Most commentators, experts, politicians and public sector workers can see the compelling benefits that would come from public services working better together. These benefits appear plentiful and obvious through the eradication of duplication, sharing of infrastructure, focussing on outcomes for the people they serve and essentially, as a result, saving lots of money.
Indeed our citizens commonly ask the question why Government and its many departments and services cannot operate more like John Lewis or Marks & Spencer with services which are easily accessible, in one place, and delivered from locations where people most need them.
The mission should therefore be quite simple. But it does not appear to be. Has Government been shooting itself in its many feet for far too long with the direction it has attempted to provide?
Let me admit that despite spending the best part of 10 years working to transform public services, leading collaborative change programmes across multi public sector services and regularly being asked to write analysis and commentary pieces on latest thinking I have often been thoroughly confused by this ‘joining up of public services’ thing.
I stopped short there of calling this thing ‘Total Place’. That’s because I detect the ‘thing’ is now being rebranded ‘Whole Place Community Budgets’. I think. I talk to many public sector managers and the mere mention of ‘Total Place’ is met with a rolling of eyes and knowing shakes of the head. But then so was ‘Area Working’ by anybody but the most senior of Director. So maybe it was time to move on and call the ‘thing’ something different.
In an attempt to understand what has happened over the last 10 years, to try and offer some clarity to what this ‘thing’ is all about and offer up some insight on a recommended way forward let’s take a journey back through time to the beginning of the century when public services were a little more flush with funds.
In the early noughties the ‘thing’ appears to have been all about local authorities giving more power and influence to local communities. This culminated towards the end of the decade in the policy Green Paper No 9 ‘Returning Power to Local Communities’ issued by the Conservative party which set out plans to give local people more power over local government and to give ‘local’ people more ability to determine spending priorities by devolving funding to local areas.
Many local authorities had a flirtation throughout this time with what was known as ‘Area Working’. Essentially how could they divvy up some of their services and allocate them to smaller community areas where those communities would then be able to have a bit more say in how they were run and therefore keep citizens happier? Some authorities tried to actually allocate delivery teams to local areas. Others devolved some funding and decision making. In many cases it started and ended with street-scene type services. Some local authorities had a go at forming local neighbourhood boards to make decisions and others kept central control but allowed services to respond to local demand more flexibly. At this point efficiency and saving money didn’t really come into the equation and working with other public services albeit an aspiration remained to all intents and purposes an aspiration.
At the same time, some say working in parallel, some say totally seamless and some say quite separately to Area Working we saw the promotion by Communities and Local Government of the initiative, Total Place. Whilst this initiative was still about allowing greater control by local areas and communities it appeared to add greater emphasis to how services across the public and third sectors could work better together to provide better outcomes for communities and citizens. This certainly sparked some attempts to forge joint working across public services. Local authorities and police forces started to work better together and in some cases, for example in Blackburn with Darwen, even pooled resources and local managers. To a lesser extent this happened with the NHS.
Efforts were also made to reinforce relationships and plans with the third sector. The thrust, for a time, seemed to be for services to integrate and operate from the same shared locations and where possible with joined up leadership in the hope that this would drive service provision to be naturally better aligned and integrated as a result.
Today the emphasis appears to be firmly back onto giving local communities more say. Local Government and Communities have recently closed their Total Place webpage and redirect you to ‘Whole place community budgets’. Rather than the focus being on locating services together or managerially reorganising services to try and trigger joint working the focus has flipped and is very much on identifying specific outcomes for people and re-engineering processes involving multi-service providers to provide these better outcomes more effectively. The message is clearly to identify processes and services that can be held up as ‘wins’ and use these as a catalyst for further change with wider integration a product of this further down the line. There have been some very successful pilot schemes delivering improved services in Manchester, Essex, London and West Cheshire.
So has it been a confusing decade? Government says that the ‘thing’ is a phased and evolving strategy and each of the above focuses has its place in the journey.
However on reading my own last few paragraphs summarising the last 13 years I cannot help immediately thinking that something doesn’t quite make sense. I have tried to work out whether it is my own muddled thinking and interpretation of events or the muddled policies of Government over this period which is creating confusion.
Well given that I am not the only one….let me take the brave step and blame Government policy or at least the communication of it.
The way I see it the policies, thrust, advice and focus have been trying to achieve the same critical results over the years;
BUT I would argue that because these have been so hard to deliver there have been subtle changes to the way that is thought the best way to achieve them;
In the beginning it was about organising delivery to the most local levels so that this might force better integration and working with other local services and give people more say.
Then there was a move to locate services together and integrate management teams in the hope that this might speed up and force services to come up with joined up solutions
Now we have a more subtle approach of giving local communities budgets in the hope that they will use funding in the most effective way and drive changes in the way services are delivered. Alongside this joint working teams (pilots) have been set up to look at improving specific outcomes and developing new processes to make it happen.
Throughout each of these approaches some local authorities who have naturally taken a lead role in areas have taken the decision to ‘stick’ to just developing joined up access arrangements in central locations across multi-services (joined up front line customer operations) and to put the actual delivery of these services in a more integrated manner on the back burner, perhaps because it is all too difficult. Arguably these local authorities have been the most successful at developing the public perception that public services are working well together.
To be fair there has been a lot of messing about around the edges since 2001. Yes there have been some local successes. Some of the Government funded pilots have developed innovative multi service processes which have improved outcomes. Some local communities have worked to develop their own management teams and have begun to secure funding to deliver services.
But something tells me it’s not happening in a big enough way to make a real multi billion pound difference. Why is this?
Because it is hard stuff.
We still have managers who are protective of their empires and don’t want to give it up, not least because of their own job security.
A necessary ingredient for much of what needs to happen is joined up IT in terms of databases, CRM systems etc. However many organisations invested so much in the noughties on new systems in their own silo’s that it is now just too painful and too expensive to redesign it. Catch 22.
At the end of the day Government is more complex than Marks & Spencers. There are many tiers, agencies, functions which have been operating separatley for years.
Local government, in particular, has a fixation with pilots, working groups and joint committees. Consult, consult, consult. It does not work. There are too many issues with sovereignty across public services and therefore a need for inclusive but independent leadership.
But the main stumbling block at the moment is the need to find the investment and the vision to develop and deliver a meaningful long term plan across multi-services at the same time that public services are under pressure to deliver hard revenue savings, quickly. This means little investment and little leadership capacity available to focus on the big picture.
I firmly believe that to be successful the public sector will have to bite the bullet and follow some robust guidelines to develop a programme which will need funding in the short term. Yes there are clearly examples of success where these guidelines appear not to have been followed but I argue that the successes are small fry compared to what could be achieved. As a starter for ten there must be;
However I fear, ironically, that the current significant funding crisis will prevent this massive opportunity from properly getting off the ground. This leads me to the conclusion that all of this should have been done in the affluent noughties.
Have we now missed the boat? I conclude that indeed the boat has left but it’s still possible to make a leap for it and secure the future but services will need to be bold and jump quickly together.