Reforming public services by liberating place based localities to work relationally with communities
Supporting people with complex needs in a locality requires a relational approach where staff work with 'do with' people in their community
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Many people, including the national political parties, are talking about public service reform, 'do with' rather than 'do to', relational working, liberating staff to do the right thing, and prevention rather than fix.
Imagine a test and learn experiment, where we allow a team of front line staff across the public sector, to work together to find the best and most effective ways of helping those in our communities that face multiple issues that are affecting their ability to live a good life. |
Two test and learn experiments, where front line staff across the public sector, were given permission to work together for 9 months in a locality, to discover the best and most effective ways of helping those in our communities.
What happened? lower demands, and far better outcomes that points to national savings of £24 billion.
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This is the comprehensive 45 page report of this work published by Locality. Or you can continue to read the much shorter summary of what actually happened in this page.
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Locality placed based working
There are many examples today where councils try different ways of working. They set up strengths-based locality working, with multi-agency teams, able to operate close to people in their community. It starts with a simple instruction to discover what individual people’s circumstances actually are, and then to take action, and do the right thing. The goal is, wherever possible, of helping people to help themselves.
In every case, costs reduced, demand fell, and value created increased.
So, we have a pretty good idea of what needs to be done, and the good news is that it doesn’t take significant resources to do it. But, as the real-life examples in this work demonstrated, it does require an alternative ‘local by default’ place based approach, and courageous public sector leaders who are willing to take a deep fresh look at what is really going on, and establish a different operating method for their teams.
This is an account of two local authorities that did this. led by my good colleague Tracey Hawkins, with Mark Burns. The write up below is in note form, extracted from a series of presentations.
In every case, costs reduced, demand fell, and value created increased.
So, we have a pretty good idea of what needs to be done, and the good news is that it doesn’t take significant resources to do it. But, as the real-life examples in this work demonstrated, it does require an alternative ‘local by default’ place based approach, and courageous public sector leaders who are willing to take a deep fresh look at what is really going on, and establish a different operating method for their teams.
This is an account of two local authorities that did this. led by my good colleague Tracey Hawkins, with Mark Burns. The write up below is in note form, extracted from a series of presentations.
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Understand how we work today |
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With a team of front line staff, we spent some time understanding what it was like for people to go through our public sector services now. We started with those that had repeated rent arrears.
We looked at 3,000 rent accounts What did we learn about our tenants in Rent arrears? Many have a regular pattern 14% were in enforcement action with us And despite our assumptions, we found that our tenants typically fall into rent arrears due to a reason related to them working!! |
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We spent some time listening to demands at the point of contact of several public sector services. These were the main demands from them.
I need help:
And we also discovered the significant amounts of failure demand at each place. |
failure demand across the locality
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The typical persons journey through the public sector
We mapped out all the interactions and the activities in the organisations involved of a typical person attempting to get some support across the public sector. |
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We looked the way that managers and decision-makers behave and make decisions. How we design our current services. This is the summary we came up with.
- Activities in the workflow are episodic led rather than person led
- Assessments are used rather than understanding.
- We use referrals to pass people around different departments, rather than ownership across those services.
- We are crisis led rather than long term ownership.
- We make peoples situations worse by applying eligibility criteria.
- We have created silo working rather than being able to work as thought we were in one room.
- We tell people to accepting our solutions, rather than do what they need.
- We focus on clinical or expert help, rather than wholistic support.
- The answer to where is the budget, defines what we do.
What is it like to be a person in this community that needs some help in their lives?
What is it like to work in such organisations?
- Accessing services is simply a repeating revolving door
- I get constant referrals & repetition
- I am unable to challenge solutions given to me - I often just give up
- I make many demands over a long time
- I am getting worse, rather than improving
What is it like to work in such organisations?
- I have low motivation
- I dont really understand those people that I engage with
- I have no ownership of anything or any decisions that I make
- I often ask myself if am I helping?
We delved into the Logic driving the current system
Targets drive behaviour, targets will improve performance.
Wait for crisis before we react.
Protect our budget.
Refer on to experts in other departments or services.
The design of our services is by discrete functions.
Standardisation drives lower cost.
Record everything so we can cover our backs.
Targets drive behaviour, targets will improve performance.
Wait for crisis before we react.
Protect our budget.
Refer on to experts in other departments or services.
The design of our services is by discrete functions.
Standardisation drives lower cost.
Record everything so we can cover our backs.
Liberating the team to work in a relational way, using a test and learn method with people 'do with'
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What did we decide to do next?
We use the three stage systemic 'test and learn' framework to apply the liberated method principles. |
this is the framework we used to apply the liberated method principles
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The teams task was to take real demands from the locality, and work with them starting with Understanding what mattered to them to live a good life.
The team was made up of front line staff from across the public sector.
• Customer services
• Rent arrears
• Social Care – Adult Services (Childrens will be pulled in as required)
• Addiction Services – Drugs & Alcohol
• Mental Health Expertise
• Police
• Money/Debt Advice
• A manager
The purpose of the team was called the LOCALITY PURPOSE, It defines what we do with people.
1. Help me to resolve the problem(s) I have in my life/family/home/community
2. Understand what I need from my community and support me to be involved
The team were given permission to not be restricted by the current organisation processes, rules, and procedures, by applying a relational set of principles:
The team OPERATING PRINCIPLES, that guides what we do with people
• You understand me and the problems I need help to solve.
• We make decisions based on knowledge and evidence, not opinion or standards.
• Only do what is needed to create value (including documenting), enabling the person to gain control.
• We take ownership through the end to end journey with the person.
• Work as a team, without department barriers.
• We are here to learn, and improve.
Rule 1 - do not break the law.
Rule 2 - do not make their situation worse.
The team was made up of front line staff from across the public sector.
• Customer services
• Rent arrears
• Social Care – Adult Services (Childrens will be pulled in as required)
• Addiction Services – Drugs & Alcohol
• Mental Health Expertise
• Police
• Money/Debt Advice
• A manager
The purpose of the team was called the LOCALITY PURPOSE, It defines what we do with people.
1. Help me to resolve the problem(s) I have in my life/family/home/community
2. Understand what I need from my community and support me to be involved
The team were given permission to not be restricted by the current organisation processes, rules, and procedures, by applying a relational set of principles:
The team OPERATING PRINCIPLES, that guides what we do with people
• You understand me and the problems I need help to solve.
• We make decisions based on knowledge and evidence, not opinion or standards.
• Only do what is needed to create value (including documenting), enabling the person to gain control.
• We take ownership through the end to end journey with the person.
• Work as a team, without department barriers.
• We are here to learn, and improve.
Rule 1 - do not break the law.
Rule 2 - do not make their situation worse.
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This is an example of one way that we tried to understand what mattered to people that had multiple issues that were interrelated.
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After some months of working with away, the team summarised their learning:
• Typically our tenants have multiple problems to solve
• A high proportion of our tenants have a problem related to finances and debt
• Tenants typically find it difficult to get the help and support they really need
• That our partner agencies approach to resolving problems is systematic and not person based
• Joined up working doesn’t always work for the benefit of the individual
• Capacity for us and our partners to spend time understanding problems are typically as a result of waste we drive into our systems (political/red tape)
• Barriers to resolving problems internally and externally are very often linked to budgets
• Typically our tenants have multiple problems to solve
• A high proportion of our tenants have a problem related to finances and debt
• Tenants typically find it difficult to get the help and support they really need
• That our partner agencies approach to resolving problems is systematic and not person based
• Joined up working doesn’t always work for the benefit of the individual
• Capacity for us and our partners to spend time understanding problems are typically as a result of waste we drive into our systems (political/red tape)
• Barriers to resolving problems internally and externally are very often linked to budgets
A typical example of applying the liberated method principlesWe worked with many people, and Anna was chosen as she was typical of those that we worked with. She was a single parent, and was having difficulties with her children and her housing that was making her life very difficult. Her children were having real problems in their development.
We looked through her interactions with the public sector over five years, which began with some low level help needed. As this help was not forthcoming, Anna and her situation became increasing worse. The trajectory of Anna was that there was a good possibility that her children would be taken into some sort of care. The graph Red line shows that trajectory, the Blue line demonstrates what the costs were when the team helped her. We also looked at the cost difference with Anna across various parts of the public sector. It showed how intertwined such work truly is. |
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The triangle of needThe triangle of need is a powerful way to demonstrate the way that an organisation impacts on people they are trying to help.
If you would like to understand more about this, there is a video on Youtube where I explain this method. youtu.be/hNKWlFHxFIY |
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Place based locality measuresThe team, helped by some analysts, created many different measures and comparisons. This one is a summary of one locality, showing how they related individual, locality, and high level metrics together into a whole way of understanding a place based locality.
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Taking cases and dismantling all of their activities across the public sector was a huge task. The team wanted to demonstrate the difference in the relational liberated way of working, completed to the current way. So, the team chose 7 typical cases at random, and compared the old vs new way of working.
This graph is what they found, a significant difference in amount and the trend line direction. |
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The financial cost to the public sector can be measured empirically as the groundbreaking studies in this work and report show. By tracking multiple demands from individuals over time and across public services, it is possible to quantify the actual costs of a service from start to finish for each individual. Analysing thousands of demands from many individuals makes it possible to confidently draw conclusions on where and how to reduce costs. If the experience in the few areas we have studied is typical, initial calculations suggest that potential cost savings for local authorities alone from a move to locality working could run to as much as £16 billion (2012) annually across England, with even further savings in other parts of the public sector.
Projecting this nationally, uncovers savings of £22 billion annually
The new approach is a new way of thinking and behaving
In the new way of working we looked comparing the way that managers and decision-makers behave and make decisions. And how we design our current services. This is the summary we came up with.
• Person led, rather than episodic activities. Understand every person rather than categorising people
• Whole understanding, rather than standard assessments.
• End to end ownership, rather than referrals.
• Risk management, rather than risk avoidance.
• Early intervention, rather than eligibility criteria.
• In one room, rather than silo working.
• We help (outside our remit), rather than rely on strict role definitions.
• Partnering, rather than commissioning (the third sector is more pronounced today)
• Experts support with, rather than define and tell.
• Person led, rather than episodic activities. Understand every person rather than categorising people
• Whole understanding, rather than standard assessments.
• End to end ownership, rather than referrals.
• Risk management, rather than risk avoidance.
• Early intervention, rather than eligibility criteria.
• In one room, rather than silo working.
• We help (outside our remit), rather than rely on strict role definitions.
• Partnering, rather than commissioning (the third sector is more pronounced today)
• Experts support with, rather than define and tell.
Shifting from
delivering services,
to,
we shape services together.
We know how to reduce millions of pounds worth of unnecessary demand on public services; simply design services which are able to do the right thing for people in the first place. More effective services are more efficient, as people have their needs met more quickly rather than having to place numerous demands on the old unresponsive systems.
The national implications for relational place based locality working
- Services that are local design and management by default.
- Our services are not about service delivery and digital, but relational working.
- Systemic leadership and design is necessary for this work to from and sustain in a regional and nationally.
- New Public Management logic is the current national current paradigm ,This doe snot allow this working to sustain.
- Relational working is led by what matters to people to live a good life - mission based.
- Help people to help themselves.
- This has to be part of strength based & 3rd sector collaboration.
- Ensure a focus on purpose, not outcomes.
- Manage value, not cost.
- Leadership conviction & long term prevention is required - not fear or politics.
- This has to be part of a long term strategy for change.
This work shows why public sector organisations fail to meet people’s needs and why demand is rising. The two main causes, discovered empirically in the studies, are the belief in ‘economies of scale’ and the belief in the standardisation of services. Together, these beliefs prevent organisations from understanding and meeting people’s needs.
We know how to reduce millions of pounds worth of unnecessary demand on public services; simply design services which are able to do the right thing for people in the first place. More effective services are more efficient, as people have their needs met more quickly rather than having to place numerous demands on the old unresponsive systems.
We know how to reduce millions of pounds worth of unnecessary demand on public services; simply design services which are able to do the right thing for people in the first place. More effective services are more efficient, as people have their needs met more quickly rather than having to place numerous demands on the old unresponsive systems.
Here we show a typical case, and how relational working shifts the whole service approach.
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An example of relational working applying the liberated method principles
An example 'do with' rather than 'do to' with someone who had been in repeated rent arrears. What we did and what we learned.
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Visit 1 - These are the actual notes of what we found:
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- They had rent & tax arrears £3760. (over 9 months)
- They were not prepared for the visit. The place was very cluttered. Childs room is used by the man to work in.
- Child slept in parents room. Gloomy, lack of natural light. Stuffy, vents closed. Child has nothing to play with.
- Filthy toilet. Energetic and under-exercised Staffie pet dog.
- They have no car. Child never went out. Recent man plays computer games all day, has behavioural issues.
- The mans PIP (personal payments) have been cancelled, so he is not receiving the money he should.
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Visit 2 - Then we went back for a second visit:
We brought some books with us for the child, to help build trust with the mother. |
- They were painting their walls. The man is stoned.
- They are worried that social services might take the boy away, and that we might tell them.
- They have not updated the system where they get their benefits from, so they have less money coming in.
- We learned she is a carer, but she hurt her arm two weeks ago. She is on a zero hour contract, so she is not receiving any wages or sick pay.
- She is caring for the man and child. She is chief cook and cleaner.
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Visit 3:
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- We find that they have multiple debts.
- Admits to a lack of food, the fridge was almost empty.
- Her family lives near, but they pull on her help, and she wants to move away.
- She is trying to get a nursery place for the child. Child speech development is slow, and he has a heart condition.
- She is exhausted and crying. Living day to day. She broke down in-front of us.
We tried different ideas and repeated this with several people. What did we learn?
- That we had to visit, in this case more than once, to discover the true situation with the family. This rarely happens over the phone, because people are embarrassed, and lack trust in us.
- The problems are always complex, involving a multitude of issues.
- We need to involve other in our organisation to help solve this
- When we begin to help solve these issues, the tenants can be in a position again to pay.
But the most important thing we learned was that, when people cannot pay their rent, most of them react very badly to the letters we send them!
We also found that sometimes the letters did help. In the end we found that there were several type of reasons why people did not pay:
Each of those types, required different approaches!
- I cannot pay, I dont have the money
- I cannot pay because I am an addict/ mental health
- I earn enough but my lifestyle puts me into debt
- I have got used to not paying, and that's not a problem.
- I can pay, but I won’t
Each of those types, required different approaches!
Old 'enforce' principles of working - Command & Control principles |
New 'help me' principles of working - liberated method type principles |
We follow instructions. |
We understand the customer, and their lives. |
We ignore the individual issues the person has. |
We adapt and do the right thing for them. |
We follow the wording of the legislation, and use that as an excuse to act forcefully. |
We use the legislation to guide the reality of how it should be implemented. |
This is just a job, tenants dont like me. |
I enjoy my job, I help people who are in need. |
We start design using digital. |
We decide how digital helps us. |
We tell residents what to do. |
We help residents to help themselves. |
Staff are controlled through rigid procedures |
Staff apply a framework to do the right thing. |
This is the standard 'enforcement' mindset, where we believe that it is our job to make them do the right thing, by imposing our will through our decisions and an atmosphere of fear. |
A very different approach, where the control and decisions remain with the organisation. We support them in the circumstances they are in, to the point where they become confident in their own abilities. |
Here is a link to a webinar where I go through this work
https://www.betterway.network/past-events-feed/how-to-reform-public-services-by-liberating-local-teams-to-do-the-right-thing
https://www.betterway.network/past-events-feed/how-to-reform-public-services-by-liberating-local-teams-to-do-the-right-thing
Liberating method is a set of principles and part of a method created by John Seddon of Vanguard. The 'liberated method' is a term coined by Mark Smith of Gateshead, to describe an element of the Vanguard method.
