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/ /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) -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 Delivery Outcomes 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