 The public sector mission driven reform, and how to implement itReal public sector reform, based on mission led systemic understanding of how the whole system works, and learning from the work that has already been achieved From the learning of the past decades we can now agree that the reform of the public sector is a clear priority. Based on this learning and tested and proven alternatives, this necessitates is a multi-level framework that provides a systemic view of what needs to be considered for a value driven, mission focused effective public sector. My journey into the sprawling public sector landscape has immersed me in "realities on the ground,” experiencing what it is like for fellow people to live in our diverse communities, understanding how the multi-layered aspects of our lives challenge so many of us at various points in our lives. While also exposing me to the perspectives of local government in its various designs of 'services', power dynamics, and support. We have also immersed ourselves in researching how and why our public services work the way they do. And we have a wealth of examples of where small pockets of new ways of working have been tried, and the outcomes that they produce have been analysed. If we include the research and examples, we ultimately get to uncovering the link this has with policy making. We now see how the patterns that we have today are a myriad of silos, misaligned incentives and bureaucratically applied power over others, that point to a system that is suffering from its own chronic disease. As it is designed today, it is fundamentally broken. We know this because the current design of our services are in many cases self-destructive, in that the way that they are designed will naturally produce the perverse outcomes that we have today. So, as an example, cutting costs in one area, gives rise to increased cost elsewhere. Therefore all the attempts to bring in improvement initiatives are bound to fail. The evidenceSince the 1980's the public sector in many countries decided to try out a fundamentally new way of working, which we now call New Public Management (NPM). An approach that is more efficient, that is based on private sector principles, where competition is used to drive efficiencies, and where people are seen as customers. NPM, is based around the paradigm of private sector business and management models. It focuses on citizens as the recipients of the services, mirroring the customers as a consumer. Its focus is efficiency and good service delivery. It can be recognised by decentralised service delivery models, centralised financial control, value for money, increasing efficiency through identifying and setting targets and central monitoring of performance. Control is enabled by legislation and top down design. Performance is assessed with audits, benchmarks and performance evaluations. A characteristic of NPM includes competition through private sector commissioning, to efficiently deliver what were formerly public services. More recently, NPM is the ideology of increasing efficiency through the use of digital service design. At a policy level the mechanisms of NPM are in legislation, guidance, policies, government and political ruling, the definition of measures, and the allocation of funding At an organisation level, this is based on measuring activity and compliance to rules, documenting actions, the creation of fixed job roles, the standardisation of work through service delivery, the design of individual specialist departments, the minimising of risk, and the use of digital technology as a primary communication mechanism. And it has now become an endemic way of thinking by most people that work in the public sector. There is an assumption that New Public Management can improve itself based on adjusting to customer need. Regardless of what the ideology we individually think about how appropriate this is, we now have plenty of evidence that demonstrates its ability to create a better, leaner public sector. The simple answer, is that it has failed in all this, except in a group of highly centralised transactional services - like renewing a passport. This failure is despite the huge amounts that have been spent on improving current services - we are still in a downward spiral. - Demand is rising for support and health. This demand is in part self generating from the failure to deal with the real issues. - Services are increasingly stretched. As austerity creates irrational short term decisions. - Prevention activities have been almost eliminated, driving up demand from escalating problems. - Costs rise because the service themselves have to adapt to complexity that they are not designed to deal with. - People are less satisfied with their lives and their communities. Poverty and lack of coherence fragments health into responding to crisis. One of the fundamental issues that we have in place today in the design of our public services is a focus on reductionism. Reductionism is characterised by the splitting up of end to end processes into discrete services and departments, applying individual targets that drive sub-optimisation, managers that manage numbers, the assumption that value created can be quantified. This is based on the paradigm that supporting people and complex public health services can be designed as though it behaves like a mechanistic model of individual transactional services. The roles of people working in those services are designed into fit standard expert processes. As a consequence of focusing on short term activities and reducing visible costs, we have created the perverse behaviour where demand and costs are rising, due to self inflicted causes. Over the past two decades, a group of us have been actively developing and applying a fundamentally different approach using an alternative design paradigm, and the outcomes demonstrate that these alternatives achieve a coherent and effective public sector. The systemic reform frameworkThe opposite of reductionism is systems thinking. Here, we look at the whole, and work backwards into the detail. We understand how things work by making sense of what is occurring starting with the human perspective. We apply an alternative set of principles to those of new public management. We surface value as defined as contributing to peoples wellbeing. Prevention activities and dealing with peoples real complex needs are seen as the primary achievement of the purpose of the public sector, as it avoids and supports people from falling off balance when that situation arises. We know the cost of everything, but the value of nothing The conclusion from 22 years of systemic research and immersing ourselves observing the patterns of thought and behaviour at multiple levels within the system hierarchy, is that systems change needs to be thought about on at least a 4 systemic levels: 1. Mission. Purpose-oriented, solution-driven, and shaping focus. A new wholistic pragmatic vision and policy design approach for politicians, policy makers and leaders. 2. Paradigm. A new systemic paradigm & principles, replacing the reductionism of New Public Management, that focus on value, people, communities, and prevention. Fostering a new way of collaboration and systemic action together with citizens. 3. Organisation. A new organisation metaphor that calls for a new way of managing, responsive local teams, and designed by learning and strength based working. That aligns with the complexity of the reality of the public sectors ability to create value. 4. People & communities. A balanced and close relationship between the public sector and the value it creates by engaging authentically with people. It uncovers the real needs and potential solutions that can support the person. It allows for different experts to work together for a common purpose. It ultimately creates a new way of working. Mission Mission is defined by the strategic direction and where the vision resides as to what the public sector and health service is about. This is defined by leadership derived from the true purpose of our local communities and health. The way it is described is through statements which represent the focus as would be described by those that it serves. And the mission is made up of other, more detailed statements, that together make up the whole. The mission has to be understood and directly linked and actionable at every level of the whole system. An effective way of doing this is with the three horizons method by Bill Sharpe. This fits in with Mariana Mazzucato and her definition of missions. Another way to understand this is to define what the opposite of mission driven is. It is when we design and impose individual services, telling people what we are going to do to them, based on a predetermined set of rules. We refer and signpost people onto to other services in the hope that also might help them deal with their issues. Paradigm Paradigm refers to the primary model or theory that the principles that we define of how we understand and design our public services are derived from. Currently, the prevailing paradigm is new public management (NPM), which is based on a logical transactional model. However, over the past decades there have been numerous examples of alternatives to NPM in both the UK and other countries - notably work in the voluntary sector, and in examples like Buurtzorg in The Netherlands. The new paradigm is not that of a simplistic machine model, but it is based on people - how people live and behave. Its application is based on local collaborative teams that work together to deal with the complexities of peoples lives and how to live a good life.  mission driven reform of new public management public sector This table demonstrates the different design and operating principles between new public management on the left, and the new person based systemic paradigm on the right. Organisation Organisation is the body of expertise that we see as a service type. The service design and control of health and local government provision are examples of such organisations; individual local authority services and multiple specialist departments in health. They are the mechanisms by which the public sector is managed and operates. This is where value is created, and is therefore the hub through which the principles of the paradigm are actioned in our communities and with individuals. The alternative organisation design is one where the hierarchy exists to support rather dictate. It ensures that the right things are being achieved using the right methods. The focus on what daily activity occurs and how it happens is decided close to where the work happens - with people, families within communities. Activities are designed flexibly around what matters to people and how to help them to help themselves. Those in the teams take on responsibility and ownership. Managers support these teams by ensuring they can do what they need to do to respond to real complex issues. People & communities People and relationships are the interactions and influence that the public sector has on individuals, families, and communities. This consists primarily of human, power based and behavioural concepts that then create the reality of how people engage, trust, and socialise to live together. This is both the most important, and most elusive level, in that this is where the engagement and value is created between the public sector and citizens, where value is developed, and where knowledge resides. The formal mechanisms of data, costing, and other logical mechanisms are less relevant here. Moving from the public sector using 'power over' others to 'power with' people. Focusing on the ability to catalyse supporting people and wellbeing to live their own lives free from handouts, strengthening communities to self sustain. From a public sector design perspective, cross functional operational teams that take on responsibility and ownership of working directly with people in the best way to create value. As an example, we often view communities as places where public services and health need to do something - to provide support, to spend resources 'fixing'. The reality is that our communities, if we allow them to thrive, become places that create healing, that generate support, that provide opportunities to emerge that allow for people to thrive. So when you look at case studies here and the work that we do, it is about bringing communities and the people within them back into a place to live good lives. The above, taken together, points towards a locus of control that is based as close to where the work occurs as possible. We can take Buurtzorg's learning about what happens when we work to these principles:
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