Office Of Public Services Reform
The next phase of reform:
Putting People at the Heart of Public Services
—
Briefing for senior people working in public services on
the ways in which the reform agenda is developing,
moving on from the messages in 2002’s Principles into
Practice
September 2004
Introduction
Public services define the nature of UK society and reflect its values and
commitment to social justice and equity. The Prime Minister’s vision combines
choice, excellence, and equality in a modern universal welfare state,
developing a ‘ new personalised concept of public services.
“Now, on the basis of clear progress, is the time to accelerate reform.
In simple terms, recasting the 1945 welfare state to end entirely the era
of ‘one size fits all’ services and put in place modern services which
maintain at their core the values of equality of access and opportunity
for all: base the service around the user, a personalised service with
real choice, greater individual responsibility and high standards, and
ensure in so doing that we keep our public services universal.”
“We are proposing to put an entirely different dynamic in place to drive
our public services: one where the service will be driven not by the
managers but by the user – the patient, the parent, the pupil, and law
abiding citizen. “
In the coming months, each of the main public services is producing a 5 year
strategy with a core narrative containing three key elements:
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At the heart of public services is a new deal with more offered to – and
more expected from – citizens.
Putting people in the driving seat, through choice, personalisation and
voice.
And through this, embedding a new process of continuing
improvement.
Investment and Reform
This next phase for public services is only possible because of the efforts of
millions of public service staff who are working with the increased public
investment in their services to provide a base for improvement. Increased
public investment has been sustained for over five years and is planned for
another three. With this investment, the capacity of public services has been
greatly increased, with over 500,000 new jobs created since 1998. Staff are
better able to meet people’s needs, because they are better-equipped, with
new buildings, IT, and supplies and are working in teams with an increasing
variety of skills and abilities.
Alongside investment, the next priority has been the development of clear
national standards and strengthening accountability for delivering them. As a
result, more progress has been made so far on national standards than on
devolution or choice. These will inform the next phase of development.
The next phase – Putting People at the Heart of Public
Services
Through GPs, teachers, personal advisers, case-managers, customer service
staff and others, we must tailor services to the diverse needs and preferences
of every individual. We live in a diverse society which means that to meet
differing needs, people will have meaningful choices on where, when and how
they access services and on the services themselves. Relevant, reliable and
timely information will be available to better inform people to make decisions
for themselves. Service providers will receive incentives that focus on
improving the customer experience. Most importantly, it will mean a new deal
in which people receive a personalised service and in return take on new
responsibilities.
Sustained improvement
For public services to be driven by the diverse needs of every individual within
a framework of national standards, our system must be capable of sustained
improvement.
Continuing focus on standards
Clear national standards must continue to be at the heart of the relationship
between the government and the people who work in public services, but
accountability between people who work in, and people who use services also
should be strengthened. This will mean continuing to focus on the areas that
people say matter most to them – access, waiting times, pupil attainment,
personal security – and improving our approach to targets.
To drive improvement, greater emphasis will be placed on what matters to
customers and their personal experience. Service standards will be
developed where there are none as yet, and targets will become part of the
overall platform of expectations. Users and professionals should be involved
in the process of target setting, securing their commitment and drawing on
their expertise. The number of central targets should continue to be reduced,
with more scope for targets that are set locally.
Stronger personal and local accountability
Objectives and targets should be expressed so it is clear what people should
expect, and wherever possible should provide a binding guarantee.
Information about performance should be relevant to individuals using the
service, telling them the things they need to know to make informed decisions.
Individual professionals and local institutions should have the devolved
responsibility they need to serve their customers well. To this end, further
moves should be made to devolve responsibility.
In addition to tailoring services to meet individuals’ personal requirements, the
public also should be offered more effective ways of exercising their collective
voice . Communities really do want to have a say in genuinely local issues
that matter to them. Real engagement in local public service issues may be
the most attractive means for people to contribute to their community.
For public services to really work, they cannot be ‘delivered’ in an external
way to ‘the public’. You cannot make a person healthy; you cannot make a
pupil learn. Unless they are actively involved in this process, very little
happens. The reasons for improving accountability at every level is to ensure
that they are.
The challenge therefore is to move to more direct forms of accountability.
Part of this will be about providing timely and locally relevant performance
data to local service users and residents so that they are better equipped to
challenge their local services. It may also mean experimenting with new
forms of participation – on single issues, the environment, anti-social
behaviours – as well as through governance of councils, schools, and other
public services.
Greater Choice and personalisation
Extending choice is both an effective driver for improving quality and a good
device for satisfying and enabling greater equity for the highly diverse
individuals and communities using public services. Accordingly, wherever
choice can be expanded to further these objectives, it should be. This will
mean going beyond providing people with a choice of where and when they
access a service (important as this is) to offering a real say over the type of
service they want.
The design of policy will be crucial, to avoid unacceptable cost, and to ensure
that everyone receives help to make ‘supported choice’ – whether it be with
transport, information or advice. There are already examples where choice is
proving successful. Not only in the health service with choice of alternative
hospitals for important surgery, but in social services with direct payments and
in social housing with choice based lettings.
More flexibility
The kind of professionals that public services need for the future are those
who put people at the heart of their service – making them central to the way
they understand their role, gain their status, knowledge and expertise. Such
attitudes and expertise are not what has traditionally driven public sector
professionals in the past.
In the early stages, it will continue to involve holding professionals to account
for the increasing public investment, making their performance more
transparent, and subjecting it to independent regulation. As the power of
choice, voice and contestability takes hold, so professionals will experience
greater accountability to their clients, and within a national framework of
standards, have greater freedom to meet their requirements. A shift of power
to the public - as informed citizens and customers – should become linked
with an empowered role for professionals.
In some cases, this involves new occupations and career paths (classroom
assistants, personal healthcare advisers, community safety officers), in others
it will mean changing responsibility for particular activities or tasks (more GP
specialists, greater nurse prescribing).
While some of these changes may need central direction, Government’s key
role is enabling greater freedom for local professionals and managers to
develop the roles and structures they need to respond to individual needs and
local requirements. Public spirited trade unions and workers will see the
benefit such changes hold for the public service, and their members.
A more diverse and vibrant capacity
The case for ending ‘one size fits all’ services will be enabled by a more
diverse set of public service providers.
Diversity helps bring choice to life by offering customers meaningful options
over the nature of the service they access (e.g. different specialist schools).
Contestability can drive improvement where user choice is inevitably nonexistent (e.g. prisons), voice is not fully developed (e.g. PCTs), and where too
much reliance on top-down controls should be avoided.
Replacing under-performers with high-performers addresses the sometimes
stark variations in performance that exist between similar providers, producing
similar services in similar circumstances.
Encouraging new providers drives innovation as they bring new ideas and
challenge existing ways of doing things. Often this means finding more
efficient ways of delivering. Encouraging successful providers to run services
in more than one area (e.g. ‘federations’ or ‘syndicates’) can be highly
effective in making the most of valuable leadership talent, enabling successful
forms of provision to be replicated, and reaping economies of scale.
Creating a more diverse and vibrant capacity will often mean contestability
between different public providers, but it will also mean doing more to
encourage new private and voluntary sector providers together with social
enterprise.
Government with people at its heart
Public services will need to be organised differently if they are to sustain
improvement that is well-governed by national and local policies, as well as
personal service requirements. They will need a set of responsive structures,
systems and people dedicated to supporting the delivery of personalised
services.
Effective leadership is critical. A programme of civil service reform is
supporting people who work in central government to rise to the modern
challenges of putting customers first, developing a wider range of delivery
skills, and improving the way that people are led, managed and developed.
Leadership is equally important to the success of local services - schools,
councils, primary care, hospitals, police services - and each of these areas is
investing in developing leaders to transform their organisations.
The relationship between central and local delivery will be key to creating this
circle of self-improvement. Policy development, target-setting, communicating
with citizens and the public, advising ministers - will be done more effectively
with the contribution of experts from local delivery as well as the centre.
Smarter information flows through the system will help, as will more selective
targeting of interventions and streamlined arrangements for planning, funding
and delivery. Successful performance should be recognised with more
freedoms, and less inspection, whilst failure must be turned around swiftly.
Public services need to be affordable to be capable of sustained
improvement. This is where the efficiency drive fits in – not as just a one off
exercise, but to introduce new ways of working that will continue to release
resources for the front line. The move to smaller and more strategic central
departments, and greater use of IT, will free up resources for the front line and
create more jobs in personal services to local communities. The transition will
need careful managing, and to provide support for people affected by the
changes.
What does it mean for people serving the public?
For reform to be self-sustaining, the millions of people involved in providing
public services will have to know what is expected of them and, with this
internalised understanding, do the ‘right’ thing whenever they are faced with a
decision. This kind of reform will be value driven. It will build on the
vocational commitment to serving the public that is the core of the ‘public
service ethos’, across different services and sectors. Values that will produce
a better personal return to citizens and users for public investment
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First, is a belief in fairness and equity. Experience shows that equity will
not result from giving everyone the same ‘one size fits all’ service.
Individuals do not start off in the same place, so if we want greater equality
of opportunity it is essential that specific support is provided for those who
are particularly disadvantaged. This is not an entirely new idea or drastic
departure from previous public policy. The formula that determines how
local authorities and services are funded provides more resources for
those areas that have greater need. But equity demands difference not
only in the distribution of resources, but also in the nature of the services
that different people are offered.
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Second, is a responsibility for every service to do its best for each and
every individual it serves. Every provider must operate to clear national
standards, and be open and honest about their performance. They will be
inspected to these standards and information will be available to better
inform the public on their record.
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Third, is for organisations to positively enable individuals to decide the
service they want, helping people to make choices between different
providers, and bringing innovation into the options that they offer in their
services. This is important in making choice the driver of change as well
as for serving people better right now.
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Fourth, is to recognise that for many services to really generate public
value, individuals using them have to take personal responsibility – for
learning, for looking after their health, for taking care of their
neighbourhoods. Professionals must not believe that they know best nor
that they can make people better or wiser.
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Fifth, in order for services to make more specific offers from which they
enable people to choose, they need to have more control over their
institutions to make them more distinctive. They need the flexibility to join
up with other organisations in the interests of serving people better. They
need to be able to attract and reward the people with the right skills and
attitudes to deliver their particular range of services.