Transcript Slide 1

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)
16
15
14
12
10
IS
10
8
Demand
6
5
4
2
0
0
-2 .0 4
-5
-5 .7
-1 0
-9 .1
-15
-1 0
-1 1 .2
-1 2 .0 7
-1 2 .9
17
/1
8
15
/1
6
16
/1
7
14
/1
5
13
/1
4
9/
10
10
/1
1
11
/1
2
12
/1
3
-1 5
-9 .5
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 Delivery
Outcomes
Commissioning
Services
Partnership
Resource mix
Finance & social capital
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…..
The Continuous Improvement Process
Plan
What do we want to achieve?
(Outcomes)
Revise
What do we need to do
next?
Learning
&
Improvement
Review & Report
How have we performed?
Do
How will we do it?
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….
Driving Improvement Through Self Evaluation
•
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
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