Austerity, political control and supplier selection in English local government: implications for autonomy in multi-level systems

Analysis of 60,000 contracts awarded by English councils between 2015-19 reveals that austerity constraints are a key predictor of councils outsourcing services to for-profit suppliers, regardless of their political control. Conservative Party-controlled councils are also more likely to contract with for-profit suppliers, although we found no link between Labour-controlled councils and not-for-profit suppliers, nor evidence that political or budgetary factors influence whether councils contract with providers based in their own region. We argue that centrally imposed funding cuts, and a belief that for-profit suppliers represent a cheaper option, could be overriding Labour Party councils’ ideological preference for not-for-profit providers

Working paper no 6. A review of integrated risk management plans in fire and rescue services: stage 1

The production, implementation and maintenance of up-to-date Integrated Risk Management Plans (IRMPs) has been a mandatory requirement for all Fire and Rescue Authorities and Services in the UK since they were introduced by the Fire and Rescue Services Act 2004. The publication of IRMPs is intended to reassure the public that Fire and Rescue Services (FRS) are aware of all of the risks to people and property in their areas and that appropriate action is being taken to protect the public, prevent and mitigate harm and expedite response to incidents. FRS will be aware that the government’s most recent National Fire and Rescue Framework for England (Home Office 2018) assumes that IRMPs are both publicly available and adequate to underpin or inform strategic decision-making as well as operational service delivery. Despite this fundamental and strategic role in public protection and service delivery, the research team became aware during the initial stages of this project that neither the government, nor the service is currently systematically reviewing the content, currency nor fitness for purpose of the existing IRMPs. As part of their new service inspections, Her Majesty’s Inspectorate of Police and Fire & Rescue Services (HMICFRS) are reviewing whether the activities and services provided by FRS are based on risks identified in the IRMPs, and that their activities and services reflect the risks identified in their IRMPs (HMICFRS 2018). The National Fire Chiefs Council (NFCC) are currently undertaking (with Nottingham Trent University) a national review of Community Risk Methodology underpinning IRMPs. However, as far as we are aware, there are currently no proposals by the Home Office, or HMICFRS or NFCC to systematically investigate the adequacy of current IRMPs to establish whether they are fit for purpose, and follow the best available practice. In addition, FRSs have recently been criticised for failure to evaluate their prevention activities and to establish the effects/benefits they are having to the public (HMICFRS 2018). The principal objective of the current research project is therefore to start to review Integrated Risk Management Plans in FRS. Although we would strongly support a more comprehensive study, we do not have the resources, at this time, to complete a comprehensive assessment of all IRMPs, nor do we currently have the resources to investigate every part of the IRMPs. The research team are therefore undertaking a review of specific aspects of IRMPs, and for practical reasons have had to base this on a sample of FRS

Midlands Engine public expenditure analysis

This presentation highlights the level of public spending in the East and West Midlands over recent years, focusing particularly on comparisons with other parts of England and the wider UK; • It draws heavily on HM Treasury’s Public Expenditure Statistical Analysis (PESA) as the best available overall source for data on expenditure by region. It is an annual publication based on two defined frameworks; budgeting and total expenditure on services for the UK; • We supplement PESA data from a variety of sources in order to provide a more granular analysis of funding streams relevant to economic development; • Where data permits we have provided time series comparison; • A variety of regional and sub-regional geographic areas are used for this analysis – again reflecting the nature of available data; • The Northern Powerhouse has a higher national profile than the Midlands Engine. Previous studies have found that the North receives less public funding, particularly for transport projects, than London and the South East (Raikes 2019). This presentation seeks to explore this phenomenon from a Midlands perspective

Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study

Objective To investigate if the widely publicized warnings in 2003 from the US Food and Drug Administration about a possible increased risk of suicidality with antidepressant use in young people were associated with changes in antidepressant use, suicide attempts, and completed suicides among young people. Design Quasi-experimental study assessing changes in outcomes after the warnings, controlling for pre-existing trends. Setting Automated healthcare claims data (2000-10) derived from the virtual data warehouse of 11 health plans in the US Mental Health Research Network. Participants Study cohorts included adolescents (around 1.1 million), young adults (around 1.4 million), and adults (around 5 million). Main outcome measures Rates of antidepressant dispensings, psychotropic drug poisonings (a validated proxy for suicide attempts), and completed suicides. Results Trends in antidepressant use and poisonings changed abruptly after the warnings. In the second year after the warnings, relative changes in antidepressant use were −31.0% (95% confidence interval −33.0% to −29.0%) among adolescents, −24.3% (−25.4% to −23.2%) among young adults, and −14.5% (−16.0% to −12.9%) among adults. These reflected absolute reductions of 696, 1216, and 1621 dispensings per 100 000 people among adolescents, young adults, and adults, respectively. Simultaneously, there were significant, relative increases in psychotropic drug poisonings in adolescents (21.7%, 95% confidence interval 4.9% to 38.5%) and young adults (33.7%, 26.9% to 40.4%) but not among adults (5.2%, −6.5% to 16.9%). These reflected absolute increases of 2 and 4 poisonings per 100 000 people among adolescents and young adults, respectively (approximately 77 additional poisonings in our cohort of 2.5 million young people). Completed suicides did not change for any age group. Conclusions Safety warnings about antidepressants and widespread media coverage decreased antidepressant use, and there were simultaneous increases in suicide attempts among young people. It is essential to monitor and reduce possible unintended consequences of FDA warnings and media reporting

A review of integrated risk management plans in fire and rescue services

The production, implementation and maintenance of up-to-date Integrated Risk Management Plans (IRMPs) has been a mandatory requirement for all Fire and Rescue Authorities and Services in the UK since they were introduced by the Fire and Rescue Services Act 2004. Despite this fundamental and strategic role in public protection and service delivery, the research team recently become aware that neither the government, nor the service is currently systematically reviewing the content, currency nor fitness for purpose of the existing IRMPs. The principal objective of this research project was to start to review IRMPs in Fire and Rescue Services in England

Do we need to review IRMPs?

Pete Murphy, Katarzyna Lakoma and Angela Toothill call for a comprehensive review of the integrated risk management plan process and outcomes