Chapter 1
Design against demand (the contextual needs of the citizen)
The current system understands demand as a transaction, e.g. a phone call. It sets handling standards (answer within x seconds) and target measures (y% of calls to be answered) against that transaction and seeks to reduce the cost at all times. From the perspective of the citizen, services designed around these ‘transactions’ rarely supply what they need and are just a wasteful part of the process.
We carried out some research for Advice UK on how well the voluntary advice sector was working. Advice organisations, local and national, help people struggling with decisions around the granting of disability allowances. They manage cases and provide advocacy. Of all the cases going to tribunal, 93% were found in favour of the plaintiff. This is eyebrow-raising in itself but the real learning comes when you find out that the agencies involved (as they were then) rarely got their sums wrong. The decisions were technically accurate but the judges found that the context had been ignored. In other words, the person had been ignored. So, for example, a person with mental health problems was deemed by the Department for Work and Pensions (DWP) to have ‘recovered’ and the support was withdrawn. The reality, as noted in the tribunal decision, was that it was precisely that support that enabled the person to cope. When it was withdrawn the recovery was reversed. The point is that the transactions – the technical aspects – don’t take ‘context’ into account. For the citizen, context means, ‘Do you understand me and my life?’
People from every agency we work with talk about andbelieve that they deal in ‘person-centred’ services. So to conclude that we need to change the public sector from a transactional perspective to a person-centred perspective will simply get the eyes rolling. The problem for most people is trying to fathom why anyone would design a system that was not person-centred. But design it they did. It is equally difficult for practitioners – how could they admit to themselves that they are not person-centred?
A better focus might be one that tackles effectiveness and efficiency, the goal being to do exactly what matters at first point of contact – either the issue is resolved for the citizen, or the right processes are designed so that problems can be resolved as efficiently as possible for all concerned. This is the critical concept that initiates change. It is the place for leaders to begin to understand what the processcould look like, and then (when you’ve tried it) what itdoes look like. The new way of thinking, doing only what matters, becomes much clearer both in principle and in practice. The paradoxical aspect is that when you seek to improve effectiveness in this way, the efficiency improves all on its own.
A Case Study
Stoke City Council
The leaders of the functional departments at Stoke City Council had been learning what worked for citizens and what did not. They had also involved other agencies, such as Fire& Rescue and the police services. They took the decision to set up a multi-agency team that would be capable, as