“Hearing the Community’s voice” - Could One Norbiton innovate by going back to the future? Dr Mike D’Souza

ONE Norbiton's current role is Stake holding Stakeholders are those who have rights to be consulted because they will be affected by budget holder decisions as Service Receivers and or Taxpayers We must see ourselves as representing Norbiton Stakeholders trying to persuade the budget holders in the local Council, NHS, Police, Schools, Housing etc to spend local resources in a better way. When (and if!) we get our own budget we will still have a stake holding role. Copyright TORCHE 1998

“What counts is what works” - but how might we measure this and what does “what works” mean?

It would be innovative to assess our success by measuring our residents’ “happiness” before and after any change in service proposed by us. Improving the happiness and Quality of life in Norbiton is “what works”

What is required to do this? 1.A simple means of acquiring happiness data on a regular basis preferably one that has already been tried and tested. 2.A tool that is easily understood by everyone and requires simple arithmetic rather than complex mathematics You may like to consider using a tool we developed to assess the Quality of life of our patients. This was based on “The Dartmouth face scale”“The Dartmouth face scale

“The Thymometer” A Face Scale to measure Feelings Simple Quick Visually obvious meaning Trans-cultural Adaptable In use for 30 yrs

Simple Face-value ‘The Thymometer’ * – A visual measure of feelings Text us +100 if you feel the “Happiest ever” down as low as -100 if you feel the “ Unhappiest ever”. This Thymometer has been used for over twenty years in many studies including one in Norbiton and is currently being used in our CareCreds project.CareCreds project

RESULTS USING THE THYMOMETER The PROPORTION happy with their Quality of Life by age group 7322 GP Consultations in Kingston area (1996 ) Best Ever Quality of Life These results show that people are least happy in middle age. They have been confirmed by two more modern sociological studies thus confirming that the Thymometer, although simple, is scientifically consistent. NB Its results cannot be averaged as everyone’s idea of happiness is individual.

Proportion happy with the Quality of their Life according to their presenting Medical Problem 7322 GP Consultations(1996) Best Ever Quality of Life These results show that people happiest when coming to the doctor to get jabs before going on holiday. Again this shows that the Thymometer gives results consistent with expectations.

How can we measure the Quality of Life of our Norbiton Population and how can we get their approval for any suggestions we might make including their approval of members of the Board?

This is difficult- but there are a number of ways forward e.g. Get elected representatives Objections: We already have a council so doing this is unnecessary Survey the total population every so often. Objections: Expensive. Unlikely to get a big response. (even council elections only get 20 to 30% turnout) OR Take a new properly stratified random sample every year to act as a Community Jury. Objections: If not done properly its results could be biased. Advantages: Feasible, inexpensive, educational for participants and more likely to be an accurate way of hearing a truly representative voice of the whole of the Norbiton community.

How could a Community Jury help us be better Stakeholders? If you decided to try my suggestion we would have three functional groups: 1 Board Members –These could be, as now, a self-selected group of interested individuals using normal committee rules. But Board members could then become democratically endorsed by the proposed Community Jury. 2 Managers- At present these are appointed council officers. Eventually they should be formally approved by the Board and see their role as helping the Board to get the democratic views of the Norbiton community on proposals for improvement 3 The Community Jury - To make this properly representative, perhaps we could go back to the start of Democracy.* Then, 2.5% of each of the sub-groups of the population were selected by lot each year as a jury to represent the views of all the citizens of ancient Athens*. Our management could use our existing Electoral role to select 2.5% random samples of the population of each the different subgroups in Norbiton viz. Shopkeepers, Owner-Occupiers, Council Tenants etc. to do the same job. * Cleisthenes Late 6 Th Cent Athens

How can the Internet and Mobile phone help us? The Internet will make it much easier and cheaper to collect opinions from our Community Jury members. Although 90% of our decisions can be made by common-sense management, being able to consult such a Jury on what might be contentious would be invaluable. Getting a meaningful (representative) measure of public opinion particularly on hard decisions like cuts could also be helpful to our budget-holders. The internet and mobile phone are ideally suited for quick voting and for using something like the Thymometer to measure quality of life. Our management team could suggest suitably framed questions (with a balance of points for and against) for the Board to approve for sending to the Jury.

How could we set up this structure?

1 AGREE THE MEMBERSHIP OF THE BOARD AND IT’S TERMS OF REFERENCE-TODAY 2 AGREEING THE ROLE FOR MANAGEMENT –TODAY 3 SELECTING A REPRESENTATIVE COMMUNITY JURY –MY SUGGESTION HOW THIS COULD BE DONE EVERY DECEMBER

Selecting a Community Jury Purchase for £25 (or borrow) the electoral roll for 2012 Use to select a 2.5% (or larger) stratified sample by road name or block of flats Send each selected person a Christmas card letter explaining the task (see draft of proposed wording) Offer to select alternatives for those unwilling or unable to serve

Draft of a suggested Jury approach letter Dear Mr. /Ms……… You have been selected by lot to speak for your neighborhood on our new 2012 Norbiton Community Jury. We want your personal opinion on how how our local services can spend their budgets better. We would welcome any ideas you might have and your views on suggestions made by us. This year we are focusing on Housing and Policing and want to make improvements in the quality of life in Norbiton. We do hope you will agree to help our voluntary Board to do as good a job as possible. If so, please will send us your and mobile phone number for us to contact you (we will keep them confidential) You can learn more about this initiative, which has the support of the Council and the Cabinet Office, by visiting our Website

How would this proposal work in practice?

1. The Board or anyone else can suggest a helpful idea “ We would have a better service and save money if the NHS ran Outpatients and did routine Surgery at the weekends”

2. The proposed role for The Board, Managers and Community Jury The Board decides on whether to put the idea up for debate or not.The Board decides on whether to put the idea up for debate or not. The Managers use text, and our Facebook page/website to ask the Jury if we should press the service budget holders to implement the idea.The Managers use text, and our Facebook page/website to ask the Jury if we should press the service budget holders to implement the idea. The Community Jury Votes.The Community Jury Votes. Results used by Board to lobby services (or spend its own budget)Results used by Board to lobby services (or spend its own budget) Copyright TORCHE 1998

3. Follow up The outcome of our policies could be reviewed by the Management in terms of gain in happiness and these should be published. The budget holder management could measure the service improvement and financial impact of our suggestions. That means I can have my operation TOMORROW when my husband is home to look after the baby! Copyright TORCHE 1998

Other ideas could be explored in this way For Example: Health: Evidence suggests that social support, good nutrition and exercise are crucial to maintaining mental health (Depression and Dementia in particular) We could survey how big this problem was in Norbiton and focus action on the vulnerable. Policing: There have been problems with our Somali youth that require special police response. But we could also look at ways to help their own elders and the rest of the community reach these kids, possibly via education and voluntary work. (Arranging some teaching for them about their great past history might helping restore their pride). Housing: Following up on last weeks discussion on fuel poverty, we could see if there was any way in which the housing department in addition to giving helpful advice, might also purchase burdensome owner occupied property to enlarge its housing stock. Perhaps in view of the high death duties, a deal might be brokered with relatives that suited all parties. The idea that only private companies should profit from so-called equity release plans seems a wasted opportunity for the Norbiton community.

Conclusion Our Council and Health management teams are to be congratulated on the ONE Norbiton initiative. Hopefully people will feel it is helpful for us to try an innovative approach to supporting them. This approach seems to be easily done and it would meet the Governments requirements for us be representative.

HOW DOES SAMPLING WORK? A JURY VOTE TOTAL POPULATION COMMUNITY JURY So for example if we asked everyone and found that 55% of our population of 6660 agreed with a proposal how similar would the result be if we just asked our 165 person community Jury? Voting population of Norbiton = 6660 By dong stratified random sampling, each member in the community stands an equal chance of being included in a Jury of 165 people. RESULT: 87 of Jury say “Yes” This is suggests that 52% of Norbiton agree. NB the bigger the size of the jury the closer to the truth.

The Seven Principles of Public Life, known as the Nolan Principles Selflessness Holders of public office should act solely in terms of the public interest. They should not do so in order to gain financial or other benefits for themselves, their family or their friends. Integrity Holders of public office should not place themselves under any financial or other obligation to outside individuals or organizations that might seek to influence them in the performance of their official duties. Objectivity In carrying out public business, including making public appointments, awarding contracts, or recommending individuals for rewards and benefits, holders of public office should make choices on merit. Accountability Holders of public office are accountable for their decisions and actions to the public and must submit themselves to whatever scrutiny is appropriate to their office. Openness Holders of public office should be as open as possible about all the decisions and actions that they take. They should give reasons for their decisions and restrict information only when the wider public interest clearly demands it. Honesty Holders of public office have a duty to declare any private interests relating to their public duties and to take steps to resolve any conflicts arising in a way that protects the public interest. Leadership Holders of public office should promote and support these principles by leadership and example.