IRRV Scottish Conference 2010

Years of Challenge: Securing the Future For Public Services

Continuous Improvement in Difficult Times

Mark McAteer

Director of Governance &

Performance Management

The Recent Past• Budget growth of 4.5% (1999 – 2008)

• Partnership with Government (‘Concordat’): support for national priorities in return for local empowerment

• Focus on results (‘outcomes’) & ‘joint working’ between LG; Police; Fire; NHS; Enterprise; Environment agencies….

June 2010 Emergency UK Budget• Overall deficit reduction of £113 billion by 2014/15 : £73 billion inherited from

Labour + further £40 billion

• 76% spending cuts: 24% tax increases

• Additional public service spending cuts of £15.7 billion to 2014/15 (£1.57 billion pro-rata in Scotland) over and above Labour

• Total public service current spending cuts £55 billion between 2011/12 - 2014/15

• Capital programme declines by 60%: £49 billion (2009/10) – £21 billion (2014/15)

Reasons To Be (Barnet) Cheerful…..• UK Government has prioritised NHS for real growth: the major Barnet

consequential (40% of Scottish Block)

• Schools education will be protected: ‘Free schools’ & ‘pupil premium’ (15% of Scottish Block)

• Council Tax freeze down South will create a positive Barnet consequential of £63 million

• Social work & social care could not be substantially cut without major change in statutory duties & large ‘knock on’ effect on NHS

• Therefore, less than pro-rata share on UK cuts

Implications• 12% real reduction assumption for next 3 years

• Further 4% between 2014 & 2016 then levels out

• Total funding gap (taking account of income, cost & demand) is massive by 2013/14 & beyond

Scottish Block Finance & Demand 2009/10 – 2017/18 (% real terms)

0

-2.04

-5.7

-9.1

-12.9-12.07

-11.2-10 -9.5

0

2

4

6

8

10

12

14

16

-15

-10

-5

0

5

10

15

IS

Demand

-15

Scottish Priorities: Potential Impact• If NHS fully protected, other services would need to find between

16% & 18% cuts (real terms) between 11/12 –13/14

• If schools protected within councils, other service areas would need to find 30%+ between 11/12 & 13/14

• Given demographic trends, demand trends & statutory duties, social work & social care cannot be significantly cut

• Implies 45% plus cuts in other areas but….police, fire, fixed costs, etc

The Outcome Focus• The National Performance Framework & SOA’s

• Quality of life; opportunities & living context

• Changing public service cultures - we can’t do outcomes to people - ‘co-production’

• Supporting & enabling positive outcomes -v- managing negative ones

So Why Adopt An Outcome Approach ?• Outcomes force issues of accountability for results

• Outcomes force questions about the impact of public services on life opportunities within & between communities

• Outcomes force questions of organisational design & the use of total public sector resources

• Outcomes force critical questions: - what matters most ?- what do we want our community/ communities to look like ?

Developing The Outcome Focus• Overcoming past patterns of success & failure – health; education; community

safety; employment …. reflect tacit dependence & frustration of co-production

• We need to invest in peoples ability to ‘co-produce’

• This may result in redefining the boundaries of the state/ rights/ responsibilities

• Means different types of service design, skills & capacity

Rethinking Service DeliveryOutcomes

Services

Resource mix

Finance & social capital

Commissioning Partnership

Some Examples (1) – Hospital Care

• Emergency admission of older people to hospital: £1.5 billion

• ‘Patients follow the money’ -v- ‘The money follows patients’

• ‘Health’ or NHS focus: Outcomes

• Family & community as part of resource mix

Some Examples (2) – Leisure

• Services & outcomes: What? For whom?

• ‘Resource mix’: Capital, revenue & sustainability

• Subsidy -v- delivery model (Trusts)

• Strategic partnership; exit & targeted subsidy, etc

Common Themes

• What are the outcomes we are seeking & for whom?

• Have we designed public services to achieve these outcomes?

• Have we the right ‘resource mix’ to achieve these outcomes?

• How do we support users/ communities to ‘co-produce’?

Challenges For Revenue Services

• Protect the ‘frontline’ ‘back office’ pressures

• Improve collection rates – ‘if you can’t even get the money in….’ balanced with debt advice & support etc

• Getting clear on outcomes & what they mean for revenue services

• Business models – integration all revenue services/ external business partners/ customer ‘profiling’ & early intervention…..

Learning &

Improvement

What do we want to achieve? (Outcomes)

How will we do it?

How have we performed?

What do we need to do next?

Plan

Do

Review & Report

Revise

The Continuous Improvement Process

Continuous Improvement & Self Evaluation

• Structured approach to improvement

• Plan resource priorities & deployment

• Involve staff in the challenge

• Focusing improvement activities

• Collaboration, learning & sharing

• Ease the scrutiny burden

Common Challenges

• Securing corporate/ service buy in

• Leadership - sticking with it

• Culture

• Resourcing implementation

• Linking to scrutiny

PSIF – What is it?

• An innovative & bespoke improvement model for public services in Scotland – 21

councils; 7 Fire & Rescue Services; 2 Third Sector orgs; 1 NDP; 1 Leisure Trust

• Based on EFQM model; fully incorporates BV2 principles; Investors in People;

Customer Service Excellence Standards (fully mapped against key LA inspection

frameworks)

• A facilitated, scored self-evaluation involving a cross-representation of employees

in reviewing 9 key organisational elements

PSIF Values

• Improving customer outcomes

• Facilitated self-assessment core to performance management

• Flexible & robust

• Collaboration & sharing capacity

How PSIF works

• Evidence based self-assessment framework

• Examines whole organisation/partnership

• How are we doing?

• How do we know?

• Where do we need to improve?

• Underpinned by robust scoring mechanism (RADAR)

How PSIF Works

PSIF Methodology

• Self Assessment

• Evidence based

• Facilitated challenge – plus scoring

• Improvement action orientation

• Consensus & inclusive

Driving Improvement Through Self Evaluation

• Clear outcomes – what/ for whom/ how/ when/ with what …

• Appraise delivery options - including resource mix & deployment; processes; leadership; results….

• Using evidence – logic modelling/ prioritisation/ base lining/ target setting/ lean/ BPR….

• Performance - getting the right evidence/ information to measure progress against outcomes (short, medium, long term)

• Holding to account – robust self evaluation against outcomes

• Changing cultures/ how we think:

- customer/ citizen (outcome) focused

- services/ partnerships as ‘delivery vehicles’

- matching resources to outcomes/ priorities

- assessing long term not just short term performance

- achieving outcomes with communities not doing to them

Driving Improvement Through Self Evaluation

End Points

• Critical juncture: finance, demand & outcomes

• Achieving outcomes: with individuals, families & communities as important as public services

• Getting clear on design principles of services – resource mix; service delivery models

• Getting on the front foot : using self evaluation to drive change & improvement against cost & outcomes