All in this together? Can citizens help transform public outcomes through co-production?

Tony Bovaird and Elke Loeffler

Co-production is big – it is rapidly becoming one of the most talked-about themes in public services not just in the UK but internationally.

Let us be clear what we mean here. We define user and community co-production of public services as “professionals and citizens making better use of each other’s assets, resources and contributions to achieve better outcomes and/or improved efficiency.” Put simply, it takes two – both the professional AND the citizen to produce these outcomes by ‘milking’ each other’s capabilities. This is potentially a transformational concept – it can turn public engagement into a ‘live’ connection, rather than the current set of contacts, which are often relatively dead, or at least misfiring.

Is this realistic? Or just a glib cover-up for public service spending cuts ? In our recent contribution to the new INLOGOV model of public services (Bovaird and Loeffler, 2013), we argue that co-production can indeed transform the achievement of public outcomes – if done well. However, this won’t necessarily come about just because we’d like to pretend it is. Co-production needs pro-active, coordinated intervention by the public sector – and it’s far from clear that this is what’s actually being provided in many parts of local government and other public agencies.

Of course, it’s obvious that co-production is indeed already happening everywhere. One of the key characteristics of services in the public and private sectors is that the production and consumption of many services are inseparable. The service is produced if and only if the service user agrees to and takes part in the process. However, the fact that co-production is happening doesn’t mean that it’s being done well. If the service user doesn’t contribute fully and creatively to the service process, or does not make full use of the potential of the service, then the service is likely to be less effective in its outcomes.

For example, a major benefit of properly co-produced services is that the right services are more likely to be commissioned and delivered, because people who use services may have the chance to influence the outcomes which are prioritised by public agencies. However, this potential is often neglected because of the paternalistic way in which services are commissioned and delivered.

Again, there is great scope for mobilising citizen inputs to help create public value. The contribution of formal volunteering and informal social activities to the overall value added in society is likely to be very high (although we are still not good at measuring it) – and potentially much higher, if it is systematically managed through a co-production strategy. However, in the current period of near-zero economic growth and major financial cutbacks in the public sector, the capacity of the third sector to help mobilise this potential has often been damaged by the very public sector which wants to make use of it.

If co-production is to be used more effectively in the future, it will be important to recognise the range of benefits which it can bring to different stakeholders and to agree to focus on the benefits which we see as the current priorities.

Potential benefits from increased user and community co-production of public services

For Users

  • Improved outcomes and quality of life.
  • Higher quality, more realistic and sustainable public services as a result of bringing in the expertise of users and their networks.

For Citizens

  • Increasing social capital and social cohesion.
  • Offering reassurance about availability and quality of services for the future.

For Frontline Staff

  • More responsibility and job satisfaction from working with satisfied service users.

For Top Managers

  • Limiting demands on the services.
  • Making services more efficient.

For Politicians

  • More votes through more satisfied service users.
  • Less need for public funding and therefore lower taxes.

With a clearer picture of the benefits we most want from co-production, we can decide on what kind of co-production we most need, from the wide range of joint activities that citizens can undertake with the public and third sectors:

  • Co-commissioning of services, which embraces:
    • Co-planning of policy – e.g. deliberative participation, Planning for Real, Open Space
    • Co-prioritisation of services – e.g. individual budgets, participatory budgeting
    • Co-financing of services – e.g. fundraising, charges, agreement to tax increases
  • Co-design of services – e.g. user consultation, service design labs, customer journey mapping
  • Co-delivery of services, which embraces:
    • Co-management of services – e.g. leisure centre trusts, community management of public assets, school governors
    • Co-performing of services – e.g. peer support groups (such as expert patients) , Nurse-Family Partnerships, meals-on-wheels, Neighbourhood Watch
  • Co-assessment (including co-monitoring and co-evaluation) of services – e.g. tenant inspectors, user on-line ratings, participatory village appraisals.

This list of various types of co-production reveals a paradox. In most public agencies it will readily be apparent that at least one of these of these types of co-production is already being harnessed. However, for many in the public sector, user and community co-production has been a well-kept secret over the past few decades – always important but rarely noticed, never mind discussed or explicitly managed. This suggests that not everyone in the public sector actually supports the concept – even though it is now fashionable to pretend that they do!

On the other hand, it is one of the great strengths of the co-production approach is that it is probably already being done well in your organisation – at least somewhere (and perhaps only occasionally). This means that the greatest challenge is not triggering co-production but rather managing it and making it more systematic.

However, to realise fully the transformative potential of co-production, the public sector needs to learn to harness, not waste, the co-production efforts of citizens and service users. Up to now, public sector accounting and evaluation systems have encouraged public agencies to be profligate in the way they have viewed citizen inputs, while being very parsimonious in their use of public sector inputs. This has meant that many opportunities for improvements of public outcomes have been lost or mismanaged. Co-production will only be well-managed when public sector managers and staff recognise what citizens are actually contributing to outcomes, rather than being fixated solely on their own contribution.

Moreover, most citizens are only likely to throw themselves wholeheartedly into co-production in a relatively narrow range of activities that are genuinely important to them personally. This is a great challenge to public agencies, which typically have little experience in tailoring their marketing to specific market segments. Moving from a ‘blunderbuss’ to a ‘rifle’ approach to citizen involvement will require a huge change in attitudes and skills on the part of staff.

Of course, co-production is not a panacea for all issues in the public sector. In particular, the role of service users and other citizens in co-production will usually demonstrate some conflicting priorities, which only political decision makers can resolve. Co-production should give politicians more choice in how they seek to have public outcomes achieved, reinforcing their role in local government, not undermining it.

Finally, we must recognise that, while citizen co-production can achieve major improvements in outcomes, service quality, and service costs, it is likely to require investment. Co-production may harness resources from outside the public sector but it always requires some public inputs as well – it is not ‘free’.

References

Tony Bovaird and Elke Loeffler (2013), We’re all in this together: Harnessing user and community co-production of public outcomes.  in Staite, C. (ed.)(2013). Making sense of the future: can we develop a new model for public services? (Birmingham: University of Birmingham/INLOGOV).

 

 

 

Authors:

Tony Bovaird is Professor of Public Management and Policy at INLOGOV and TSRC, University of Birmingham.

Elke Loeffler is CEO of Governance International.

tony-bovaird-Cropped-110x146

Tony Bovaird is Professor of Public Management and Policy at INLOGOV.  He worked in the UK Civil Service and several universities before moving to the University of Birmingham in 2006.  He recently led the UK contribution to an EU project on user and community co-production of public services in five European countries, and is currently directing a project funded by the Arts and Humanities Research Council on using ‘nudge’ techniques to influence individual service co-producers to participate in community co-production.


 

Reducing Public Risk and Improving Public Resilience: What’s to Be Done?

Tony Bovaird and Barry Quirk

All is not well in the risk assessment and management field. Current approaches don’t seem to work well and may not even be worth the time and energy we spend on them – indeed, they may be actively damaging our ability to cope with the current risks in our environment. Why is this?

Risk is how we measure today the adverse impact or losses we think may happen in the future.  While risk is something that can be priced or measured, uncertainty is much harder to gauge. In line with practice in the risk assessment and management industry, we here use the word ‘risk’ to cover all the factors which contribute to uncertainty, whether or not they can be captured by probability estimates.

Although risk can be found everywhere, in public service it takes on a slightly different character.  One of the core purposes of government is to minimise risks to the public.  People expect their governments to act when there is a risk of serious harm, whether it be from market failure, social crisis or environmental disaster. And in a world of “big data” and hypercritical commentators, it is little wonder that politicians and public managers can often seem frozen in the glare of the possible risks of failure.

Paradoxically, some risks are themselves partly caused by public institutions.  In the current climate of reducing public resources, those risks that require perhaps the most attention are the risks to the public and to service users from the scale and nature of changes in the public sector itself. The prospect of public service failure is higher than ever before.  The radical cuts in public spending are in some areas leading to service withdrawal, service rationing and reductions in service standards.  This is occurring alongside significant welfare reform changes.  In consequence, many service users are experiencing a degradation of the service levels, standards and facilities which they may have previously regarded as critically important.   As part of the Government’s “Localism” strategy, local authorities are being encouraged to increase the level of their partnership and community engagement activities but it is already clear that there are real risks that partner bodies (from the community, voluntary, social and private sectors) may be unable to deliver the required services at an acceptable standard, particularly given the rapid pace of the transition that is underway.

The White Paper on Open Public Services commits HM Treasury and the Cabinet Office to working closely with departments in order to develop ‘continuity regimes’, as an integral part of their modernisation programmes. However, it offers few details of what this might mean in practice.

The traditional approach to risk management is founded in institutional audit that understandably privileges financial control by pricing future uncertainties in a measurable way.  It fosters managerial compliance strategies that attempt to reduce or avoid repeated or systemic operational errors as well as measure foreseeable hazards and harms. These approaches are useful up to a point.  However, they have also resulted in complex “blame avoidance strategies” where public agencies attempt to minimise damage to themselves and deflect blame for failure.  Rather than opening up options, these approaches often close them down, undermining pragmatism and common sense.  The ubiquity of risk management in public service organisations can seem to stifle innovation by fostering a culture of paralysis focussed fearfully on, “what worst events might happen” and encouraging low risk appetites and risk averse behaviour.

While people are eager to embrace accountability for their actions when things go well, they are perhaps even more keen to avoid blame for when things go wrong. The difference, within public agencies, between a mature approach to accountability that fosters responsible and empowered risk taking and an immature blame culture that seeks to personalise error and fault, is the key to understanding how our approaches to public risk can be improved.

We therefore suggest that a radically new approach to risk is now urgently needed. This should begin with a focus more on risks to the public service outcomes experienced by service users and their communities.  In practice, more weight often appears to be given to risks experienced by politicians, senior managers, staff and their organisations. This is only likely to be put right if the power imbalance in public agencies is directly addressed, so that users and communities become directly involved in the strategic decisions around risk, and their views count in the calculus employed within the agency – a co-production approach between citizens and public agencies.

Secondly, the approach to risk in the public sector has also suffered from how it has been used in strategic decision making.  We can distinguish four quite distinct strategies towards risk in public services:

  • activity portfolio management: choosing a portfolio of activities with lower risk attached;
  • risk reduction in the environment: either reducing the likelihood of key risks or influencing their character so that particularly worrying features of those risks are made less damaging;
  • building resilience to risk into the service system, including the activities of providers and the behaviours of service users, their support networks and their communities;
  • risk enablement: encouraging decision makers in the service system to choose activities with appropriate levels of risk, rather than assuming that risk minimisation is always right.

These strategies are not, of course, mutually exclusive. The first two are essentially  preventative, the third is about mitigation of risks and the fourth is about learning to live appropriately with the levels of risk which the organisation faces.  In practice, the public sector has been highly selective in the risk strategies on which it has focused, giving most weight to the first two strategies. This needs to change, with risk enablement in particular becoming more dominant.

The concept of a  ‘risk enablement strategy’ builds in particular on innovative risk enablement practices in adult safeguarding in social care. It involves taking a balanced and proportionate approach to risk, finding ways to enable individuals, communities and organisations to achieve what care about, while considering what keeps individuals and the community safe from harm in a way that makes sense for them (Neill et al, 2008: 7). It requires public agencies to foster a culture of positive risk taking, where these ‘risky’ proposals offer a good prospect for raising the level of outcomes for citizens. A strategy of risk enablement rather than risk avoidance or minimisation needs to build on principles of: outcome-driven policies and activities; user and community co-production; transparency; resilience; collective responsibility and integrity; and professional responsibility and integrity.

Thirdly, we need to get to grips with resilience. The recent social science literature on resilience has stressed the idea of resilience as ‘adaptive ability’.  This goes beyond traditional definitions of resilience – ‘engineering resilience’ (where the level of resilience is measured by speed of return to the pre-existing equilibrium) and ‘ecological resilience’ (where the level of resilience is measured by the size of shock or disturbance that can be absorbed before the system changes structure or function, shaped by a different set of processes).

A truly resilient system of public services, fashioned to achieve publicly desired outcomes, requires attention to the resilience of the agents within the system, specifically citizens (both as co-producting service users and collectively as communities) and organisations (specifically service providers), as well resilience in the design of the overall service system. We suggest that there must be at least some suspicion that public agencies often over-emphasise the embedding of resilience into the formal service provision process, given the potential for damage to agencies and their staff when service provision fails – but have therefore tended to underemphasise resilience of service users and communities.

Let us be clear. We are not suggesting that public organisations or staff should launch into radically higher levels of risk – what we are discussing is more likely to result in a different portfolio of risks. Indeed, our  approach is partly about owning up to the facts that service users are already facing quite high levels of risk to their desired outcomes and that the interventions of the public sector have only ever achieved limited risk reduction. The key is that the appropriate risk reduction strategies should be agreed by users and communities, not by agency leaders (based on their own self-interest).

We see this radically new approach to risk as being urgently needed. However, this new approach must itself be seen as tentative and unproven. The uncertainty that the public sector in that part of its work which operates in complex and chaotic knowledge domains requires all of us to possess more humility about how much we can know, how much we can change and how cost-effective our public interventions are likely to be.

Consequently, this new approach requires both experimentation and research.  Until better evidence is available, we need to own up to how little we really know about the risks we face in relation to the outcomes that matter to citizens.  We need to acknowledge the scale of the unknown factors and dynamics which can undermine the efficacy of even the best designed service.  And we also need to recognise the partial character and limited effectiveness of those mechanisms that are designed by government and public agencies to protect the public from future harms.  Such humility is a prerequisite to learning. Refusing to acknowledge the limitations to our knowledge is perhaps the biggest risk of all faced by government in this era of public service austerity.

Source: This blog is a summary  of: Tony Bovaird and Barry Quirk (2013), Reducing Public Risk and Improving Public Resilience: An Agenda for Risk Enablement Strategies. In Staite, C. (ed.)(2013). Making sense of the future: can we develop a new model for public services? (Birmingham: University of Birmingham/INLOGOV).

The full paper contains a set of references to the sources used in this blog.

Authors:

Tony Bovaird, Professor of Public Management and Policy, INLOGOV and Third Sector Research Centre, University of Birmingham.

Barry Quirk, CEO, London Borough of Lewisham and

tony-bovaird-Cropped-110x146


 

Beyond Nudge is behaviour change and demand management

Catherine Mangan and Daniel Goodwin

A three-fold change to the design and delivery of public services has been taking place over the past decade. Expectations of user choice or personalisation, the drive for localism and most particularly the implications of cuts in public spending, all increase tensions within the public service framework. One key factor underpins all of them: they require fundamental change in the expectations of individuals, communities and service providers if best use is to be made of ever diminishing resources whilst securing public well-being.

Many experts have said that the critical public service challenge of the decade is to encourage behaviour that benefits both the individual and the state, whilst preventing long term expense. They want to discourage behaviour which creates user dependency and attracts further costs. Behaviour change is vitally important, they say, because we can no longer provide the services we have always done, in the way we have always provided them. Various approaches to altering the behaviour of citizens have been outlined in a growing body of evidence.

Councils are navigating within a ‘perfect storm’ of reducing funding and increasing demands from demographic change, public expectations and the rising cost of delivering services.  We know that we cannot continue to meet the level of demand for services in social care and children’s services. Councils’ financial modelling shows that at the current levels of demand, by 2022 the council’s entire budget will not be enough to cover the costs of children’s and adults social care services.

Somehow, the level of citizen demand on services needs to be contained, and reduced. Merely changing the way in which existing services are delivered will not save enough money. For example if the current trend of people needing care continues and the use of personal budgets in their current form is extended, there is a clear risk of double pressures on the public purse, as current services such as day care continue to be provided rather than de-commissioned.

We believe that following simultaneous outcomes will be required in the future, some of which will be the responsibility of public services:

  • Reduced dependence/reliance on state to pick up the pieces.
  • Improved individual well being and resilience.
  • New and improved community/social networks.
  • Sustainability – both in terms of the environment and also the future of public services.
  • A better understanding in the community of the cost of public service and its relation to taxation.
  • A shift in the underlying expectations of individual citizens and communities of the ‘deal’ that they have with the state as to the provision of public services.

There is a need to change the contract between the individual and the state. There has been a range of reports and statements from think tanks and central government departments extolling this approach. The RSA 2020 Public Services final report provides a good summary of many of the more detailed points. It calls for a new ‘social citizenship’ approach where as citizens we should have a duty to contribute as well as a right to receive support. This takes us beyond the simplistic ‘Nudge’ theory towards a better understanding of how to navigate the challenges of the present to achieve a better future.

This blog summarises some of the key messages in:

Beyond Nudge – How can behaviour change help us to do less with less? By Daniel Goodwin and Catherine Mangan in  Staite, C. (ed.)(2013). Making sense of the future: can we develop a new model for public services? (Birmingham: University of Birmingham/INLOGOV).

Portrait of OPM staff member

Catherine Mangan is a Senior Fellow at INLOGOV.  Her interests include public sector re-design, outcomes based commissioning and behaviour change.  Prior to joining INLOGOV she managed the organisational development and change work for a not-for-profit consultancy, specialising in supporting local government; and has also worked for the Local Government Association, and as Deputy Director of the County Councils Network.  She specialises in adult social care, children’s services and partnerships.

 

Why do we need a new model of public services?

Catherine Staite

Public services, including those commissioned and delivered by local government, have changed substantially in the past ten years. There have been changes in service delivery mechanisms, in relationships between users and services, in organisational structures and in partnership arrangements. It appears likely that the next ten years will bring at least as much change, if not more. One thing is clear: the old model of public services – people expect and services provide – is no longer tenable.  The growing gap between demand and resources has been described in terms of ‘the jaws of doom’.  That is one way of looking at the future.  Another way is to see the opportunities which we have to renegotiate ‘the deal’ between people and public services.

INLOGOV is working with a wide range of local authorities and other bodies to test a new model of public services. The model draws together many of the themes in current debates about the ways in which the public sector is likely  to have to change, in particular, how public services can manage demand, build capacity and achieve better mutual understanding, through the development of stronger relationships with communities as well as through co-production and behaviour change.  The purpose of this model is to support public service leaders – both political and managerial – to make better sense of a complex world.

INLOGOV’s model brings together the disparate cultural, structural, political and financial challenges facing local government and wider public services into an integrated framework, which takes account not only of individual drivers of change but also of the inter-relationship between changes in public services and the wider political and social context in which those changes are taking place. If we have a coherent model which reflects current and future realities it will be easier for us to explore possible solutions together.

We have concentrated on the challenges and opportunities for local government, in partnership with other local and national institutions.  That is not because we think local government is the most important player on the public service stage, it is because we think it plays a unique role as a convenor and mediator between conflicting interests within complex networks of players.  It is in this role that it can provide the creativity and connectivity to help shape solutions to the seemingly intractable problems of rising demand and falling resources.

The key drivers for a new model are: building stronger relationships with and between individuals and communities, increasing co-production of better outcomes by focusing on capacity, as well as need, and changing expectations and behaviours.  Before we can deliver these benefits we will need to change the way we think, plan and act.  There are many good, small scale examples of innovation which are delivering real change but now we need to scale up change to have a real impact – reducing dependency, building confidence and improving outcomes.  These are not quick fixes, so the sooner we start and the more energy we invest the sooner we’ll be able to achieve a sustainable relationship between public services and the communities they serve.

 

This blog post summarises some of the key messages in:

Why do we need a new model for public services? By Catherine Staite

Ch. 1 in Staite, C. (ed.)(2013). Making sense of the future: can we develop a new model for public services? (Birmingham: University of Birmingham/INLOGOV).

Catherine Staite

Catherine Staite is the Director of INLOGOV. She provides consultancy and facilitation to local authorities and their partners, on a wide range of issues including on improving outcomes, efficiency, partnership working, strategic planning and organisational development, including integration of services and functions.

A relational revolution in local public services

Chris Lawrence-Pietroni

On June 13 2013 BBC News broadcast CCTV footage of 83 year old Muriel Price suffering in her own home. Like so many elderly people receiving local authority care, Muriel relied on a private provider to send care staff to look after her basic needs. Taken over the course of one month, the footage revealed a pattern of neglect: carers turning up late or not at all; Muriel suffering the indignity of having her incontinence pads changed in full view of her neighbours; her food being prodded by a carer to test its temperature.

Yet despite her treatment Muriel still found a reason to be grateful: ‘It’s terrible the way they treat old people. I’m lucky I’ve got a family to look after me. Those that haven’t got a family – God help them, poor Devils’.

Public concern over the treatment of vulnerable people supposedly being cared for by public services has increased as a number of scandals have hit the headlines with Winterbourne View and the Mids-Staff Inquiries being only the most high-profile. Shocking as these cases are, anyone working in health and social care knows that it’s casual neglect like Muriel’s that is far more common. And with the ageing population and financial constraint that is the backdrop to any contemporary discussion of local public services, the likelihood of others facing similar experiences is growing.

When confronted with these tragedies the question that lingers is: how could anyone treat another human being in this way? How is it possible to knowingly leave an elderly person alone for 13 hours? How could you expose an adult to the shame of having their incontinence pads changed in public when all that is required is that you draw the curtains? Why stick your fingers into someone else’s food? Would you treat a member of your own family like that?

The answer to this last question is (one hopes) “no” – and that of course is the point. As Muriel so rightly points out, she is lucky to have family that care for her and look out for her welfare. It is these relationships that not only give her life meaning (the regular visits of her grandson and trips out in her wheelchair) they also keep her safe (it was her grandson who installed the CCTV). These relationships, built up over years of mutual exchanges of love and practical support, mean that Muriel and her grandson see each other not as ‘clients’ or ‘tasks’ but as human beings to be valued.

The challenge of enabling genuinely relational services is not new, but it is growing and becoming more urgent. It is a simple fact of demography that personal social care is going to become an even greater part of public service and (for the foreseeable future at least) a political reality that the financial resources available to support it are going to be even fewer. Working out how to meet the needs of vulnerable older people with humanity is one of the most pressing issues facing local public services. The relational challenge, however, goes much further.

Firstly, enabling relationships to flourish between public service providers and those they serve – individually and collectively – is an absolute necessity if our aspirations for co-production and behaviour change are to be realised. It is increasingly understood that achieving significant change in so many of the challenges facing society – obesity, living well into old age, educational attainment, training and employment in an uncertain job market (to which you can add the pressing issue of your choice) – requires the active engagement of all of us as citizens. It is therefore at this point of interaction between citizens and the public services they use that we should focus our attention. As the new model of public services presented in Chapter 1 suggests, effective relationships, building trust and behaviour change are intimately connected.

Secondly, we know that the quality of the relationship between citizen and service provider can be a key determinant in the quality of the outcome of the service: evidence from fields as diverse as education, employment services and healthcare all suggest this.

Finally, we are slowly coming to understand that the complexity of organisations like those delivering local public services and the rapidity of change that they face mean that only those that are flexible and adaptive will excel. The process of constant learning needed to enable success itself requires a fundamental shift of attitude towards the nature of work – a shift of attitude that takes seriously the need to create meaning for staff within our organisations such that they carry with them the motivation, courage and adaptability needed to face the challenges of their daily tasks.

In this context enabling genuine relationships – relationships that carry with them more than a transactional or instrumental benefit – are not a soft option ‘nice to have’ but a hardnosed prerequisite for effectiveness. What we need is a relational revolution in our local public services.

This blog draws on ideas in Chapter 2 of a new book ‘Making Sense of the Future’

lawrence-pietroni

Chris Lawrence Pietroni joined INLOGOV as an Associate in September 2012. His work focuses on achieving sustainable systems change cross public services in the UK and the US. Building on over 15 years’ experience in local government working with senior leaders on the design of innovative service improvement and community engagement strategies, his work now focuses on the intersection between service design, leadership development and community empowerment. Much of Chris’ current work provides accessible ways for leaders to draw on systems thinking to enhance their collective effectiveness. Together with Mari Davis, Chris is pioneering the application of insights drawn from social movements and community organizing to achieve sustainable systemic change.