set a high benchmark for what the industry will look like for years to come. We need to modernise the offering for care staff and ensure that they can remain dedicated to delivering the best quality care while having a work life balance that allows a career around family and personal life.”

Robert Kilgour, executive chairman of Renaissance Care, has been a consistent industry voice throughout the pandemic, calling for more support for care homes across the country.

Last year, he spearheaded a group of the country’s leading care home operators who joined forces to help uncover answers to the many questions around the handling of the coronavirus pandemic in Scotland. 

Robert Kilgour, executive chairman of Renaissance Care, said: “The last two years have been an incredibly tough time for residents, families and hard-working team members in care homes across the country and it is important to us that we provide the best possible care and facilities for our people.

“Despite all that we have been through since the start of the pandemic, we remain very positive about the direction of the business and at the heart of our plans for recovery is our people.

“We are investing, developing and working alongside our team, ensuring that we can attract and retain the very best of talent to perpetuate a person-centred approach across each of our homes for staff, as well as residents.” 

Renaissance Care has a strong people service strategy which focuses on learning and development for individual staff members, as well as onus on creating a person-centred culture of inclusivity and care.

Vaccination pop-up on Pennywell Road

TODAY (Thursday 17th March) and tomorrow, Friday 18th March, there will be a pop up vaccination clinic from 9am – 2.30pm at the North Edinburgh Community Resource Centre on Pennywell Road.

All vaccines including boosters can be administered.

Spring Covid booster rollout begins in Scotland today

At-risk groups to be offered further dose  

Spring booster jabs will be offered to those aged 75 and over and people at highest risk of severe COVID-19 disease from today (Monday).

To protect these groups a spring booster dose will be offered at least 24 weeks after the last vaccine dose to:

  • adults aged 75 years and over
  • residents in care homes for older adults
  • individuals aged 12 years and over who are immunosuppressed

Following recent advice from the Joint Committee on Vaccination and Immunisation (JCVI), letters are also now being sent out to parents and guardians inviting children aged five to 11 for their first vaccination appointments. Children in this age group with specific medical conditions have already been invited.

Health Secretary Humza Yousaf said: “We know that those in high-priority groups are at higher risk of serious illness from COVID-19, and I therefore welcome the start of the rollout which will offer a further dose to these people.  

“Vaccination has been our most effective tool against coronavirus. However, the degree of protection offered wanes over time, which is why booster vaccination is needed to maintain the best protection against COVID-19 for those at highest risk of severe effects of the virus.

“The additional booster dose will improve your level of protection significantly and is the best way to protect your health and those around you. 

“I continue to encourage everyone to receive the doses they are eligible for as and when they become available.”

Following the latest JCVI advice, at-risk groups will be invited as they become eligible from at least 24 weeks after their last booster with the first groups receiving appointments from Monday 7 March.

Crisis: Scottish Government asleep at the wheel on crisis in NHS dentistry

   
The British Dental Association Scotland has greeted the unanimous support of opposition parties, while accusing the Scottish Government of failing to take needed action to halt an exodus from NHS dentistry and restore access to millions. 
 
In a debate in Holyrood today Scottish Government MSPs voted against a motion on support for NHS dentistry tabled by the Scottish Conservatives and backed by both Scottish Labour and Liberal Democrats.

Ministers have been planning to cut pandemic support from April. While the Government has recently indicated that there will be no “cliff edge”, the BDA has consistently warned that the plans to end Covid support payments and return to a low margin/high volume model of care would devastate dental services across the country.
 
Morale in the profession is at an all-time low, with more than a third of dentists saying they intend to leave the profession in the next 12 months, and 80% planning to reduce their NHS commitment if the Government reverts to pre-pandemic arrangements. Failure to act risks sparking an exodus from the workforce which would mean families across Scotland losing access to NHS dentistry for good.   
 
Over 3.5 million NHS dental appointments were lost in Scotland as a result of the pandemic. As infection prevention and control measures continue to limit the number of patients dentists can see, this unprecedented backlog continues to grow and will likely take years to clear. 
 
The BDA has warned the SNP’s 2021 election pledge of free NHS dentistry for all will be unrealisable without meaningful support and real reform. It is pressing for a workable interim funding model, and long-term change to a system that prioritises prevention, is patient-centred and reflects modern dentistry.   
 
David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: “NHS dentistry in Scotland is facing crisis, but sadly Ministers seem asleep at the wheel. 
 
“Opposition parties are all seeing the plain facts that Scottish Government plans could devastate services millions depend on and widen already unacceptable health inequalities. 
 
“Promises have been made to the voting public that simply that can’t be kept unless we see meaningful support and real reform as we head out of the pandemic.” 

Reform of NHS key to pandemic recovery, says Audit Scotland report

The Scottish Government must focus on transforming health and social care services to address the growing cost of the NHS and its recovery from Covid-19.

Improving the NHS will be very difficult against the competing demands of the pandemic and an increasing number of other policy initiatives, including plans for a National Care Service.

The health service in Scotland is on an emergency footing and remains under severe pressure. There is a growing backlog of patients waiting much longer for treatment because of the response needed to Covid-19. That has made workforce planning and delivering on ambitious recruitment plans all the more important. But the Scottish Government has historically struggled to recruit enough people with the right skills.

The NHS’s ability to plan remains hindered by a lack of robust and reliable data, including workforce, primary care, community, social care, and health inequalities data.

Meanwhile the pandemic has increased the fiscal pressures on the NHS, which remains financially unsustainable. This is despite the Scottish Government allocating £2.9 billion for pandemic-related costs in 2020/21 and committing more funding in 2021/22 and beyond.

Stephen Boyle, Auditor General for Scotland, said: “Reforming the NHS is key to the Scottish Government’s pandemic recovery plan and needs to remain a priority. Putting Covid costs to one side, health spending is rising every year, meaning less money for other public services.

“There’s now a clear opportunity to do things differently by building on the innovation and collaboration we’ve seen across the NHS in the last few years.

“For that to happen, our leaders must take the public with them and involve them in the shift from care being delivered in hospitals to much closer to people’s homes. But better-informed policy decisions and services won’t be possible without better collection and use of data.”