Laura Bunt - 05.11.2010
If you take one thing away from this series, it’s the insight that the only way to make savings sustainably is to start from how services can be better, not from how to save money.
Image: Narayana Hrudayalaya hospital in India, which provides quality cardiac care affordably by rethinking what services its users really need. Source: Radical Efficiency (2010), NESTA and the Innovation Unit.
Over the past ten days, we’ve been exploring different aspects of the challenges facing public services and how innovation can be a way to respond to them. We’ve tried to think about how working with service users, community groups and a wider range of partners can be practical answers to real, very current questions – how can we save money sustainably, and how can we make services better.
If you take one thing away from this series, it’s the insight that the only way to make savings sustainably is to start from how services can be better, not from how to save money. This means doing things differently and finding more effective ways to prevent and solve problems for citizens. For many service providers, cuts may mean that some existing services are no longer viable. But by thinking again about the outcome you want to achieve – and the outcome wanted by service users – there is a chance that these outcomes could be met in better, cheaper ways.
This distinction can help to explain the debate around some councils’ plans for radical reform. It’s striking how councils that are perceived to be trying to save money have met with controversy and public unease. Suffolk’s plans to outsource the majority of its services to local providers, or Barnet’s future shape programme that offers ‘no frills’ services to restructure provision. There has been considerably more public support for change that is driven by outcomes for service users: West Lothian’s commitment to integrated services; Lambeth’s push to become a cooperative council, engaging the local area in different, more reciprocal ways.
Central government is being radical. There are concerns around the speed and scale of proposed reforms to major service areas – health, education, welfare. Not only will local leaders have to manage these structural and political changes, but this will happen alongside steep reductions in spending. But there is undoubtedly ambition. Radical moves by central government have granted legitimacy for big shifts in how local areas provide services. Unknown territory for many, but time to invest in how we want services to operate in the future, and the innovation needed to get us there.
In health for example, how can we stop people needing hospitals, or start to receive more care at home? In justice, how can we support prisoners to stop re-offending and build more stable lives? In social care, how can we help people to age well and maintain strong relationships into later life? These are radical, transformative questions. But it was by starting from people’s aspirations – not from saving money – that Southwark Circle decided to build a network of social support around older people in a London borough and why User Voice engaged ex-offenders as the people to help prisoners change their lives.
There will be little guidance or best practice from central government. The reduction in national targets and local performance measures mean less central control over local outcomes. One of the big questions over the next few months will be how areas can usefully share experience and learn from each other, and what sorts of evidence will determine success. There’s a risk that the only measure of innovation will be how much money was saved, not its impact on people’s lives. But as we’ve tried to spotlight in this series, there are a whole range of approaches that can support you to achieve both, and a whole community of pioneers already leading the way.
Reducing spending on public services is the Government’s most pressing and difficult challenge.
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Confronting the challenges facing Scotland’s public services.
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