delivering services in the age of devolution · • greater manchester devolution agreement settled...

Delivering Services in the

Age of Devolution

FRIDAY 6 NOVEMBER 2015

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Account details - The Meeting Space

Password - 1nn0v8tion@EMCouncils

#EastMidsInnovation

Cllr Cheryl ButlerLeader, Ashfield District Council

CONFERENCE CHAIR

Devolution – Unlocking Opportunities in Greater Manchester

Cllr Sue Murphy – Deputy LeaderManchester City Council

4GVA – Gross Value AddedLEP – Local Enterprise Partnership

Greater Manchester: a snapshot picture

Pioneering city

A city of firsts – birthplace of the industrial revolution, splitting of the atom and the modern computer

Legacy of driving change – home to the suffragettes and the worldwide co-operative movement

City of innovative pioneers – the city where graphene, the world’s thinnest and strongest material, was isolated

Today, Manchester is the first devolved economic city resulting in a pro-business environment

“BEST UK CITY TO LIVE”Economist Intelligence Unit, 2014

“FASTEST GROWING ECONOMY OUTSIDE LONDON”Grant Thornton, 2014

“NUMBER ONE CITY IN THE UK TO LOCATE A HEADQUARTERS”Cushman & Wakefield, 2012

“ BRITAIN’S MOST VIBRANT CITY ”Experian Vibrancy index, 2013

“THE MOST COMPETITIVE BUSINESS LOCATION IN EUROPE ”KPMG Competitive Alternative Survey, 2014

Recognition

Devolution

• Greater Manchester Devolution Agreement settled with Government in November 2014, building on GM Strategy development.

• Powers over areas such as transport, planning and housing – and a new elected mayor.

• Ambition for £22 billion handed to GM.

• MoU Health and Social Care devolution signed February 2015: NHS England plus the 10 GM councils, 12 Clinical Commissioning Groups and NHS and Foundation Trusts

• MoU covers acute care, primary care, community services, mental health services, social care and public health.

• To take control of estimated budget of £6 billion each year from April 2016.

• Commitment in July 2015 budget to align the Spending Review process for health and social care to our Strategic Sustainability Plan

The background to GM Devolution

• Greater Manchester will remain within the NHS and social care systems and continue to uphold standards in national guidance and statutory duties in NHS Constitution and Mandate – and for delivery of social care and public health services

• Decisions will continue to be made at the most appropriate level to the benefit of people in GM – sometimes locally and sometimes at a GM level

• Organisations will work together to take decisions based on prioritisingtheir people and their place

• From 1 April 2015 ‘all decisions about GM nationally are taken with GM’

What will – and won’t - this mean for the NHS and social care

• Devolving powers to GM will enable us to have a bigger impact, more quickly, on the health, wealth and wellbeing of GM people

• It will allow us to respond to the needs of local people by using their experience to help change the way we spend the money

• It will allow us to better co-ordinate services to tackle some of the major challenges supporting physical, mental and social wellbeing

How will we do this?

• By integrating our governance: being binding on all the partners, decisive and bold

• By integrating planning: working across CCGs, local authorities and trusts in our 10 areas to create aligned local plans feeding one GM strategic plan

• By integrating delivery: by doing best practice at pace and scale

Why do devolution?

• Improve the health and wellbeing of all Greater Manchester people – of all ages

• Close the health inequalities gap faster within GM, and between GM and the rest of the UK

• Integrate physical health, mental health and social care services across GM

• Build on the Healthier Together programme

• Continue to shift the focus of care closer to homes and communities where possible

• Strengthen the focus on wellbeing, including a greater focus on prevention and public health

• Contribute to growth and connect people to growth, eg helping people get in to and stay in work

• Forge a partnership between the NHS, social care, universities and science and knowledge industries for the benefit of the population

• Make significant progress on closing the financial gap

What have we said we’ll do in the MoU?

To ensure the greatest and

fastest possible improvement

to the health and wellbeing of

the 2.8 million citizens of

Greater Manchester

The vision for GM Devolution

| 13

So what do we think could be achieved?

Strategic Plan – our vision – by December

By April 2016 we will take care of our own £6bn

funding, and with this money we will make a

number of significant investments so that by

2020 we will have…

• 64,000 less people with chronic conditions

• 10% less visits to urgent care

• 6,000 less people being diagnosed with

cancer

• 25,000 people with severe mental illnesses

will benefit from better community-based

care, reducing need for urgent services by

30%

• 18,000 children better supported by local

services

• 700,000 people with chronic conditions,

better able to manage their own health

14

Worklessness & Low Skills Children & Young People Crime & Offending Health & Social Care Long-term JSA claimants ESA claimants (WRAG) ‘Low pay no pay’ cycles

Working Tax Credit claimants

Low skill levels (vocational or academic)

Insecure employment

NEET (Young People) Compounding factors:

Lone parents with children 0-4

Poor literacy and numeracy

Poor social skills

Low aspirations

Living alone

Child in Need Status (CIN) / known to Children’s Social Care Child not school ready Low school attendance & exclusions Young parents Missing from home Compounding factors:

Repeat involvement with social care

LAC with risk of offending

Poor parenting skills

SEN

Frequent school moves

Single parents

Repeat offenders Family member in prison Anti-social behaviour Youth Offending Domestic Abuse Organised Crime Compounding factors:

Lost accommodation

Dependent on service

Vulnerability to sexual exploitation

Missing from home

Violent crime

Mental Health (including mild to moderate) Alcohol Misuse Drug Misuse Chronic Ill-health (including long-term illness / disability) Compounding factors:

Unhealthy lifestyle

Social isolation

Relationship breakdown / loss or bereavement

Obesity

Repeat self-harm

Living alone

Adult learning difficulties

The roots of poor health are found across society and the public service – we need to do more than just respond at the point of crisis. This requires integration of not just health and care, but contributing wider public services focussing on health, wealth and wellbeing

Devolution isn’t just about health & social care

Highlights & opportunities

15

• A genuinely galvanising effect – whole system enthusiastic participation. Everyone wants to help. This is true at both the local and national levels, as well across the statutory and voluntary/third sector.

• A collaborative breakthrough – system governance across all partners underpinned by clear joint decision making capability. This includes the unique elements of a GM Joint Commissioning Board and an NHS Providers Federation Board and explicitly priortisespublic benefit about organisational self interest.

• A lifting of the ambition – now planning to bring together £2.7bn of commissioning resource. Also looking at more radical change through the Transformation Initiatives.

• Devolving power/evolving citizenship – generating enthusiasm for a different relationship between the public and their public services, responding to social action, tapping into the strengths and assets of our communities.

• The Economics of Prevention – the key opportunity for us to understand the associations between key preventive interventions (early years investment, employment support, lifestyle adjustment, community development etc) and impact on the characteristics of current demand.

Challenges

16

• Subsidiarity and operation at the right spatial level– getting the balance right between what we do 10 or more times to hold relevance at the ‘place’ level and what we do once at the GM level to secure the benefits of transformation at scale.

• The financial case for prevention & early intervention – we are challenging ourselves to make the most powerful case yet for the ‘economics of prevention’ demonstrating the link between public health, employment and early intervention outcomes and setting this out in a joint submission to the Spending Review.

• Exciting the public about devolution – we have some way to go to opening out the discussion and engagement to the public at large at a level where we could genuinely drive a significant shift in social action and citizenship.

Devolution and Shaping Local ServicesCllr Neil Clarke, EMC Vice Chairman

Leader of Rushcliffe Borough Council

How Devolution can help shape and deliver

better services and outcomes for local

people.

What are our Key Priorities?

Effective and efficient

delivery of local public

services

Driving local economic

growth

For both - the need for

strategic collaboration has

never been greater.

Collaboration across Councils

Ambition is over and above that of shared services.

Transformational services should focus on places we represent.

To genuinely ‘shape place’ – we need to innovate and collaborate.

‘Best of the best’ approach.

5 key themes that influence collaboration; leadership, selflessness, trust, momentum and risk

…..And Devolution?

It is not a panacea for all our woes!

So …. What’s in it for us?

Opportunity to drive and influence future change.

A buying club for local government

Strength in numbers

Opportunities of Devolution

Releasing un-tapped growth potential.

Rebalance economy.

Reforming public services – better outcomes, lower cost.

Renewing our democracy.

What Devolution Should Not Be

About!

Not about more taxes

Increasing bureaucracy

Pushing greater financial burdens onto our businesses

Introducing or re-introducing additional layers of Government

Local Government re-organisation

Losing sovereignty for areas we represent

Drowning in governance discussions

How will Devolution Improve

Service Provision

…..Because currently….!

Lack of flexibility of nationally developed policy.

Benefits and skills system not producing the best outcomes for our area.

Bureaucratic, inefficient and unaffordable.

MEETING THE CHALLENGES OF DEVOLUTION

Why is it important?

Steve Atkinson – Chief ExecutiveHinckley and Bosworth Borough Council

East Midlands Councils6 November 2015

24

The Challenges (1)

• Reduced (and reducing) Finance

- Revenue Support Grant

- Cap on Borrowing

- Council Tax Limits / Referenda

- Rent Reductions

- ‘Forced’ Sales of Assets

- New Homes Bonus

- Propaganda on Charges / Reserves

25

The Challenges (2)

• (Welcome) Increases in Responsibility

- Universal Credit / Wider Welfare

- Discretionary Housing Payments

- Troubled Families

- Housing / Supporting Refugees

26

The Challenges (3)

• Increasing Demands

- Housing (Build)

- Homelessness

- Minimum Wage

- Business Growth

- Planning Approvals (Appeals!)

27

OpportunitiesHinckley and Bosworth Experience

• Combined Authorities

• Shared Services

• Business Rates

• Ingenuity, Innovation and ‘Risk’

• ‘The Best’ of Public Service

• Collaboration, Collaboration, Collaboration

28

The Importance (1)

• Business Growth

• Houses to meet demand

• Community Wellbeing

• Social Housing

29

The Importance (2)

• Because we are the last resort to those in greatest need

• Because our closeness to local communities gives us the insight … and the power … to collaborate to improve their quality of life in

so many ways

30

The ‘To Do‘ ListCouncils will be:

• Setting Place Priorities

• Coordinating Collaboration- Local Authorities

- Businesses

- Health

- LEPs

- Police

- Voluntary Sector

- Education

• Evaluating Effect

• Taking Risks

• Making Things Happen31

Questions and Answers

Break

Workshops Exploring Innovative Changes to Service Delivery

Delegates will have the opportunity to attend both sessions

Workshop 1 - Digital Devolution (Main Room)

Workshop led by Cliff Graham and Sara Whiteside, Agilisys

Workshop 2 - Public-Private Partnerships Delivering Service

Transformation (Board Room)

Workshop led by James Drury, Chesterfield Borough Council and John Wybrant, arvato UK

© 2015 Agilisys Commercial-in-Confidence

Presentation Title

Presentation Subtitle

July 2014

Powering Devolution – Digital as an enablerMeeting demands of citizens in a digitally enabled

world - but with significantly reduced budgets


Behaviours are changing… and your citizens are no different

92% of the

UK have

web access

(ONS)

In 2014, 71%

of UK adults

banked

online

(OFCOM)

69% of dis-

advantaged

UK citizens

access the

web weekly

(EU)

68%

(Google)

own a

Smartphone,

24% a tablet

(OFCOM)

65% of

people find

your contact

centre

number on

your

website

76% of

adults

access web

daily (ONS),

50% by

phone

(BBC)

In 2014 75%

of UK adults

transacted

online (ONS)

In 2014 the

average UK

consumer

spend p.a.

was £1,174


Devolution, delivering through regional systems, locally driven, fundamentally

changes the delivery model:

• Managing the balance between Central influence and Local identity

• Predicting and managing changing customer and service demands

• Commissioning model with small core

• Multiple providers, multiple gateways

• Single set of ‘customers’

Can technology enable these new models?

The public sector also needs more:


Resources

Influence

Leverage

Identity

Engage-ment

Social Capital

The Challenge:

Managing in systems - the central/local balance


• Single citizen record (client centred, client owned?)

• Access and customer journeys:

• Simple – Efficient - Effective

• Behavioural change – hints, nudges, shoves to support a move away

from dependency

• Analytics, insight and the power of Big Data to support planning:

• What works, what doesn’t

• Targeted, expedient investment

The power of data across devolved systems:

Predicting and managing demand


Place as a Platform

Sara WhitesideClient DirectorAgilisys Engage

November 2015


“We will prioritise spending which promotes, “innovation and

greater collaboration in public services” and “growth and

productivity including through devolution within England” – along

with “choice and competition…which drive efficiency and value

for money”. .”

George Osborne, Treasury Spending Review, 21 July 2015


“Local government has a long history of collaborating and

sharing services, but devolution will require councils to

challenge themselves to go much further. For devolution to

deliver better results for communities, councils will have to be

bolder about how they work across boundaries and become

champions of a wider place.”

ENGLISH DEVOLUTION: LOCAL SOLUTIONS FOR A SUCCESSFUL NATION

Local Government Association Paper, May 2015


Enabling Digital Leadership

Imperatives driving change

Citizen

engagement

DevolutionDigital

First

Reduce

Cost to ServeReform

Connecting the

elected with the

citizen

Outcomes

Effective

collaboration

with community

partners

Better,

personalised

digital services

Savings through

shift to right

channel & partner

Data driven,

outcomes focussed

transformation

Community partner network tools & insights

User engagement tools & services

Digital analytics tools & dashboards

Behaviour driven personalised user journeys

…with people, places and partners


• Leicestershire/Melton Population of 667k/51k & 26k/2.1k

Business Enterprises

• Millions of web interactions per month

• Individual view of total customer journey, blind to other data

• Demand management opportunity limited to own site activity

• Lack of content alignment or dynamic signposting

• Citizen experience fragmented and repetitive

• Challenge = handling and optimising this digital

engagement holistically across a Community


Citizen

Signs Posts

Surveys

Road Blocks

Assisted Self Serve & Web Chat

Analytics & Journey Tools

Geo Zones

BusinessDigital Value Optimisation

e-Partnering + Rev Gen

Open Profile Community

Social Media


Sign posts

Chat Geozones

Road blocks Advanced Analytics

Data Insight


Sign Post

Web Chat

Citizen


Discover

Understand

Co-Design

Reward

Advocate

Execute

Personal

Place-Aware

Optimised acrossMulti-agencies


Mobile Digital Dashboards - Focus on transformational

outcomes

Executive Dashboard

• Targeted at members and officers• Simple interface• Snapshot of 3-6 metrics• Connecting citizen, place and service

• Targeted at officers and operations staff• Agilisys Engage and Agilisys Digital data• Option to filter by place, and time• Benchmark, social media and news reports

Operational Dashboard


A Digital Leadership Opportunity For Local Authorities

A Local Digital Infrastructure is the fabric which knits together the local community, people, providers, social enterprises and businesses

This sits at the core of the Local Authority role. If the Local Authority is not providing this, who is?

Local Authorities have THE key role to play in building stronger, place-based, partnerships and digital communities for;

Immediate supply-side efficiencies

Effective management of the demand-side through behaviour change

Better, ‘locality’ commissioning

Economic development and (re)generation

Stronger local democracy, citizen engagement and ‘citizen participation’


‘Place as a platform’ is the digital

infrastructure for a ‘whole place’;

promoting, developing and regenerating

the offline world – driven by devolution,

powered by digital


Collaboration, not integration:

• Managing the sum of the parts may be better than the whole

• Avoiding monoliths, hierarchies and bureaucracy, but retaining

influence and leverage from scale

• Enabling active citizenship: peer-peer, self-sustaining choice, control

and engagement for communities to manage ‘outside the system’

• Developing social capital

• Fundamentally changing the role of the professional: moving away

from alleviating distress to drawing on the capacity of communities

and individuals to avoid it

Sovereignty and identity


Principles

Focus on removing customer frustration

Ineligible transactions (e.g. ASC)

Chaser calls (e.g. status)

Information calls (e.g. apt time)

REDUCE

Avoidable

Contact

Data entry (e.g. reporting)

Administration (e.g. scheduling)

Data management (e.g. RAS)

AUTOMATE

Transaction

Processing

HAND-OFF

Transaction

Fulfillment

Chasing data (e.g. incomplete)

Chasing payments (e.g. highways)

Posting / printing (e.g. licence)


Is there a better customer focused model?

Could technology

enable a joined up public sector without loss of sovereignty?

Lunch

Workshops Exploring Innovative Changes to Service DeliveryDelegates will have the opportunity to attend both sessions

Workshop 1 - Digital Devolution (Main Room)

Workshop led by Cliff Graham and Sara Whiteside, Agilisys

Workshop 2 - Public-Private Partnerships Delivering Service

Transformation (Board Room)

Workshop led by James Drury, Chesterfield Borough Council and John

Wybrant, arvato UK


Presentation Title

Presentation Subtitle

July 2014

Powering Devolution – Digital as an enablerMeeting demands of citizens in a digitally enabled

world - but with significantly reduced budgets