Local Government


A challenge to the idea of economies of scale in public services…

Posted on 28th February 2015 by

Locality has published some research which counters the argument that large organisations will deliver public services the most efficiently and cost effectively.  It’s timely when budget holders are looking at cutting the small, perhaps seduced by the arguments of the large.

A new paper, ‘Public Services, Civil Society & Diseconomies of Scale’, outlines this research project arguing that human scale operations deliver high quality services as well as value for money.

Locality’s members, some of the most active and ambitious community organisations, have described inefficiencies in large-scale services across the UK. This ranges from youth to legal aid services, mental health interventions through to employability schemes such as the Work Programme. It is having disastrous consequences for poorer communities and smaller providers.

– See more at: http://locality.org.uk/news/diseconomies-scale/#sthash.GJtoAlqX.64MXMylL.dpuf

13 pages. Have a read.  There’s also and event in Birmingham on March for the launch of their keep it local campaign http://locality.org.uk/events/local-campaign-launch/

Social Media Surgeries and Open data – a new thing.

Posted on 21st January 2015 by

Since 2008 our approach to social media surgeries has remained pretty much the same.  If we’ve done anything it’s seek to protect their simplicity and simplify them even further.

That is now changing – a little bit.

We are working with Digital Birmingham and the Cabinet Office transparency team to introduce  (in some cases release) a new set of knowledge and skills into the social media surgery movement – skills that will help community groups make better use of data, including open data.

Why do this? (more…)

#nhscitizen and local involvement – Birmingham session, some thoughts.

Posted on 3rd October 2014 by
NHS Citizen information flow

NHS Citizen information flow

This week NHS England has been in Birmingham picking many brains to try and understand how their #nhscitizen idea might work best at a local level.   Overnight I chewed over the things below but for context.  NHS Citizen is an attempt to encourage people to voice their experience and ideas about health care and for the NHS England board and other levels of the NHS to learn how to join, listen to and use that conversation.  It’s not a concrete thing at the moment and this video gives a sense of it…

Below are some of my slightly generic thoughts on what this might need to be like…

Is it a problem that this is about citizens talking to NHS England only, after all health and social care are experienced the same.

Err towards Solutions focus (not problems focus)

Focus not just on problems but experiments and solutions.   A process that channels problems up will not shift the way we deliver good or better health to each  other.  One that frames problems partly through things people have done to try and solve them will create:

  • a tone that encourages those at  the top to use (rather than avoid) the discussion and information.
  • a source of inspiration for people (citizens) and practitioners (also citizens) which includes new ways of fixing/doing things
  • room for those who act very differently from prevailing structures to share why they think what they do makes things better and then go an make things change.
  • a chance to celebrate people who act to make things better.

Use people’s stories to inspire fixes

When you make thing personal you want to solve it.  At the personal level solutions can be more practical than at a systemic level.

Don’t wait for change: 

Some traditional structures says tell us your problems and we’ll come back with our solution or reason why we can’t solve it.  that involves waiting for change.  If you send a problem to the top and wait for change until permission comes back it stifles innovation.  NHS Citizen should be able to track innovation, solutions and change – the board can learn faster from that and it will help shift the culture from what Steve FairmanHelen Bevan and other’s have described as a focus on the “disruptive troublemakers” in their paper on NHS culture change.

We are all citizens

So enjoy being one – whether the NHS pays you or not.

Don’t be an institution. 

The problem of being both a thing and not a thing.  Anthony Zacharzewski was quoted as saying “there will never be a chief executive of NHS Citizen”  and yet we still tend to think of things as things.  This is more like the internet –  few people ask who is head of the internet. yet we use it and trust it, accepting it as a platform we can shape.

To understand NHS Citizens more:

Watch the live stream of the discussions

Keep track of the development at http://www.nhscitizen.org.uk/

The four organisations managing the NHS Citizen design process: The Tavistock InstituteInvolveThe Democratic Society and Public-i.

Declaration – we are currently working with NHS-Improving Quality plus a number of Clinical Comissioning Groups and a Clinical Support Unit and have/do work with Demsoc and Public-i