The public sector is broken, this is how we can begin to fix it

How can we achieve real public sector reform, based on mission led systemic understanding of how the whole system works, and learning?from the work that has already been achieved

Transformation in any organisation is mostly a mix of small changes, in the hope that they will all link up and create a better way of working. This tends to be more of a haphazard approach rather than what was originally designed. This article brings together the various aspects of systemic change, into a whole framework.

Systemic change

From the learning of the past decades we can now agree that the reform of the public sector is a clear priority, a necessity. Based on this learning and tested and proven?alternatives, this necessitates is a multi-level framework that provides a systemic view of what needs to be considered for a value driven, mission focused effective ?public sector.

My journey into the sprawling public sector landscape has immersed me in learning from 'realities on the ground,' experiencing what it is like for fellow people to live in our diverse communities, and understanding how the multi-layered aspects of our lives challenge so many of us at various points in our lives. This also exposed me to the perspectives of local government in its various designs of 'services', power dynamics, digital by default, and central support.

We have also immersed ourselves in researching how and why our public services?work the way they do. And we have a wealth of examples of where small pockets of new ways of working have been tried, and the outcomes that they produce have been measured.?Learning from the research?and examples, we ultimately get to uncovering the links this has with policy making. Looking at this as a system, we see how the patterns that we have today are a myriad of silos, misaligned incentives and bureaucratically applied power over others, that point to a system that is suffering from its own chronic disease of its design.?As it is designed today, it is fundamentally broken. We know?this because?the current design of our services?are in many cases?self-destructive, in that the way that they operate naturally produces the perverse?outcomes that we have today. So, using a popular method we have employed numerous times, cutting costs in one area, gives rise to increased cost elsewhere.?This summary points to the fact that all the attempts to bring in individual improvement?initiatives are bound to fail.

Why is it broken, and the evidence

Since the 1980's the public sector in many countries applied a fundamentally new way of working, which we now call New Public Management (NPM). This is an approach that is more efficient, that is based on private sector principles, where competition is used to drive efficiencies, and where citizens are seen as customers. NPM, is based around the concepts of private sector?business and management models. It focuses on citizens as the recipients of the services, mirroring the customers as a consumer who has choice. Its goal is?efficiency and good service delivery. It can be recognised by standardised service delivery models, centralised financial control, value for money, increasing efficiency?through identifying and setting targets and central monitoring of performance. Control is enabled by legislation and top down design. Performance is assessed with audits, benchmarks, feedback of measures, and performance evaluations. More recently, NPM is the ideology of increasing efficiency through the use of digital service design.

At a policy level the mechanisms of NPM are in legislation, guidance, policies, government and political ruling, the definition of measures, and the allocation of funding. At an organisation level, this is based on measuring activity and compliance to rules, documenting actions, the creation of fixed job roles, the standardisation of work through service delivery, the design of individual specialist departments, the minimising of risk, and the use of digital technology as a primary communication mechanism.?And it has now become an endemic way of thinking by most people that work in the public sector. There is an assumption that NPM can improve itself based on adjusting to customer need.

Regardless of what the ideology we individually think about how appropriate this is, we now have plenty of evidence that demonstrates its ability to create a better, leaner public sector. The simple answer, is that it has failed in all this, except in a group of highly centralised transactional services - like renewing a passport. This failure is despite the huge amounts that have been spent on improving current services - we are still in a downward spiral, which is the hallmark of a broken system:

- Demand for services and health is rising. This demand is in part, self generating from the failure to deal with the real issues.

- Services are increasingly stretched as austerity creates irrational short term decisions.

- Prevention activities have been almost eliminated, driving up demand from escalating problems.?

- Costs rise because the service themselves have to adapt to complexity that they are not designed to deal with.

- Citizens are less satisfied with their lives and their communities. Poverty and lack of coherence fragments health into responding to crisis.

One of the fundamental issues that we have in?place?today in the design of our public?services is a focus on reductionism.?Reductionism?is characterised by the splitting up of end to end processes into discrete services?and departments, applying individual targets that drive?sub-optimisation, managers that manage numbers, based on the assumption that value created can be quantified. This paradigm believes supporting people and complex public health services can be designed as though it behaves like a?mechanistic model of individual transactional services. The roles of people working in those services are designed into fit standard expert processes. As a consequence of focusing on short term activities and reducing visible costs, we have created the perverse behaviour where demand and?costs?are rising, due to self inflicted causes.

Over the past two decades, a group of us have been actively developing and applying a fundamentally different approach using an alternative design paradigm, and the outcomes demonstrate that these alternatives achieve a coherent and very different effective public sector.

The systemic reform framework

So, this article is not the detailed method on how to fix it, because that would fill a book. This is the overarching framework that we need to uncover, to begin the shift to a new way of thinking and a way of pulling in the right methods. Systemic change means 'root and branch' change.

The opposite of reductionism is systems thinking (hence the shift in system paradigm). Here, we look at the whole, and work backwards into the detail. We understand how things work by making sense of what is occurring starting with the human perspective - citizens. We apply an alternative?set of principles to those of new public management. We surface value creation, defined as that which is contributing to peoples wellbeing. Prevention activities and dealing?with?peoples real complex needs ?are seen as the primary achievement of the purpose of the public sector, as it avoids and supports people from falling off balance when that situation arises.

Systemic change include the way we think about how we design and work. Perhaps for the leaders in this system, the greatest change that needs to occur is that they need to stop, go and learn, listen, to understand. Learn what is going on in the workplace, not from reports, data, or managers. This is an example of a change in mindset.

We know the cost of everything, but the value of nothing. Oscar Wilde

The?conclusion from over 22 years of systemic research and immersing ourselves observing the patterns of thought and behaviour at multiple levels within the system hierarchy, is that systems change needs to be thought about on at least a 4 systemic levels:

1. Mission. Purpose-oriented, solution-driven, and shaping focus.?A new wholistic pragmatic vision and policy design approach for politicians, policy makers and leaders.

2. Paradigm. A new systemic paradigm & principles, replacing the reductionism of New Public Management, that focus on value, people, communities, and prevention. Fostering a new way of collaboration and systemic action together with citizens.

3. Organisation. A new organisation metaphor that calls for a new way of managing, responsive local teams, and designed by learning and strength based working. That aligns with the complexity of the reality of the public sectors ability to create value.

4. People & communities. A balanced and close relationship between the public sector and the value it creates by engaging authentically with people. It uncovers the real needs and potential solutions that can support the person. It allows for different experts to work together for a common purpose. It ultimately creates a new way of working.?

These levels, we often just look at them individually, and link them together. However, in this article, this framework, is not linked, it is the same one thing. The learning occurs within it, by those in it, moving through each level.

Mission driven

Mission?is defined by the strategic direction and where the vision forms to specify what the health service is. This is defined by leadership derived from the true purpose of our local communities and health. The way it is described is through statements which represent the focus as would be described by those that it serves. And the mission is made up of other, more detailed statements, that together make up the whole. The mission has to be understood and directly linked and actionable at every level of the whole system.?An effective way of doing this is with the three horizons method by Bill Sharpe.

Paradigm

Paradigm?refers to the primary model or theory that the principles that we define of how we understand and design our public services are derived from. Currently, the prevailing paradigm is New Public Management, which is based on a logical transactional paradigm. However, over the past decades there have been numerous examples of alternatives to NPM in both the UK and other countries - notably work in the voluntary sector, and in examples like Buurtzorg in The Netherlands.?The new paradigm is not that of a simplistic machine model, but it is based on people - how people live and behave. Its application is based on local collaborative teams that work together to deal with the complexities of peoples lives and how to live a good life.

This table demonstrates the different design and operating principles between new public management on the left, and the new person based systemic paradigm on the right.?

Organisation

Organisation is the body of expertise that we see as a service type. The service design and control of health and local government provision are examples of such organisations; individual local authority services and multiple specialist departments in health. They are the mechanisms by which the public sector is managed and operates.?This is where value is created, and is therefore the?hub through which the principles of the paradigm are actioned in our communities and with individuals.?

The alternative organisation design is one where the hierarchy exists to support and lead rather than dictate. It ensures that the right things are being achieved using the right methods. The focus on what daily activity occurs and how it happens is decided close to where the work happens - with people, families within communities. Activities are designed flexibly around what matters to people and how to help them to help themselves. ?Those in the public sector teams take on responsibility and ownership. Managers support these teams by ensuring they can do what they need to do to respond to real complex issues.

People & communities

People?and relationships are the interactions and influence that the public sector has on individuals, families, and communities. This consists primarily of human, power based and behavioural concepts that then create the reality of how people engage, trust, and socialise to live together. This is both the most important, and most elusive level, in that this is where the engagement and value is created between the public sector and citizens, where value is developed, and where knowledge resides. The formal mechanisms of data, costing, and other logical mechanisms are less relevant here.?Moving from the public sector using 'power over' others to 'power with' people.?Focusing on the ability to catalyse supporting people and wellbeing?to live their own lives free from handouts, strengthening?communities to self sustain. From a public sector design perspective, cross functional operational teams that take on responsibility and ownership of working directly with people in the best way to create value.

As an example, we often view communities as places where public services and health need to do something - to provide support, to spend resources 'fixing'. The reality of what we know, is that our communities, if we allow them to thrive, become places that create healing, that generate support, that provide opportunities to emerge that allow for people to thrive. ?So when you look at case studies here and the work that we do, it is about bringing communities and the people within them back into a place to live good lives.

The above, taken together, points towards a locus of control that is based as close to where the work occurs as possible.

Local by default

None of this is wishful thinking, or theoretical analysis. All of the above has been derived from real practice, what has been learned from the successful and unsuccessful prototypes that have occurred in so many small examples across the UK and other countries.?

A layered mission focused public sector reform framework

Each of the areas are not distinct, but are simply four different areas of focus of the whole system. Each area is intertwined with the next in such a way that each feeds into?each?other, and none can be understood or developed without all the others.?

The diagram itself is a gross simplification of the true nature of what this is. It is primarily a learning cycle, that links all the levels of how strategy is developed to the reality of working at the front line. It starts from where the work occurs, and as we move around the areas of the system, knowledge builds up that then builds each of the areas at the same time. Each element is part of each other, so those in this cycle engage with each level as part of the systemic design process.

These are steps that repeat as we build up knowledge of how the system should work:

Step 1 is where we first learn about people in their communities, and experiment with new ways of working.

Step 2 is where we redesign our areas based on evidence and what we have trialled with new ways of working.

Approaching the implementation

If we managed to fundamentally shift the whole direction of the public sector in the 1980's, then we know it can be done. We can do it again. Rather than go towards New Public Management, we need to remove NPM and design a new paradigm. Some of us that have been doing this over the past decades, but we have been struggling against the stormy waters of NPM, which prevent our small experiments from scaling into something bigger. Those stormy waters need to be calmed before we can venture into those new territories.?

There are surprising few methods that help us to reform and redesign services in this way. When we attempt systemic change we might pick our tried and tested project management and OD change approaches. But in this field of complex people derived services, those methods do not work. We need to use alternate approaches, derived from intervention theory, systems thinning and behavioural theory. We need to understand and design with complexity. Some notable people and groups doing this with, for example, methods derived from the Vanguard method, and concepts from Human Learning Systems ?Human Learning Systems , and the myriad of organisations that surround these groups.

This is a video that highlights what happens when we move past new public management. How to do it and what the the new mission based approach looks like.

https://youtu.be/FCWHFjxz7KE

The approach at the next level of detail would incorporate systems thinking perspectives and principles, coupled with intervention theory and methods that are designed for systems change. It would bring together into an innovative group, the core elements of the system, to begin to design an intervention design, incorporating policy, structure, and operations

I wanted to reference some key sources of this article, but the list got too long and cumbersome. If anyone wishes to have background information, or case studies of this type of work, then please get into contact with me.