Performance Tracker 2025: Cross-service analysis

The picture in July 2024

The inheritance: spending

Services had to manage serious spending restraint over the previous 14 years 

Public services have been on a funding rollercoaster since the last time Labour were in power. While by 2024 spending on most services had returned to and indeed exceeded levels seen at the beginning of the coalition government in 2010, many were still recovering from deep cuts in the first half of that decade.^*

_{*    All changes in spending are real terms unless otherwise stated.}

Local government received some of the most difficult budget settlements, with its grant funding (including business rates) falling by 40.0% between 2010/11 and 2019/20. This saw the overall spending power of councils, including council tax receipts, fall by almost a quarter in the same period (24.0%). There were also steep spending reductions across the criminal justice system, particularly in HM Courts and Tribunals Service (HMCTS), which oversees criminal courts, which saw cuts of 23.3% from 2010/11 to 2017/18.

Funding subsequently rose but still left services with often extremely tight budgets, particularly in local government and criminal justice. Leaders were therefore tasked with making up lost ground or in some cases reducing what they could offer
to the public.

For example, in local government, while a decade of funding restraint meant overall local authority core spending power was still 13.5% lower in 2024 than 2010, spending on adult and children’s social care and homelessness rose. The legacy of the pressures on acute services combined with overall spending cuts has been closed youth centres and libraries, along with markedly reduced services from leisure centres, waste collection and planning. This will not have gone unnoticed by voters.

Spending rose by more in the NHS. Hospital spending increased by 45.8% between 2010/11 and 2023/24 and spending on general practice rose by 35.3% over the same period.^* However, while this may look generous when compared with many of the services covered in this report, judged by the NHS’s own historical standards it is far from that: the average annual increase of 2.5% for hospitals over this period is dwarfed by the 3.9% per year increase in health^** spending between 1950/51 and 2009/10. Likewise, per-pupil funding for 5–16-year-olds was 3.7% higher in 2023/24 than in 2010/11 but the cost of employing teachers had increased substantially due to the doubling of the employer contribution rate to teachers’ pensions (from 14.1% in 2010 ¹ Local Government Association, ‘Teachers’ pension scheme – Employer and member contribution rates historic information’, Local Government Association, (no date) retrieved 11 November 2025, www.local.gov.uk/our-support/workforce-and-hr-support/local-government-pensions/teachers-pension-scheme/historic-2  to 28.7% in 2024 ² Teachers’ Pensions, ‘Updates to contribution rates’, Teachers’ Pensions, (no date) retrieved 11 November 2025, www.teacherspensions.co.uk/news/employers/2024/02/updates-to-contribution-rates.aspx ). All services had to stretch their budgets to meet rising demand and address the lingering impacts of the pandemic.

_{*    Based on estimated spending on general practice in 2023/24}

_{**    There is no comparable numbers for spending on hospitals before 2010/11, so the measure here includes spending on all health, which is wider than just hospitals}

Capital budgets suffered particularly deep cuts

Throughout the 2010s, the Conservative-led governments prioritised day-to-day spending over investment. Capital spending – used for things like buildings maintenance or IT equipment – was cut particularly steeply in the first years of the coalition, by almost a third in just three years between 2009/10 and 2012/13 (-31.9%). ³ Atkins G, Tetlow G and Pope T, Capital spending: Why governments fail to meet their spending plans, Institute for Government, 21 February 2020, p. 6, www.instituteforgovernment.org.uk/publication/report/capital-investment-why-governments-fail-meet-their-spending-plans

Of the five key public services departments that we look at, the Ministry of Justice (MoJ) experienced the deepest cuts in the 2010s, with annual spending between 2010/11 and 2019/20 averaging just 43.3% of the pre-financial crisis baseline in 2007/08. From 2019/20 onwards, MoJ and DHSC capital budgets were increased substantially, and Home Office spending also rose, but by the time of the 2024 election capital spending by the Ministry of Housing, Communities and Local Government (MHCLG) and Department for Education (DfE) was still much lower than it had been before the global financial crisis.

The impact of these cuts was exacerbated by a failure to spend remaining budgets well. The Institute has previously highlighted that public services have an inadequate understanding of their current capital stock and future needs; capital spending is often focused on new projects over maintaining existing assets; internal spending controls do not incentivise departments to manage capital budgets well; and there is often poor co-operation with the private sector contractors, leading to poor value for money. ⁴ Atkins G, Tetlow G and Pope T, Capital spending: Why governments fail to meet their spending plans, Institute for Government, 21 February 2020, www.instituteforgovernment.org.uk/publication/report/capital-investment-why-governments-fail-meet-their-spending-plans

As a result, Labour inherited a public sector estate unsuited to the needs of modern public services. Much of it was old. A quarter of the general practice estate had been built before the NHS was established, and many prisons were older still, dating back to the Victorian era. ⁵ Hoddinott S, Delivering a general practice estate that is fit for purpose, Institute for Government, 8 June 2024, www.instituteforgovernment.org.uk/publication/general-practice-estate  Even more of it was showing signs of a decade and a half without proper upkeep, with record maintenance backlogs in the NHS, schools, prisons and courts. Closures of operating wards, classrooms and prisons cells due to unsafe conditions had become a common occurrence, even before the RAAC crisis of 2023 forced the closure of many other public buildings. Cuts to capital budgets had left most public services with out-of-date and inadequate IT systems and equipment; ⁶ Hoddinott S, Rowland C, Davies N, Kim D and Nye P, Fixing public services: Priorities for the new Labour government, Institute for Government, 22 July 2024, www.instituteforgovernment.org.uk/publication/fixing-public-services-labour-government  an unpropitious context for Labour’s manifesto pledge to “harness new technology”. ⁷ Labour Party, Change: Labour Party Manifesto 2024, Labour Party, 2024, https://labour.org.uk/wp-content/uploads/2024/06/Labour-Party-manifesto-2024.pdf

These failures in capital damaged productivity and undermined the service improvements that might have been delivered in those services that did receive extra day-to-day spending.

Spending had become more weighted towards acute services

From 2010 onwards, Conservative-led governments and local authorities found it easier to make cuts to preventative programmes, where the benefits from investment tend to accrue over a long period and are dispersed across a wide range of public sector bodies, but savings from cuts can be realised immediately by a single organisation. As a result, by the 2024 election, acute services were swallowing an ever-growing share of spending.

While objectively defining and measuring preventative spending is notoriously challenging, ⁸ Hoddinott S, Davies N and Kim D, A preventative approach to public services: How the government can shift its focus and improve lives, Institute for Government, 22 May 2024, pp. 10–11, www.instituteforgovernment.org.uk/publication/preventative-approach-public-services  the trend across multiple public services has been clear. In local government, spending on safeguarding and looked-after children (the most acute children’s services) increased by 71.3% between 2009/10 and 2023/24, whereas spending on the more preventative children’s centres and services for young people fell by 78.6% over the same period. A similar pattern can be seen in local authority housing, where spending on homelessness services, which are predominantly acute, rose by 125.9% between 2009/10 and 2023/24. In contrast, spending on housing welfare, which includes the Supporting People programme intended to help vulnerable residents live independently, fell by 75.3% over the same period.

It was the same story in health and care services. While spending on acute trusts grew by 29.6% between 2016/17 and 2022/23, preventative services fared much worse. For example, community trusts grew by less than half this (13.9%), while public health spending fell by 6.6% over the same period. ⁹ Hoddinott S, Davies N and Kim D, A preventative approach to public services: How the government can shift its focus and improve lives, Institute for Government, 22 May 2024, pp. 77–78, www.instituteforgovernment.org.uk/publication/preventative-approach-public-services  As a result, spending is heavily skewed towards acute services. In 2022/23, the government spent a total of £144.5billion on acute trusts, GP primary care services, mental health services, community trusts, adult social care and public health. Of this, 62% was spent by acute trusts, whereas spending on community trusts and public health was just 5.4% of the total.

Labour inherited a negative spending spiral. Cuts to preventative services had fed increased acute demand and political pressure to fund acute services, leaving the government to contemplate further cuts to preventative services to fund ever higher acute demand.

Spending plans for 2025/26 onwards were undeliverable

The Sunak government left the incoming Labour administration with only vague spending plans from April 2025 onwards. As noted by Richard Hughes, chair of the Office for Budget Responsibility, in January 2024:

“It is just two numbers, one for total current spending and one for total capital spending done by departments. And I think some people have referred to that as a work of fiction. I think that’s probably generous given that someone’s bothered to write a work of fiction, whereas the government hasn’t even bothered to write down what its departmental spending plans are underpinning the plans for public services.” ¹⁰ Markson T, ‘OBR: Government spending plans beyond 2025 ‘worse than fiction’’, Civil Service World, 24 January 2024, retrieved 11 November 2025, www.civilserviceworld.com/news/article/obr-calling-government-spending-plans-a-fiction-is-generous

The lack of detail allowed both the Conservatives and Labour to avoid, during the general election, discussing the difficult trade-offs that would be required. However, based on reasonable assumptions about the amount that any incoming government would spend on the NHS, defence, schools and foreign aid, it was clear that it would be politically impossible to deliver the Sunak government’s spending plans.

In particular, the plans implied cuts to an already struggling criminal justice system. Our analysis suggests there would have been a growing gap between spending and demand. For example, in prisons we project that spending would have fallen by 2.4% a year on average, while demand would have grown by 3.3% annually, a difference of 5.7%. Implementing Sunak’s spending plans would likely have necessitated reducing the number of police officers, allowing acceleration in the growth in magistrates’ and crown court case backlogs, and making cuts to the prison workforce at a time when prisons were already overflowing.

The inheritance: staffing

Recruitment had improved and staff turnover had stabilised

Labour inherited a public services workforce that had grown substantially in recent years but was, in some cases, still smaller than the one it left in 2010. One of the most sustained rises had been in the number of doctors and nurses working in hospitals, with particularly fast growth from 2019 onwards. Overall, there were 49.9% and 42.3% more doctors and nurses respectively in May 2024 than in May 2010.

The adult social care workforce also hit record levels in 2023/24, up 13.7% since 2012/13 – with the growth since 2020/21 entirely due to international recruitment, which increased substantially after the Johnson government added care workers to the shortage occupations list in February 2022. However, the Sunak government’s tightening of visa rules made it more challenging for providers to recruit internationally.

There had also been a dramatic increase in the number of direct patient care staff, such as pharmacists and physiotherapists, working in primary care, with their numbers swelling by 418.2% between September 2015^* and June 2024. In contrast, the number of fully qualified, permanent GPs fell by 5.4% over this period, despite an increase of 1.9% in the year before the election.

The number of police officers increased by more than 20,000 from 2019/20 onwards, due to the Johnson government’s police uplift programme, and was higher than it had been when Labour last left office. However, on the eve of the 2024 election it was still 7.3% below 2009/10 levels on a per capita of the population basis. Likewise, the number of front-line prison staff^** per 1,000 prisoners grew 27.4% between 2016/17 and 2023/24, but prisons still had 4.2% fewer than in 2009/10.

In some services, Labour has benefited from a drop in staff leaving rates following spikes in 2021 and 2022. In the NHS, for example, 10.0% of staff left their roles in 2024, which was, outside of the pandemic, lower than any 12-month period since 2010. It is a similar picture in children’s social care, where turnover in 2024 had fallen to 13.8% from a high of 17.2% in 2022. Aside from the pandemic, this is the lowest figure since 2017 and lower than 2013, the first year for which figures are available. By 2023/24, the leaving rate of prison officers had fallen from the highs seen in the pandemic, but was still more than triple that seen in 2009/10.

In schools, the proportion of teachers leaving the service had increased since the Covid-era lows, bringing the leaving rate in 2023–24 to 9.0% largely in line with, if not slightly lower than, pre-pandemic levels. However, new teachers were leaving the system earlier. Just 67.6% of teachers who qualified in 2019 were teaching five years later compared to 73.5% of those who started between 2006 and 2010.

_{*    The first month for which figures are available}

_{**    Operational staff in public sector prisons.}

Workforces, particularly in criminal justice, had become less experienced 

Due to staff turnover and high recruitment in the years before the election, key workforces had become less experienced.

In prisons, more than half of band 3–5 prison officers had less than five years’ experience in 2023/24, compared to just 22.5% in 2009/10. In contrast, the number of officers with at least 10 years’ experience had fallen 40.8% over the same period. Likewise, the proportion of police officers with more than 10 years’ experience had fallen from two thirds in 2015/16^* to less than half in 2023/24. In the CPS, the recruitment of a large number of lawyers between 2022 and 2024 led the inspectorate to warn of “high levels of inexperience”, ¹¹ HM Crown Prosecution Service Inspectorate, Annual report 2023–24 (HC 302), HM Crown Prosecution Service Inspectorate, 31 October 2024, p. 7, https://cloud-platform-e218f50a4812967ba1215eaecede923f.s3.amazonaws.com/uploads/sites/24/2024/11/2024-10-28-Annual-report-2023-4-Final.pdf  and 12% of all spending on criminal legal aid for barristers in 2023/24 went to barristers who had been practising for just one or two years – up from 2% in 2015/16.

The substantial increase in the number of nurses and midwives in recent years had also diluted the experience of the workforce. In September 2024, 28.3% of registered nurses and midwives had less than five years’ experience, compared to 19.9% in September 2017.

In contrast, the GP workforce had, proportionally, become more experienced in recent years. However, rather than being a cause for celebration, this instead reflected the high leaving rates of GPs aged under 40. The same is true of criminal legal aid solicitors, particularly duty solicitors, more than 40% of whom were over 55 in 2024.

_{*    The first year for which figures are available}

Workforces lacked back-office capacity

The increases in some front-line staff over the years before the election had not been matched by a commensurate rise in the number of managers, analysts and other support staff. While the use of such staff has often been characterised by ministers as wasteful, they play a critical role in the effective delivery of services, bringing specialist skills to back-office roles and freeing up front-line staff to focus on public-facing work.

In the NHS, the number of managers grew by 8.4% between July 2010 and July 2024, but lagged far behind the growth in the number of doctors and nurses. As a result, the number of FTE NHS staff for every manager and senior manager grew by 23.9% over this period. This left the NHS severely undermanaged compared with other health systems and the overall UK economy. ¹² Freedman S and Wolf R, The NHS productivity puzzle: Why has hospital activity not increased in line with funding and staff?, Institute for Government, 13 June 2023, p. 42–43, www.instituteforgovernment.org.uk/publication/nhs-productivity

Cuts to local government spending power necessitated a drastic slimming of the workforce, which fell by almost a third (31.7%) between June 2010 and June 2024. ¹³ Office for National Statistics, ‘Public sector employment: June 2025 edition’, Office for National Statistics, 16 September 2025, www.ons.gov.uk/employmentandlabourmarket/peopleinwork/publicsectorpersonnel/datasets/publicsectoremploymentreferencetable  Given the need to protect spending on statutory responsibilities such as the provision of adult and children’s social care, staff cuts likely fell disproportionately on back-office staff, contributing to weaknesses in analytical capacity. For example, the What Works Centre for Children’s Social Care reported in 2022 that “most [councils] employed a very basic analysis” of demand for children’s social care. ¹⁴ Bach-Mortensen AM, Murray H, Goodair B and others, Are Local Authorities Achieving Effective Market Stewardship for Children’s Social Care Services?, What Works for Children’s Social Care, 2022, p. 23, https://webarchive.nationalarchives.gov.uk/ukgwa/20230308122151mp_/https://whatworks-csc.org.uk/wp-content/uploads/WWCSC_sufficiency_report_Final_Mar…  Likewise, a local authority leader attending a 2024 Institute for Government roundtable on homelessness stated that poor analytical insight contributed to local authorities being caught off-guard by the rapid increase in demand for temporary accommodation.

The Police Productivity Review, published in 2023, noted that police staff – such as crime scene investigators, digital forensics experts, analysts and call centre staff – can often fill capability gaps “more cheaply and effectively” than police officers, ¹⁵ Home Office, The Policing Productivity Review: Improving outcomes for the public, October 2023, p. 28, https://assets.publishing.service.gov.uk/media/655784fa544aea000dfb2f9a/Policing_Productivity_Review.pdf  yet there was a 5.8% fall in these staff between March 2010 and September 2023. ¹⁶ HM Chief Inspector of Constabulary, State of Policing: The Annual Assessment of Policing in England and Wales 2023, His Majesty’s Inspectorate of Constabulary and Fire and Rescue Services, 2024, https://s3-eu-west-2.amazonaws.com/assets-hmicfrs.justiceinspectorates.gov.uk/uploads/state-of-policing-2023.pdf  There was an even steeper decline in the total number of HMCTS staff, with a drop of around 20% between 2010/11 and 2023/24. Given the critical role these staff play in the operation of courts, it is probable that these cuts contributed to the productivity problems in courts that are discussed in more detail below.

Most strikes had been resolved but pay was still substantially below 2010 levels 

The two years before the election saw the worst public sector strikes in a generation. Sparked by the sudden rise in inflation following Russia’s invasion of Ukraine in 2022, they were fuelled by longer term dissatisfaction with pay and conditions following more than a decade of pay restraint and the privations of the pandemic.

Since 2009/10, public sector pay on average has fallen in real terms, by 2.5% in 2023/24. But key staff groups in the services that we cover have experienced larger real-terms declines in that time. Nursing professionals’ earnings fell 10.8%, secondary and primary school teachers by 18.8% and 19.1% respectively, while police officers ended up with the largest fall at 20.0%. Taken from a different dataset, doctors’ pay had also fallen by around 20% by 2023/24, though this was up from the lows of -23.4% and -23.6% for consultants and resident doctors respectively (please see the hospitals chapter for more details). The relative generosity of public sector pensions compared to those in the private sector has grown over this period but, ¹⁷ Boileau B, O’Brien L and Zaranko B, Public spending, pay and pensions, Institute for Fiscal Studies, 8 October 2022, https://ifs.org.uk/sites/default/files/2022-10/Public-spending-pay-and-pensions-R219.pdf  as one interviewee put it, public services are “losing out in the labour market because the revealed preference of graduates and professionals is to take more in pay and less in pension”.

However, by the time of the 2024 election, most disputes – including those with teachers, nurses and hospital consultants – had been settled by the Sunak government and the incoming Labour administration benefited from some stability, at least at a surface level, in industrial relations. The major exception was resident doctors (formerly ‘junior doctors’), who had already taken part in 11 separate strikes in 2023 and 2024 and threatened to strike again in the weeks immediately following the election. ¹⁸ Mundasad S, ‘Doctors strikes: BMA and Streeting talks ‘constructive’’, BBC News, 17 June 2025, retrieved 11 November 2025, www.bbc.co.uk/news/articles/cq8z9xllx3xo

Resident doctors seeking a better deal from the new government reflected a wider belief among unions that Labour would make more generous offers and, as discussed below, has led to further strikes since the election. Despite the deals that had been reached, pay for key professions such as nurses, teachers, police officers, prison officers and GPs had still fallen relative to inflation and the private sector, and staff dissatisfaction was high. So, while Labour inherited a more peaceful context of staff relations, this is better understood as a temporary ceasefire rather than a permanent cessation of union hostilities over pay.

The inheritance: performance

Performance was worse than pre-pandemic and much worse than 2010 

Lockdowns, social distancing and higher rates of staff sickness dramatically reduced what most public services could do during the pandemic. Under the Sunak government activity increased and, in most cases, exceeded pre-pandemic levels. For example, the number of appointments in hospitals and general practice, arrests by the police and cases disposed of by the crown court were all higher in July 2024 than they had been in March 2019.

However, this ramping up of activity was slower than might have been expected given the amount of extra resource – particularly staffing – that had been put into many of these services. In hospitals, for example, the number of doctors and nurses grew by 25.2% and 27.9% respectively between March 2019 and July 2024 but the number of completed elective cases in the previous year grew by only 4.9% over the same period. The number of outpatient appointments grew by 13.1%. Similarly, there were 19.9% more police officers at the time of the election than the eve of the pandemic, but only 5.2% more arrests and 7.4% fewer charges. The crown court sat for 10.7% more days but closed just 2.8% more cases.

While activity had largely bounced back, the recovery in performance was much more sluggish. As a result, all services were still performing worse when Labour took over than they had been before the pandemic, and all but one were doing substantially worse than when the party was last in power.

In hospitals, 58.8% of people had waited for less than 18 weeks for elective care in July 2024, compared to 83.2% in February 2020 and 91.9% in May 2010, against a target of 92% throughout this period. Waiting times in major A&E departments were similarly dire, falling from 95.2% meeting the four-hour standard in 2011^* to 70.4% in 2019 and 58.1% in the year to July 2024. Satisfaction with general practice had dropped from 88.4% in 2012 to 82.9% in 2019 and 71.3% in 2023.^**

Waiting time had also grown in the criminal justice system. In 2023/24, it took 40 days from an offence being committed until a charge was recorded in the median case, almost three times as long as in 2015/16 when it took just 14 days. Delays post-charge have also got longer. In 2024, it took an average of 6.5 months for a case to progress from offence to completion in the magistrates’ courts. That was up from 5.6 months in 2019 and from 4.5 months in 2010.

Access to long-term, publicly funded adult social care for older adults was only down a little compared to pre-pandemic, falling from 3.7% of those aged over 65 in 2019/20 to 3.6% in 2023/24. However, the drop since the last Labour government was more dramatic, with 6.9% of older adults accessing care in 2009/10.

Of all the services we assess, mainstream schools was the only one to be performing better at the 2024 election than in 2010. While there is not a directly comparable measure, all the evidence suggests that primary and secondary school attainment both improved over this time period. However, school performance suffered due to the pandemic, with the proportion of children meeting the expected standard in reading, writing and maths (combined) at the end of primary school (Key Stage 2) falling from 65% in 2019 to 61% in 2024.

_{*    The first full year for which figures are available.}

_{**    2023 is the last year before the NHS changed the methodology on the GP patient survey which means that subsequent years are no longer directly comparable}

Performance gaps had widened across the country

The gaps between the best and worst performing public services had grown because of the pandemic, with those operating in more deprived communities generally seeing the biggest drops in quality and access.

London schools pulled even further ahead of other regions. Although London’s KS2 attainment fell, it did so by less than elsewhere, meaning the gap between London and other regions grew from 6 to 8 percentage points between 2019 and 2024. For KS4 attainment and KS4 progress, performance improved over the pandemic in London while it fell outside the capital. The attainment gap between disadvantaged and non-disadvantaged children had also grown at both KS2 and KS4, unwinding much of the progress that had been made over the 2010s.

In the NHS, the gap between the best and worst performing trust^* on the 18 weeks waiting target grew from 25.9 percentage points in February 2020 (73.0% vs 98.9%) to 47.2 percentage points in February 2025 (49.8% vs 97.0%). In general practice, gaps in patient satisfaction have increased. In 2023 the gap between the top quarter and bottom quarter areas grew to 7.2ppt from 4.2 in 2019.^** Satisfaction had fallen further in poorer areas. Patient satisfaction in practices in the most deprived 20% of areas fell from 79.0% in 2019 to 68.2% (10.8ppt) in 2023, compared to a fall from 86.4% to 77.2% (9.2ppt) in the 20% least deprived areas. ¹⁹ Hoddinott S, Adult social care across England: Performance Tracker Local, Institute for Government, 25 June 2025, www.instituteforgovernment.org.uk/publication/performance-tracker-local/adult-social-care

There was also greater variation in performance between prisons. The gap between the top quarter and bottom quarter of performers for prisoner-on-prisoner assault rates and self-harm rates were both higher in 2023 than in 2019, despite having fallen during the pandemic. Likewise for incident at height rates (when prisoners climb on netting or roofs), which were higher in 2023/24 than in 2019/20. ²⁰ Rowland C, Inside England and Wales’s prisons crisis: Performance Tracker Local, Institute for Government, 7 March 2025, www.instituteforgovernment.org.uk/publication/performance-tracker-local/england-and-wales-prisons

In local government, there is now greater variation in the use of distant placements^*** in children’s social care, which can disrupt children’s access to other public services and isolate them from their support networks. In 2024, a quarter of local authorities placed at least 27% of children in distant placements, while a quarter placed at most 13%. This gap, which now stands at 14 percentage points, was 11ppt in 2019. ²¹ Dellar A, Children’s social care: Performance Tracker Local, Institute for Government (forthcoming).  In contrast, the rationing of adult social care has had the opposite effect. The largest reductions in access occurred in those local authorities that had been providing the greatest proportion of the older population with community care, compressing the differences between councils. As a result, there was less variation in the proportion of older adults receiving community care in 2023/24 than in 2010/11. ²² Hoddinott S, Adult social care across England: Performance Tracker Local, Institute for Government, 25 June 2025, p. 31, www.instituteforgovernment.org.uk/publication/performance-tracker-local/adult-social-care

_{*    We use the difference between the trusts at the 5th and 95th percentile of the distribution to exclude trusts that have very high performance due to being a small specialist trust or are particularly low}

_{**    This is the gap between the 25th and the 75th percentiles (known as the inter-quartile range) for satisfaction at the local (sub-ICB) level.}

_{***  Placements that are more than 20 miles from a child’s home.}

Poor performance reflected growing demand and poor productivity 

Spending on public services and the volume of activity they undertook were both generally higher in 2024 than in 2019. Yet performance was consistently worse at the 2024 general election than it had been before the pandemic across all services. This disparity can largely be explained by the growth in demand and decline in productivity over this period.

Some services were just working with more people than they had been previously. The prison population increased from 83,708 in February 2020 to 87,739 in July 2024, a rise of 4.6%. Likewise, the number of households living in temporary accommodation, which accounts for the vast majority of homelessness spending, grew by 33.5% during this time.^*

In other services, it was more a matter of complexity than volume. For example, pupil behaviour became worse following the pandemic, the volume of digital evidence (which had already been steadily increasing over many years) made police work more time-intensive, and many local authorities reported growing complexity among children in care, in the most extreme cases pushing the cost of some individual support packages above £1million a year.

Much of this demand, whether in terms of numbers or complexity, was ‘failure demand’ – that is, it was the result of public services not providing sufficient support at the first opportunity. Interviewees frequently mentioned the lack of availability of good quality housing, cuts to benefits, a lack of access to mental health services, slow processing of immigration cases and difficulties securing SEND support as increasing the demand on and reducing the apparent productivity of other services.

There was a particularly notable drop in the productivity of hospitals and criminal courts, despite some improvements in the former in the year before the election. In hospitals, the key drivers of the drop had been underinvestment in capital, insufficient management capacity and autonomy, poor alignment of incentives from central government, and high levels of staff churn and inexperience combined with low morale. ²³ Freedman S and Wolf R, The NHS productivity puzzle: Why has hospital activity not increased in line with funding and staff?, Institute for Government, 13 June 2023, www.instituteforgovernment.org.uk/publication/nhs-productivity

The causes of declining criminal court productivity included a shortage of criminal lawyers and judges, poor administration and organisation, problems with technology and the new digital system introduced in 2016, and the disrepair of the courts estate. The size of the case backlog was also a factor. Delays to cases coming to court meant individual cases took up more court time, in part due to the need for more interim hearings on bail and custody time limits. Memories also fade, making witness testimony less compelling and sentencing potentially more complex.

More broadly, Labour inherited structures and systems of governing that impeded the efficient and effective delivery of public services. Previous governments provided front-line services with single-year financial settlements, even when departments were set multi-year budgets, making it harder to plan and to invest in preventative programmes.

As the Institute for Government has documented in previous reports, inconsistent, siloed and highly prescriptive funding and policy making also stymied efforts to collaborate and respond in innovative ways to local circumstances. ²⁴ Hoddinott S, Rowland C, Davies N, Kim D and Nye P, Fixing public services: Priorities for the new Labour government, Institute for Government, 22 July 2024, www.instituteforgovernment.org.uk/publication/fixing-public-services-labour-government  Finally, services often found it difficult proactively to identify those who might need support, or to intervene early due to the difficulties of accessing data held by other organisations. All of these factors led to duplication of effort and expenditure by services and worse outcomes for those who used them. ²⁵ Hoddinott S and Davies N, The case for Total Place 2.0, Institute for Government, 8 May 2025, www.instituteforgovernment.org.uk/publication/total-place-2.0

_{*    This is the percentage increase between the figures for March 2020 and June 2024.}

The picture since the Labour government took office

Progress: spending

The government substantially increased day-to-day spending in 2024/25 and 2025/26, but set tighter budgets for the rest of the parliament

The spending plans that Labour inherited were undeliverable. As shown in Figure CSA 6, they implied cuts of 1.8% per year to unprotected areas of spending.^* This is nearly as tight as the 2015 spending review, which proved impossible to implement due to declines in public service performance. So it was inevitable that a new government would increase departmental budgets somewhat.

The spending increases announced at the autumn budget 2024 were genuinely substantial. Day-to-day spending in 2024/25 and 2025/26 was set to grow by 3.5% and 4.3% respectively. That equates to £23bn more in 2024/25 and £39bn in 2025/26 relative to the plans set out in the Sunak government’s last fiscal event.

This was one of the biggest increases to day-to-day spending in more than two decades, with the average annual growth planned at the budget larger than all Conservative-led spending reviews since 2010, with the exception of 2019 and 2020 (even excluding Covid spending). It is also larger than New Labour’s first and last multi-year spending reviews.

Among public services, health^** and education did relatively well but there were particularly big increases for local government^*** and justice. These are two areas that had had to manage some of the deepest cuts over the previous 15 years and where there were immediate pressures to address in the form of possible local government bankruptcies, record court backlogs and overcapacity in prisons.

_{*    These are areas that are not health, education, defence and foreign aid.}

_{**    Though health received a lower settlement than the estimated cost of implementing the NHS Long Term Workforce Plan, which allowed for bigger increases in other services.}

_{*** Though most of the increase in local authority core spending power will come from council tax, rather than from central government grants.}

However, this generosity is a little short-lived. Day-to-day spending is set to increase more slowly in the second half of this parliament, growing by an average of 1.3% between 2025/26 and 2028/29, compared to 3.6% between 2023/24 and 2025/26. Perhaps unsurprisingly, it is the NHS, with 3.0% per year spending growth, that is set to see the biggest increase beyond 2025/26, though the other services covered in this report will also see higher spending.

In all cases, though, this is likely to be at a slower average rate than across 2024/25 and 2025/26. These relatively small increases are from a higher baseline due to the decisions made at the autumn budget 2024 and, based on our forecasts, we expect spending growth to outpace demand growth in most services across the whole parliament and 2025/26–2028/29 (see Figure CSA 8). However, with some key costs such as pay likely to rise faster than inflation, this will mean budgets feel tight and the government will need its public service reforms, discussed below, to be a success if it wants to deliver meaningfully better performance by the next election.

The government hopes that budgets can be stretched further through the delivery of efficiency improvements. To that end, it published departmental efficiency plans ²⁶ HM Treasury, Spending Review 2025: Departmental Efficiency Plans, 11 June 2025, https://assets.publishing.service.gov.uk/media/68492799d0ca5d7801e4e709/Efficiency_delivery_plans_-_supplementary_document_-_FINAL.pdf  alongside the spending review. These assume that departments will be able to make average annual efficiency savings of 4% to their day-to-day budgets by 2028/29.

A focus on efficiency is welcome, as is the government’s commitment to update these plans every two years and report on them annually. However, the ‘plans’ are generally vague about the contribution that individual initiatives are expected to make or how efficiencies will be delivered practically. For example, the DHSC plan states that “the demand for temporary staff will be reduced by reducing sickness absence rates and improving retention” but no further detail is provided.

There is also heavy reliance on AI and other technologies. While this is a fruitful avenue for reform and the government has ramped up investment in these areas, the targets are highly ambitious given the mixed success of past government digital transformations and the reality that many of the AI tools are untested or yet to be meaningfully scaled up. Data infrastructure is currently not sufficient to make best use of many AI tools in any case: in the NHS, only 2.0% of trusts store all medical records electronically, while 4.5% store them entirely on paper. ²⁷ NHS England, ‘Estates Returns Information Collection’, NHS Digital, (no date), https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection  Likewise, plans to use AI to address problems with mistaken releases from prisons ²⁸ Syal R, ‘AI chatbots could help stop prisoner release errors, says justice minister’, The Guardian, 10 November 2025, retrieved 11 November 2025, www.theguardian.com/society/2025/nov/10/ai-chatbots-stop-prisoner-release-errors  will be extremely difficult to realise given current paper-based processes.

If efficiency savings prove harder than anticipated to find, services will have little choice but to make cuts to stay within their budgets.

The government has committed to higher capital spending, but public services are not the main beneficiary

At the autumn 2024 budget, the government set the overall capital spending envelope through to 2029/30. Capital spending will grow much faster over the next few years than day-to-day spending. Overall, annual departmental capital spending between 2026/27 and 2029/30 will be around 20% higher than in 2024/25. At the June 2025 spending review that envelope was allocated, revealing the government’s priorities for investment.

The chancellor prioritised investment in defence, transport, energy and business. The level of departmental capital spending on public services will be higher than the 2010s, but the increase is less generous than for some other parts of government, as Figure CSA 9 shows.

Health remains by far the largest capital budget among public services departments. The DHSC capital budget increased by 14% from 2024/25 to 2025/26 but will now remain fairly flat until the end of the decade, as Figure CSA 2 shows. It is a similar story for the smaller MoJ capital budget, which has been increased significantly over the past few years. The Home Office capital budget has also increased since 2021/22, after a sharp decline in the 2010s, and is set to remain roughly flat in real terms for the rest of this parliament. Capital budgets for MHCLG and DfE^* will remain roughly in line with the average of the last decade.

The government has made some positive changes to address the previous weaknesses in the allocation, planning and delivery of capital spending in public services. The fiscal rules now focus on current budget balance rather than overall borrowing. ²⁹ Tetlow G, ‘Rachel Reeves has made welcome changes to the fiscal rules’, Institute for Government, 1 November 2024, www.instituteforgovernment.org.uk/comment/rachel-reeves-welcome-changes-fiscal-rules  This distinguishes between borrowing to fund investment and borrowing to finance day-to-day spending and addresses the perverse incentives provided by the rules that were in place for 2015–19 and 2022–24, which encouraged chancellors to cut investment spending rather than day-to-day spending when times were tight. This helped previous governments to meet the fiscal rules while meeting immediate spending demands, but it stored up problems in the long run, with deteriorating capital assets undermining the performance of many public services. Such problems have been apparent in DHSC, MoJ and DfE in recent years. ³⁰ Pope T, Tetlow G and Pattison J, Capital spending in public services: Fixing how the government invests in the NHS, schools and prisons, Institute for Government, 26 June 2024, www.instituteforgovernment.org.uk/publication/capital-spending-public-services

The new 10-year infrastructure strategy ³¹ HM Treasury and National Infrastructure and Service Transformation Authority, UK Infrastructure: A 10 Year Strategy, CP 1344, The Stationery Office, June 2025, https://assets.publishing.service.gov.uk/media/6853c5db99b009dcdcb73649/UK_Infrastructure_A_10_Year_Strategy_Web_Accessible.pdf  set out an increased focus on the maintenance of social infrastructure in response to backlogs, which the NAO has estimated to be worth at least £49bn. ³² Comptroller and Auditor General, Maintaining public service facilities, Session 2024–25, HC 544, National Audit Office, 2025, www.nao.org.uk/wp-content/uploads/2025/01/maintaining-public-service-facilities.pdf  The government announced explicit allocations for maintenance in DHSC and DfE, which had not been committed to in previous spending review documents; these had instead focused on new building projects. The strategy also set out a social infrastructure roadmap with plans to improve data collection, infrastructure needs assessment, procurement and supply chain engagement across public service departments in the coming years.

To finance more capital investment in public services, the strategy also highlighted opportunities for new public–private partnership models to bring private sector investment into two areas of social infrastructure: primary and community health infrastructure and public estate decarbonisation projects. The government is aware of the delivery and reputational issues associated with the Blair-era private finance initiatives, and any new private financing models will need to respond to those challenges. And it will need to provide more clarity about how a new model will work and add these opportunities to its new infrastructure pipeline. ³³ Infrastructure and Projects Authority and HM Treasury, ‘National Infrastructure and Construction Pipeline 2023’, GOV.UK, 2 February 2024, www.gov.uk/government/publications/national-infrastructure-and-construction-pipeline-2023

_{*    DfE’s settlement may be more generous than it initially appears, however. Falling pupil numbers mean that there is less need for new schools, so capital funding will likely be freed up for maintenance or improvements on existing buildings.}

The government has provided public services with greater funding certainty and flexibility

Longer term certainty over funding allows public services to plan more effectively and make timely investments that will improve their productivity. In recent years, however, Conservative governments struggled to provide such certainty. In both 2019 and 2020, departments were only set budgets for a single year and even when multi-year settlements were set in the 2015 and 2021 spending reviews these were tight and proved impossible to stick to, requiring emergency injections of cash to mitigate major performance problems. Worse, when departments have – at times – had multi-year settlements, these have not been passed down to NHS providers, schools, criminal justice agencies and local authorities.

The 2025 spending review and other announcements mark a welcome departure from this approach.^* The spending review set day-to-day budgets for 2026/27 to 2028/29 and capital budgets up to 2029/30, covering the rest of this parliament. The government has also confirmed that the next spending review will be published in 2027, bringing a more sustainable rhythm to a process that since 2022 has, according to one official, effectively involved a reassessment of spending every six months. ³⁴ Institute for Government interview.

More innovatively, the government has reconfirmed ³⁵ HM Treasury, Spending Review 2025, CP 1336, The Stationery Office, June 2025, www.gov.uk/government/publications/spending-review-2025-document/spending-review-2025-html  its pre-election commitment to provide local authorities with multi-year settlements. Central government funding for 2026/27 to 2028/29 will be announced at the local government finance settlement published later this year. The 10 Year Health Plan similarly pledges to introduce multi-year budgets for NHS trusts, though it is unclear when the details of these allocations will be published. ³⁶ Department of Health and Social Care, Prime Minister’s Office, 10 Downing Street, The Rt Hon Sir Keir Starmer KCB KC MP and The Rt Hon Wes Streeting MP, Fit for the Future: 10 Year Health Plan for England, CP 1350, The Stationery Office, 3 July 2025, https://assets.publishing.service.gov.uk/media/68760ad755c4bd0544dcae33/fit-for-the-future-10-year-health-plan-for-england.pdf

Labour has also given front-line providers greater flexibility and autonomy over how they spend their budgets. For example, while some ring-fences around local government funding have been retained, the number has been substantially reduced. This includes the decision to consolidate multiple homelessness grants into a single funding pot. Likewise, the government will extend integrated settlements to five more strategic authorities to give “mayors a single flexible pot to invest in growth and public services”. ³⁷ HM Treasury, Spending Review 2025, CP 1336, The Stationery Office, June 2025, www.gov.uk/government/publications/spending-review-2025-document/spending-review-2025-html

These are positive changes that the Institute ³⁸ Hoddinott S, Davies N and Kim D, A preventative approach to public services: How the government can shift its focus and improve lives, Institute for Government, 22 May 2024, pp. 10–11, www.instituteforgovernment.org.uk/publication/preventative-approach-public-services  and others have long called for and will support the government’s ambitions to integrate services, improve outcomes through a focus on prevention and devolve power to local areas.

_{*    Though we do not yet know whether the government will be able to stick to these spending plans.}

Progress: staffing

The government moved quickly to improve industrial relations but still faces the prospect of strikes

The newly elected Labour government moved quickly to avert possible industrial action. On 29 July, within weeks of taking office, it accepted the recommendations of the pay review bodies (PRBs) for pay rises in 2024/25 that averaged 5.5% for public sector workers. ³⁹ HM Treasury and The Rt Hon Rachel Reeves MP, ‘Chancellor: I will take the difficult decisions to restore economic stability’, press release, 29 July 2024, www.gov.uk/government/news/chancellor-i-will-take-the-difficult-decisions-to-restore-economic-stability  On the same day, it concluded a separate agreement with the BMA to give resident doctors a 22% pay increase for 2023/24 and 2024/25 and bring an end to long-running strikes. ⁴⁰ Reed J, ‘Junior doctors offered 22% pay rise in deal to end strike action’, BBC News, 29 July 2024, retrieved 11 November 2025, www.bbc.co.uk/news/articles/cjqe82lk5g5o  In addition, it is fulfilling its manifesto commitment to repeal the Sunak government’s Strikes (Minimum Service Levels) Act 2023^* via the Employment Rights Bill that is currently passing through parliament.

The pay deals were announced on the same day that Rachel Reeves revealed billions of pounds of unfunded pledges inherited from the previous government and committed to making difficult cuts. This gesture of goodwill was welcomed by unions, but many saw it as a down payment on a longer path to restoring real-terms pay to the levels it had reached during the last Labour government. Despite the government subsequently accepting the PRB recommendations for 2025/26, which again exceeded inflation, this was not enough to avert further strikes.

The BMA announced on 8 July 2025 that it had received 90% approval from resident doctors for further strikes. ⁴¹ Tonkin T, ‘Resident doctors vote yes to strike’, British Medical Association, 9 July 2025, retrieved 11 November 2025, https://www.bma.org.uk/news-and-opinion/resident-doctors-vote-yes-to-strike  Negotiations between the government and BMA proved unsuccessful, with the latter unwilling to accept offers to improve working conditions rather than higher pay, leading to strike action between 25 and 30 July. Industrial action by resident doctors is ongoing, with a further strikes beginning on 14 November. ⁴² Tonkin T, ‘Resident doctors set strike date’, British Medical Association, 23 October 2025, retrieved 11 November 2025, www.bma.org.uk/news-and-opinion/resident-doctors-set-strike-date  Strikes from other professions are also possible, with the Royal College of Nursing opening a ballot on 9 June over 2025/26 pay ⁴³ Pym H, ‘Nurses to vote on pay deal as potential strike looms’, BBC News, 9 June 2025, retrieved 11 November 2025, www.bbc.co.uk/news/articles/c2e3lp9dl7xo  and the National Education Union threatening a further dispute if the pay award for teachers is not fully funded. ⁴⁴ National Education Union, ‘Teacher pay announcement’, press release, 22 May 2025, https://neu.org.uk/press-releases/teacher-pay-announcement

In July 2025, the government published remit letters that will guide PRB recommendations for 2026/27. Bridget Phillipson, the education secretary, has taken a different approach in her letter to the School Teachers’ Review Body to that taken by other departments, asking for formal recommendations for 2026/27 and 2027/28, as well as an indicative recommendation for 2028/29. Agreeing a longer term pay settlement would provide certainty for teachers and schools alike and it is welcome to see a minister innovating in this way. ⁴⁵ Department for Education and The Rt Hon Bridget Philipson MP, ‘School Teachers’ Review Body remit letter for 2026 and 2027’, letter, 22 July 2025, https://assets.publishing.service.gov.uk/media/687f6227791bb4d8c309a0fc/the-school-teachers-review-body-remit-letter-for-2026-and-2027.pdf

The Labour government’s relatively conciliatory approach to unions appears more likely to defuse tensions than the strategy adopted by the Sunak government, ⁴⁶ Hoddinott S, Davies N, Fright M, Nye P and Richards G, Performance Tracker 2023: Public services as the UK approaches a general election, Institute for Government, 30 October 2023, www.instituteforgovernment.org.uk/publication/performance-tracker-2023  and it may also benefit from the growing weariness among both staff and the public about further industrial action. Public support for resident doctor strikes had already started to wane before Labour returned to power, with polling in January 2024 finding that 50% supported resident doctors striking, down from 61% in April 2023. ⁴⁷ Smith M, ‘Public support for strikes slips as 2024 begins’, YouGov, 8 January 2024, retrieved 11 November 2025, https://yougov.co.uk/politics/articles/48279-public-support-for-strikes-slips-as-2024-begins  By May 2025 this had fallen to 39%, with a further five-point drop by July 2025. ⁴⁸ Kirby J, ‘Public support for doctor strikes is declining – YouGov poll’, The Standard, 22 July 2025, retrieved 11 November 2025, www.standard.co.uk/news/politics/yougov-nhs-wes-streeting-nhs-providers-trusts-b1239395.html  Support had rebounded somewhat to 38% by October 2025, but remained well below that seen in 2023 and 2024. ⁴⁹ YouGov, ‘Would you support or oppose resident doctors (formerly junior doctors) going on strike over pay and job insecurity?’, YouGov, 7 October 2025, retrieved 11 November 2025, https://yougov.co.uk/topics/health/survey-results/daily/2025/10/07/ece33/1  There also appears to be less enthusiasm among resident doctors themselves, with 90% support on a turnout of 55% for the latest full ballot, down from 98% support on a turnout of 77% in February 2023. ⁵⁰ Tonkin T, ‘Junior doctors vote yes to industrial action’, British Medical Association, 20 February 2023, retrieved 11 November 2025, www.bma.org.uk/news-and-opinion/junior-doctors-vote-yes-to-industrial-action

_{*    This restricts the ability of certain public service workforces to strike.}

The government’s staffing goals could be undermined by insufficient funding, changes to immigration rules and rhetoric on managers

The government set itself some ambitious staffing goals. In schools and further education colleges, Labour had pledged to recruit 6,500 additional teachers by the end of the parliament. ⁵¹ Department for Education and The Rt Hon Bridget Philipson MP, ‘Education Secretary begins push to recruit 6,500 new teachers’, press release, 8 July 2024, www.gov.uk/government/news/education-secretary-begins-push-to-recruit-6500-new-teachers  However, following a DfE assessment in February 2025 that meeting this would be a “significant challenge” due to the tight funding settlement, ⁵² Comptroller and Auditor General, Teacher Workforce: Secondary and Further Education, Session 2024–25, HC 854, National Audit Office, 30 April 2025, p. 40, www.nao.org.uk/wp-content/uploads/2025/04/teacher-workforcesecondary-and-further-education.pdf  the pledge was revised to include teachers staying in the profession through improved retention. ⁵³ Chantler-Hicks L, ‘The Shapeshifting 6,500 Teachers Pledge’, Schools Week, 4 July 2025, retrieved 24 October 2025, https://schoolsweek.co.uk/the-shapeshifting-6500-teachers-pledge  Similarly, the commitment to “train thousands more [GPs] in the coming years” ⁵⁴ Department of Health and Social Care, Prime Minister’s Office, 10 Downing Street, The Rt Hon Sir Keir Starmer KCB KC MP and The Rt Hon Wes Streeting MP, Fit for the Future: 10 Year Health Plan for England, CP 1350, The Stationery Office, 3 July 2025, p.29, https://assets.publishing.service.gov.uk/media/68760ad755c4bd0544dcae33/fit-for-the-future-10-year-health-plan-for-england.pdf  made in the 10 Year Health Plan will mean little if – as was the case under the last government – practices cannot afford to hire more salaried GPs even if they wanted to.

International recruitment has been absolutely central to public services being able to square the circle of the need for more staff with tight budgets in recent years. However, Labour plans to rely less on this route. The Institute has previously warned about the risks of extensive international recruitment, given global competition for qualified staff, the lack of UK government control over the available workforce and the political sensitivity of immigration. ⁵⁵ Hoddinott S, Davies N, Fright M, Nye P and Richards G, Performance Tracker 2023: Public services as the UK approaches a general election, Institute for Government, 30 October 2023, p. 79, www.instituteforgovernment.org.uk/publication/performance-tracker-2023  It is sensible for the government to reduce the dependence of public services on those recruited from abroad, although this will require boosting domestic recruitment and policy stability. This is not an easy switch to make.

The government has taken different approaches to recruitment in the NHS compared to adult social care and prisons. The 10 Year Health Plan sets an ambition to reduce international recruitment to less than 10% by 2035, with details on how this will be achieved to be published in a workforce plan due later this year. In contrast, Labour abruptly ended the visa route for new adult social care workers in July 2025, ⁵⁶ Samuel M, ‘Overseas care worker recruitment ban comes into force’, Community Care, 22 July 2025, retrieved 11 November 2025, www.communitycare.co.uk/2025/07/22/overseas-care-worker-recruitment-ban-comes-into-force  (with a transition period until 2028 in which extensions and in-country switching for those already in the country with working rights will be permitted). ⁵⁷ Home Office, Restoring Control over the Immigration System, CP 1326, The Stationery Office, 12 May 2025, p.27, https://assets.publishing.service.gov.uk/media/6821f334ced319d02c906103/restoring-control-over-the-immigration-system-web-optimised.pdf  Likewise, prisons, which have also become increasingly reliant on international recruitment, have had little time to respond to the May 2025 decision to raise the threshold for a skilled foreign worker visa above the pay of most prison officers outside of London. ⁵⁸ Hymas C, ‘Mahmood and Lammy heading for showdown in prison staff visa row’, The Daily Telegraph, 9 November 2025, www.telegraph.co.uk/politics/2025/11/09/mahmood-lammy-showdown-prison-staff-visa-row  While reducing reliance on international staff in any of these sectors will be far from easy, the more gradual, long-term approach in the NHS is less likely to lead to workforce shortages.

Another response to tight budgets in recent years has been to cut back on back-office staff. This has often been accompanied by (incorrect) suggestions by ministers that spending on managers, administrators and analysts is wasteful, almost by definition. Labour has shown signs of continuing with this counterproductive approach. For example, in the NHS it is making cuts of 50% to ICBs’ running costs and Starmer’s foreword to the 10 Year Health Plan talked of the need to “slash unnecessary bureaucracy” to give “more power and resources to the front line”. ⁵⁹ Department of Health and Social Care, Prime Minister’s Office, 10 Downing Street, The Rt Hon Sir Keir Starmer KCB KC MP and The Rt Hon Wes Streeting MP, Fit for the Future: 10 Year Health Plan for England, CP 1350, The Stationery Office, 3 July 2025, https://assets.publishing.service.gov.uk/media/68760ad755c4bd0544dcae33/fit-for-the-future-10-year-health-plan-for-england.pdf  The risk is that rather than freeing up front-line staff, they will instead be forced to spend more of their time on administrative tasks that could be better done by others.

Progress: performance

The government has stabilised the most urgent public service crises

Ahead of the election, Sue Gray, then chief of staff to Keir Starmer, had written a ‘government risk register’, identifying the six most pressing issues that a new Labour government would face. ⁶⁰ Pickard J, Fisher L and Gross A, ‘Labour faces series of crises if elected, internal dossier warns’, Financial Times, 21 May 2024, retrieved 11 November 2025, www.ft.com/content/b95976ff-d861-4baf-a168-fd262b4e2f95  This included four areas covered by Performance Tracker: public sector pay negotiations, overcrowding in prisons, failing local authorities and an NHS funding shortfall. In each area, the government has acted and brought a measure of stability.

As noted above, by the end of its first month in office, the Labour government had accepted the recommendations of pay review bodies and reached agreement with resident doctors, leading to a sharp drop in the number of days lost to strikes.

The government moved even more quickly on prisons. Just one week after gaining power, it announced that some prisoners would be released after serving 40% of their sentence in custody, rather than 50%. ⁶¹ Ministry of Justice, HM Prison and Probation Service, Youth Custody Service and The Rt Hon Shabana Mahmood MP, ‘Lord Chancellor sets out immediate action to defuse ticking prison ‘time-bomb’’, press release, 12 July 2024, www.gov.uk/government/news/lord-chancellor-sets-out-immediate-action-to-defuse-ticking-prison-time-bomb  The scheme was as well planned as could be expected, with the first tranche of releases scheduled for September, to allow time to prepare. This, combined with additional emergency measures later on, bought the government time to await the opening of a new prison in April 2025 and to consider longer term reforms.

The government used the autumn budget to address problems with NHS and local authority funding. In cash terms, the NHS was the biggest beneficiary of Rachel Reeves’ first budget, receiving £22.6bn of additional day-to-day funding in 2024/25 and 2025/26. While the impact of this on performance has not been dramatic, and funding growth is still low by historical standards, it likely helped ease problems over winter 2024/25 and has enabled the NHS to continue making progress on waiting times.

Following the autumn budget, the government increased core spending power for local government by £4.4bn (4.1% in real terms) in 2025/26, including with higher-than-expected grant funding increases (though much of this was swallowed by rises in the National Living Wage and employers’ National Insurance contributions) and the Local Government Finance Settlement for that year provided more funding for disadvantaged areas. In February 2025, the government announced that it would provide 30 local authorities with ‘exceptional financial support’ worth more than £1bn ⁶² Ministry of Housing, Communities and Local Government, ‘Exceptional Financial Support for local authorities for 2025-26’, GOV.UK, 20 February 2025, www.gov.uk/guidance/exceptional-financial-support-for-local-authorities-for-2025-26  and in June it extended the ‘statutory override’ that allows councils to keep SEND deficits off their books, until March 2028.

These measures, both of which extended schemes initiated by the Johnson government, are not sustainable in the long term but without them many local authorities would have had to issue section 114 notices this year (councils do this when they cannot balance their budget in a financial year – in effect, declaring themselves ‘bankrupt’). Instead, no section 114 notices due to insolvency have been issued since the election.^*

_{*    Barnet issued a S114 in January 2025 for making unlawful payments to its pension fund between 2020 and 2023.}

The government has set out proposals to address long-term challenges

The government has grasped the nettle on some of the most challenging long-term issues facing government, putting forward serious proposals for reform, though further detail is needed in many areas.

The Ministry of Housing, Communities and Local Government has been particularly active, making generational reforms to local government. Under the English Devolution and Community Empowerment Bill, introduced in July 2025, the powers of strategic authorities will be deepened and widened, all English non-unitary local authorities will be converted into unitary councils and local audits will be reformed.

On local government funding reform, an initial consultation over the winter of 2024/25 has been followed by consultation on detailed proposals over summer 2025. This follows years of consultations and subsequent inaction under multiple Conservative administrations stretching back to the Cameron government in 2016. If implementation follows the proposal in the consultation, it will mean that the government redistributes funding from less deprived to more deprived councils, and better matches funding with demand for adult and children’s social care, road maintenance and some SEND services. Angela Rayner, the former secretary of state at MHCLG, had also been leading a cross-government taskforce on homelessness, with a strategy expected to be published shortly.

The Ministry of Justice commissioned two substantial reviews from David Gauke and Sir Brian Leveson on how to address the ballooning prison population and record case backlogs in the criminal courts. Following detailed reports and recommendations from these reviews, the government’s Sentencing Bill is making its way through parliament and it is drawing up its response to recommendations for structural reform in the courts, expected at the end of this year. It remains uncertain, however, whether these will match the scale of the problems in these services. Further reform proposals are expected in the police white paper, initially promised for spring 2025 but as yet unpublished.

The government set out a positive vision for children’s social care reform in November 2024 ⁶³ Department for Education, Keeping children safe, helping families thrive, CP 1200, The Stationery Office, 18 November 2024, www.gov.uk/government/publications/keeping-children-safe-helping-families-thrive  and is seeking to address the dysfunction of the market for children’s social care placements through the Children’s Wellbeing and Schools Bill, introduced in December 2024. This will create new regional care co-operatives and put in place regulations to try to address profiteering in the care market. More contentiously, it will also make substantial changes to the schools system, the one major public service performing better now than in 2010, including through limiting the autonomy of academies. In addition, DfE is due to publish plans for reforming SEND in 2026 and has been working with DWP to create a strategy for tackling child poverty, a key driver of demand for public services. In both cases however, the government could and should have made quicker progress.

In the NHS, the government’s 10 Year Health Plan sets out an ambitious reform agenda aiming to fundamentally change how care is delivered, so that it is more community-based, preventative and digital, though the plan provides little indication of how this will be delivered and what will be prioritised. DHSC is also undertaking major structural reforms by scrapping NHS England, merging its functions into DHSC, and reorganising ICBs. While ambitious, this will, as discussed below, cause major disruption in the short term.

In contrast, the government has done nothing to address the well-understood problems facing adult social care, apart from launching the Casey review, which has been instructed not to issue its final report until 2028 – meaning the implementation of any of its recommendations would be unlikely to start before the next general election.

The government has established a positive cross-cutting vision for public service reform

In July 2024, we called on the new government to implement a bold programme of public service reform, with a particular emphasis “on outcomes, rather than inputs; on prevention, rather than acute provision; on capital, rather than day-to-day spending; on front-line innovation, rather than top-down command and control; and on the contribution of staff to performance, rather than their cost to the exchequer”. ⁶⁴ Hoddinott S, Rowland C, Davies N, Kim D and Nye P, Fixing public services: Priorities for the new Labour government, Institute for Government, 22 July 2024, www.instituteforgovernment.org.uk/publication/fixing-public-services-labour-government  The government has made progress towards these goals. In addition to changes to capital spending, industrial relations and budget allocations, and the specific reform programmes cited above, the government has started to set out a cross-cutting approach to public service reform.

In the spending review, it elucidated three principles that will underpin reforms: to integrate services, to focus on prevention, and to devolve power. ⁶⁵ HM Treasury, Spending Review 2025, CP 1336, The Stationery Office, June 2025, www.gov.uk/government/publications/spending-review-2025-document/spending-review-2025-html  While major decisions in the spending review were not shaped by these principles, the government has announced a range of relatively small-scale programmes to put these principles in practice. Community help partnerships, also announced at the spending review, are a £100m scheme to provide earlier, co-ordinated support to adults in crisis. Under the test, learn and grow programme, around a dozen areas are receiving £100m of support to develop innovative solutions to entrenched problems. And Total Place-style pilots will enable councils and mayors to pool budgets and better join up services. ⁶⁶ Rayner A, ‘A speech from the Deputy Prime Minister at the Local Government Conference’, speech at the Local Government Association, 3 July 2025, www.gov.uk/government/speeches/local-government-association-conference-2025

While this Cabinet Office reform programme has not, as discussed below, been fully integrated into work led by individual departments, there have been some positive examples of the principles being embedded in specific policy proposals. Most notably, the 10 Year Health Plan proposes using regulation to achieve prevention aims, commits to prevention demonstrators in which mayors will have ‘total place’ powers, and plans to further pool funding through integrated health organisations.

The government has been held back by insufficient preparation while in opposition

Keir Starmer became Labour leader in 2020 and, from 2022 onwards, the polls strongly suggested that he would be prime minister following an election, likely in 2024. Rarely has an opposition had as much certainty that it would soon be in charge or been given so much time to prepare. While the government has made reasonable progress over the past year, it would have been in a much stronger position had it devoted more time in opposition to preparing and co-ordinating its plans for public service reform.

The government has made good use of independent reviews to identify problems, develop policy proposals and build public support for reform. But some of these took longer to establish and respond to than was necessary. For example, the criminal courts review should have been launched at the same time as the sentencing review, which started two months earlier. The government has still not published a substantive response to the criminal courts review, even though it was published in July 2025.

More broadly, it took the government almost a year to set out a cross-cutting vision for public service reform. The public service reform principles published in the spending review are very welcome, but they could and should have been developed before the election. Had this been done, the government could have properly embedded the principles into the spending review and the reform programmes being implemented by individual secretaries of state. As it is, there is a lack of coherence, with no consistent philosophy of public service reform across departments. For example, one of the three principles set out at the spending review was greater devolution of power. This is evident in the funding reforms being undertaken by MHCLG, which will provide strategic and local authorities with greater autonomy. In contrast, DfE is centralising decisions over the curriculum and workforce that were previously left to academies. The abolition of NHS England will give the secretary of state more control over the day-to-day running of the NHS. And the Home Office is trying to exert more central control over police forces.

Relatedly, it appears that the government has failed to consider properly how its reform plans will work together, particularly the interaction between its decisions to conduct major structural reforms to local government and to the NHS. There is a reasonable case to be made for phasing out district councils, merging NHSE into DHSC and rationalising ICBs, but to do all three simultaneously will be hugely disruptive. Labour will be judged at the next election on the performance of public services, but large swathes of staff in the NHS and local government will spend most of this parliament thinking about how to make this transition and whether their job is safe, rather than how their service can work more effectively.

While local government reforms were relatively well thought through, with a white paper published within six months of the election, in December 2024, the decision to abolish NHSE was announced suddenly in March 2025 with no clear plan articulating how this would be delivered. The NHSE decision is symptomatic of Labour’s wider failure to think through the details of its health and care reforms in opposition. The government has kicked reform of adult social care into the long grass with yet another review, plans for general practice – which will be central to the health mission – lack substance, and the 10 Year Health Plan was released in July 2025 without the planned chapter on delivery. Five months later and key details on delivery have still not been published.

Despite publishing its five missions in February 2023, almost 18 months before the general election, it is apparent that Labour had also not given sufficient thought in opposition to how ‘mission-led’ government would work in practice. For example, outside of DESNZ,^* it took lead departments too long to establish their mission boards, clarify their remits and set up consistent meeting schedules. Likewise, there has been limited progress in involving experts from beyond Whitehall, such as those from business, trade unions, civil society, faith groups and communities in decisions. And the mission milestones used in the Plan for Change show little evidence of being shaped by detailed consideration of how to meet cross-departmental goals. Most importantly, it had been hoped that taking a missions-based approach would enable the government to conduct a spending review that recognised the cross-cutting nature of the challenges facing the country, but this failed to materialise. While mission-led departments received some of the most generous settlements, the spending review did not result in joint budgets with shared outcomes and showed little evidence of cross-government working.

The scale of the challenges in public services requires significant political capital to address. Ministers and civil servants recognise the value of taking a cross-government approach. But in the absence of effective planning in opposition about how missions would be co-ordinated from the centre of government and strong leadership on public service reform from the prime minister, there has been a lack of impetus for cross-departmental co-ordination. This means that the positive reforms ministers have introduced are likely to add up to less than the sum of their parts.

_{*    DESNZ established its mission board and mission control (chaired by the former chief executive of the Climate Change Committee) within a month of the election.}

The government has made more progress in some services than others 

Labour inherited a vertigo-inducing list of public service problems. Fixing these was always going to take more than one parliament and performance improvements over any government’s first year in power will inevitably be limited. So we have graded the government based on the extent to which it has addressed the underlying causes of poor performance, rather than on performance trends since the election. The results are varied to say the least.

General practice: Progress on salaried GPs, but no steps taken to make partnership more attractive

A declining fully qualified GP workforce has been one of the largest challenges facing general practice for years. So it is positive that the government allowed primary care networks to use previously ring-fenced money to employ recently qualified GPs. This does seem to have had an effect, leading to an increase in the rate at which salaried GPs are joining the service.

But this is far from the only issue in general practice. Far more pressing is the rapidly declining partner workforce. The government has thus far done nothing to make partnership more attractive. Indeed, the 10 Year Health Plan for England even creates new contracts that it could be argued further undermine the partnership model, without providing a template for a general practice that does not rely on partners. The estate is crumbling and while the government has announced £102m to refurbish some practices, ⁶⁷ Department of Health and Social Care and The Rt Hon Wes Streeting MP, ‘GP surgery refurbs to enable over 8 million more appointments’, press release, 6 May 2025, www.gov.uk/government/news/gp-surgery-refurbs-to-enable-over-8-million-more-appointments--2  this comes nowhere near meeting the scale of the challenge.

Hospitals: Government has set out high-level ambitions and reduced competing priorities, but no detail of implementation

Hospitals have been the government’s focus in the NHS since winning the election. The 10 Year Health Plan for England set out a very high-level vision for what the government wants the NHS to achieve, but there was little detail about how it expected the service to achieve those ambitions.

More immediately impactful has been the government’s ‘reforming elective care for patients’ plan and the decision to reduce the targets in the 2025/26 planning guidance. The former implemented measures such as new funding flows and better collaboration between primary and secondary care to reduce waiting times. The latter reduced the number of targets for hospitals, allowing them to focus better on elective recovery.

There is still a mountain to climb on hospitals, however. Trusts are reporting persistent deficits, which are causing them to freeze hiring or even cut staff.

Adult social care: Largely ignored. Ending the care visa route without a workable solution for fair pay agreements could cause workforce shortages

Compared to the other services in this report, the government has roundly ignored adult social care. Launching the Casey commission will, at best, delay substantive reform of the sector until the next parliament. Maybe more immediately damaging is the decision to end the care visa route, which cuts off the largest recent source of staff for the sector, without any plan for how to implement fair pay agreements (FPAs, the government’s purported solution to make the sector more attractive). This could lead to staffing shortages.

There is no guarantee that FPAs will work well when the government eventually legislates for them. Experience from New Zealand shows they are deceptively difficult to implement, with that government abandoning them after a couple of years. ⁶⁸ Davison, N, ‘Labour’s Fair Pay Agreements: lessons for Keir Starmer from New Zealand’, Institute for Government, 24 July 2024, www.instituteforgovernment.org.uk/comment/labours-fair-pay-agreements-new-zealand  Even if they do work well, higher wages means that someone has to pay more for care. That will either be private users of care, local authorities or central government, or a combination of all three. The government has so far chosen to elide this fact when discussing better pay for the sector. It will have to face that reality at some point.

Children’s social care: Government has set out a clear and ambitious vision for reform and has backed it with relatively generous funding

Labour has set out a clear and ambitious vision for children’s social care reform, which emphasises early intervention, supporting families to stay together, reducing reliance on residential care, fixing the dysfunctional care market and improving how data is shared across services. Backed by a relatively generous funding settlement in the spending review, the plans represent a serious attempt to move the system in a better direction.

Delivering change at this scale, particularly alongside wider local government and NHS reform, will be hard. The proposals also stop short of addressing the failures in other services that have fuelled growing complexity in the system. Tackling that will require far better co-ordination across government than we have seen to date.

Even so, this is good progress for such a short time in office and a marked step away from the drift and dysfunction that has defined children’s social care in recent years.

Homelessness: Early signs are encouraging, but government has yet to set out its homelessness strategy

The government’s homelessness strategy, due later this year, should bring much-needed clarity to its approach to tackling homelessness. Early signs are encouraging: ministers have begun to scrutinise the spiralling costs of temporary accommodation, have ring-fenced funding on prevention and boosted investment in social and affordable homes.

But important gaps remain. The government has yet to define what ‘prevention’ means in practice, or set out how services will work together to deliver it. Perverse incentives, both in the housing market and across government, still drive poor outcomes and wasted spending. And without stronger local analytical capacity to predict demand and plan provision, councils will struggle to get ahead of the problem.

Schools: Government’s plan to reduce inequalities in schools and tackle teacher shortages are unclear, and the crisis in SEND services casts a long shadow

The government’s expansion of free school meals and its roll-out of free breakfast clubs are both tangible steps to support children’s learning, and align with its opportunity mission: to break the link between a child’s background and their future success. However, its child poverty strategy, which will surely be key in achieving that mission, has yet to be published, and expanding free school meals is an inefficient way to reduce child poverty, if that is the government’s main aim. It is also still unclear exactly which metric will be used to judge its progress on the opportunity mission in schools.

Labour’s plan to tackle teacher shortages lacks clarity and evidence. Its pledge to boost teacher numbers by 6,500 is poorly defined, lacks a delivery plan, and is not obviously related to actual shortages.

The crisis in special educational needs and disabilities services casts a long shadow. A long-awaited government SEND strategy is due in 2026, but there is a real risk that the reforms it sets out will absorb much of the recent funding uplift for schools. Its approach also risks being disjointed, given that it comes after key funding decisions in the spending review and at a different time to announcements about the statutory override.

Police: Government has made limited progress in increasing neighbourhood officer numbers and has yet to announce details of planned reforms

The major issues facing policing are low public trust and confidence and a justified and widespread sense that vast swathes of crime go uninvestigated and unpunished. The government’s plan to increase the number of police officers and PCSOs in neighbourhood roles and its ambitions to cut neighbourhood crime, knife crime and violence against women and girls are all sensible steps to address these, but very little progress has been made so far.

There has been a small increase in the number of police officers in neighbourhood roles, up 5% from March 2024 to March 2025. But this has been largely offset by a decline in PCSOs, so the overall increase was just 1%. The government is planning police reform and potentially a restructure, but no details have yet been announced. There has also been little sign of a step change in the response to knife crime or violence against women and girls since the election. The proposed Young Futures hubs and Sure Start-style centres are likely to have positive impacts on children and young people and reduce the risk of involvement in violence, but the government’s actions so far do not seem to match the scale of its ambitions.

Criminal courts: Increasing court sitting days was welcome, if done too late, but the government has yet to announce a longer term plan

Commissioning an independent review of options for criminal court reform was a positive step. But the government is yet to announce how it proposes to respond to Brian Leveson’s recommendations, published in July, and it has not taken any meaningful steps to address the productivity problems that are the main cause of growing backlogs in criminal courts. The review itself could have started earlier, rather than waiting until six months after the election. Even if the Ministry of Justice was concerned that the courts backlog could not be tackled before resolving the worst of the prison population crisis, starting sooner would have given the government time to consider its options and approach criminal justice reform in the round, rather than taking a siloed approach to courts and sentencing.

Labour also made only a small initial increase to crown court sitting days when it first came to power, despite the size of the crown court backlog and the judiciary maintaining it could sit more days than those for which it was funded. The later top-up of 2,000 sitting days for 2024/25 did not come until December 2024 – sufficiently late in the financial year that the court only actually managed to sit for 1,300 of them.

Prisons: Rapid action addressed the immediate population crisis, but there has been limited progress towards a longer term solution

On coming into office, the government took swift and decisive action to address the urgent population crisis in prisons. SDS40, the emergency measure announced within a week of the new government to release some prisoners after 40% of their sentence, was by that point the only sensible option available. When that has proved insufficient to keep the population at manageable levels, the government has taken further steps to stave off system collapse.

The government has also begun to put into action its longer term plan to keep the prison population on a sustainable footing. It has accepted most of the recommendations from David Gauke’s sentencing review and is currently introducing legislation to implement them. However, these may not go far enough quickly enough to avert further emergency measures. They will certainly not be enough to get prisons out of their permanent state of crisis and support meaningful performance improvements.

Recommendations

In this section we set out five key recommendations for how the government, in its second full year in office, can begin to improve services across the board, which it will need to do not just to meet its own ambitious manifesto pledges but to improve the lives of citizens up and down the country.

1.    Establish a cross-cutting approach to public services

The analysis in this year’s report highlights just how interdependent public services are. Reducing elective waiting times depends not just on hospital performance, but also on a well-functioning general practice and adult social care sector – just as police charges lead to court cases that in turn result in prison sentences. Unfortunately for the government, the interconnectedness of services means that failure in one service can result in failure in others. There is no silver bullet and none of these problems can be fixed in isolation as failures in one service pile pressure on the others – ultimately, public services are systems, and central government must treat them as such.

‘Missions’ were Labour’s attempt to do this. The party, in opposition, during the election and in 2024, recognised that the biggest problems facing the country are deeply rooted and cut across organisational boundaries. That tackling them would require greater collaboration between the different arms of the state, and the involvement of those working in the private and voluntary sectors, will have been plain to readers of Performance Tracker since its inception in 2017 – so it was welcome to hear senior government figures up to an including the prime minister publicly recognise this.

However, while this is as true now as it was before the election, the missions agenda has seemed to shrivel in scope since, from five missions in opposition, to three ‘priorities’ in the spending review ⁶⁹ Pope T, Tetlow G, Haile D and others, ‘Spending review 2025: Six key things we learned from Rachel Reeves’ announcement’, Institute for Government, 11 June 2025, www.instituteforgovernment.org.uk/comment/spending-review-2025  and to one ‘defining mission’ – economic growth – in the prime minister’s 2025 Labour conference speech. ⁷⁰ Starmer K, ‘Speech at Labour Party Conference’, speech at the Labour Party Conference 2025, 30 September 2025, https://labourlist.org/2025/09/labour-conference-2025-keir-starmer-speech-in-full

Labour’s pledge to lead a mission-led government has not yet been realised but this has been a failure of preparation and implementation, rather than destination. Whether through re-energised missions or an alternative approach, the government must urgently establish a cross-cutting approach to addressing the public service failures identified in this report.

The lesson from past cross-government initiatives, such as the use of public service agreements (PSAs) under the Brown government, is that sufficient prime ministerial engagement is a prerequisite for making a mission-style approach work. PSAs were initially introduced as 600 disparate targets in 1998; by the time Brown became PM in 2007 they had evolved into 30 priorities that cut across departmental boundaries.

As with missions, each of the PSAs had a lead department and secretary of state, with a wider board bringing together key people from other relevant departments. In addition, PSAs were overseen by a cabinet committee to which delivery boards regularly reported.

Despite having a more developed management architecture than PSAs had under Blair, the Brown-era system was less effective than it had been under the former prime minister, who was much more closely involved in setting and monitoring priorities than Brown was. With less direct involvement of the PM, it was difficult to “motivate departments to be a good number-two or number-three player when somebody else would take all the credit for what was achieved”. ⁷¹ Panchamia N and Thomas P, Public Service Agreements and the Prime Minister’s Delivery Unit, Institute for Government, 2014, www.instituteforgovernment.org.uk/sites/default/files/case%20study%20psas.pdf

Missions are struggling for the same reason. The machinery of government will not prioritise the missions unless the prime minister does too. If the government wants to make fundamental improvements to public services, then Starmer must be much more engaged than he has been to date. If continuing with missions, that will require consistently chairing the mission boards as he said he would before the election.

There are two key activities that the government should use revamped missions boards or other cross-cutting decision making structures for. First, they must properly prioritise. The government is not short of objectives and policy proposals to achieve these, but it is in desperate need of clarity regarding how these fit together and, where there are trade-offs, what should be prioritised. What, for example, should DHSC prioritise if meeting the elective waiting-time target in the short-term conflicts with the long-term objective to shift care and funding away from hospitals? To achieve this, the government should publish detailed theories of change for how it expects to achieve its mission milestones, identifying the metrics that will be used to determine whether or not it is on track. Those included for public services we cover in the Plan for Change are not fit for purpose.

More broadly, the government needs to better co-ordinate across the huge number of public service reforms it is attempting to implement. It must ensure alignment between the Plan for Change, outcome delivery plans, the Local Government Outcomes Framework, the 10 Year Health Plan and other key policy documents. Without this, different public services will continue to be pulled in different, often opposite, directions by the incentives created by siloed performance frameworks.

This should be co-ordinated from the centre by Darren Jones in his new roles as chief secretary to the prime minister, chancellor of the Duchy of Lancaster and minister for intergovernmental relations. However, it will require sustained engagement from the prime minister to break down departmental silos and ensure that ministers are working in a co-ordinated way. The government must also ensure that it creates short feedback loops across the delivery chain so that the centre of government and departments are responsive to feedback from front-line public services. ⁷² Conway E and Howes D, ‘How Keir Starmer’s government can be built for delivery’, Institute for Government, 24 September 2025, www.instituteforgovernment.org.uk/comment/starmer-government-built-delivery

Second, mission boards should decide how to allocate budgets. While the spending review set top-line departmental budgets and made some specific spending pledges, most of the detailed work on what will be funded is still to be done. With clearer priorities and theories of change, the mission boards, if chaired by the PM, would be well placed to decide how best to allocate departmental budgets, including transferring funding between departments where necessary.^* To maintain clear parliamentary accountability over value for money, the core membership^** of each mission board would need to make recommendations to the ministers and accounting officers of relevant departments, who would then implement these recommendations under their authority. ^***

More radically, the government could adopt a collective approach to accountability, drawing on the example of New Zealand. ⁷³ Scott R and Boyd R, Interagency Performance Targets: A Case Study of New Zealand’s Results Programme, IBM Center for The Business of Government, 2017, p.38, www.businessofgovernment.org/sites/default/files/Interagency%20Performance%20Targets.pdf  Under this model, ministers and accounting officers would be held collectively responsible by parliament for their progress against mission milestones. This could be via the existing departmental select committees and questions sessions or newly established mission committees and questions. The experience from New Zealand suggests that this would be most effective if responsibility for each mission was held by a core group of two or three departments, with others consulted as needed. ⁷⁴ Scott R and Boyd R, Interagency Performance Targets: A Case Study of New Zealand’s Results Programme, IBM Center for The Business of Government, 2017, p.39-40, www.businessofgovernment.org/sites/default/files/Interagency%20Performance%20Targets.pdf

_{*    This process would need to begin with each department identifying the programmes and projects contributing to each mission and the total spend planned for these.}

_{**    The government is not transparent about the membership of all mission boards but outside observers participate in some.}

_{*** Managing Public Money includes six models for how accountability mechanisms can be used for cross-cutting programmes, https://assets.publishing.service.gov.uk/media/684ae4c6f7c9feb9b0413804/Managing_ Public_Money.pdf, pp. 76–79.}

2.    Operationalise and scale up public service reform plans

Labour has used its first year in office to do a lot of public service policy development. It has set out ambitious reform proposals for the NHS, local government, sentencing, children’s social care and schools, and is in the process of developing plans for criminal courts, SEND and homelessness. But, to date, meaningful changes to how services on the ground, particularly universal ones, are delivered and experienced by the public have been few and far between.

The government should move quickly to turn its plans into action, putting particular focus on operationalising and scaling up its cross-cutting public services reform agenda. This includes the three ‘principles’ that will guide its approach to public service reform – to integrate services, focus on prevention, and devolve power to local areas – and the series of small-scale programmes that embody them, including test, learn and grow, community help partnerships, Total Place-style pooled budget pilots and prevention demonstrators.

The government should focus on creating the conditions that will support more public services to become more preventative, integrated and devolved. The ultimate goal must be to fully embed these features within mainstream services so that they become the default way of working. That will not happen overnight but good progress can be made before the next spending review in 2027, where the government has the opportunity to use spending allocations far more strategically to scale up its reforms to meet cross-cutting public service objectives.

First, the three principles should be incorporated into the government’s performance framework, including the refreshed version of outcome delivery plans that are expected to be published alongside the budget. Key departments should also work closely with relevant regulators and inspectorates – particularly Ofsted, the Care Quality Commission and His Majesty’s Inspectorate of Constabulary and Fire and Rescue Service – to ensure that their assessment of services properly recognises public bodies that are seeking to work in these ways.

Second, the government should make it easier for public services to share data with each other. The existing legal framework largely allows this but the process can be onerous, not least due to pervasive risk aversion and limited incentives for public bodies to share the data they hold.

Previous Institute for Government work has recommended that the Government Digital Service (GDS)^* should create a data sharing ‘playbook’; that MHCLG and the GDS should establish a data sharing framework for key departments and public services; and that MHCLG should provide a data brokering function for local authorities. ⁷⁵ Freeguard G and Shepley P, Data sharing during coronavirus: lessons for government, Institute for Government, 20 February 2023, www.instituteforgovernment.org.uk/publication/government-data-sharing-pandemic  The creation, immediately after the election, of a ‘digital centre of government’ within the Department for Science, Innovation and Technology provides an excellent opportunity to make progress on this issue.

Other Institute for Government work looking at justice data specifically has recommended justice agencies should clarify data sharing protocols and that relevant departments should publicise the success of data sharing initiatives to build buy-in for further data sharing among key stakeholders. ⁷⁶ Pope T, Freeguard G and Metcalfe S, Doing data justice: Improving how data is collected, managed and used in the justice system, Institute for Government, 18 September 2023, www.instituteforgovernment.org.uk/publication/doing-data-justice  These actions would be helpful in other service areas as well. In some cases, legacy IT systems make it harder to access and share data. Where this is the case, the government must be willing to invest to modernise creaking critical data infrastructure.

Third, the Treasury should create a broad ring-fence around preventative spending. The definition of preventative spending should be based on mission priorities and developed in consultation with departments and the wider public sector. Departments and other public bodies would have a single ring-fenced ‘prevention fund’ and be able to shift spending between different preventative programmes – but, crucially, would require Treasury permission to move funds outside of them.

The overall objective should be to provide front-line services with greater financial flexibility while also protecting preventative spending. The next spending review would be the ideal opportunity to develop and implement this, but the government can make progress in the meantime by continuing with its efforts to reduce the number of smaller ring-fences. Ultimately, the provision of a single prevention ring-fence to each front-line service would facilitate the pooling of prevention budgets in local areas, also helping to deliver the government’s objective of better integrating services.

Finally, the government could go further in reforming the local government finance system. It has made an excellent start with the launch of the Fair Funding Review 2.0, which will better match grant funding with need for services. But if the government is going to make large changes to grant funding, it is unfair to penalise local authorities that have low council tax income due to historic decisions. Central government should allow local authorities more flexibility to determine how much council tax they raise. More broadly, the government should be far more relaxed about allowing local and strategic authorities to raise revenue from new streams, as the Institute for Government has previously argued. ⁷⁷ Pope T and Rutter J, ‘Rachel Reeves should allow local tourist taxes’, Institute for Government, 29 July 2025, www.instituteforgovernment.org.uk/comment/rachel-reeves-local-tourist-taxes

By the time of the next spending review, the small-scale reform programmes will have become more established and, if combined with the implementation of the recommendations we offer here, should put the government in a position to radically scale up these new ways of working.

_{*    Our previous work recommended that this be done by the Central Digital and Data Office (CDDO) but the CDDO was incorporated into the GDS in January 2025.}

3.    Support services to make better use of capital budgets

Public services received smaller uplifts to their capital budgets at the spending review than other parts of government. However, these capital budgets, particularly in health and justice, are still substantially higher in real terms than they have been for two decades. Spending these budgets well could make a major contribution to boosting public service productivity.

The 10 Year Health Plan and English devolution white paper make welcome commitments to multi-year capital budgets for NHS providers and local authorities respectively. The DfE should likewise provide larger multi-academy trusts with rolling five-year capital budgets, in line with its departmental allocation.

The publication of the government’s 10-year infrastructure strategy is also a positive development. Individual departments should build on this by publishing 10-year equipment and estates plans for each of the services they oversee. Likewise, we welcome the government’s commitment that every department will have a 10-year strategic maintenance plan operating from 2027. ⁷⁸ HM Treasury and National Infrastructure and Service Transformation Authority, UK Infrastructure: A 10 Year Strategy, CP 1344, The Stationery Office, June 2025, https://assets.publishing.service.gov.uk/media/6853c5db99b009dcdcb73649/UK_Infrastructure_A_10_Year_Strategy_Web_Accessible.pdf  The plans should assess the extent to which allocated maintenance budgets are sufficient to cover identified needs. We also recommend that all departments should have a more maintenance-intensive mix of capital spending by the end of this parliament.

The 10 Year Health Plan also commits to “radically streamlining the capital approvals process”. ⁷⁹ Department of Health and Social Care, Prime Minister’s Office, 10 Downing Street, The Rt Hon Sir Keir Starmer KCB KC MP and The Rt Hon Wes Streeting MP, Fit for the Future: 10 Year Health Plan for England, CP 1350, The Stationery Office, 3 July 2025, https://assets.publishing.service.gov.uk/media/68760ad755c4bd0544dcae33/fit-for-the-future-10-year-health-plan-for-england.pdf  The principles set out in that plan – including holding more capital budgets locally and reducing the number of approval levels – are welcome and should be applied to other public services. In addition, departments should allow bids to nationally managed programmes from the services they oversee to be rolled over each year if they remain relevant and provide flexibility to roll funding over between years.

At the centre of government, the Treasury should encourage a higher proportion of capital budgets to be spent on maintenance by updating the Managing Public Money guidance “to make clear that accounting officers should ask for a ministerial direction if they believe that adecision not to maintain assets reflects poor value for public money in the longer term”. ⁸⁰ Pope T, Tetlow G and Pattison J, Capital spending in public services: Fixing how the government invests in the NHS, schools and prisons, Institute for Government, 26 June 2024, www.instituteforgovernment.org.uk/publication/capital-spending-public-services  The Treasury should also reconsider the delegated spending limits of departments. For example, the Home Office has a delegated spending limit of £150m, three times higher than that of DHSC, despite the overall capital budget of the former being nine times smaller than that of the latter (£1.5bn vs £13.6bn). This means the Home Office can spend 10% of its CDEL budget without Treasury approval, whereas the equivalent figure for DHSC is just 0.4%. We recommend that the Treasury raises the delegated spending limit for DHSC to £100m-plus.

Finally, select committees should use their oversight powers to encourage more effective spending of departmental capital budgets. They should scrutinise underspends against planned budgets just as thoroughly as they do overspends, asking ministers and permanent secretaries questions about these in oral evidence sessions. They should also hold ministers and permanent secretaries to account for the publication and quality of their long-term equipment and estates plans.

4.    Develop workforce plans

The government has set out some ambitious public service recruitment goals but has provided little detail so far on how these will be met. In the NHS, this information should come in the 10-year workforce plan that has been promised for later this year, and the DfE has promised a more detailed delivery plan for its pledge to boost teacher numbers by 6,500 by December 2025. ⁸¹ HM Treasury, Treasury Minutes, CP 1404, The Stationery Office, 2025, p.21, https://assets.publishing.service.gov.uk/media/68cd779ba1e4472207995df6/E03449792_CP_1404_Treasury_Minutes_Accessible.pdf

The government should publish comprehensive workforce strategies for all key public services. These will need to be based on a clear vision for what they want the service to deliver – something that is missing in some services. Each strategy should include:

•    Delivery and funding plans for meeting recruitment targets, which clearly set out the objectives, interim milestones and which organisations are responsible for meeting these.

•    Consideration of how to mitigate the undesirable knock-on effects on recruitment and retention of successful efforts in other services. For example, the welcome introduction of fair pay agreements in adult social care may attract staff that are currently employed as low-paid early years workers, exacerbating workforce problems in that sector.

•    Details on how the government will encourage a greater proportion of those undertaking training to enter and stay in full-time employment in those roles. This is particularly important for careers in medicine, nursing and teaching.

•    Proper consideration of how the government will meet its recruitment targets while at the same time reducing net migration. This is especially relevant in adult social care, general practice and hospitals, where a high proportion of the workforce has been recruited internationally. There is also evidence that children’s social care has become increasingly reliant on recruiting abroad. ⁸² Association of Directors of Children’s Services, ADCS Safeguarding Pressures Research – Phase 9, 2025, p. 55, www.adcs.org.uk/wp-content/uploads/2025/01/ADCS_Safeguarding_Pressures_Phase9_FINALv1.pdf

•    Recognition that adding more front-line staff is not always the best way to improve service performance. As we have previously argued, management and support staff are critical to public service productivity and the government could achieve better outcomes at a lower cost by not just focusing on the front line. ⁸³ Hoddinott S, Rowland C, Davies N, Kim D and Nye P, Fixing public services: Priorities for the new Labour government, Institute for Government, 22 July 2024, www.instituteforgovernment.org.uk/publication/fixing-public-services-labour-government

•    Realistic strategies for retaining staff and reducing sickness absences. As the NAO has pointed out in relation to teachers, there is a particular dearth of evidence on the effectiveness of retention initiatives that focus on improving workload or wellbeing. ⁸⁴ Comptroller and Auditor General, Teacher Workforce: Secondary and Further Education, Session 2024–25, HC 854, National Audit Office, 30 April 2025, www.nao.org.uk/wp-content/uploads/2025/04/teacher-workforcesecondary-and-further-education.pdf  But effective strategies would likely include clear professional pathways and opportunities – including high-quality continuing professional development (CPD) – that make the workforce feel valued.

The government will also need to navigate demands for higher pay from an expanded public service workforce, with many staff in roles that pay substantially less in real terms than they did 15 years ago. There are no easy options. Paying staff more will require higher taxes, cutting non-staff budgets, or reducing other parts of government expenditure. On the other hand, limiting staff pay is likely to harm recruitment and retention and may lead to further strikes, both of which will damage public service performance.

The government could face these trade-offs whether or not more staff groups take industrial action. That is because the Starmer government has so far indicated that it will accept the recommendations of pay review bodies, many of which have in recent years proposed pay awards over and above what the government has budgeted.^* At the very least, the government should provide services with greater certainty by asking PRBs to make multi-year pay recommendations, just as Bridget Phillipson has done with the School Teachers’ Review Body.

_{*    They have often done so because they think that higher pay is necessary to meet the government’s workforce aspirations.}

5.    Fix data problems and gaps

Ministers, civil servants and front-line staff are much more likely to make good decisions if they have access to high-quality data. Reliable, granular data on demand, staffing, activity and performance enables a better understanding of what is happening, the likely causes and how services can be improved. Unfortunately, serious problems with the quality and range of certain datasets means policy makers and practitioners alike are often flying blind. The government should address these problems as a matter of urgency.

Problems at the Office for National Statistics, particularly the questionable reliability of the Labour Force Survey, the UK’s main labour market dataset, have been discussed extensively in policy circles and the press. ⁸⁵ Nye P, ‘The Office for National Statistics must change to fix its data problems’, Institute for Government, 12 March 2025, www.instituteforgovernment.org.uk/comment/office-national-statistics-fix-data-problems ^{, 86} Strauss D and Borrett A, ‘How flawed data is leaving the UK in the dark’, Financial Times, 7 February 2025, retrieved 11 November 2025, www.ft.com/content/dd5515cc-e628-4e17-a4fd-1a10cc9f81e4  But serious problems with courts data have been much less high-profile. In 2024, HMCTS was forced to pause data publication for several months due to issues with data quality. Publication has now resumed but several figures have continued to be revised substantially, and time series before 2019 in magistrates’ courts and 2016 in the crown court remain unavailable. Among several key criminal justice stakeholders that we interviewed, trust in the data remains low. Likewise, there is wide variation in how police forces record outcomes, which makes it hard to compare performance.

Beyond these errors, there are big gaps in the information collected about critical services. In policing, for example, there is limited reliable data on officer or staff deployment, with figures for officers and PCSOs in neighbourhood roles only available for two years (2023/24 and 2024/25). There are also data gaps for certain forces on key areas like crime outcomes that make it challenging to construct a reliable time series.

In the criminal courts, the high proportion of magistrates’ court defendants who enter no plea means it is impossible to tell from the available data whether the decline in magistrates’ court trials is because fewer people need a trial or there has been a fall in courts’ capacity and activity.

In children’s social care, the government’s reform plans depend on staff working in preventative services, such as early help and family support, but the government has unhelpfully little data on the shape, size and make-up of that workforce or, indeed, on the wider local government workforce. There is also evidence that children’s social care has, like other services, become more dependent on international recruitment, ⁸⁷ Association of Directors of Children’s Services, ADCS Safeguarding Pressures Research – Phase 9, 2025, www.adcs.org.uk/wp-content/uploads/2025/01/ADCS_Safeguarding_Pressures_Phase9_FINALv1.pdf  but, unlike in adult social care, general practice and hospitals, official data is not collected on this. Collecting this data would help the government to better understand the impact of its visa changes on the children’s social care workforce.

There have long been gaps in adult social care data. As we noted in 2022, this includes information on “private funding of social care, staff/resident ratios, staff qualification levels in residential homes and home care, the number of unpaid carers, and what happens to adults who request but do not receive publicly funded adult social care” ⁸⁸ Davies N, Hoddinott S, Fright M and others, Performance Tracker 2022: Public services after two years of Covid, Institute for Government, 17 October 2022, www.instituteforgovernment.org.uk/publication/report/performance-tracker-2022-0 . In addition, the government could helpfully publish data on the level of need in each local authority^*, continuity of care and preventative care activities.

Previous work by the Institute for Government and Centre for Homelessness Impact has highlighted the inconsistencies and gaps in the data held on homelessness. For example, some local authorities cannot easily match the data they hold in different systems and the quality of their data on the financial circumstances of low-income residents is declining due to the transition from Housing Benefit, which is managed by councils, to Universal Credit, which is overseen by DWP. ⁸⁹ Hurst G, Teixeira L and Davies N, A smarter approach to homelessness: Prioritising prevention in the 2025 spending review, Institute for Government and Centre for Homelessness Impact, 13 May 2025, www.instituteforgovernment.org.uk/publication/smarter-approach-homelessness

In general practice, there is no reliable data on the number of people contacting practices, the proportion that successfully book an appointment, the length of appointments, the number of appointments that are needed to resolve a query, the outcome of ‘advice and guidance’ requests, or a reliable time series of continuity of care. This makes it much harder to assess how well practices are meeting demand and the efficacy of different methods of triaging and consulting with patients. Despite the huge increase in direct patient care staff, there is also no public data on how they have been allocated to individual practices.

Even for hospitals, where the published data is most comprehensive, there are meaningful gaps. In particular, the government and trusts would benefit from data on the diagnostics, outpatient appointments, admissions and other activity required to complete each elective case.

Despite these gaps, the following chapters provide the most comprehensive assessment to date of the public services inheritance left by the Sunak government and what the Starmer government has done since the election. While Labour should have made more progress over the past 16 months, more than two thirds of this parliament remain. This report sets out the issues that the government should focus on if it is to deliver tangible improvements to public services and the lives of those who use them by the next election.

_{*    This should include more regular data on disability rates, which are currently only updated once a decade via the census.}