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The challenge of devolution and integration – are you ready?
With changes in the political landscape across England and Wales following the local, mayoral and assembly elections, one thing is sure to remain constant: central government’s reform agenda.
This can be summarised in two words: devolution and integration. Together, they capture the direction of travel in public services over the next five years.
Devolution describes the transfer of power from central government to the regions, with local decision-makers granted greater autonomy and budgetary control in return for working together.
Integration, an allied concept, describes a more joined-up approach to service delivery, and is most conspicuous in plans for the future of health and social care.
The trailblazer for devolution is Greater Manchester, with the ten councils signing an agreement with the Chancellor back in November 2014. Following in their footsteps, more groups of local authorities in England are seeking their own ‘devolution deals’. The map below (courtesy of the Local Government Association) gives you a sense of the plans that are in the offing.
The changing distribution of power is exciting for local areas but brings a new set of challenges relating to the governance, structure and commissioning of public services:
- How do local authorities maintain local democratic accountability while power becomes aggregated over a wider geographical area?
- How can services come together and provide greater economies of scale while at the same time becoming more joined-up and personalised?
- How do commissioners work across larger geographical areas, broader service pathways, and work to common outcomes? And how should providers respond to this?
These questions strike at the heart of local decision-making, both in town halls and the NHS. Mutual Ventures is working with public service colleagues across the country to find answers and support local leaders to make the most of the opportunities afforded by the reforms.
So what have we learnt so far and what approaches are we developing?
– Making the most of devolution:
Getting consensus among local partners on devolution can be a real struggle. After high-level agreement is reached, the devil is in the detail. The intricacies of governance arrangements, agreeing common outcomes and sharing data are just some of the issues that need to be worked out. These conversations are happening in Greater Manchester, where the combined NHS/social care budget is progressing. Partners are also looking at other innovative ways to work together, such as in the delivery of children’s services.
Our Maximising Devolution methodology can help partners come together to take a high-level devolution deal and work through how it can be delivered on the ground.
– Making sure your service is integration ready:
When tested, many struggle to define what integration means for them and their organisation. What is simple in concept is more complex in reality, as two or more organisations, with different cultures, professional languages, budgets and incentives come together. Progress integrating health and social care in Cornwall shows how strong relationships have to be the starting point for joining-up services.
Our Integration Readiness methodology helps clearly identify the benefits of integration, what it means for each party, the barriers to progress, and how to break them down.
– A “devo ready” contracting solution for social enterprises and charities:
Devolution is a challenge to providers, as they must find new solutions to manage the demands of a new approach to commissioning and find innovative solutions to join-up services.
We are working with the Health and Well-being Partnership, a group of nine social enterprises in the north of England that have joined forces to form a new legal entity. Through a Limited Liability Partnership, they can provide commissioners a single entity through which they can provide entire service pathways across a wide geographic area.
There is no doubt that devolution and integration are here to stay. In this article we have given a sense of some of the approaches we are developing to support local decision-makers navigate the changes in the public service landscape. Change may be challenging but the prospect of improving services makes it worth while.
For more information on the support we can offer on devolution and integration please click HERE.