IRRV Scottish Conference 2010 Years of Challenge: Securing the Future For Public Services

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

2. 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….

3. 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)

4. 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

5. 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

6. Scottish Block Finance & Demand 2009/10 – 2017/18 (% real terms) -15

7. 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

8. 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

9. 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 ?

10. 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

11. Rethinking Service Delivery Outcomes Services Resource mix Finance & social capital Commissioning Partnership

12. 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

13. 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

14. 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’?

15. 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…..

16. The Continuous Improvement Process Plan What do we want to achieve? (Outcomes) Do Revise Learning & Improvement How will we do it? What do we need to do next? Review & Report How have we performed?

17. 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

18. Common Challenges • Securing corporate/ service buy in • Leadership - sticking with it • Culture • Resourcing implementation • Linking to scrutiny

19. 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

20. PSIF Values • Improving customer outcomes • Facilitated self-assessment core to performance management • Flexible & robust • Collaboration & sharing capacity

21. 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)

22. How PSIF Works

23. PSIF Methodology • Self Assessment • Evidence based • Facilitated challenge – plus scoring • Improvement action orientation • Consensus & inclusive

24. 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….

25. 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

26. End Points Critical juncture: finance, demand & outcomes Achieving outcomes: with individuals, families & communities asimportant 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