Public Services Lab Blog

Don’t ignore the innovators

Philip Colligan - 22.10.2012

This article originally appeared Thursday 18 October in the MJ. The article can also be viewed here.

Ask any local authority Chief Executive what three things keep them awake at night. It's a safe bet that funding social care will be on the list.

At its conference this year, the LGA launched Barnet's graph of doom showing that, if the assumptions stand up and legal responsibilities remain the same, it won't be long before councils basically have no money to fund services other than social care.  At a recent workshop with Chief Executives and Treasury officials to discuss the options for the next local government spending settlement the top issue by far was integration of health and social care budgets.

There's no doubt that behind closed doors some big structural changes are being debated.  We're told that "definitive steps" are being taken to progress the Dilnot recommendations. We've had a White Paper and a draft Bill already, with more to come.

It's not hard to imagine the possibilities and some will be more palatable than others.  What isn't disputed is the need for something dramatic to change.

In amongst these big debates about structures, finance and legal responsibilities there's a risk that we overlook the innovation that is already happening.  People at the frontline of public services, charities and social enterprises are getting on with the hard graft of inventing the new ways in which society will be supporting people to live great lives long into the future.

Local authorities are at the forefront of that work.  In Wigan, the council is introducing a complementary currency alongside personal budgets as a way to kick start the social economy to support older people.  The Royal Borough of Windsor and Maidenhead is working with Age Concern and the WRVS to pilot time credits for people who support their older neighbours.

The Circles movement created by Participle and Southwark Council uses a community currency as the engine driving social action.

Care 4 Care is the creation of Professor Heinz Wolff, who has turned his considerable intellect to the challenge of an ageing society.  Currently being trialled on the Isle of Wight, it allows volunteers to build up a time-based pension.  You earn credits by giving your time to support older people to live well and save up those credits for when you yourself need support.

Why such an interest in credits and currencies?  There's lots of theory and Nesta published a review of it last year.  Complementary currencies do three things in this context.  They allow us to put a value on things that the mainstream economy undervalues; they fuel the social economy, generating more transactions; and they introduce reciprocity, creating a more equal relationship between the giver and receiver.

For the older people of Wigan spending their new community credits, the way that they ask for help is transformed. 

The Good Gym captures reciprocity in a different way.  Runners integrate visits to older people on their route - for many the only human contact they experience all day. What's so smart is that the older people are coaches and see their role as encouraging, supporting and even chiding the runners to keep fit.

Technology is also playing an important role.  Tyze is an innovation imported from Canada that creates a network of helpers around an older or vulnerable person, using simple technology to organise the practical tasks that can make the difference between living successful independent lives or having to enter the care system.  Wouldn't we all be prepared to do a bit more for our neighbours if we knew what they would find useful?

What unites these innovations is that they are finding new ways to combine the limited resources of the state with the much more abundant resources that exist in all communities.  Reframing the challenge from "what can we do with diminishing resources" to "how can we unlock the assets and resources that are already out there".  It's about finding ways to encourage and enable people to help each other out.  People helping people: hardly rocket science. 

Let's take the critics head on.  Yes, these innovations are about reducing costs to the taxpayer.   We have to recognise that our current model - where we raise taxes to hire professionals to "care" for our neighbours - is simply unsustainable in the face of changing demographics. 

But this isn't a cover for the state retreating.  Taxpayer funded professionals continue to play a central role, working alongside citizens. Tyze networks include the GP and other paid professionals, working collaboratively with family, friends and neighbours to help people live independently.

It's about much more than the cost of public services.  Time and again ethnographic research with older people and others who rely on social care services tells us that what they really want is to feel valued, connected and in control.  Three things that paternalistic models of state delivered care consistently fail to achieve.

To its credit the Government is taking notice.  The Social Care White Paper highlighted many of these innovations and both the Department of Health and Cabinet Office are providing the seed funding that has helped them grow.

The challenge for all of us is to figure out how we connect these promising innovations to the deals that have to be done on the structures, finance and legal responsibilities.