Why is the Good Practice Exchange at the Wales Audit Office running seminars that focus on frequent users? Dyfrig Williams outlines our thinking and how services can provide efficient citizen-centred public services.
The Good Practice Exchange at the Wales Audit Office decide on our programme of events based on the following criteria:
- New legislation and other significant developments affecting public service delivery
- Work undertaken by the Wales Audit Office
- Topics that are identified through consultation with key stakeholders
In the case of our seminar on Designing effective services for frequent users, it was a combination of all three.
If you’ve attended any of our recent seminars, you’ll have heard the Auditor General for Wales talking about how the Wellbeing of Future Generations Act is a gamechanger for Welsh public services. Organisations are required to integrate and collaborate; to think about prevention and the long term; and to involve people.
The Social Services and Wellbeing Act reinforces this by focusing on people, wellbeing, prevention, partnership and integration. The current public service environment clearly supports public service delivery that centres on citizens. If you’re looking to revamp your service to meet this focus, then these acts provide a framework and a rationale for change.
Our colleagues in the Health Audit team approached us to put a seminar together on Designing effective services for frequent users as they were reviewing emergency ambulance services commissioning. Fflur Jones wrote a great post for the Wales Audit Office on joining a Welsh ambulance crew for a night shift, where she says that:
“The calls ranged from the routine to the extreme: from a caller that did not require any urgent treatment who had contacted the service for the third time that night to a patient suffering life-changing injuries as a result of a road traffic collision. I’m assured that the life of a paramedic is never dull…..
“Calling an ambulance is not always the right choice and other alternatives, such as pharmacies and out of hours services can get patients seen quicker and allow ambulances to respond to the cases where they’re most needed. It also taught me that the need for the public sector to work together to provide better services and to provide services for unmet needs and to fill service gaps is greater than ever.”
The Good Practice Exchange have been working on our first piece of audit work on behaviour change, where we’ve worked with Good Practice Wales and a range of other organisations on festivals in Bangor and Swansea. Behaviour Change techniques can potentially improve public services when there are increasing demands placed upon them by enabling people to choose the right service in the right circumstance.
The Wales Audit Office’s Picture of Public Services report also paints a stark picture of the challenges that devolved public services’ face. The report shows that public services have faced significant and growing financial, demand and capacity pressures since the previous report in 2011. Some of the headline messages include that:
- Organisations are in a position where they have to take well-managed risks to deliver sustainable solutions to financial and demand pressures on public services
- there are difficult barriers to overcome in order to radically reshape services, including political and cultural barriers
- ‘What gets measured gets managed’ – public services are increasingly adopting ‘outcome’ measures, but there remains a tendency to measure and manage how much activity is going on and how long it takes
- public services need to work together through the difficult choices to understand the short and long-term impacts for the public and other public services, and to mitigate those impacts where possible.
From a purely economic perspective, the case for change is clear. Public services will continue to waste valuable resources unless we work together, resources that could be better spent to provide services that people actually want.
And to me that’s the crux of it – more than anything services need to be fit for purpose so that they provide what people really want. On my last day of working for Participation Cymru, I wrote that working with the Citizen’s Panel for Social Services had been the most fulfilling work that I had ever done. Seeing people actively challenge systems that had repeatedly let them down because they believed that things could and should be better was incredible. I’ve been lucky enough to work with some fantastic teams, projects and organisations since working for the Good Practice Exchange, but unfortunately these services are still the exception rather than the norm.
Working with key stakeholders
Every event that we run is developed in conjunction with a range of stakeholders, and this is no different. We’ll have speakers from local authorities, health boards, the Ambulance Service, Fire Service and the Older People’s Commissioner. More than anything though, the event will look to share good practice from delegates’ own experiences and will throw out issues that people are facing to the collective expertise at the event.
We’ll also be ensuring that the focus of the event is firmly on what people want from their services. When I was tasked with working on this event, I immediately thought of a workshop that Simon Pickthall from Vanguard delivered at our Reshaping Services with the public event. In this seminar Simon shared how traditional public service interventions had failed to meet people’s needs because inefficiencies were resulting from maintaining broken organisational processes. These inefficiencies become obvious when we think about how public services work – people are made to fit into organisational silos, instead of organisations working together to meet people’s needs. Simon gives a really good overview of some of what he’ll be talking about at 6:37 in the below video.
The Stoke-on-Trent case study in the Picture of Public Services report (p.108) is an example of the approach that Simon will share. But we won’t be telling people what to do or directing people to use particular methods. We don’t believe that one size fits all – we need to look at the good work that organisations are doing and think about how we might adapt those approaches to suit the needs of people in our areas. And if we can do that, then we’ll be better placed to deliver the best possible services for the people of Wales.