How is Northern Ireland performing? (part one)

Today’s public sector in Northern Ireland is about results.

Outcomes-based accountability focuses on what has been achieved (or not) rather than long lists of tasks and actions and processes that may or may not work as intended.

The last draft Programme for Government (PfG) was put out for consultation in 2016 and, despite the collapse of Stormont soon after, it continues to form the basis for directing public services today.

The draft PfG listed 14 high-level strategic outcomes that, taken together, provide the aspirational targets for improving our society.

Each outcome has an attached list of relevant indicators allowing regular quantitative measurement of progress towards the outcome itself – the accountability part of this process (note that several of these indicators are used to measure more than one outcome, where appropriate).

Last month, the Executive Office published its Outcomes Delivery Plan End-Year Report for 2018/19: Improving wellbeing for all -by tackling disadvantage and driving economic growth.

Only 12 of the 14 outcomes are being tracked by these reports, due to limitations caused by the absence of a government.

Per the report: “Whilst  there  are  examples  of  success  under  each  of  the  outcomes,  it  is  evident that much more could be achieved with ministers and a functioning Executive in place to shape policy in response to changing need, determine public  expenditure  priorities  and  take  decisions  on  major  programmes  and  schemes.”

The end-year report is a very large piece of work. Scope is here to provide a highlights reel and, in order to adequately cover each of the 12 outcomes, this will take place over three articles – one published in each of the next three weeks, so please check back later.

This week covers the first four outcomes. Take a look – and decide for yourself if we are doing well or not.

Outcome 1 - We prosper through a strong, competitive, regionally balanced economy

The aim is to transform the economy, across the private, public and third sectors, to provide growth for the benefit of everyone.

Indicators include the NI Composite Economic Index (the official quarterly measure of our local economy’s performance, an approximate parallel of GDP), external sales (i.e. exports), the percentage of businesses engaged in innovation, and employment rates – both overall and comparisons between council areas.

The results are not great. Per the report: “Notwithstanding a small positive change in our private sector NICEI, progress against this Outcome has generally been slower than we would like.

“In fact, we are seeing negative movements in several indicators. Our employment rate (70.0%) remains well below the rate of the UK average (76.1%), and considerable regional imbalances endure, with 13.5 percentage points separating the highest and lowest rates at a Local Government  District level.

“After an all-time peak in our external sales in 2016 at £23.8bn, we have seen a reduction to £21.4bn in 2017, driven by a substantial decline in the Food, Beverages and Tobacco sub sector.

“Our rate of innovation activity, already the lowest in the UK, has also declined to 39% in the 2014-16 period, a fall from 45% in the baseline period and significantly below the UK as a whole (49%).”

Outcome 2 - We live and work sustainably – protecting the environment

This outcome again speaks about economic growth but, at the same time, protecting and sustaining our wider environment.

The Executive Office report notes fears, both local and global, about climate change and notes that DAERA is developing an Environmental Strategy, while the six indicators used to measure outcomes are:

• Percentage of all journeys made by walking/cycling/public transport;
• Greenhouse gas emissions;
• Percentage of household waste that is reused, recycled or composted;
• Annual mean nitrogen dioxide concentration at monitored urban roadside locations;
• Levels of soluble reactive phosphorus in our rivers and levels of Dissolved Inorganic Nitrogen in our marine waters; and
• Biodiversity (percentage of protected areas under favourable management).

The results have been OK. As yet, there is insufficient data to measure our biodiversity compared with the baseline year (in this case, 2015-16). Of the five other indicators, three have been evaluated as having no significant change, while there have been meaningful improvements in nitrogen dioxide measurements at roadsides, and the percentage of household waste that is used purposefully.

Improvements in the recycling rate are set to tail off, with the paper stating that low-hanging fruit in terms of food waste has now been picked while some other initiatives have been delayed due to an absence of ministers.

 While a consultation for an NI Clean Air Strategy could be released before the end of this year.

Other interesting details include a continuing firm stance on increasing use of public transport: “Progress has been slower on the proportion of all journeys made by walking, cycling or public transport (26% in 2017). However, we are committed to increasing the use of public transport and  encouraging people to consider active travel options.

“This requires the right infrastructure and facilities, as well as an emphasis on behavioural change.  In particular, the Belfast Rapid Transit Glider service has exceeded expectations with over 45,000 additional passenger journeys on the routes each week, representing a 30% increase. The Glider vehicles also demonstrate a 90% reduction in Nitrogen oxides and particulate matter emissions, compared with the existing fleet.”

Outcome 3 - We have a more equal society

This outcome looks at efforts to reduce the effects that someone’s background, identity or ability has on playing a “full and constructive role in society”. The indicative measures are:

• Gap between highest and lowest deprivation quintile in healthy life expectancy at birth;
• Gap between the percentage of non-FSME school leavers and percentage of FSME school leavers achieving at Level 2 or above including English & Maths;
• Percentage of the population living in absolute and relative poverty;
• Employment rate of 16-64 year olds by deprivation quintile;
• Economic inactivity rate excluding students
• Employment rate by council area

The report says: “Progress towards the outcome of achieving a more equal society has been mixed. The gap in educational achievement between those entitled to free school meals and those who are  not entitled is closing.

“The percentage of people living in absolute poverty (before housing costs) has reduced from 20% in 2014/15 to 14% in 2017/18, and the percentage of people living in relative poverty (before housing costs) has also reduced from 22% in 2014/15 to 16% in 2017/18. The latest data in relation to  regional imbalance in employment rates suggest no improvement.”

The paper asserts that more is being done, including through encouraging uptake of benefits entitlements, and that it is “accepted that work is one of the best routes out of poverty.”

It says further that the full roll out of Universal Credit to NI – which completed in December 2018 – is “making work pay and encouraging more people to move into work”. This statement might raise a few eyebrows in the third sector, where Welfare Reform is seen as a real threat to the most vulnerable people in society and, thus, a potential cause of greater inequality.

There has been “no statistically significant change” to the life expectancy gap between people living in areas with the highest and lowest deprivation quintiles. Scope wrote previously about how large these differences are.

Per the outcomes paper: “Changes to healthy  life  expectancy  are  complex,  with  influences  and  causal  factors  beginning  before conception  and  running  through  to  the  latest  stages  of  life.  It  will  therefore  require  a  long-term,  systematic  focus  on  multiple  health  determinants  to  have  a  sustained  impact  on  this  indicator.”

Outcome 4 – We enjoy long, healthy, active lives

Improving people’s ability to improve and maintain their own health is a key part of ongoing health reform.

This is not meant to take the place of quality health and social care but to work in parallel with good services to maximise people’s wellbeing throughout their lives.

The six indicators used to measure performance against this outcome are:

• Healthy life expectancy at birth;
• Preventable mortality;
• Percentage of the population with GHQ12 scores ≥4 (signifying possible mental health problem);
• Satisfaction with health and social care;
• Gap between highest and lowest deprivation quintile in healthy life expectancy at birth;
• Confidence  of  the  population  aged  60  years  or  older  (as  measured  by  self-efficacy)

Again, performance against the measured has been less than stellar – but this is perhaps understandable because many of these indicators are resistant to quick fixes.

People’s satisfaction with health and social care is impossible to gauge because there is no data beyond the baseline. Of the five other measures, only one is assessed as having significant improvement, with the other four showing no change.

The latest figures show 21.6% of the 60+ population have low self-efficacy, compared with 26.9% at baseline, which is a good shift.

It is worth noting that the measure of healthy-life-expectancy gaps between highest and lowest deprivation quintile at birth has been assessed as having no significant change, despite this gap leaping from 12.2 years to 14.3 years amongst males (there has been a fall from 14.6 to 14.5 years for females).

Per the report: “In common  with  many  of  our  delivery  partners,  the  Department  of  Health  (DoH)  continues  to  manage  a  challenging  financial  position  and  we  work  closely  with  stakeholders to maximise available resources.

“The Health and Social Care Workforce Strategy 2026: Delivering for Our People, addresses the need to tackle serious and ongoing  challenges  with  supply,  recruitment  and  retention  of  staff.  Both  these  elements impact on the delivery of the desired outcomes.

“Progress towards the overall Outcome (We enjoy long, healthy, active lives) continues to reflect the fact that many of the influences on health and wellbeing are both inter-dependent and long-term and require significant focus over an extended period of time to deliver clear, positive and measurable change.

“Changes in Preventative Mortality, Healthy  Life  Expectancy  at  birth  and  reducing  the  Healthy  Life  Expectancy  gap  between  the  most  and  least  deprived  is  a  significant  challenge  which  requires  sustained collaboration both at regional and local levels.”

Part two next week.