1. How Policy Contexts Disable Implementation
I would like to take you on a journey to Sydney, Australia where young, emerging adults with severe behavioural challenges until recently were served by the Department of Family and Community Services – FACS.
How Policy Contexts Disable Implementation
IGNITE 1 #sircIGNITE #IGNITE1

2. “ … underfunded, unfair, fragmented, and inefficient …”
IGNITE 1 #sircIGNITE #IGNITE1
“ … underfunded, unfair, fragmented, and inefficient …”
But before looking at them, let’s travel back in time. In 2011, the Productivity Commission in Australia finalised an inquiry into the disability sector. Their verdict: Underfunded, unfair, fragmented, and inefficient.

3. 460,000 IGNITE 1 #sircIGNITE #IGNITE1
That was the beginning of a comprehensive reform of Australian disability services. It introduced the National Disability Insurance Scheme – NDIS. By 2020 it will cover 460,000 people with different types of disabilities.
IGNITE 1 #sircIGNITE #IGNITE1

4. IGNITE 1 #sircIGNITE #IGNITE1
Such a change does not occur overnight. The roll out of the reform happens in phases. And over the course of four years more and more areas in the country will take up the scheme. You can see the roll out waves on this slide.
IGNITE 1 #sircIGNITE #IGNITE1

5. Goal: 12 Cases – Achieved: 7 Opened: July 2016 – Closed: July 2017
IGNITE 1 #sircIGNITE #IGNITE1
Now back to FACS, our government department. In mid 2016, they found resources to fund the implementation of MST-EA, an adaptation of standard MST. So, two program developers came to the country to train a team of practitioners.
Leaving Care program
Goal: 12 Cases – Achieved: 7
Opened: July 2016 – Closed: July 2017

6. IGNITE 1 #sircIGNITE #IGNITE1
At the same time, the roll-out of the NDIS was in full swing. That puts extreme stress on the system because it contains many unknowns. It is like a plane that is built while being in flight. So, FACS makes an administrative decision.
IGNITE 1 #sircIGNITE #IGNITE1

7. July 2016: MST - EA IGNITE 1 #sircIGNITE #IGNITE1
They say: Clients from districts in their initial year of the NDIS roll-out could not be referred to MST-EA. That was a problem. One important district for MST-EA was in roll out – they could not send any clients.
IGNITE 1 #sircIGNITE #IGNITE1

8. Hm ….. IGNITE 1 #sircIGNITE #IGNITE1
That raises 2 questions: Why did FACS begin with MST-EA in the first place if they knew the NDIS was coming? And: Why creating an implementation barrier for MST-EA by reducing referral sources to nearly nothing?
Hm …..

9. Policy Context Inner Context
Intervention
Intervention
Implementation science concepts and models are not the strongest to explain this. They are better at describing how they view interventions, and inner contexts. But things get blurry and foggy when they involve policy processes.
IGNITE 1 #sircIGNITE #IGNITE1

10. Advocacy Coalition Framework (ACF)
Policy Process Theory Clarke et al., 2016
Advocacy Coalition Framework (ACF)
Multiple Stream Theory
Punctuated Equilibrium Theory (PET)
Institutional Analysis and Development (IAD)
Institutional Theory
Garbage Can Model
Bacchi’s Theory
Agenda setting theory
Incrementalism
Rational Choice Theory (RCT)
Actor Network Theory (ANT
IGNITE 1 #sircIGNITE #IGNITE1
Theories developed within political science are better at this. Clarke et al. did a systematic review last year, and identified studies that used policy process theories to understand implementation. They found the theories listed here.

11. ORGANISATIONS = ORGANISED ANARCHISM
IGNITE 1 #sircIGNITE #IGNITE1
ORGANISATIONS = ORGANISED ANARCHISM
Take the garbage can theory. It views organisations are anarchies. Because they are not sure of their preferences; their members don’t quite understand how they work; and those who participate come and go.
ILL-DEFINED PREFERENCES
UNCLEAR TECHNOLOGY
FLUID PARTICIPATION

12. … choices looking for problems
IGNITE 1 #sircIGNITE #IGNITE1
Cohen, March & Olsen, 1972
… choices looking for problems
… issues & feelings looking for decision situations
… solutions looking for issues to which they might be the answer
… decision-makers looking for work
In that context, choices are looking for problems; issues and feelings look for decisions to which they fit; solutions look for issues to which they might be the answer; and decision makers look for work.

13. Bounded Rationality SUBOPTIMAL DECISIONS IGNITE 1 #sircIGNITE #IGNITE1
Simon, 1989
Cognitive Limitations
Information Imperfection
Time Constraints
Bounded Rationality
SUBOPTIMAL DECISIONS
Or take the idea that our decisions are pretty rational. NOT. The theory of bounded rationality says: Our cognition and level of information is flawed, and we work under time pressure. Organisational decision making is suboptimal – at best.
IGNITE 1 #sircIGNITE #IGNITE1

14. IGNITE 1 #sircIGNITE #IGNITE1
Policy process theories have something to offer for understanding implementation.
And Clarke et al. did more. Across included studies, they extracted policy factors important to implementation. Let me walk you through them.
IGNITE 1 #sircIGNITE #IGNITE1

15. Policy Connectedness IGNITE 1 #sircIGNITE #IGNITE1
Firstly, coalitions, groups, and networks in implementation land need to be well connected to policy land. For implementation friendly decision making, they must be integrated into government, and have influential relationship.
IGNITE 1 #sircIGNITE #IGNITE1

16. IGNITE 1 #sircIGNITE #IGNITE1
Secondly, there are political institutional factors to consider. Clear accountability structures enhance implementation – they were challenged in the MST-EA implementation because everyone was on the move to a new system.
IGNITE 1 #sircIGNITE #IGNITE1

17. IGNITE 1 #sircIGNITE #IGNITE1
Thirdly, key individual leadership generated within the policy context is important. So, connectedness with senior bureaucrats and political leaders can enhance implementation.
IGNITE 1 #sircIGNITE #IGNITE1

18. IGNITE 1 #sircIGNITE #IGNITE1
Fourthly, the way in which we frame implementation is is important. If our basic narratives align with the dominant policy agenda, there is a greater chance for success than when in opposition to it.
IGNITE 1 #sircIGNITE #IGNITE1

19. IGNITE 1 #sircIGNITE #IGNITE1
Finally, pay attention to political ideologies. They influence key policy stakeholders to acknowledge the problem an implementation wants to solve and to prioritise it as an issue that deserves attention from policy.
IGNITE 1 #sircIGNITE #IGNITE1

20. What Matters? Policy Implementation Mechanisms
Coalitions, groups networks
Political institutional factors
Key individual leadership
Narratives / framing
Political ideology
Timing
Evidence
So, theories and concepts from political science do help in explaining implementation. Retrospectively today. In the future it would be great to se it done prospecitively – through policy informed implementation strategy development.
IGNITE 1 #sircIGNITE #IGNITE1