Tag Archives: white paper

Keeping our finger on the pulse: recent additions to our collection across health

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The health and care landscape has been changed in unprecedented ways over the past year. The coronavirus pandemic has not only highlighted strains within the system and required a response to a public health emergency unlike anything else that has been seen for decades, it has also provided an opportunity to push innovation in areas like digital infrastructure and partnership working, and encouraged decision makers to look at public health as an essential part of policy making in all areas.

The Knowledge Exchange database is full of reports, articles and documents which offer insight into these themes, published by organisations from across the heath and social care landscape. In this blog post, we’re highlighting some recent additions to our collection and some of the big themes being discussed within the sector.

Covid-19, “building back better” and a “health in all policies” approach

In March 2021 think tank IPPR published their report State of health and care: the NHS Long Term Plan after Covid-19. The recommendations form a £12 billion blueprint to ‘build back better’ in health and care and the report calls for an adaptation of the NHS Long Term Plan published in 2019 focusing on cancer, mental health, cardiovascular disease and multimorbidity. The authors believe the Long Term Plan needs to change to ‘build back better’ health and care post-pandemic, in relation to: ensuring a sustainable workforce; resourcing the NHS to deliver transformation; empowering integration; upgrading the digital NHS; funding and reforming social care; and levelling up the nation’s health.

Another report, from the Local Government Association (LGA), published in September 2020, provides specific guidance to local authority councillors on ways to improve the approach to population health and use of public health resources in dealing with the pandemic, highlighting the Health in All Policies (HiAP) approach to addressing health inequalities and improving wellbeing. There are a number of other resources which look at public health approaches to tackling other areas of policy such as youth violence and urban regeneration.

Build back fairer: the Covid-19 Marmot Review: the pandemic, socioeconomic and health inequalities in England, published by the Health Foundation and the Institute of Health Equity examines inequalities in coronavirus mortality, looks at the effects that the pandemic, and the societal response, have had on social and economic inequalities, the effects on mental and physical health, and the likely effects on health inequalities in the future. The report assesses the inequalities in the risk of COVID-19 and mortality and explores the impact of containment on inequalities in the social determinants of health, in terms of: early life; education; children and young people; employment and working conditions; a healthy standard of living; healthy and sustainable places and communities; and healthy behaviours.

Mental health

Mental health services have been under significant pressure in the UK for a number of years now, with children’s services (CAMHS) particularly stretched as the number of specialist practitioners is limited. The coronavirus pandemic has, according to many specialists, exacerbated existing pressures and placed even more demand on services. In April 2021 the All-Party Parliamentary Group on a Fit and Healthy Childhood published a report: The COVID generation: a mental health pandemic in the making – the impact on the mental health of children and young people during and after the COVID-19 pandemic  which explores a range of themes in relation to the impact of the pandemic on the mental health of children and young people. The report presents evidence from a range of sources on the potential implications of the pandemic on young people’s mental health and discusses the impact of school closures on children’s future health and well-being.

The Children’s Commissioner for England recently published a report  which looks at the progress made in improving children’s mental health services in England, and  the impact of the pandemic on the mental health of children. The report also examines the provision and accessibility of children’s mental health services in 2019/20, finding that access is still not adequate and not improving as quickly as expected.          

The other pandemic: the impact of Covid-19 on Britain’s mental health  explores how the mental health of people in the UK has been affected by the pandemic, drawing on a survey of over 4000 people. It describes the different experiences of groups across society and the highlights the disproportionate mental health impact on people who are exposed to higher levels of social deprivation, as well as on women, younger people and those who live alone.

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Structural reform

In August 2020 the Health Devolution Commission launched its final report, Building back health and prosperity. Among other themes, such as taking a “health in all policies approach”, the report found that devolving accountability and power to a more local level creates the potential to understand communities and places better, and to meet their needs.

One of the main focuses of the health and social care white paper published in February 2021 is around developing an integrated health and social care system and taking a ‘population health’ preventative approach to healthcare, while a report from the NHS confederation recommends a reformation of the framework for elective care and increased healthcare funding.

Digital transformation

Even before the pandemic, The King’s Fund was publishing widely on digital transformation. But their recent report Understanding factors that enabled digital service change in general practice during the Covid-19 pandemic  looks specifically at the impact of the pandemic on accelerating the transformation of the delivery of some services by GPs to focus more on digital delivery and whether this change can (or should) be sustained once the pandemic is over. It explores the challenges around trust, staff and patient digital literacy and the evaluation of digital tools in practice. Parliamentary Office of Science and Technology (POST) published their own review of AI and healthcare , providing an overview of AI in the healthcare system and its potential impacts on the cost and quality of healthcare, and on the workforce.

Final thoughts

The landscape of health and care is changing. The Covid-19 pandemic has placed unprecedented demands on a system which was already facing significant challenges. While in some instances this has led to innovation and accelerated the pace of change, it has also exposed some of the significant weaknesses of the system.

This blog highlights some of the big topics the sector is currently grappling with, but there is more available for TKE members on our database. Members can also sign up to receive our health Topic Update, which will provide fortnightly email updates of items recently added to the collection in health, easily allowing you to stay up to date.

If your organisation is not a member of the Knowledge Exchange and you would like more information, please contact us.

If you liked this article you may also be interested in reading:

A nudge in the right direction? Using behavioural insights in health

Virtual reality: a game changer for mental health treatment?

Devolving health and social care in England: an opportunity to transform how we approach health and care?

Cross-border handshakes: what’s next for digital contact tracing?

Can they fix it? Reactions to the white paper on housing

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By James Carson

After a delay of several months, the government’s housing white paper was finally published last week.  Its title – “Fixing our broken housing market” – makes clear that England’s housing market requires radical reform. The communities secretary, Sajid Javid underlined this when presenting the paper to MPs:

“We have to build more, of the right homes in the right places, and we have to start right now.”

The key proposals

The white paper contains 29 policy proposals. These include:

  • developers will be forced to use-or-lose planning permission within two years
  • local authorities will be required to keep an up-to-date local plan to meet housing demand
  • an expanded and more flexible affordable homes programme, for housing associations and local authorities
  • developers will be encouraged to avoid “low-density” housing where land availability is short
  • the time allowed between planning permission and the start of building will be reduced from three to two years
  • incentives for build to let
  • the Green Belt will continue to be protected, and may only be built on “in exceptional circumstances”

In addition, the paper proposes the establishment of a £3bn fund to help smaller building firms challenge major developers, and a “lifetime ISA” to help first-time buyers save for a deposit. The white paper also confirmed government plans to ban letting agency fees for tenants.

The paper proposes placing a cap of £80,000 (£90,000 in London) on starter homes (new-build homes for first-time buyers between 23 and 40 years old and sold at least 20% below market value). And it signals that 10% of all new homes should be starter homes (the current requirement is 20%).

Reaction to the proposals: the politicians

The communities secretary described the white paper’s proposals as “bold” and “radical”, but some responses have suggested that the new strategy will fail to meet the challenge of England’s housing crisis.

Describing the plans as “feeble beyond belief”, Labour’s shadow housing minister, John Healey observed: “This white paper is not a plan to fix the housing crisis. And it will do nothing to reverse seven years of failure on housing we’ve seen since 2010. There are 200,000 fewer home-owners, homelessness has doubled, and affordable house-building has slumped to a 24-year low.”

The Green Party’s co-leader Jonathan Bartley said the policies were a “slap in the face for the millions of people in this country desperate for bold plans to reduce rents and make their housing affordable”.

On build to rent, Tom Copley, Labour’s London Assembly housing spokesperson welcomed the shift in focus from home ownership, but was concerned about the scope of the proposals:  “…whilst the promise of longer tenancies is welcome, its bearing will be miniscule unless it is extended to existing rental properties, where the vast majority of renters actually live.”

Reaction: architects, housing bodies and builders

Simon Henley, of architects Halebrown, welcomed the paper’s proposals to help smaller building firms challenge major developers – “More and smaller housebuilders will bring variety and inspiration.”  But he added that “reasonably priced land is vital to the equation for great homes.”

Alex Ely of the Mae architecture practice was disappointed with the continuing restrictions on building on the Green Belt, observing that “We know that just a 1km ring of Green Belt from inside the M25 would yield enough land for a generation of building at current rates.”

Terrie Alafat, chief executive of the Chartered Institute of Housing said the package of measures demonstrates a commitment to tackle the housing crisis. “However our concern is that much housing remains out of reach for a significant number of people and we would like to see the government back up the package of measures with additional funding and resource in the budget.”

Stewart Baseley, executive chairman of the Home Builders Federation welcomed plans to bring forward more developable land: “If we are to build more homes, we need more land coming through the system more quickly.”

Reaction: homeowners and renters

Dan Wilson Craw, director of Generation Rent argued that the white paper failed to offer renters anything of substance. “Renters on stagnant wages need homes that cost no more than a third of their income, not ones let at 80% of the market rent, with a sticker that says ‘affordable’.”

Meanwhile, Paula Higgins, chief executive of HomeOwners Alliance, called for more action and fewer words. “It’s difficult to see how these measures will enable the government to meet its target of one million new homes by 2020.”

Reaction: the LGA and Shelter

Speaking for the Local Government Association (LGA), housing spokesman Councillor Martin Tett noted that the white paper contains signs that the government is listening to councils on how to boost housing supply and increase affordability. But he called for more support to enable local authorities to tackle the housing shortage: “…councils desperately need the powers and access to funding to resume their historic role as a major builder of affordable homes. This means being able to borrow to invest in housing and to keep 100 per cent of the receipts from properties sold through Right to Buy to replace homes and reinvest in building more of the genuine affordable homes our communities desperately need.”

Writing on the organisation’s blog, Shelter’s Steve Akehurst described the white paper as a step, rather than a leap in the right direction:

“Overall, the shift in emphasis – towards tackling big developers and dysfunctions in the land market, towards making renting more stable, and delivering more affordable homes – is really welcome, and there are some good first steps to making them a reality. In reality more will be needed to deliver upon these lofty ambitions in full… But today is a good start.”

The next steps

The government is consulting on the planning proposals set out in the first two chapters of the white paper, with a closing date of 2 May 2017. After considering the responses, the government will decide on how to take its strategy forward.

As the paper concludes, millions of people who can’t afford to buy or rent already know that the housing market is broken. Fixing it will be a job not only for the government, but for local authorities, developers, housing associations and local communities.

Time will tell whether the proposals set out in the white paper are radical enough to help the homeowners and tenants of tomorrow.

You may also find these blog posts on housing of interest: