public service innovation - 2011 version

1.Service Innovation CourseInnovation in public services Manchester Institute of Innovation Research IAN MILES[email_address] MIoIR, University of Manchester

Public sector is a huge area of expenditure, employment, etc. and under heavy political pressure and facing challenges of social change (e.g. ageing).Innovation is vital for increasingefficiency , for deliveringnew and better quality services

Importantmarketfor innovative products (goods and services) from across economy impact of public procurement on innovation systems

Importantdemonstratorof scope for new services, infrastructures and standards

Not necessarily ownership, butGovernance.Not market- or third sector- led.Structured through state financing/control by state employees, or through public service industry or outsourcing to charities.

Funds from taxation/national insurance/government revenue

Different levels of governance national, (regional), local.

Varies a lot across countries

Typical services include...

Education (all levels)

Health

Social care, community services, social and employment services

Criminal justice

Emergency services

Sanitation, waste disposal

Business support services

Public administration

Defence

EU employment shares,2000

Public administration,defence; compulsorySocial Security11.4%

[Other community, social and personal service activities 7.0%]

NACE1 sections L to O ACTIVITY (not governance)groups

Education 10.0%

Health and social work 14.3%

Intangibility (issues of transport, storage, coterminality)

Interactivity (Production and consumption often intertwined)

Information-intensity (Much specificity as to service, client)

Need to relate service product and production process to service client often extended affair, degree to which individual details involve specialised or customised production varies immensely.Affects scope for innovation of various kinds.

Public services have to confront the variety ofhuman characteristicswith the dictates of large systems andbureaucratic rationality .

There can be ambitious innovation programmes (e.g. Current NHS IT programme)

There can be substantial problems (this applies to all sectors)...

.. these can become highly politicised and debated in media (less common, though not unknown, in private services).

Governments target public sector though whether this is really innovation is at issue

Many commentators conclude that public services face particular problems.

Key Assumption (here):

competition drives innovation

Threats and rewards->doing better

Individuals will be motivated

Organisations will be motivated

Use instruments like IPR

Solution: make PS more like private sector:

New public management

Features: quasi-markets

Indicators and targets

Performance measurement[Acted upon!]

Outsourcing

Reform without considering impacts on innovation may be problematic.

Thus we see various efforts to stimulate innovation in new ways alongside general reform and modernisation efforts.

E.g.NHS Institute for Innovation and Improvement http://www.institute.nhs.uk/

Est. 2001 to support NHS and partner organisations in modernising services and improving experiences and outcomes for patients.

Focused on four areas:

improving access,

increasing local support,

raising standards of care,

capturing and sharing knowledge widely.

10 high impact changes:

Treat day surgery as the norm for elective surgery

Improve access to key diagnostic tests

Manage variation in patient discharge

Manage variation in patient admission

Avoid unnecessary follow-ups

Increase the reliability of performing therapeutic interventions through a Care Bundle approach

Apply a systematic approach to care for people with long-term conditions

Improve patient access by reducing the number of queues

Optimise patient flow using process templates

Redesign and extend roles

Numerous essays on why public services might have an innovation problem

On why the solution might lie in introducing new public management and/or market principles

Various studies of public service innovation start off from this perspective

Even PUBLIN only examined public services

But there is one comparative study, which tells a different story..

Earl, L. (2004)An historical comparison of technological change, 1998-2000

and 2000-2002, in the private and public sectorsOttawa: Statistics Canada (also see Earl 2002)

Can you find any other comparisons?

- EC is trying to develop a public sector equivalent of CIS

PUBLIN differentiated between innovations involving:

changes incharacteristics and design of service

products andproduction processes including development, use andadaptation of relevant technologies,

delivery innovations involving new or altered ways of solving tasks,delivering services or otherwise interacting with clients for the purpose of supplying specific services,

administrative and organizational innovations involving new or alteredways of organizing activities within the supplier organization,

conceptual innovations in the sense of introducing new missions, newworldviews, objectives, strategies and rationales (particularly important to institutions operating under social or public objectives, linking the social objectives of the policy and institution and the operational and economic goals and functions of the agency)

system interaction innovations new or improved ways of interacting withother organisations and knowledge bases.

Genetic screening

Intraocular lenses

Health informatics

Electronic patient records system huge scale, clear benefits (and professional risk perception)

NHS Direct:most radical innovation in recent history of health service

Tier Two reduced waiting lists through appropriate secondary care rather than using hospitals

Creation of new mental health trust specialisation

Pilot out of hours link with Aus/NZ consultants

Modernisation Agency

[and now organisational change GP commissioning -is this innovation? ]

Each group is providing a online and/or phone-based interface to a public service.

What are the design features of this innovation?(what does it provide, to whom, when and how? What does this mean in terms of ease of use by different population groups?Availability of platforms?) 10 mins

What stakeholders need to be engaged (public, professionals, telecomms, private services, etc.?) How can alliances and partnerships be built?10 mins

Whatskills and training are required?10 mins

High level of staff expertise, creativity, problem solving

Strong public spirit ethos, motivations beyond personal financial rewards

Controversial shifts underway (e.g. competitive framework of Foundation hospitals) believed by proponents to increase innovation by:

Allowing for flexibility and experimentation within target culture and common standards

Incentivise staff (and management) financially, status-wise, and through improved service quality

Improve patient choice (will drive resources as money follows patients) aand consumer feedback into innovation process

Management draws on external sources for directed creativity and organisational innovation and knowledge mananagement

Conscious efforts at innovation management (under various guises)

Research Policy bringing in the public sector where it is absent, taking better account of it where it is present

Public sector policy governance, regulatory reform, efficiency, modernisationBuilding innovation into public policyAssessing innovation processes and impacts to guide policy, validate expenditure

Many commonalities many ideas and instruments can be borrowed can we use innovation models (PLC etc)?

Different selection processes internally and externally.Processes of diversity generation too.

Much is public-private mixture (many kinds)

Public services highlight areas where innovation studies are weak

Explore new innovation strategies

efforts

underway

is a topic crying out for research

Policymakers desperately want good knowledge

Innovation studies themselves can benefit from looking at this

Its important for public expenditure, social well-being, and innovation across the economy

Must not be a ghetto!

Concept of innovation recognised and people can work with it (to some extent) in interviews, but the actual term innovation often was not employed many other terms used.

Innovation often seen as fashionable jargon or as new technology or problem-solving

Or as a matter of adoption of top-down guidelines, meeting targets (important procedural innovation).

Often incremental developments, often hard to establish boundaries between innovation and replication.

Huge number and range of developments, not subject to much direct recording/compilation in databasesThough some recording through incentive schemes, and through efforts to impose IPR models

Internal diffusion / roll-out repeatedly a major issue - much effort now being spent on identifying, codifying and spreading good practice, new procedures. Lack of structures and mechanisms for organisational learning seen as major issue efforts being made here. But

Initiatives to diffuse good practice seen as short-lived reorganisations lead to loss of corporate memory

Infrastructural and procedural/occupational heritage and legacy, entrenched practice and procedures are commonly experienced.

Professionalised resistance e.g. clinicians, ambulance service form disconnected hierarchies, some self-governing professionals, others quasi-military forces.Lack of common command and control structures conflict with established roles, politics, empires

In particular lack of commitment to consumer orientation was often cited as a major issue (mirroring political rhetoric in UK).

Public resistance to reorganisation though public seem very open to new ways of operating

Lack of ownership of innovation top-down initiatives

and IP issues

Resistance to out of the box thinking plus risk aversion (generic issue in public sector related to nature of service (large-scale and severe risks) and to political cycles. High public/political profile plus blame culture, accountability and risk of litigation (but US?).

Pace and scale of change (NHS in particular) shifting targets and absence of opportunity to reflect/asses consequences

Very complex organisation composed of multiple tiered interlinked systems with - Huge staff numbers; Many occupations; Many organisational arrangements; Many service processes

Lack of patient information connectivity between actors in system

Lack of dedicated budgets for innovation at relevant (local, Trust) level.

Some areas (mental health) not high profile priority for investment (cf. surgery)

Requirement to consult, lack of clear picture of all eventual effects

Those more at the strategic/management level

Organisational:governance relation changes, new agencies, etc

New roles, responsibilities, new ways of operating (need forknowledge managementcapacity), role in training

Technical and technological(huge) some systemic, esp.IT-based,

New specific practices e.g. round pharmaceuticals, clinical practice, techniques, devices, etc.Huge range of artefacts involved.Again, much IT impact.

Often technological innovation closely tied to further organisational/process change/innovation

Could we have innovation audits? We have yet to measure public service innovation and impacts systematically (several partial attempts)!

Can we do better in assessing costs and benefits of attempts to impose certain private sector models on the public sector are there other elements of innovation management that should be engaged with (first?)

Research, Consultancy, facilitation for gvt, local gvt, CSOs, etc.

Esp. education

Working Party of National Experts on S&T Indicators (NESTI): methodological guidelines for measuring S&T activities (Frascati, Oslo Manuals) Task Force

Centre for Educational Research and Innovation (CERI) measuring innovationin education and training

OECD Public Governance and Territorial Development DirectorateGovernment at a Glance (2009 and 2011) + various activities on innovation in public governance

OECD Health Division performance indicators for health systems, ICTs in health