Concern ratings: our assessment of public service performance

As the preceding chapters show, most of the public services covered in this report have made some efficiencies over the past 10 years. The public sector pay cap played a big role in this, and staff are working more productively.

However, public services are now struggling to maintain the efficiencies they have made and pressures are growing – particularly in recruiting and retaining staff. There are no public services that we are confident have met all the demands placed on them in the last 10 years, or will be able to keep operating as efficiently as they have. There are trade-offs to be made between spending and service performance but any government would have to spend more than is currently planned to improve services.

In this chapter, we outline risks to performance of each of the nine public services, including which public services face the largest increases in demand and in which the government has a credible spending plan in place.

We are most concerned about prisons and adult social care, where performance has declined furthest and neither service will be able to keep operating at its current level of efficiency. Adult social care, alongside general practice and hospitals will also face a steep increase in demand over the next five years.

How we made our judgements

We summarise our conclusions from the preceding chapters in a ‘concern rating’ – with a coloured rating for three different elements of past performance and future risks. In most categories, public data is not adequate to allow hard boundaries between the different ratings. Instead, we made qualitative judgements – the basis of which is outlined in Table 12.1 – informed by quantitative analysis.

Methodology for concern ratings

Category

Criteria

2009/10 to 2018/19

 

 

Has demand risen faster than spending?

Green: Spending has risen in real terms at the same rate as or faster than demand

Amber: Demand has risen somewhat faster than spending (0–10%)

Red: Demand has risen significantly faster than spending (>10%)

Grey: Insufficient information to make a clear judgement

 

 

Has the service made efficiencies?

Green: Clear evidence of efficiency improvements in the service

Amber: Mixed evidence of efficiency improvements

Red: No efficiencies made – or efficiency has declined

 

Were those efficiencies enough to bridge the gap between spending and demand?

Green: No signs of unmet demand, queuing or overspending

Amber: Some evidence of unmet demand, queuing or overspending

Red: Widespread evidence of unmet demand, queuing or overspending

Grey: Insufficient information to make a clear judgement

2018/19 to 2023/24

 

 

How will demand change?

Green: At or below the rate of population growth (2.9%< )

Amber: Somewhat faster than population growth (2.9–10%)

Red: Significantly faster than population growth (>10%)

Grey: Insufficient information to make a clear judgement

 

Can the service keep operating as efficiently as it is?

Green: No clear pressure as a result of efficiencies

Amber: Moderate pressure as a result of efficiencies

Red: Widespread pressures as a result of efficiencies

Grey: Insufficient information to make a clear judgement

 

 

 

 

Are there credible plans in place to meet demand, make efficiencies, or reduce scope?

Green: Plans in place to meet demand by increasing spending or making efficiencies, with clear indications that this will be achieved and/or existing efficiency strategies have further to go

Amber: Plans in place to meet demand by increasing spending or making efficiencies, with some indication that they will achieve their aims

Red: No plans in place to meet demand by increasing spending or making efficiencies; or a plan in place with evidence that it will not achieve its aims – or no evidence that it will achieve its aims. Existing efficiency strategies cannot be pushed further

Grey: Insufficient information to make a clear judgement.

 

Concern rating for nine public services

Concern rating for nine public services