Saturday 30 April 2016

Prison Musings 2

It's becoming clear that the forthcoming European Referendum has induced complete paralysis within government, with the result that pretty much nothing is happening, and that includes any serious moves in relation to prison reform. To say the least this is somewhat regrettable because the situation is deteriorating fast. This from the Independent:-

UK prison system 'in total meltdown' as sexual assaults and violent crimes soar in jails

An alarming rise in the number of murders, sexual assaults and attempted hangings has sparked warnings the prison system is on the "verge of collpase". Damning figures released by the Ministry of Justice have revealed that violence has increased in the past 12 months and, in some cases, is close to double rates from 2010 before the Coalition government came to power and began controversial reforms.

Campaigners, MPs and former prisoners have told The Independent that the prisons system is in "total meltdown" following staff shortages, overcrowding and funding cuts.

Between 2010 and 2015, the number of sexual assaults recorded has more than doubled from 137 incidents per year to 300. In the same period, the number deaths in prisons has risen from 198 to 257 per year. Self-harm and suicide attempts have also risen at an alarming rate.

Recorded incidents in which someone has attempted to hang themselves has spiked from 580 to 2,023 while the number of attempted overdoses has risen from 1,414 to 2,523. The number of recorded incidents of prisoners cutting themselves has risen from 15,159 incidents in 2010 to 21,282 incidents in 2015.

Other concerning figures include the number of people recorded as suffering from a serious bite wound as a result of an attack in a prison more than doubling from 89 in 2010 to 209 in 2015. The number of people sustaining an injury after being attacked with urine or excrement has increased nine-fold in this time frame from 20 attacks to 180 per year.

The data has been released by the Ministry of Justice as part of its annual Safety In Custody figures. Shadow Minister for Prisons Jo Stevens told The Independent: “These shocking figures have blown the lid off Michael Gove’s claims that he is the man to deal with the worsening Tory prison crisis. Now we know that the Government’s own statistics reveal that rates of self-harm, homicides and serious assaults on staff have surged.

“This paints a picture of a system in total meltdown and on the verge of collapse. How can it be right that hardworking prison staff are expected to put up with such a toxic workplace environment? David Cameron’s Government must immediately act to address the prison crisis which they have caused through their failure to deal with staff shortages, overcrowding and a complete breakdown of any sense of safety in our prisons.”

Campaigners and experts say staff shortages and over-crowding were resulting in chaos and undermining the wellbeing and safety of prisoners and staff. “These shocking statistics spell out the scale of the problems in a prison system that is failing after years of rising numbers, chronic overcrowding and deep staff cuts," Frances Crook, Chief Executive of the Howard League for Penal Reform, said.

“We are hearing a lot of fine talk from the Government about how things will be put right, but at the moment there appears to be no action. Meanwhile, people are dying. How many more people will die before something is done?”

Peter Dawson, Deputy Director of the Prison Reform Trust, backed calls for reform saying the figures highlighted that the "need for reform is urgent."

Commenting on today's findings, Prisons Minister Andrew Selous said: "These figures demonstrate the very serious challenges facing the prison service. They show how badly prison reform is needed. We must do better at reducing violence and preventing drugs entering prison. We must do more to help prisoners with mental health probles. We have to ensure prisoners can be rehabilitated so they are no longer a danger to others.

"We have secured £1.3 billion to modernise the prison estate and we will put governors in charge. These reforms will ensure prisons are places of decency and improve public safety by reducing reoffending."

--oo00oo--

There doesn't seem to be an area of prison operation that isn't currently causing concern and I note Ian Dunt has picked up on the extraordinary goings-on with the Independent Monitoring Board at HMP Hollesley Bay. This extract from the Politics.co.uk website:- 

Targeting the whistleblower: Prison critic fights for her job

There is now just one member of the independent monitoring board of Hollesley Bay prison. Last Tuesday, the board wrote to their chair, Faith Spear, telling her that either she resigned or they did. She didn’t resign. So they did.

Spear’s crime was to write an article in the 2016 edition of the Prisons Handbook, using a pseudonym, in which she issued several complaints about the way the the boards operate. These strange little groups, which are supposed to scrutinise prisons, use a baffling recruitment process to recruit an army of wealthy retired people to monitor prisons full of people whose lives they will never be able to understand. Why, Faith asked, was the secretariat for the boards literally in the Ministry of Justice and entirely dependant on it for funding? Why were they discouraged from speaking to the press, or conducting night-time visits?

These criticisms did not go down well.

"I had a call from my vice chair saying I’d been identified as Daisy Mallet [the pseudonym the article was written under]," she says. "She said I had to prepare a statement for the annual board meeting on the 19th and to state in it that I was the author of the piece."

Spear prepared her statement, went to the board meeting and delivered it. What she didn’t know is that they had already met and prepared questions for her.

"One by one they all fired questions at me," she says. "For 50 minutes I was bombarded. The venom in some of those people was unbelievable. Every one of them. Then I was asked by the vice-chair to leave the room while they deliberated. On what? I didn’t know because no one would say anything."

They told her to go home and come in again tomorrow to hear the outcome, but she refused. Instead, she went and sat in her car for 40 minutes. Then a member of the board came out and took her to meet the vice chair.

"They sat me down and said there’d been a unanimous vote for me to step down as chairman," she says. "I had no clue that was what they were doing. I said: 'I won’t make that decision right now'. They said if I didn’t, the whole board would refuse to work with me. I would receive a formal letter in the post."

The letter came. She sent one back refusing to step down. So now Spear is, to all intents and purposes, the one and only member of the monitoring board.

Spear’s article was critical of the boards, but it was hardly man-the-barricades stuff. The reaction to it suggests a culture which is desperate to shield itself against criticism. And for good reason, because in a justice system which blocks almost all forms of scrutiny, many independent monitoring boards are failing to hold prison authorities to account.

There are three parts to the prison scrutiny system: The press, the inspectorate and the monitoring boards. The first part is useless. It’s very difficult indeed for journalists to access prisons. And even if they could, most couldn’t care less, outside of a couple of shrieking tabloid headlines about Playstations. There is almost no media scrutiny of the way prisons operate.

So a lot of responsibility is left to the chief inspector of prisons. The outgoing inspector, Nick Hardwick, has proved hugely impressive and, consequently, ended up at loggerheads with former justice secretary Chris Grayling, who tried to get him to take out criticism of government policy from his annual report. The chief inspector is appointed by the Ministry of Justice (MoJ) and reliant on it for his budget, setting up a rather unhelpful dynamic given he’s supposed to be scrutinising the results of its policies.

And then there’s the monitoring boards. These are small local groups made up of volunteers who will very often make daily trips to the prison. In a way they’re more useful than the chief inspector - or they could be - because they know the place inside and out.

But there’s a fundamental problem with their purpose: no-one knows exactly what it is. They are, on some level, meant to be the eyes and ears of the justice secretary, sending him reports about how the prison and its governor are doing. But in fact those reports take a route through the governor, even though there are rules about how much they can influence it.

On another level they are plainly scrutinising MoJ policy, because most things going wrong in prison are as much a reflection of the orders that came down from Whitehall as they are the behaviour of the governor. For others they’re not a scrutiny body at all, just a sort of administrative organisation helping connect prisoners with services. Although that being said, many prisoners have never heard of the independent monitoring boards.

In short, it’s a mess. The first part of the prison scrutiny system is useless, the second part is in an MoJ headlock, and the third part isn’t sure what it’s supposed to be doing. This is why, incidentally, penal reform groups like the Howard League are so crucial: their contact with prisoners and their families, even when hamstrung by the government, is invaluable.

You can see this discrepancy in the work on the monitoring boards. You really never know what you’re going to get with their reports. Take the 2014-15 report into Long Lartin. It is absolutely brilliant, particularly on the issue of education, where the board highlighted the insanely counter-productive practice of actually stopping prisoners from receiving education past basic skills.

"Men who have these basic skills, whether acquired in prison or without, continue to seek what Education can provide," the report says. "This is particularly true of those who face many years in custody. Education offers them stimulus and challenge, engagement with a wider world and a framework for reflection. If imprisonment is to work it has to hold the possibility of individual development.

"It is frustrating to long term prisoners – and galling to the board – when they find that success at City and Guilds Level 2 or its equivalent disqualifies them from further formal study. In a broad sense it is opportunities for rehabilitation which are being lost; underlying this is a denial of something which our society claims to value. More immediately, it is a neglect of opportunities to contribute to the stability of the prison."

Clear-sighted and very useful. Now compare that to the 2012-13 report for the Serco-run Thameside prison, where the board appears to have gone native. The report came just after a damning assessment by the inspectorate, which said the "prison’s regime was one of the most restricted we have ever seen". (continued)


--oo00oo--

Despite the paralysis, there's no shortage of advice regarding what needs to be done, as with this piece from the Guardian:-

We should assess prisons by what happens once offenders are released

The prime minister’s vision of autonomous prisons is ambitious. He has called for prisons to “be held to account with real transparency over outcomes”. But the current metrics for prisons are a long way off doing that. It will require a step change in how performance is measured, but getting it right has the potential to transform the prison estate.

Official performance measures at the moment focus on evaluating what goes on inside prison walls, but fail to focus on the long-term outcomes that really matter, such as reoffending or sustained employment. Whilst the Prison Service’s mission statement says that it should help offenders “lead law-abiding and useful lives … after release”, no accountability system has been put in place to make sure this is realised.

Failing to include reoffending in prison performance measures ignores its cost to society. The National Audit Office estimates that reoffending costs the economy between £9.5bn and £13bn a year. Offending also disproportionately impacts disadvantaged communities, which for a government committed to improving life chances should be of particular concern.

Reform’s new report, Unlocking prison performance, sets out a new way for measuring performance. One that not only takes into account what happens within a prison but that also looks at what happens once offenders are released. In doing so it provides a blueprint for producing the performance league tables the prime minister has pledged to introduce – and the Ministry of Justice is yet to provide a model for.

The report paves the way for an increased understanding of what best practice looks like in the prison system. It finds a wide variation in performance both in terms of what happens within and outside of a prison’s walls.

Even when using the comparator groups developed by the National Offenders Management Service, wide variations remain. Some prisons clearly outperform their “peers” in providing, for example, courses addressing offending behaviour or substance misuse – interventions that are likely to reduce an inmate’s chance of reoffending. Closing the gap between the best- and worst-performing prisons, therefore, presents a sizeable opportunity to deliver greater value for money.

The diversity and quality of current data, however, presents a major obstacle to really identifying best practice. Better data would mean a more accurate and meaningful understanding of performance at a prison level, which in turn would enable greater accountability. For example, measuring whether a prisoner has accommodation on release is an inadequate outcome metric. It fails to differentiate between those offenders who have a place to call “home” and those who have just secured housing for one night. Better measures of reoffending are also needed, and Reform has recommended comparing proven reoffending rates with a particular prison’s predicted rate.

Exposing both successes and failures should, ultimately, lead to better prison outcomes. The prize is not just better value for money, but improved lives and safer communities.

Eleonora Harwich is co-author of Unlocking Prison Performance, published by the public services think tank Reform


--oo00oo--

Finally, it's probably just as well that we don't get too starry-eyed with Gove's big ideas and here's why spelt out out by Will McMahon on the Justice Gap website:-

Treating prisoners as ‘assets’ – and the real reason behind Gove’s prison reforms

When given time to prepare, politicians can demonstrate exceptional presentation skills. Astute political communication often rests on the ability to craft messages to engage the chosen audience on their preferred terrain and to develop a narrative that gives the listener reasons to support the policy proposals being suggested.

Using this technique it can be possible to develop broad coalitions to support ostensibly simple policy platforms with radical implications, even though the different audiences might be listening from very different standpoints. Being ‘tough on crime, and tough on the causes of crime’ is perhaps the most well known example of this technique in the field of criminal justice policy.

Who could possibly disagree?

Yet, despite being lauded by much of the liberal reform sector for this engaging couplet, the concrete outcome of Tony Blair’s prescription was a rapid expansion in prison numbers and the staffing and operations of criminal justice as a whole. Many, frankly desperate to see the end of Conservative rule, had a valence to hear the message they wanted to hear, ‘tough on the causes’, rather than to look at the policy in the round. When Tony said he was going to be ‘tough on crime’ he meant it, but that was the message heard by the other side of the grand coalition that was ‘New’ Labour.

This experience needs to be considered when appraising the recently announced prison reform policy.

Assets, not liabilities

Michael Gove has been busy in delivering messages aimed at corralling the reform movement behind the government’s prison transformation programme, with an emphasis on the closure of old prisons, the opening of new estate more able to deliver on rehabilitation, and the idea that prisoners should be seen as ‘assets’ rather than liabilities.

This approach has received a more than warm reception from parts of the reform movement. Rather than despairing about the overall lack of efficacy of the reform strategies since the early 1990s, and the burgeoning of prison numbers, there is an understandable desire to focus on the positive presentational messages that appear to reinforce and reinvigorate reformist ambitions.

Yet, if we listen from a different standpoint the messages being delivered can take on a different hue. It is no secret that the present government is committed to both reducing the size and scope of the state and believes that private delivery of most services should be the preferred policy option. Indeed, over the last generation more and more services, including those for vulnerable groups, such as the frail elderly and children in care, have been transferred to the private sector.

So those in the business of private provision will have had their ears cocked during the various announcements unpacking the prison reform programme to hear what opportunities might be arising. From this standpoint, the government will have left them hopeful that the prison service as a whole is to be opened to full-scale privatisation.

Preparing for market

Localism is usually thought of as a common good. Indeed, local prisons for local prisoners that family members can be more easily reach is often thought to be a sine qua non of a genuine commitment to rehabilitation. Yet, local management of prisons does not in and of itself promise this and is in fact quite a different proposition.

Its real effect may be to break the existing state-managed system into smaller units that are much easier to contract out or privatise. Creating a market in prison provision requires the break-up of the system, otherwise what is regarded as the necessary competition to produce more effective outcomes will not take place – a public monopoly will just be replaced by a private monopoly.

In his Policy Exchange speech on prisons, the Prime Minister made reference to prison regulations allowing prisoners to have only a certain number of underpants and jigsaws and no more than 12 sheets of music. This can be heard as a call for the relaxation of certain onerous and unnecessary aspects of the punishment regime and a welcome liberalisation. However, from the perspective of a private investor, this is a signal that an over complex regulatory regime is to be curtailed, with the effect of creating cost savings for any entrepreneur wishing to invest in the prison reform programme. As in other areas of the government’s programme, the emphasis is firmly on a ‘bonfire of the red tape’ with a purpose, the simplification of service delivery processes to allow for the creation of a viable space for market profit to be realised.

The promise to introduce league tables for locally managed prisons creates the impression that prisons will be measured on outcomes for individual prisoners. However, as with school league tables, rather than measuring outcomes for individual students so that parents can judge which school to send their child to, the underlying purpose is to measure one institution against another so that market information can be created that allows competition to be in some way meaningful.

Markets in punishment and education do not arise as a result of everyday life, the conditions need to be created for them to develop, the ground has to be prepared for their construction. Localism, league tables and deregulation were the tried and tested processes used to the break up and pass into private hands of much of the primary and secondary education system and prepared the way for forced academisation – there is little reason to suppose that a similar method will not be used for the prison system.

The reader may, or may not, be in favour of private investment in education or the prison system, that is beside the point; what is crucial in politics is that governments will often offer ‘a reason’ or a series of ‘reasons’ in order to draw a coalition behind a policy that has a desired outcome for the policy objective – the ‘real reason’. In the case of prison reform, the real reason may be a long-held government ambition, the delivery of a privatisation programme that began with British Aerospace in 1981 and has been a core purpose of Conservative policy ever since the Ridley Report was drawn up in 1977 in the policy aftermath of the Heath Government.

It is to be expected, as part of building a coalition for the full privatisation of prisons, that government will dress the policy to make it as palatable as possible for the prison reform sector. Talk of belief in redemption, combined with the clothes of localism, an end to over controlling prison regulations, and new prisons offering greater promise of rehabilitation, and the almost subversive comment that prisoners should be seen as ‘assets’, is the type of astute political packaging and communication that is aimed at neutralising opposition to the real reason for reform.

Friday 29 April 2016

That NAO Report Explained

Key findings

The performance of the reformed system


6 23% of service users note things have got worse, they are particularly upset with housing, employment and having to repeat themselves.

7 Data collection is inaccurate and difficult to gather making it difficult to see how successful this has been. There will be no re-offending data for at least 8 months.

8 Contracts are tightly controlled in the CRC but the CRC are kicking back. The NPS has not got a clue what it is contracted to do.

9 The two organisations have conflicting objectives and are bickering with each other and pointing fingers.

10 NPS are over worked now, CRC will be once they have laid off enough staff to make a profit.

11 IT systems are a joke, inefficient, late and not fit for the job.

12 Phew. Some how the wheels did not come off. Lets give 'em a gong. There is a lot of rubbish we kicked into the long grass and the bidders did not have a clue what they were buying. Lets hope we have bought enough time. Fingers crossed.

13 We got our split numbers wrong meaning that the CRC's have not got enough work to make a profit from. If one of them gives the contract back WE ARE FUCKED.

14 Payment by Results. See the bit about long grass at 12. Also Innovation...we were joking. Lets put some guff in here about fees for service "Incentivise" is that a word? Who cares the policy wonks like it.

15 The NPS - too many cases, managers drowning, systems in flux, lots of inconsistent policies inherited. We have a change programme, somewhere over there in the field.

16 Through the gate...Well on track..Sorry cannot keep this up, it's a mess. We have a thing called "Through the Gate" in the prisons but what it is, how it works and when it will make a difference, who knows.

17 Voluntary sector. Well, come on, that was just bid candy. Sadly they all seemed to see that we had just put lipstick on the pig and they laughed and left. Never mind, the boss was able to stand up and talk about it and in any event we were always going to sell it off to the French and the yanks Brexit anyone?

18 Well, we got away with it so far. It did not fall completely to bits. Lets give the credit to the staff at NOMS, not the idiots with vocations who kept the show on the road while we shafted them all (Sorry people, but this is me and I do have a reputation to uphold PC)

19 But you know we are not out of the woods and it will just take something we have buried to start to smell and we are fucked.


Recommendations

a You know the problems with this are exacerbated by the fact that it was rushed and done half arsed to a stupid timetable. But hey we got away with it. Please take more care from now on. (Key point with any report is that the most difficult to understand sentence is the one where they are trying to cover up something).

b Ask the CRCs what they need in order to stay the course. If they leave WE ARE FUCKED

c GIVE THE CRCs MORE MONEY

d Reform the NPS and for gods sake sort their IT and back office.

e The best way to ensure CRC buy-in is to give them more money and less oversight. Cannot see a problem with this, it worked so well with the SERCO tagging contract.

f Try and count things monthly. If we are constantly updating our numbers, then we appear to be doing more work.

g When giving more money to the CRCs (see c above) say it's for innovation.

That is what I got from that document. They have managed to write up "We avoided total disaster" as this is a great success. Its like Dunkirk, we get 300k soldiers off the beach but not a single gun, no tanks and no artillery. The Germans ran us into the sea in six weeks and knocked out our major European Ally. But when you read the reports its all plucky little boats and British grit and stiff upper lip. Be ready though from now on this will be used to counter any suggestion that anything is less than rosy.

(Thanks to 'Pina Colada')

--oo00oo--

Rob Allen had this to say:-

The Invisible Transformation

Back in January 2013, then Justice Secretary Chris Grayling was admirably clear about what he expected his “revolution in the way we manage offenders to achieve”. "My vision is very simple", he wrote . "When someone leaves prison, I want them already to have a mentor in place. I want them to be met at the prison gate, to have a place to live sorted out, to have a package of support set up, be it training or drug treatment or an employability course. I also want them to have someone they can turn to as a wise friend as they turn their lives around”. The private Community Rehabilitation Companies which were contracted to provide 70% of probation work were supposed to implement this simple vision.

Three and a half years on, the National Audit Office today reported on how Transforming Rehabilitation has been going. It includes this gobbledygook.

“Through the Gate’ resettlement services began on 1 May 2015; there have, however, been some initial problems associated with the ambitious delivery timescales. For example, some providers encountered challenges in accessing prisons and mobilising their resettlement suppliers. NOMS’ assurance checks found that providers initially focused too much on whether offenders complete the process, which is one of the CRC service levels, rather than the quality of their resettlement plans. NOMS has worked with CRCs to clarify what more they must do for offenders beyond simply completing an offender’s resettlement plans within a five-day period (20 of the 21 CRCs were meeting this target in December 2015) and signposting them to services”.

If you have trouble understanding what that means, you can find an illustration in the Prison Inspectorate’s report on HMP Lewes published earlier this week. They reported that 30% of prisoners were released homeless.Their survey of prisoners (carried out at the end of last year) found that a much lower proportion knew anyone in the prison who could help them on release than in 2012- whether with problems relating to accommodation, employment, finance, education or drugs.Somehow however the Inspectors reached the conclusion that “CRC arrangements had developed well”.

In similar vein the NAO flies in the face of their evidence by highlighting the successful restructuring of the probation landscape “within ministerial timescales and without major disruption to services”. The report makes much of the fact that more than three-quarters (77%) of service users said they had not noticed any change in the overall service they personally received. In fact more felt that the overall level of support and help with housing and accommodation had got worse rather than better.

But isn’t it a strange revolution when most of the people its designed to influence don’t notice any difference?

--oo00oo--

This is Richard Garside's take on things:-

Probation reforms looking dicey

A couple of years ago I argued that the privatisation of the probation service – the so-called 'Transforming Rehabilitation' programme – would be something of a slow motion disaster. Ministers might push through their ill-thought-out plans, I wrote. The problems would come in the implementation.

A report out this week from the National Audit Office (NAO) notes that the Ministry of Justice 'successfully restructured the probation landscape and avoided major disruptions in service'. But it goes on to add that 'this is only the beginning' and stresses that the the Ministry of Justice needs to 'stabilise and improve' how the new system is operating.

The most striking finding in the report is the yawning gap between the estimated caseload volumes the new private 'Community Rehabilitation Companies' (CRC) used to cost up their bids, and the actual caseload volumes they are currently working with.

Among the 21 CRCs, four have caseloads one tenth lower than their estimates; eight have caseloads a fifth lower. A further three are falling short by a quarter and five have a shortful of a third.

The CRCs are paid according to the number of cases they manage. Fewer cases therefore means less money.

This may be something the CRCs can manage in the short-term. Over the lifetime of their contracts these shortfalls could place them under significant financial pressure.

As the NAO report points out: 'CRCs had proposed to raise significant levels of external debt to fund transformation activity and bridge their financial position during the first two years of their contracts. Lower than expected revenues increase the risk that CRCs may breach the terms of their debt facilities'.

This is polite auditor speak for 'looks a bit dicey to us'.

There is little glory in claiming success over the implementation of a badly thought-through set of reforms, and the Transforming Rehabilitation programme was particularly badly thought-through.

Ministers and civil servants would do well to place a premium on stabilising the current system in the short-term. It is also to be hoped that the NAO report will act as a spur for a longer-term rethink.

--oo00oo--

Sadly my car giving out on the Motorway prevented me getting to Paul Senior's valedictory lecture yesterday. Would anyone who attended be kind enough to consider writing a guest blog piece? Alternatively, leave some thoughts/reflections here? Thanks. 

Latest From Napo 103

No doubt as a result of numerous things going on, the Napo General Secretary's blog was published a day early this week and contains some important information:-

NAO report reflects reality

Today’s publication of the National Audit Office Report into Transforming Rehabilitation https://www.nao.org.uk/report/transforming-rehabilitation/ has mirrored everything that our members have been saying about life post-TR.

We will be studying this carefully in terms of how we engage with Michael Gove on a range of issues and we have already served notice that we would welcome an invitation to appear before the Public Accounts Committee scheduled for July.

The essence of the report is that there are now a number of clearly identifiable areas, where the NAO agree with Napo’s analysis, that need serious attention from Ministers and NOMS. These include: service delivery and performance data, staff well-being, ICT and workloads.

It was also interesting to note that two CRC providers have been pulled up by the MOJ contact compliance team and been handed down some £78k in fines (service credits). Somehow I don’t think they will be the last.

We will issue more news once we have had a good look at what the NAO have said, but meanwhile I would welcome any observations that you may have about their findings especially in advance of our meeting with the Secretary of State later next month.

VLO and AP Job Evaluation – Important clarification

I have issued the following self-explanatory Branch Briefing today.

It has come to Napo’s attention today that many members are expressing confusion about the appeals process due to some erroneous communications that are circulating (these were not seen or issued by Napo). In light of this we feel that we need to clarify exactly what is happening and where we are in this process.

At the moment the NOMS unions are involved in a brief and specific consultation with the employers about the process we should use to help individuals move forward with appeals following the above Job Evaluations. This consultation is NOT the appeal process itself, but a discussion as part of the wider E3 negotiations, about how to moderate the system following Napo and the probation unions having secured a halt to the appeals system after the unsatisfactory outcomes from these and other Job Evaluations.

Do not submit an Appeal!

The deadline of the 10th May which appears in these communications is the date by which the Unions have been asked to respond collectively to the employers about this consultation. No individual appeal process has started, and Napo members are not required to lodge individual appeals.

Napo are working to ensure that the views of our VLO and AP members are incorporated into the response, and we are currently seeking 3 Napo volunteers from each group to work closely with us to ensure that all of the issues helpfully raised by members are properly covered and incorporated into our response to NOMS.

Please be reassured that you do not need to take any action at this point unless you have been specifically approached by Ian Lawrence or Katie Lomas.

This situation is not of Napo’s making but we felt it important to issue this clarification.

Napo tells the TUC - this ‘deal’ is just unacceptable!

The heat has been turned up a few degrees in the ‘in or out’ Euro referendum debate following the joint article by former TUC Chief Brendan Barber and David Cameron in yesterday’s Guardian. This promoted the cause of the ‘remain’ camp and among other things proffered a view on how the rights of working people would be better served by staying in the EU.

Napo has adopted a neutral position on Europe absent any debate by our members - although staying in is actually TUC policy. Nevertheless, an alliance of this nature was always going to create controversy and the situation has become more complicated following extremely well informed speculation that it was part of a ‘Faustian’ like deal which has led to some late concessions on the wretched Trade Union Bill, this now being the subject of ‘ping pong’ between the Lords and Commons.

Two issues here for me. One being the legitimacy of engaging with the leader of a government whose policies have created such societal division and even if that could be at all justified as the basis for concessions on the TU bill, it hardly presents as the greatest bit of backroom negotiation since what is supposedly on offer in return for the obvious leg up for ‘remain’ falls woefully short of being anywhere near acceptable.

Here’s what we have said to Frances O’Grady following views expressed by the FBU

Frances O’Grady, 

General Secretary TUC
Congress House
Great Russell Street
London WC1B 3LS

28 April 2016

Dear Frances,

Guardian Article and the EU debate

I am writing to you with regards to the letter that Matt Wrack sent to you yesterday. Napo would like to join the FBU in expressing our concerns about the Guardian article and to have those concerns formally placed on record. Napo is not mandated either way in the EU referendum but we feel it is deeply inappropriate for Brendan Barber to use his previous position as TUC General Secretary to promote an alliance with David Cameron's 'Remain' campaign.

At a time when the media are already speculating that a "deal" has been done with the Trade Unions in order to secure so called concessions to the Trade Union Bill, this publicity, in our view, damages our campaign. No real concessions have been made to the Bill which is still currently being debated, and those which have been signalled as possibilities, are of little help to Napo who have incurred substantial expenditure to prepare for our current Direct Debit switch campaign as a result of the cessation of 'checkoff'. Aligning ourselves with a Conservative driven 'Remain' campaign undermines further the work that affiliates are doing to stop the Bill and to the wider fight to protect the rights of working people.

The implication in the Guardian article to the effect that the TUC supports Cameron's EU campaign as a 'quid pro quo' for some minor concessions, implies that the movement supports their continuing systemic assault on workers and trade union rights. Napo urges the TUC to publically distance itself from this article and the views expressed by Brendan as a matter of urgency and to reinforce the view that trade unions have not "done a deal" nor will we with this Conservative government.

As always I am happy to discuss the situation at your convenience
Yours sincerely,

IAN LAWRENCE
General Secretary

Thursday 28 April 2016

NAO : Problems with TR

Every now and then regular readers are irritated by bald statements on this blog saying things to the effect 'TR is a success' . I normally delete them. Well, here we have the key findings of today's National Audit Office report and despite some brave attempts at positive spin, I think it's pretty clear as to how TR is doing:-

Key findings 

The performance of the reformed system 

6 Services have been sustained throughout a period of major change, with users reporting that services had stayed the same or improved since the reforms. Based on survey data from service users across four CRCs, overall 77% of service users considered they had not noticed any change in the overall service they personally received. However, users also provided views on specific services they received. User dissatisfaction was highest in obtaining help with housing; having to repeat information to different people; the level of support that supervisors provided to offenders; and help with finding employment. Such aspects are in part influenced by wider factors outside the control of probation bodies (paragraphs 3.14 to 3.18). 

7 The performance of CRCs and the NPS remains unclear given limitations around data quality and availability. Until data on reoffending are compiled in late 2017, data on performance are limited to information on service levels for the completion of probation activities. The Ministry allowed eight months until September 2015 before performance of CRCs would be open to contractual penalties.
  • As at December 2015, NOMS has no data for three of 24 CRC service levels and assurance metrics, and insufficiently robust data in another two. Nationally, CRC performance is at or above target levels in seven of the remaining 19 measures, including positive completion of court orders, seen by the Ministry as a leading indicator for future reoffending. However, performance varies significantly across CRCs and the contracts require that CRCs achieve all targets by February 2017. NOMS is currently only applying service credits for poor performance against one level, due to data availability and quality for others. To date some £78,000 in service credits have been applied, at two CRCs. 
  • The NPS has similar issues including currently no data for five of 25 NPS service levels and insufficiently robust data in another two. Performance is at or above targets in seven of the remaining 18 measures. However service level agreements require that NPS achieves all targets by April 2017. In the important measure of positive completion of court orders, NPS performance is lower than the equivalent performance by CRCs (70% versus 80% in December 2015) (paragraphs 2.2 to 2.8). 
8 NOMS has established robust and thorough contract management and assurance arrangements but has no plan for moving to a more risk-based approach as delivery under the contracts matures. NOMS has applied lessons from previous failures and has invested heavily in robust CRC contract management, which accounts for 2.1% of contract spend. However, many staff in CRCs were concerned about the extent and trajectory of contract management and operational assurance activity. NPS has much more limited contract management capability, albeit for much lower-value contracts. It is currently trying to identify all the contracts it holds, establish precisely what goods and services it is paying for and revise its approach to commercial activity (paragraphs 2.9 to 2.19). 

Meeting current operational challenges 

9 The reforms have established new organisations with different incentives, creating unsurprising frictions between CRC and NPS staff at working level, which will take time to work through. Close cooperation is essential to handle the transfer of offenders between CRCs and the NPS when their risks change or when they breach the terms of their probation. Many junior staff we spoke to in CRCs considered their NPS contacts were often unduly critical and dismissive, while many junior staff in the NPS thought that their CRC contacts were often not providing them with necessary information and had become too focused on their commercial interests as opposed to the best interests of offenders. We saw efforts by local CRC and NPS managers to address such differences and build trust, but at this early stage the organisations have more to do to ensure that they work together more effectively to improve case management (paragraphs 3.1 to 3.4).

10 Concerns over probation workloads are not new, although staff in both the CRCs and the NPS considered that high workloads have reduced the supervision and training that they receive and the service they provide. CRCs are reducing their workforce in advance of transformation while the NPS is increasing staff. There is no single ‘right’ number for workload, which depends on case risk and complexity. In the four CRCs we visited, only three provided individual caseload data and these were presented as an average, which masks any variation within and across CRCs. While the average caseload was between 34 and 42 cases, we met staff handling significantly higher caseloads, which they considered prevented them providing an adequate service. The NPS has been operating above recommended capacity in two of its seven regions, although ongoing recruitment of some 650 trainee probation officers should help address shortfalls in the medium term (paragraphs 3.8 and 3.9). 

11 The various ICT systems used in probation casework create severe inefficiencies. New tools used by the NPS for assessing and allocating offenders are cumbersome and require repeated data re-entry. Staff also attributed several hours per person per week of lost working time to nDelius, the main probation case management system adopted before the Transforming Rehabilitation reforms. The NPS expects to continue using these systems for the foreseeable future. All CRCs planned to replace existing ICT systems once they could develop new case management and assessment systems, but NOMS was delayed in developing and implementing the interface (the Gateway) required for CRCs to share data on offenders. The interface was originally planned for delivery in June 2015, but was delayed due to other priorities and increased scope. At the time of finalising this report the Ministry advised us that the Gateway had been developed and was awaiting joint testing with CRCs’ systems. As CRCs consider such links as essential to their transformation plans they have estimated consequent costs, which are subject to ongoing negotiations (paragraphs 3.10 to 3.13). 

Ensuring that transformation is achieved 

12 The Ministry did well to sustain competition and conclude deals for all 21 CRCs within the cost limits and timescales set by ministers, but the procurement has left some difficult issues to manage. The Ministry attracted interest from many providers new to probation and as a result secured affordable bids for an expanded range of services at all 21 CRCs by February 2015. Selected bidders offered cost savings sufficient to fund the expansion of supervision to short sentence offenders, and to fund an estimated £259 million of success payments over ten years for reducing offending. Offers were received from a total of 19 bidders, down from 30 originally invited to negotiate, as the Ministry maintained its position on key contract terms. This reduction in bidders resulted in only one compliant bid for five of the 21 CRCs, although these all met the qualitative and financial thresholds required by the department. Completing the procurement in a challenging timetable, combined with uncertainties arising from the concurrent changes in the probation system, limited bidders’ understanding of their exposure to business risk (paragraphs 1.5 to 1.10).

13 CRC business volumes are much lower than the Ministry modelled during the procurement, which, if translated into reduced income, would affect the ability of CRCs to transform their businesses. The volume reductions vary greatly, from 6% to 36%. The Ministry attributes the volume reductions to fewer cases going through the justice system, including fewer than expected low- and medium-risk cases for CRCs, and the declining use of certain sentences, which was accentuated by new deadlines for allocating cases. Income shortfalls, which are under commercial negotiation, would affect CRCs’ capacity to bring in new ways of rehabilitating offenders, introduce new ICT systems, implement estates strategies and reform corporate support services. They also increase the risk of underperformance or default. The Ministry has contractual powers to help it mitigate some of these risks, although having to replace a failing provider would be challenging and disruptive. Its insights into CRC finances and funding challenges are still developing (paragraphs 4.1 to 4.10). 

14 CRCs are paid primarily for completing specified activities with offenders rather than for reducing reoffending, which also risks hindering innovative practice. This was a realistic choice, reflecting the limited appetite of providers to accept a higher element of payment by results. But given the limited weight of payment by results, it is critical that these fees for activities (‘fees for service’) better incentivise CRCs to adopt innovative approaches to reduce reoffending, and not just established practice (paragraphs 1.14 to 1.19). 

15 The NPS has higher than predicted caseloads and faces a difficult further period of change if it is to play a fully effective role in the transformed and national probation service. Its front-line managers face increasing pressure, including dealing with higher than expected workloads, now of high-risk offenders, while assimilating a heavy influx of trainees, who will take time to become fully effective professionals. At the same time, probation managers are acquiring new responsibilities for managing support services, such as human resources and office management; a key source of dissatisfaction among staff we interviewed. The NPS’s new change programme, announced in November 2015, is attempting to tackle regional variations in probation practices but has not focused specifically on support services (paragraphs 3.6 and 3.7). 

16 Arrangements to resettle offenders ‘Through the Gate’ are still in their early stages. CRCs delivering resettlement services in prisons have been focused on commencing services and meeting contractual measures based on completing processes, rather than on service quality, which we understand varies significantly across prisons. To date, it is unclear what new processes CRCs will introduce into resettlement services and the impact these will have on providers’ overall payment by results (paragraphs 4.15 and 4.16).

17 The Ministry has more work to do to sustain the supply chain of mainly voluntary sector bodies now working to CRCs and the NPS. Although the Ministry put extensive effort into attracting voluntary sector bidders, these largely lost out to private sector contractors when bidding to lead CRCs, due to their more limited resources and appetite for risk. The voluntary bodies still have a major role as suppliers to CRCs, although recent surveys of the sector indicate increased uncertainty and instability in funding of their work with offenders. Similarly, the Ministry has identified gaps in provision, which it and CRCs will need to address (paragraph 4.11). 

Conclusion on value for money 

18 The Ministry has successfully restructured the probation landscape, avoiding major disruptions in service during a difficult transition period. But this is only the beginning. If the Ministry is to stabilise, and improve, the performance of CRCs and the NPS it needs to continue to address operational problems, such as underlying capacity issues, weaknesses in ICT systems and performance data, and improve working relationships between NPS and CRC staff – some of which are unsurprising given the scale of reforms. 

19 Ultimately, the success of the Transforming Rehabilitation reforms will depend on the extent to which they create the conditions and incentives to reduce reoffending. While NOMS’ oversight of CRCs is robust, significantly lower levels of business than the Ministry projected will affect some CRCs’ ability to deliver the level of innovation they proposed in their bids. Furthermore, the NPS is not yet operating as a truly national, sustainable service. Achieving value for money from the new probation system will require resolving these fundamental issues, and ensuring the right incentives for all participants in the system. 

Recommendation to the Infrastructure and Projects Authority 

a The Authority should ensure that its guidance to departments outsourcing complex transformed services considers how to mitigate or reduce risk and uncertainty from concurrent changes, including through different phasing. High uncertainty over future business can reduce competition during procurement and cause later problems. Key issues affecting Transforming Rehabilitation during and since procurement are due to outsourcing immature CRC businesses within a changing new probation system.

Recommendations to the Ministry of Justice 

Sustaining the new market 

b NOMS should combine its ongoing analysis of the CRC supply chain with feedback from voluntary organisations to identify and address gaps in provision in consultation with CRCs. 

Achieving business transformation 

c NOMS needs deeper understanding of the financial and service viability of CRCs. It should focus its analysis on CRCs’ financial capacity to sustain their full transformation and service delivery plans. 

d The NPS should expand its change programme. The programme should be expanded to include corporate support services and establish an operational assurance function to assess the quality of work and regional compliance with the new ways of working. 
  • NPS risks being left behind by CRCs’ investment in new offender management systems; it needs to replace its own unfit and inefficient systems, learning from CRCs’ progress in making replacements. 
Contract management 

e NOMS should map out the trajectory of its investment in contract management and how that will impact its CRC contract assurance functions. NOMS should also give CRCs a stronger incentive to improve the rigour of their own performance and reporting systems by offering reduced contract management oversight to proven robust systems. 
  • The management of NPS’s CRC contracts should be delivered by the existing teams in NOMS who already manage CRCs. 
Managing and incentivising performance 

f The Ministry should, as a matter of urgency, ensure data are available to support the contract and performance management of CRCs and the NPS. Performance against all service levels should be based on at least monthly data. 

g The Ministry should regularly review the composition of the fee for services to ensure that it incorporates and incentivises innovative approaches to reducing reoffending.

Time to Reflect

On the day that probation stalwart Professor Paul Senior gives his *valedictory lecture before retirement, it seems appropriate to highlight the following blog post published recently on the Probation Institute website, together with just two contributions from yesterday's debate that particularly struck me:-  

Reluctantly retired member speaks out against the new world of the CRC

Handing my resignation letter to the CEO was a strange experience: a mixture of heartfelt regret with an eagerness to simply get out from my CRC. In the weeks leading up to this, a couple of my friends were worried I’d made a big mistake and were asking questions….

“Why would you do such a thing? You haven’t been made redundant, you haven’t taken a payoff and you even made it through the restructure – so why would you resign?”.
“You mean you’ve quit your job and you’ve taken a lower paid job somewhere else…. are you mad?”
These were all good questions to ask and, to be honest, they were the kind of difficult questions only a true friend would have the courage to ask. So here’s a few thoughts on why I threw in my probation career.

What works
Perhaps like many other colleagues in the Criminal Justice System, I remember my early years in Probation during the 1990s; I grew and matured on the What Works philosophy. This really made an indelible impression on me and it made so much sense i.e. you do what is proven to work and in the right way. Nowadays that all seems to be forgotten, evidence-based practice seems less important and the spectre of privatisation has wrecked the Probation Service. Despite this, you may wonder why I would leave. After all, with over twenty years service paying into the LGPS and of early retirement age, you’d think I ought to stay a while longer….

Let’s go back in time, to those 1990s and What Works. Comparisons were made with the medical profession in providing treatments and medications in the right dose, according to what is needed to treat a person’s condition. During those years staff room conversations were all about evidence based practice, programme integrity, change control and the like. Home grown group work programmes were replaced by Accredited programmes, underpinned by research to prove their effectiveness. Considerable skills were demanded in making sure the right people attended the right programmes and this was informed and supported by the right OGRS scores. Hazel Kemshall’s diagrams were on notice boards, loads of colleagues enthusiastically attended Maguire & Priestly based training and this whole movement shaped Probation practice in those days and well into the new century. Sure, it wasn’t perfect but everyone agreed the principle made complete sense.

While the What Works strictness and rigour were occasionally seen as restrictive and ruled out a certain professional judgement, there was a compelling case for the approach. Arguably it was simply a case of using the What Works principles and applying it in a common sense approach, recognising this may need a little time to work through the system and the very individual culture of Probation. What Works went further into other areas of Probation practice and even saw the rise of regional What Works Managers at lofty ACO salary levels. It all seemed to make sense and some great work was done.

Sure, the What Works mindset has evolved; we have a greater emphasis on professional judgement, a less automated sentence plan and a sense of on-going commitment to many of the What Works principles. A classic example could be Integrated Offender Management. While IOM may allow some greater flexibility from case to case, it is supported by the principle of aligning intensive resources with those who commit a disproportionate number of offences and have a higher level of need.

Roll forward to 2016 and we see the new Transforming Rehabilitation agenda bedding in and the true horrors becoming apparent. You wonder if the whole world has gone crazy. The What Works research has largely flown out of the window and replaced by something else. This “something else” is little more than an eloquently worded fag packet design, or possibly of the “back of used envelop” variety. CRCs have been established and sold off to owners who, in my experience, persuaded the Ministry of Justice to let contracts whereby all kinds of unproven work would be carried out right across England and Wales. Naturally it was Chris Grayling, former Justice Secretary who was driving the change and, it seemed, civil servants had been sucked into this new mindset and were tasked with the job of rushing the reforms through. I remember seeing how each of the civil servants I knew, one by one, were outwardly brainwashed into obediently doing their own part to see the TR plans take shape. 

New owners
I was utterly dismayed at how convincing the new owners thought they were. Frequently the new owners reminded us that many of their high level folk had grown up in Probation and apparently “seen the light”. Did that make it all okay then? Absolutely not.

It was frightening how flimsy plans and ideas were foisted onto my CRC and we were simply told to “get on with it” and implement the new working model. Office moves were planned and filled with delays and snags, IT delays were always predictable and gradually the new owners were changing from their initial introductory words of “light touch management” through to having complete control of the CRC. You might question the point in having a CEO at all. In fact I remember having a good measure of sympathy for the CEO (who was a very decent colleague) and yet gradually having any power or authority down graded to the point of becoming a figurehead only.

Change within? Nah….
I remember thinking amidst all the madness, whether I should dig my heels in and become a thorn in the side of the TR changes. My modus operandi was to be a persuader, not a dissident or an outright rebel. I tried to question things, to point the new owners to What Works, the merits of pilots and controlled reform. I even remember when the Right Honourable Kenneth Clarke MP was Justice Secretary and his approach. Clarke knew reforms were necessary and there were few who would disagree. The Clarke approach was to try a few new ideas out i.e. pilot projects. While some aspects of the Payment by Results approach may have been dubious, there was at least an opportunity to start trying a few ideas out. Alas all of that was swept aside as a result of the Ministry of Justice – v – No 10 tensions, where Clarke lost out in a reshuffle and Grayling was shuffled in.

Changing direction did not seem to be much of a goer. Many colleagues escaped through a lucrative EVR settlement and others through subsequent redundancies and resignations. The new owners had a firm grip of my CRC and the initial “light touch” was replaced by a wholesale reorganisation which, in my view, could only result in disaster. Even the Ministry of Justice’s contract management staff could see the results of the changes going badly wrong and one can only hope they have the balls to recommend the contract is revoked and the CRC brought back into public hands for some rehabilitation.

And so that’s why I left. Nowadays I question whether I have been unfaithful to those years in Probation which started as a calling, a vocation. I question whether it was right to abandon many colleagues who remain and who are dismayed at the effect of TR. Yet, I know I must move on, albeit with a heavy heart and no pay-off.


--oo00oo--

....but you have missed the 'old days' when we did have fun, and laughed with each other at work and had frequent team nights out, knocking back the beer, the odd vintage wine and even pina coladas.... Now the ramshackle workplaces are so soulless, with people desperately trying to keep up the workload of so many other staff who have left, (in the mad world of deafening office noise, or no office at all). They have no time or energy to have decent pressie collections, and great leaving do's, as every time someone leaves, that's someone else's case load rising.

*******
We all need to conserve as much energy as possible to survive the tremendous changes happening in the Probation world. I work for a CRC and feel as if the whole organisation is perched on the edge of a cliff - the operating model is due to be published and the tension is palpable. Having worked through so many changes in 20 years in Probation, this is definitely going to be the most far-reaching in terms of changes in organisational culture and identity. Staff are worried, nervous, anxious, angry, complacent and in denial. Turning up for work on a Monday morning and surviving the working week from one weekend to the next is an important goal for survival. Maybe things will turn out better than anticipated. Who knows? At least we have a job which pays the mortgage and feeds our children.


--oo00oo--

*This valedictory lecture will explore the future(s) of probation seeking to adjust to the new criminal justice landscape of austerity, plurality in delivery and the consequential loss of direction and purpose for many probation practitioners and managers. This will be Professor Senior's last contribution as a member of Sheffield Hallam University as he will retire from the university after 34 years at this lecture. The lecture will launch a special issue of the British Journal of Community Justice, his last as editor, which will include contributions from leading probation thinkers in the field who will reflect on the future for probation. This will be an important volume and will be available and launched at the lecture. Professor Senior has always been a trenchant defender of probation as an institution and continues to argue for the maintenance of probation as a profession. The lecture will challenge our thinking and will be delivered in a characteristic robust and entertaining manner.

Wednesday 27 April 2016

Support For Junior Doctors

I suppose like many of us, I've been mightily impressed with the Junior Doctors campaign and in particular the sheer number of them prepared to be interviewed live on TV and radio. They have more than held their own against some tough questioning and it's understandable to make comparisons between their current battle and our failed one over TR. 

There are some very similar themes, particularly in the government deliberately clouding the issue with the endless repetition of the '7 day NHS' mantra and now trying to say it's all about a pay claim - all aimed at trying to break public sympathy for their cause. I notice a new twist is that the doctors 'are trying to bring down the government' and defy an election pledge for a '7 day NHS'. The latter was in fact just one line in the Tory manifesto, with no explanation.

I heard someone yesterday making the comparison between the junior doctors strike with that of the miners, but the difference 'being we've all met a doctor'. It's a good point and the public are still clearly behind the doctors because, lets be honest, who'd trust a politician in comparison, but just like our problem with the government, I suspect most people don't understand the underlying issues, which suits the government just fine of course. So, with this in mind, I was interested to find the following on Facebook which I feel explains things perfectly. 

--oo00oo--      

I have kept quiet on here until now about the junior doctor's strike but the time has come to stand up and say what needs to be said. Apologies in advance for the long essay, I will try to keep it simple. This is aimed at those of you who are not medical; those who are will know exactly what I am talking about.

If you simply believe what is said in the media, you might think that this is all about Saturday pay or even that junior doctors don't want to work at nights or weekends. It is depressing to overhear people express these views but hardly surprising given the public coverage of the issue.

So what exactly is going on? A junior doctor is any doctor who is not a GP or consultant who is in training to be one of those two. Most doctors spend 8-9 years as a junior but many stay as juniors for longer, especially female doctors who may take time out for families, academics who take time out to do research and doctors in specialities where training in two specialities is needed such as paediatric intensive care. I myself spent 14 years as a junior doctor so was still one aged 37. Junior doctors are the doctors you will see first when you go to A&E or get admitted to a ward and will be responsible for delivering your day to day care when you are in hospital. Junior doctors are covering the hospital 24/7, 365 days a year and always have done. And contrary to what you might believe from the papers, they don't have any choice in the matter, their contracts say they have no choice in working evenings, nights and weekends.

So what is all the fuss about? Well it is about being able to be safe. When I was a JD, I used to work ridiculous hours. In one job in my 1st year, every 3rd weekend I would go to work at 9am on a Saturday and leave at 5pm on a Tuesday. That was 80 hours in a row with sleep grabbed when the chances arose. It was dangerous and dehumanising and the even crazier thing was that I was actually paid at a lower rate for the unsocial hours than basic pay (1/3 of basic in fact).

Fortunately my generation of juniors was amongst the last to have to do that and things slowly changed. Now junior doctors get paid at a higher rate than basic for unsocial hours, that rate determined by the intensity of work in that speciality e.g. emergency room work would be a higher rate than dermatology. Standard hours are defined as 7am-7pm Monday to Friday (which are not exactly standard working hours for most people) and there are rules on the maximum number of hours per week and consecutive hours that can be worked. There are also safeguards in place so that if employers are consistently making juniors work beyond these rules, they can be fined; hence there is a disincentive for employers to overwork junior doctors, therefore they are not tired and dangerous 1990-style.

But work done outside standard hours is NOT overtime. These hours are contracted hours and have to be worked and, quite rightly, are paid at a higher rate than basic pay. In specialities where there is not a lot of emergency work, the majority of work is in routine hours, but areas like A&E, paediatrics, intensive care have a lot of work done in unsocial hours and attract a higher rate of pay for those hours. I stress again that this is not overtime; overtime is work done in addition to contracted hours. All doctors and nurses do overtime - staying late to complete work and ensure patient safety and very rarely if ever does anyone claim for these overtime hours.

But Jeremy Hunt wants to change the contract for junior doctors, his logic being that doing this will help to deliver the “7-day NHS”. Nobody is really sure what exactly this means. It may mean that he wants routine services such as outpatient clinics and planned surgery or scans for non-urgent problems to take place on Saturdays and Sundays, not just Monday to Friday. If this is the case then changing the juniors’ contract is not going to make this happen as without doing the same for (deep breath) consultants, nurses, porters, receptionists, pharmacists, operating department assistants, radiographers, physiotherapists and many other staff these things won’t be able to happen at weekends.

The 7-day NHS may refer to emergency work. If this is the case then it already exists. Junior doctors are already there at night and at weekends. The proposed contract changes are not going to change the numbers who are there as there is no plan to increase the total number of junior doctors. What is proposed is that the definition of normal time changes from 7am-7pm to 7am-10pm Monday to Friday and from 7am to somewhere between 5pm and 10pm on Saturday. This means that employers could make junior doctors work more unsocial hours as they have redefined as standard hours. It is true that the basic rate of pay for standard hours will be increased by 13%, which sounds great doesn’t it? Except that for the emergency specialities as above that routinely have a lot of evening, night and weekend work, what is currently paid at an enhanced rate will be paid at standard rate; even at 13% higher for standard rate, total pay for junior doctors in these specialities will drop considerably, maybe by as much 30% for some. Doesn’t sound so good now really.

And, of course, there will be the same number of doctors but spread over 7 days rather than 5 so there will be weekdays where there will be fewer juniors than there are now. A great analogy I heard was to imagine that you have a 10-inch pizza cut into 5 slices. You decide that 5 slices isn’t going to fill you up so your mum cuts the same pizza into 7 slices and tells you that you’ll be full with that. But she won’t get you a bigger pizza.

So same number of junior doctors spread more thinly is going to reduce cover on weekdays as compared to now. And weekdays are when not only emergency work but also routine planned work that also needs input from junior doctors takes place so this will have a detrimental effect on waiting lists for clinics and operations as well.

Junior doctors with children will be hit particularly hard, especially those who have junior doctors spouses, as more unsocial hours will be worked. Childcare is generally difficult to get hold of outside of 8-5 on weekdays; the department of health have actually said (with no hint of irony) that in this situation, family members who are non-medical and don’t work evenings or weekends should be asked to provide child care to get over this problem! It is very likely that couples could go several days without actually seeing each other or their families if rotas do not coincide.

But what about the increased deaths at weekends we have been hearing about? Actually, the statistics have been completely misrepresented and even the authors of the research paper that gets quoted regularly have pointed this out. The statistic was that if you are admitted to hospital on a weekend, your risk of dying within 30 days of that admission was higher than if admitted midweek. Your risk of dying is very low anyway and that very low risk is marginally higher (but still very low) if admitted on weekends. This is probably because admissions to hospital in the week consist of not only sick people but also well people coming in for routine things, whereas at weekends you would tend to avoid hospital unless you were desperately unwell and most likely would leave things as long as possible and so be sicker when you got there. Interestingly they also showed that if you were already in hospital on a weekend, having been admitted in the week, your risk of death within 30 days was lower than it would have been. Either way, there is no evidence of cause and effect in terms of numbers of junior doctors around at weekends. The so-called weekend effect has also been seen in the USA and Australia too so it isn’t peculiar to state-funded health as opposed to private insurance-based systems.

Interestingly the misrepresentation of this study has led to ill people actually avoiding hospitals on weekends and delaying presenting till Monday with potentially devastating consequences. Have a look online for the ‪#‎hunteffect‬. Scary.

Another worrying thing about the proposed new contract is that it takes away the safeguards against juniors being made to work ridiculously long hours. Whereas currently there is a mechanism that makes it in the interests of an employer to ensure the hours are not exceeded, the new contract removes these safeguards. It does suggest that each hospital trust has a “guardian” to whom junior doctors can flag up concerns about their hours but this “guardian” will also be a senior member of the trust who has no obligation to actually do anything about these concerns. I think back to my days as an exhausted junior doctor and it scares me to think that such unsafe and dangerous hours could make a return.

The pay scales are also changing. There has been automatic pay progression as you gain experience and seniority until now. The new system means that there are fewer points where pay is raised. This is not necessarily a bad thing as it can be argued that you shouldn’t get a pay rise unless you deserve it. But remember that over 10 years can be spent as a junior doctor in which time you are likely to acquire husbands, wives, children and mortgages; many existing junior doctors have made their financial plans for the next few years based on the expectation that there will be pay progression. One part-time junior doctor who has worked with me told me that if the new contract came in she would no longer be able to pay her mortgage and would have to sell her home. 


Bear in mind that these are young people who have spent at least 5 years at university accruing debts from both student loans for living expenses and now also £45000 in tuition fees before even starting work. The new pay scales do not reflect the levels of responsibility taken by junior doctors at different stages of their training at all which makes no sense whatsoever. For female doctors who are likely to take time out to have children and then return to work part-time, the consequences on their income will be huge. The department of health actually acknowledged that women would be hit unfairly but suggested that this had to be accepted as an unfortunate consequence.

The BMA junior doctors committee walked out of talks with the Department of Health because the DH’s definition of negotiation was that they would reserve the right to do what they wanted if they didn’t agree with what the committee was suggesting. In other words, they did not want to negotiate so there was no point in the BMA trying. This is why industrial action was proposed because there was no other way to try to get Jeremy Hunt to talk. Sadly, even when negotiations restarted, he could not see that without a bigger pizza nothing was going to improve patient care and in fact things would be worse and so talks stopped. He has now said he is imposing the contract and that is that, he won’t talk anymore. When a strike ballot (of, let’s face it, intelligent reasonable and educated people) has a 75% turnout and 98% vote in favour, it is clear that there is a serious problem with the DH’s thought processes and they need to listen. It is highly improbable that a small bunch of radical lefties have brainwashed 50000 intelligent doctors who have been trained to analyse information and draw conclusions, much as the press like that idea.

If you have read this far, please take it on board and share with your friends. I’ve tried to keep it simple (even though it may not seem that way!) The public is not getting the full story from the TV and newspapers and if this contract is imposed then we will all be on the receiving end of the consequences eventually.

I’ll stop there for now but will write some more about what will happen on the days of the full strike (April 26th and 27th) and why you should not have to worry about what may happen on those days if you or your family have to come to hospital.


Dr Ravi Jayaram

Tuesday 26 April 2016

Innovation not Soundbites

Just one of the many things that annoyed me about Grayling and his rubbish arguments for introducing TR was the constant reference to how new players to the probation world would bring much-needed 'innovation'. Apart from being the usual political disingenuous crap, it completely ignored the fact that probation has always been one of the most innovative of public services as anyone with time under their belt know full well. 

But the sin is far worse than that because, as the following story from Manchester admirably demonstrates, everywhere innovation is being driven out of a once gold standard service:-  

'It's ripped my heart out': Ex cons' despair as Manchester probation group has Government funding pulled

A group of ex-offenders are fearing for their futures as they stand to lose their beloved Manchester community probation group. The HOPE (Hope Outside Prison Environments) Project, which supports ex-offenders in the community, has been funded by the Government for the past six months, having previously been funded by the NHS. But the decision has now been made to end the project’s financial support, which currently has capacity for 20-30 clients, and it will finish at the end of April. One HOPE client told MM: 

“I feel like my heart’s been ripped out. My life has been turned around by this project. Here you’re being treated like a human being. It has a real impact on your mental health.”
Clients stand to lose a tight-knit support network alongside activities like cooking classes and boxing which provide them with support, builds self-esteem and a routine unlike anything else on offer in Manchester. Another explained he feared his mental health would suffer without HOPE support.

“There’s nothing else like this with good role models and like-minded people,” he said. “The support they give is above and beyond help I’ve ever had before. Without it I would be isolated.”

A weekly reading group currently takes place each Thursday for those who want to give shared reading a try. Due to the cuts, HOPE’s partnership with The Reader, who run the group, will also end this month. Session leader and Reader in Residence for Greater Manchester West NHS, Kate Hughes-Jenkins, told MM: 

“Losing this group is really hard. You get to know them well and develop relationships. It’s frustrating to know there currently isn’t anything we can offer instead.”
The reading group is just one part of HOPE’s holistic approach, which HOPE Project Manager Sue Casey believes is seldom used elsewhere in the probation service. They also welcome back ex-clients who still struggle post-probation. Ms Casey, told MM: 
“The Project gives people hope, belief. I’ve put my heart and soul into this project. Without Hope it’s almost like I have no hope. The project is a life saver. Offending is instant gratification. We provide positive alternatives, like the boxing. With the reading, they hear a voice telling them a story, something many of them never had as children. It’s like putting back that part that is missing. Probation is risk management, and we take risks with people by having them in the community. We see them as a person, rather than a label. But for this government, management seems more important than rehabilitation.”
Ms Casey, who will return to an office role for the Community Rehabilitation Company (CRC) when the project ends, teamed up with one HOPE client to work out the costs involved if he were to ever end up reoffending. It was around £157,000 for one year.

“They aren’t thinking of the long term higher costs,” she said.

Labour politician and life peer Lord Bradley, who has been a champion of the HOPE, attended the reading group’s penultimate session on Thursday to hear concerns to take to the Community Rehabilitation Company (CRC). “Invariably the alternative to this group is back through the system, and then there are the expenses involved in that,” he said.

At this point, the group do not know what, if anything, will be done to keep some activities running when the project finishes.


--oo00oo--

By a strange coincidence, I was recently looking around on the internet for something unconnected to probation and I came across the following obituary in the Guardian. I think it not only rather neatly illustrates our proud history of innovating, but also the nature and calibre of leadership in times past:- 

Michael Varah

Michael Varah, who has died aged 62, was the former chief probation officer of Surrey and a Great Britain international 800 metres record holder. He was the eldest of triplet brothers born to Chad and Susan Varah. His father was rector of St Stephen Walbrook in the City of London, where he started the Samaritans in 1953; his mother, apart from raising five children, was the world president of the Mothers' Union in the 1970s.

By the age of 18, Michael was a national schoolboy 800m champion; he later ran for Great Britain in the World Student Games in Tokyo, and the Commonwealth Games in Jamaica, plus several international meetings. He went on to captain Loughborough College athletics team, and in 1966, at Crystal Palace, broke an unusual world record by 2.4 seconds in the 4 x 800m relay.

After graduation, he joined Rugby school as the director of physical education. In his own time, he began to work as a volunteer education tutor at Onley Borstal, then decided to train as a probation officer and joined the Warwickshire service in 1973.

The qualities that marked him out as an outstanding athlete shone in his probation career: determination, energy, leadership and the courage to break new ground. Early in his career, he created the Rugby Mayday Trust for homeless ex-offenders, which now runs several hundred housing units for the vulnerable homeless.

He extended his repertoire of experience by working as an assistant chief probation officer in inner-city Birmingham in 1985, when the city was scarred by industrial collapse and racial tension. Michael was impressed by the scale of unemployment, particularly among poorly educated offenders.

After he became the chief officer in Surrey in 1988 he devoted much of his time to setting up the Surrey Springboard Trust, providing training, vocational skills and jobs for unemployed offenders. He played a key role in raising over £4m for this.

In an unorthodox move, Michael sent 32 offenders on community service to work for a fortnight in a poorly maintained children's hospital in Romania, doing essential repairs under professional supervision. None reoffended; two years later, nine of them returned to do more electrical and plumbing work under their own steam.

Michael retired in 2004, having raised the reputation of the Surrey service to the highest levels. He was appointed a deputy lieutenant and was to have been the high sheriff of Surrey in 2008-09. He was a national trustee for Victim Support and the Samaritans and a part-time panel member of employment tribunals in Surrey.

Michael had an extraordinary capacity for friendships - people knew they were special in his eyes - and a scurrilous wit that made him the centre of any room that he was in.

He was disappointed by the government's gradual demolition of the probation service. Not long before he died he noted: "It is a pity successive governments cannot get their act together - they all need to be put on probation and find that change takes time."