Fiscal Devolution key to nationwide Covid-19 Economic Recovery

ADDITIONAL financial freedoms; such as the ability to set their own taxes or devolving national taxation from Central Government; would empower communities to help kickstart a national COVID-19 economic recovery, the Local Government Association says today. Councils across the country continue to lead local communities through the Covid-19 crisis, which has underlined the transformative role they can play in supporting their communities and economies if they are given the freedom to deliver. However, a new report by think tank Localis, commissioned and published by the LGA today, finds that; across the western world; Local Government has been able to react with greater power and autonomy than in the UK.  The UK economy is 1 of the most centralised in the world. The report finds that local Authorities in Germany, Switzerland and Holland can access a diverse range of revenue sources and are able to adjust and introduce local levies in consultation with their residents and businesses. The Government has committed to releasing a wave of investment across and country to bounce back from the pandemic. The LGA wants to work with Government on how its forthcoming Devolution and Recovery White Paper can explore options for greater fiscal freedom for local communities. This should include the power to raise more money locally, for example through a tourist or e-commerce levy, and have greater control over how national taxation is spent, such as income tax or a share of fuel duty to invest in roads. The LGA said this is a crucial part of ensuring every part of the country is to bounce back from the economic shock we face.

Cllr Kevin Bentley, Chairman of the LGA's People and Places Board, said:-  "England is an outlier when it comes to fiscal devolution with international communities having much greater levels of financial freedom.  As we look ahead towards the long process of economic and social recovery, this gap in local power and autonomy across England risks seeing our communities fall ever further behind. The forthcoming Devolution and Recovery White Paper expected is a real opportunity to do things differently.  Councils want to work with the Government on how local communities can have the freedoms and flexibilities to play a lead role in the nation's economic recovery and better connect local leaders to decisions made about how money is spent and raised for the benefit of their communities."

Localis Chief Executive Jonathan Werran, said:- "There can be no genuine roadmap to future recovery and devolution without entrusting English Local Government with the freedom to use and choose locally generated growth revenues to direct vital place led priorities for economic and social reform. The examples Localis drew upon from the German federal system, the Dutch municipalities and the Swiss cantons neatly disprove the bogey man argument that fiscal devolution should always lead to a:- 'race to the bottom' or an iniquitous postcode lottery. Far from it.  The evidence suggests instead that without greater decentralisation of Local Government finance, the levelling up agenda will fail to provide either the targeted economic development support to rebalance Regional economies or the social infrastructure to cement place prosperity."

Community Discharge Grant

CARE England, the largest representative body for independent providers of adult social care has welcomed the Community Discharge Grant. Professor Martin Green OBE, Chief Executive of Care England, says:-  "It is imperative, despite the increased pressure the care system has come under in light of the Covid-19 pandemic, that people with a learning disability and / or autism are enabled to enjoy their rights to live purposeful lives as active members of families and communities. This additional funding will be given to Local Councils to accelerate discharge of patients with learning disabilities and/or autism from Mental Health Hospitals into the community."

In March 2019, former Minister for Care, Caroline Dinenage MP, outlined that the ambition for March 2020 was to reduce the rate of inpatients with a learning disability and / or autism by 35% from the total number of inpatients in March 2015. Figures released earlier this year in April by NHS Digital, showed that there had only been a 27% reduction, therefore missing the outlined target by 8%. This is almost 300 more adult inpatients than the target. Equally as significant, of those in hospital at the end of May 2020, 1,255 (61%) had a total length of stay of over 2 years. On 16 July 2020, the Department of Health and Social Care announced a ₤62 million fund to help discharge people with learning disabilities and autism into the community:-

► Funding will be given to local Councils to accelerate discharge of patients with learning disabilities and / or autism from mental health hospitals into the community.

► The funding can be spent on costs associated with discharge, including establishing community teams, funding accommodation and staff training.

► A new independent Oversight Panel has been set up to improve care and support for inpatients with learning disabilities and / or autism.

Martin Green continues:-  "Care England has long highlighted the issues around meeting the objectives of the Transforming Care agenda, accordingly it is encouraging to see a decisive step taken in the right direction. However, this money must be earmarked and used to meet the needs of the most vulnerable. We welcome this grant and look forward to working with Baroness Hollins to help reach a long term solution to the admission of the most vulnerable in society into inappropriate settings."

Data project drives improvements in care for patients

MILLIONS of people across the North West Coast will benefit from improved health thanks to a project aimed at better managing patient data. Connected Health Cities., which involved the Innovation Agency, was a ₤20m, four-year pilot funded by the Department of Health to unite local health data and technology to improve care for patients in the North of England. The project put patients at the heart of how their health data was used, with great success. It was co-ordinated by the Northern Health Science Alliance and delivered through Regional centres covering the North East and North Cumbria, the North West Coast, Yorkshire and Humber and Greater Manchester. Connected Health Cities. has delivered outstanding results, saving lives, protecting capacity within the NHS worth many millions of pounds per year and improving the care of millions of patients. An impact report has been published demonstrating how the project has:-

► Linked 10 million health records in the Region.

► Created at least ₤30 million of investment.

► Shown early indications at least ₤150 million worth of cash savings is being made in the North of England's NHS and social care every year.

In the North West Coast, Connected Health Cities. was delivered by the Innovation Agency in partnership with AIMES Management Services, the University of Liverpool and Lancaster University. The focus was on 3 clinical pathways: chronic obstructive pulmonary disorder (COPD), alcohol related liver disease and epilepsy.

The partners developed a:- 'Learning Health System' which involved collecting, linking and analysing data and presenting information to staff to help them to plan and deliver care more effectively. The Innovation Agency actively involved patients, helping them understand choices in sharing health information and developing a consent app for data-sharing preferences.  It also worked with industry and involved a number of local companies such as ORCHA health app organisation and the Hartree data centre. AIMES provided the infrastructure and technical support to develop a trusted research environment where the data was housed and analysed. Researchers at the University of Liverpool's Health Data Laboratory used advanced statistical techniques to turn routinely collected data into insights to improve health services and developed algorithms to more accurately capture patient cohorts. The results were:-

► An extra 66% of epilepsy related admissions were identified when compared to just using the primary diagnosis code, now capturing more accurate average length of stay

► An extra 45% more people with COPD currently being provided with NHS care being identified compared with the national analysis.

► An extra 40% of cases of alcohol related liver disease being detected when compared with standard approaches for capturing data on emergency admissions meaning more patients are getting the right treatment.

Lancaster University led on workforce development, hosting PhD students and working with business informatics teams to up skill health professionals with digital skills to use data effectively to support improvements in patient care. The Innovation Agency supported workforce development with digital coaching, developing a patient and public involvement group and working with people to gain trust for consent to use data, as well as working with industry to develop innovative tools to support clinicians and the health service. The Connected Health Cities. methodology is transferable to other chronic conditions and a toolkit has been developed to share it with local health systems. The programme has been instrumental in providing the foundation for more work on building a trustworthy approach to using patient data to improve health in the Region, including the Liverpool City Region Civic Data Trust which is currently being developed.

Innovation Agency Associate Director Dr Julia Reynolds said:- "Connected Health Cities. proved that using data that exists in the health and social care system in a smarter way can transform health and care, save lives and protect NHS resources in the NHS. This project has helped us gain a huge amount of learning for our Region and allowed us to take big steps in developing our academic expertise, working collaboratively to support frontline staff in using data to make improvements to services, including gaining further funding to develop this work. It has also been an important lesson in building public trust and ensuring the patient's voice is heard. We will be building on this important work and spreading our learning to other conditions in the future."

Read the report here:- CHC-Impact-Report.Co.UK.