People Powered Public Services in practice
In his Hugo Young Memorial lecture, Ed Miliband set out a vision for people powered public services.
He described a world where citizens have control over their data; service users are seen as assets and equal partners in their relationship with professionals, taking decisions together about personal care as well as the overall configuration of services; and peer groups and social networks are actively fostered by public services.
If you know anything about Nesta’s work in this area, you’d expect us to welcome this vision and we do.
Our narrative around public services reform starts with the need to move from a paternalistic model of public services where they are “done to” people, to a more collaborative approach where people are involved in the design and delivery of the services that they rely on.
This isn’t about austerity, although that accelerates the need for change. What it’s really about is a recognition that the public services bequeathed to us by our great grandparents aren’t up to the challenges of the 21st Century.
I’ve argued elsewhere that getting citizens more engaged is the next phase of public service reform and that we need to focus the state on building social connectedness as a route to resilience.
Nesta first coined the phrase people powered public services in 2010 as a way of trying to make sense of the hundreds of (mostly) small scale innovations that were already putting these ideas into practice at the front line of public services and community organisations. Over several years, we’ve done our best to catalogue and learn from those examples and our previous reports are well worth a read for those who are new to the field (see side bar).
There is no shortage of compelling examples of people powered public services.
That’s one of the most striking things about this movement (if I can call it that): it wasn’t started by policy-makers or speech writers. It started at the front line and was led by practitioners who were frustrated by the model of public services they inherited and wanted to create something different and better.
Our contribution at Nesta has been trying to figure out how we move from a series of compelling, but isolated examples of people powered public services to making these ideas central to our model of public services and a normal part of life.
That was the question we set out to answer through People Powered Health – a programme we launched in 2011 with our partners the Innovation Unit. Over eighteen months we worked with six teams of front line health practitioners from across England to test new people powered models for helping people live better with long term health conditions.
What emerged from were great examples of innovative practice – GPs prescribing exercise alongside pills and clinical tests; partnerships between health practitioners and community organisations to help people be active and be connected to other people; group consultations and peer support groups that changed the power dynamic and helped patients take control.
While it’s great that Ed Miliband has committed to making these kinds of interventions a matter of national policy (and I hope that we’ll hear similar commitments from other party leaders soon), the question remains: how does that translate into practice?
Through People Powered Health we developed a plan for how the health system would need to change, from restructuring financial incentives to new approaches to workforce development. What we learnt was that having well tested and evidenced interventions was a critical first step, but integrating those into the routines of healthcare involves a wider change in culture, systems and processes.
We’re now part of an emerging coalition – including NHS England – that is working together to put that plan into action. In Scotland they have launched a People Powered Health and Well-being alliance and the Wales Government has put coproduction at the heart of its plans for public services reform.
Through the Centre for Social Action (a collaboration with the Cabinet Office) we’re now working with dozens of public services, non-profits and social enterprises who are already running people powered public services from healthcare, to schools and even prisons.
Our mission there is to help them reach and benefit many more people and get better evidence of the impact they are having on people’s lives.
One of the challenges we’re taking head on (and this will definitely be the subject of future blogs) is the different models of scale and which ones work best in what circumstances.
When you find a model of peer to peer support for people with Diabetes that actually works and is low cost, how do you get that spread across the country – with fidelity – as quickly as possible?
Grow a social business one customer at a time? Get an organisation with national scale to adopt it and integrate it into what they do? Create a playbook and franchise it out across the country? Or just put it online for free and hope people stay true to the bits that work?
All have their challenges, but if we’re going to make the next phase of public services reform a reality – whoever wins the next election – we need to know how to put the policy commitments into practice.
Philip Colligan is Nesta's Deputy Chief Executive and a Government Adviser on Social Innovation
You can find him on twitter @philipcolligan