public services

Damaged reputations (and how to repair them)

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Ian Briggs

During a recent conversation with a senior product development engineer who works for a high end vehicle manufacturer, the importance of ‘halo products’ opened up an interesting conversation. Investment in such ‘halo’ products is a given in a highly competitive marketplace and the known impact they have on consumer behaviour is a strong justification for the high levels of investment needed in them.

The conversation turned to the near universally low esteem that this talented, hard working professional engineer held local public services in. To him, they were poorly managed, overly costly and rarely related to the wants and needs of the local people. Perhaps I should not have been surprised that he held this view but I did ask him if there was anything he really valued about local public services.

There was very little, but one service emerged as something that he did value – the local Fire and Rescue Service. He could find little to criticise about them. He cited a number of times that he was called upon to work professionally with them, and he saw them as having a very high level of professionalism when exploring vehicle safety issues. Any cut backs in this service he felt was poor political judgement. He was continually impressed by them and appreciated that in many cases the conditions within which they worked were challenging, dangerous and above all professionally demanding.

So why, if within the case he was putting forward that in the commercial sector investment in halo products and services is seen as a key way of leading and managing the overall brand, did the public sector not think and behave in the same way?

This contrasts with two papers that have crossed my desk recently. In both cases a strong argument is put forward for increasing the importation of private sector talent into the public service. However, in both cases the argument centres around the skills that commercial managers and leaders have in controlling inputs whilst at the same time improving the outcome quality of products and services. No mention is made of strategic investment in halo products and understanding of how careful promotion of those products and services that are known to be valued, even by those who consume products lower down the range, have a positive impact on overall consumer behaviour.

We did go on to discuss how the reverse could be true; could poor product perception have a negative impact upon products and services across the brand? The answer was a clear yes but the means by which this was countered was revealing. He cited cases of increasing management and leadership attention on those products and services that are valued. Clearly this has to be done simultaneously with rectifying where possible poor product and service across the portfolio, but it makes me reflect upon the tactics we apply in public service management. Are we missing a trick? The media is full of challenging stories of very serious public sector failure and the reputational damage that the NHS is suffering is potentially immense, as are sections of local government and other governmental agencies. But within this there seem to be few issues that lead to reputational harm to the Fire and Rescue Services – although I do not wish to tempt fate here!

So, should we explore this transferability of positive product and service a little more closely? My product engineer friend said that lessons could be learned in how these high value products are developed – in certain cases the positive impact of the product was achieved through a ‘less is more’ approach. Consumer behaviour can be positively impacted on by taking out unnecessary or unappreciated elements of a product or service; this is perhaps counterintuitive but is now an established mechanism for commercial organisations. The giving of more or adding more leads to a rapid acceleration of wants and needs but positively promoting the efficiency of a product that closely matches the expectation of the consumer adds value.

It would appear that within the highly tuned commercial mindset the notion of meeting the needs of the consumer is not always about the surprise and delight extras that are offered, but rather exists within the precise tailoring of need to product – even if somewhat perversely it may cost the provider more to take things out than to put additional things in.

What seems to be key here is the amount of attention that is paid to understanding what you do well whilst at the same time seeking address what you may not do so well. This is a principle that is commonly adopted in commerce – it is drawn from the theoretical perspective of ‘appreciative enquiry’ – seeking to understand what is positive and then taking active steps to deploy the factors that lead to success. There is an extensive literature on the subject that rarely seems to have an airing in public management circles, but perhaps this is something that we could learn from other sectors.

The key point here seems to be the accepted dimension of the transferability of reputations, both positive and negative, and the need for commercially savvy organisations to pay close attention to the ‘halo’ product and service. If that positive transferability is a reality then we should perhaps pay more attention to where we are succeeding and achieving high reputational advantage, even if the media still wants to pay rightful attention only to those areas where we may deserve a poor reputation. Maybe it could be a case of not seeking to import private and commercial sector savvy to wider public services, but to recruit more fire-fighters into wider public sector jobs.

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Ian Briggs is a Senior Fellow at the Institute of Local Government Studies. He has research interests in the development and assessment of leadership, performance coaching, organisational development and change, and the establishment of shared service provision.

Doing local politics differently: learning from an inspiring community campaign against the cuts

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Catherine Durose

For the second time in as many years, the south Manchester neighbourhood of Levenshulme where I live, has faced the closure of vital public facilities. This time, the library and swimming pool have been targeted. Both these facilities are community hubs which bring people in a diverse, and in many ways disadvantaged, community together. To continue to build cohesion and understanding in our community, we need these spaces. In an economic context, where literate, educated, skilled people are the key to our future growth as a city, closing the library seems a perverse decision. In an area with some of the worst health outcomes in the city, where health services are stretched and we desperately need to encourage people to take responsibility for their own health, closing down the swimming pool seems obscene. The context of these closures is that Manchester is facing one of the toughest and most unfair financial settlements for local government which has been compounded by the loss of substantial deprivation linked funding. Many in Levenshulme feel that the proposal to close our local facilities is not only short-termist, but is self-defeating.

The anger in the community has been directed in a sustained, vibrant, thoughtful and provocative campaign to save our facilities, which has engaged hundreds of people. Yesterday, a flash mob of dancers from Levenshulme wearing masks of council leader Sir Richard Leese’s face performed a routine outside Manchester Town Hall proclaiming a ‘Lev-olution’. Last week, local people held a ‘beach party’ protest outside the pool before occupying it into the night. These actions followed months of well-attended demonstrations, occupations, vigils, petitions, fundraising events and public meetings which have attracted extensive local and national media coverage. These actions reflect the importance not only of persistence – a similarly vital community effort saved the swimming baths and sports hall in 2011 – but also of a sense of humour in mobilising people. We documented similar approaches in our recent INLOGOV pamphlet, ‘Beyond the State – Mobilising and Co-Producing with Communities’.

Today sees both – in a timetable which has generated a somewhat cynical interpretation in the community – the ending of the consultation by Manchester City Council on proposals for a new community hub in Levenshulme to open in Autumn 2014 and the debate of these proposals in full council. These proposals now have an amendment, tabled by local councillors following local pressure, to work with community groups to explore whether a viable business plan can be developed to allow our existing facilities to remain open until replacement facilities are available. Teams of local people are actively working to find a way to make this happen.

The council has been unable or unwilling – until demanded to by the community campaign – to communicate with the communities in Levenshulme and unable to – until led by the community –find a way to work in collaboration to find community-based solutions to dealing with unprecedented cuts to public services. Hopefully, the inspiring community campaign in Levenshulme adds another example of how local authorities can begin to learn to do local politics differently.

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Catherine Durose is Director of Research at INLOGOV. Catherine is interested in the restructuring of relationships between citizens, communities and the state. Catherine is currently advising the Office of Civil Society’s evaluation of the Community Organisers initiatives and leading a policy review for the AHRC’s Connected Communities programme on re-thinking local public services.

On silos and why we thought joint commissioning was a good idea

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Stephen Jeffares

I heard it again – in a discussion on last Tuesday’s BBC Radio 4 Today programme, Nick Herbert’s piece about the civil service – the problem is that silos remain .

Most of us have never seen a silo in real life, although those who have spent time on farms know that it is a really big tank or pit for storing grain or animal feed.  But we learn on our MBA courses and from our management textbooks about the curse of the silo mentality.   They say we need to drive silo working out – we need to work across boundaries, we need to collaborate, work in partnership.  So much of what is wrong with how we do public policy is blamed on working in silos.

Couple this with the popularity of separating those that steer from those that row and we find an increased importance placed on commissioning.  For several years consultants have dined out on their ability to tell us that commissioning is not the same as procurement, for procurement is just one important aspect of the complex but vital process of commissioning.  But, they tell us, the worst thing you can do is commission in a silo.  No no.  We need to commission jointly, with others.  Why?  Well, two reasons.  First, because the world is complex and cannot be solved by the efforts of one department or organisation alone.  Second, all the reform and hollowing out of the last decades has meant our public services are fragmented in terms of budgets and decision making capacity.  So joining up how we commission is a no-brainer.

Is it any wonder, then, that we ended up with the marriage of the concepts of joint and commissioning.  But as a compound: ‘Joint commissioning’. It is rather an ugly and unwieldy pairing.  But both concepts are viewed as desirable and essential, therefore joint commissioning is the solution.  Nowhere was joint commissioning seen as more desirable or essential as in health and social care.

People’s needs for support or treatment do not neatly divide across how we organise health services and care services.   While not everybody requiring acute health treatment requires social care, many with long term chronic illnesses require both.  Nowhere is this more apparent in what happens when older or vulnerable adults are discharged from hospitals.  So, often, it makes sense that within localities decisions and priorities should be commissioned jointly, and over the last decade, structures and practices have been aligned in the name of joint commissioning.  However, such reforms can be expensive, destabilising and reveal profound professional tensions.

Various changes occurred over the last 10 years in the name of joint commissioning, with localities introducing social care partnerships, pooled budgets and, in some, full blown care trusts.  The structures imposed depended on the discretion of local authorities, the PCTs and the Council.  Some chose to share chief executives.  Service users and carers might have seen no difference, or perhaps were confused by the change in logos and livery.  The staff involved in the change, with their strong professional identities as occupational therapists, district nurses, social workers, care home managers, were told that this was an opportunity to work differently. In some cases, the changes were symbolised by lifting and shifting to a single site, to new purpose built office locations – no more NHS or Council badges – there’s a new ID card in town, swinging from a fresh corporate lanyard.

But to what avail?  The shift to joint commissioning means that we also have to be interested in evaluating.  Not just the processes, but the outcomes.  With further integration on the horizon, the question on everybody’s lips is what good this has brought.  Was it worth the effort?  The answer to the question has to go further than populist or political expediency: did it save money or did more people get seen sooner?

To answer the question we need to start by asking  – what do you want from this joint commissioning?  When you explore the ambitions for these joint arrangements in literature and in conversation with professionals, not one but a whole range of competing aspirations arise.    In a project funded by the SDO and led by colleagues at HSMC, I had the opportunity to do just this – to capture the range of aspirations for joint commissioning.  A full report of the research and the findings, published earlier this month, can be found here.

In terms of what joint commissioning meant to different people, four broad points of view emerged. Yes, predictably, there were timely aspirations about productivity, saving money, efficiencies.  In contrast, though, there were those who focused on implications for people, service user and carer involvement, personalisation, choice.  A third set of aspirations focused on what comes from partnership – the development of synergies, the benefits of closer working, joint location; and a fourth set revolved around aspirations and implications for professions – developing professional empathy of the challenges faced, but also concerns for maintaining professional identity and autonomy.

And it’s here that we get to the problem of motherhood and apple pie – so often an issue in public policy.  Read off a list of 40 aspirations for joint commissioning – synergy, empathy, cost saving, choice, user involvement, and we’ll say yes to all, all of the above please.  But spend some time in conversation with people working in joint commissioning arrangements and it soon becomes apparent that there are different priorities that can easily conflict, either implicitly or explicitly.

Joint commissioning, like so many policy ideas, is what Cornwall and Eades call a ‘buzzword that has become a fuzzword’, one that clouds rather than clarifies understanding.  The turning point for our research was when we asked our respondents, those working in joint commissioning across England, to prioritise differing (competing?) outcomes.  They rank ordered them using a tool called POETQ.  We found two things.  First, that everybody is unique, that everybody had a different take on what was more important.  But second, and perhaps most importantly, there were patterns.  Taken as a whole we found five distinct viewpoints (page 87 of the report) on what they thought joint commissioning would achieve.  The technique allowed us to cut through the nebulous language that collects around policy ideas.  It also challenged our assumptions that people think according to their professional group or position in the hierarchy.  These insights then guided the remainder of the project and our visits to our five case study localities.

The current reforms that focus on integrated working and the creation of Clinical Commissioning Groups are in some part a shift in emphasis and in some part a renewal of language.  If there is one thing I have learnt from spending time thinking about joint commissioning, it is that we need to accept that public policy labels activity and coins and fosters policy ideas.  Some of these ideas are old wine in new bottles, or existing bodies in new raincoats.  But not everybody involved has the same memory or associations. For some these approaches are genuinely new. Therefore whatever approach we take, we need to ensure that it allows us to unpick and clarify these policy ideas and their associated meanings: this should be our first priority.  While we cannot easily predict what will be the next big idea, what we can be sure of is that analogies like ‘silo mentality’ run deep and will shape new policy ideas yet to be coined and fostered.  But when the next big idea appears on the horizon we needn’t shy away from nebulous language or accept notions without question.  Assisted with tools like POETQ, next time we’ll be ready.

This article gives the views of the author, and not the position of the INLOGOV blog, the University of Birmingham or National Institute for Health Research (NIHR).

This research is discussed at greater length in the article Beyond the Berlin Wall?, by Helen Dickinson, Stephen Jeffares, Alison Nicholds, and Jon Glasby, published in Public Management Review.  The article can be viewed here.

jeffares-stephen

Stephen Jeffares is a Roberts Fellow in the College of Social Sciences based in INLOGOV, Institute for Local Government Studies.  His fellowship focuses on the role of ideas in the policy process and implications for methods.  He is a specialist in Q methodology and other innovative methods to inform policy analysis.