charlotte alldritt (rsa): practicing public sector innovation
TRANSCRIPT
Practicing Public Sector Innovation
The case of the UK
Charlotte Alldritt
Director, RSA Public Services and Communities
New Public Management (NPM)
1979 1992 1997 2010
Citizens’ Charter
Choice and Voice Inspection and AuditOpen Data & Transparency
Compulsory Market Testing
PrivatizationPublic-Private Partnerships
Private Finance Initiatives
Input measures Output measures Outcomes measures Payment by Results
Mixed economy ‘what works’
Local Boards / Select Committee oversight
Public Service Regulators
Post NPM: health (i)
Problem 1: Health outcomes are improving, but outcomes are variable across the country, particularly for mental health and cancer care.
Problem 2: The costs of delivering the NHS in its current guise are unsustainable:• Rising demand (due to ageing and the effects of unhealthy behaviours)• Rising patient expectations (as new technologies become available)
Problem 2: NHS went through major structural change between 2012 and 2014. How can we convince the workforce they can and want to do more with less?
Can we afford to keep the NHS free at the point
of need?
Should the taxpayer pay the £8bn gap?
What services can we cut to make the bills add up?
Post NPM: health (ii)
• Innovation 1: Role of open data and transparency to identify best practice and combat systemic underperformance.
• Innovation 2: Put prevention at the heart of the NHS. • Innovation 3: Give patients greater control, including integrated
health and social care personal budgets. • Innovation 4: GPs led Clinical Commissioning Groups with new
models available to bring together nurses, GPs, hospitals, social care and mental health as Multi-speciality Community Providers.
• Innovation 5: Devolve budgets and accountability to Combined Authorities with elected mayors (e.g. Greater Manchester) so that places can take a holistic approach to health.
• Innovation 6: Work more closely with local voluntary organisations and employers to take health beyond healthcare.
Isn’t this just an excuse to make more cuts and
force structural change? What are the risks in switching focus from acute to prevention?
Devolution and city-regions
• UK often cited as ‘the most centralized political economy in the developed world’ (Travers, 2015).
• While the nations within our United Kingdom are making their own journey towards greater devolution, each remains highly centralised and the UK Treasury (finance ministry) still holds the strings.
• Partly in response to this process, the UK government has been increasingly receptive to devolving power to the city-regions – strategic, functional economic areas. Smaller and thought more appropriate in scale than RDAs.
• New arrangements developed rapidly – since end of City Growth Commission (Oct’14), seen at least 4 substantive city/rural deals and more anticipated in next Spending Review (Nov’15).
Rewriting UK orthodoxy
Major break with longstanding narrative about the need for economic and social policy centralisation.
Now, the question is how we can build capacity, capability and confidencewithin local government to allow for place-based service design and innovation
Done well, devolution to city and county regions could: • Align economic and social policy decision making under appropriate
governance structures; • Tailor policy to needs and priorities of local areas; • Foster collaboration across public/private sectors and civil society; and, • Reconnect citizens and the state.
Connectivity is key
Since the recession, economic growth has been the central driver of much of government policy during the Coalition (2010-15) and under the current Conservative administration.
But, economics is only part of the story. At the RSA, we believe that to thrive we need to build inclusiveness and sustainability into the structures, processes and incentives of the system.
For this, the idea of connectivity is key:
1. Economic connectivity – ensuring efficient physical and digital infrastructure, including housing, transport and broadband, supported by sufficient access to finance and locally applicable industrial strategies.
2. Social connectivity – harnessing the power of social networks, which are integral to a range of outcomes, including public health, employability and skills and social cohesion.
3. Political connectivity – building a genuine link between people and systems of governance, enabling citizens’ voices to be heard and valued in decision making.
New Public Leadership (NPL)
A new public leadership is needed, which can:
• Create a shared vision for their place;
• Collaborate across geographic and organisational boundaries;
• Respond flexibly to citizens’ needs and priorities; and,
• Open itself to ‘new power’ in community leaders, civil society and social/economic entrepreneurs – allowing public innovation to flourish.
“New power isn’t held by a few, it’s made by many.”
Henry TimmsHarvard Business Review (2014)
Public innovation: Chile
1. What are the specific challenges for Chile’s regions, provinces and municipalities across the nation’s diverse economic geography?
2. What are the major opportunities for collaboration between private and public sector leaders within places?
3. How can these collaborations be sufficiently flexible and robustto be a platform economic growth, social inclusivity and a thriving democracy?
4. What is the capacity for Chilean civil society to be at the heart of its political economy? How might this be nurtured?
