There are two stories today which suggest that public services are struggling to cope with demand.
The first refers to the “sheer volume” of cases being referred to MARAC meetings. (Multi Agency Risk Assessment Conference – these try and get as many organisations together as possible so there is a co-ordinated response to high risk domestic violence cases.)
The second follows the release of a report from the Royal College of Psychiatrists and states that there are systemic shortages of beds within mental health services across the country.
But a few days ago, Sir Tom Winsor (Her Majesty’s Chief Inspector of Constabulary) was sat before the Home Affairs Select a Committee saying that most police forces do not understand their demand.
No-one could have escaped the news over the last few months about how the NHS and particularly A&E and ambulance service almost melted down due to the level of demand being placed on them.
I had a conversation the other day with a friend who told me that his small team is currently trying to manage 30 CSE cases with more coming in all the time.
Meanwhile, in Kent, the Chief Constable has recently said that his force is practically overwhelmed by the immigration situation following events in Calais.
Speak to any front line police officer and they will tell you they do not stop going from job to job every shift. Speak to any control room dispatcher and they will tell you about the backlog of calls waiting to be attended. Only last week I spoke on Twitter about how three of my colleagues answered over 700 calls in 8 hours.
Whether you are trying to get an ambulance, seen in A&E, police attendance, your call answered, bed space in a mental health ward, cell space in Kent – the sheer volume of people wanting and needing the same thing is huge.
It is huge and increasing at the same time as budgets for all of these services are smaller and shrinking.
I don’t have the figures or analytical skills to claim that there is correlation let alone proof of causation but from where I am sat – everywhere seems to have got a whole lot busier over the last few years.
The sheer volume of matters for discussion at MARAC meetings appears (according to the article anyway) to suggest that solutions then become tick box and, by the sixteenth case or so, things might be missed. The same could be said of the volume around the reports of missing people which have become enormous.
There are two facts here – demand is rising (across all public sector agencies) and resources are contracting. Not only is demand rising but the expectation on how well this demand is dealt with is increasing. The CSE cases and the MARAC referrals all need to be properly investigated or managed so that we don’t let an individual victim or victims down.
We are all being told to do more with less but it seems to be becoming plainly obvious that demand is beginning to outstrip supply.
Are any of these case loads manageable? Is service provision for this amount of calls (to all services) sustainable? Just because a case is 22 in a list of 23 doesn’t mean it is less high risk – otherwise it wouldn’t be at MARAC in the first place.
How long will it be before a service simply isn’t where it is needed to be due to levels of competing demand?
This increase in demand shows no sign of slowing down. For the police you can add historic demand now being added to the mix as sexual offences from decades ago are being reported in the light of recent media.
This isn’t a bad thing – but someone has to deal with it and it means that there are less people to deal with the here and now.
With more budgets cuts on the way it is going to mean some very radical thinking on how this demand is managed and who manages it. Further radical thinking will be required to determine who responds to it and how it is responded to.
Where is the tipping point?
At what point does demand on public services reach a critical mass where they simply cannot cope with any more?