The time is right for co-production
10 November 2010
Probably the most asked question in public services right now is how to get "more for less". Instead, we should be asking how to get "more for more" by reshaping the relationship between people and the public services they rely on, says Philip Colligan
Our public services face unprecedented challenges. We need to restore the health of public finances and that means serious savings across public services – and quickly. Naturally this dominates the debate, but it's only part of a wider, interconnected picture, which we ignore at our peril.
Long before the financial crisis we were seeing the limits of our approach to public services in dealing with the demands of an ageing population and more people living with long-term health conditions, the impact of lifestyle choices, rising expectations and persistent challenges such as entrenched poverty or the cycle of re- offending. Despite real progress in lots of areas there is a growing consensus that we need to find radical ways of getting greater impact at lower cost to the taxpayer.
At the heart of the problem is the way we think about public services. During the past 60 years, we have held onto an essentially passive view of the recipients of those services. We do things "to" people. They "consume" the services provided, even if we do offer more choice.
This creates a culture of dependency, disempowering people and reinforcing their reliance on services. Even more, it neglects the skills, capabilities, time and other resources that lie in the people who receive those services, in their families and communities. Viewed from this perspective our approach to public services starts to look like a fundamentally inefficient way of meeting social needs. At the very least, it seems incapable of dealing with the challenges of tomorrow.
Over the past three years, NESTA has been working with a wide network of partners to develop imaginative solutions to these big challenges. We are increasingly finding that the most powerful answers emerge when we harness the potential of users, communities, frontline workers and collaborative technologies. It's an approach that we call people-powered public services.
As part of this, we have been working with the new economics foundation (nef) to develop the concept of co-production. It's a simple but powerful concept: people's needs are better met when they are involved in an equal and reciprocal relationship with professionals and others, working together to get things done. It combines the resources allocated to public services with the assets of those who benefit from them.
This isn't an approach crafted in a policy ivory tower. It is a transformation that started at the frontline of public services and our insights come from the experiences of a network of more than 100 professionals, who have delivered far better outcomes at significantly lower cost.
From these practical experiences we have identified principles that underpin successful co-production. First, the users of services need to be recognised as assets with skills and capabilities to offer. Services need to promote mutuality and reciprocity between groups of users, professionals and the wider community, a key part of which is peer support networks. Finally, the role of professionals has to change, blurring the distinctions between provider and recipient, with publicly funded professionals becoming facilitators rather than deliverers.
Probably the most asked question in public services right now is how to get "more for less". Our work suggests that is the wrong question. Instead we should be asking how to get "more for more" by reshaping the relationship between people and the public services they rely on to access the hidden wealth, reduce waste, and reduce the cost to taxpayers.
Sounds good doesn't it? And it works. Across the three reports published over the past year we have captured a range of case studies – like the Scallywags parent- run nursery in Bethnal Green or the Holy Cross Community Trust mental health daycare services in Camden – showing better outcomes and real financial savings. This movement has been developing on the periphery of public services for some time and it needs to come into the mainstream. It offers real transformation for services struggling with rising demands and shrinking budgets.
Public service professionals need to be at the heart of bringing about this change. Those of us who have worked at the frontline know just how difficult it is to bring about real transformation. The barriers are substantial and deeply embedded in the culture of almost all organisations. One common feature across the examples of co-production we have found is that it has happened despite, not because of, the current rules of the game.
That's the next phase of our work, understanding how we can take these approaches to scale across the public services – what that means for the way we commission services, how we train a new cadre of professionals, how we measure and account for a wider understanding of outcomes.
If we get it right we can look forward to better public services focused on prevention, rather than cure, where users, their families and communities are as responsible for their care as the professionals who deliver services to them, and where everyone gets more for more.Philip Colligan is executive director of NESTA's public service innovation lab