2015 was always going to be a roller-coaster year for public services, especially with a General Election and subsequent spending review.
With that now behind us and the New Year on the horizon, it’s a good time to ask what lies ahead in 2016. What changes can we expect in our public services, and how might they be different twelve months from now?
The team at Mutual Ventures have picked out four themes which we think will shape 2016:
The ‘Devolution Revolution’
In our view, devolution will be chief driver of public service reform in 2016, as responsibility for the funding and delivery of local services is increasingly passed down the chain to towns, cities and regions. ‘Local leaders know best’ seems to be the new mantra of Whitehall.
Budgetary measures announced in 2015 support this direction of travel. From next April, local areas will have the power to raise council tax to pay for social care and retain their own business rate revenue. This provides a financial incentive for more authorities (and their partners) to seek a devolution deal, following the example of Greater Manchester, Cornwall, Sheffield, Merseyside and the West Midlands.
You’ll be forgiven for thinking that this all sounds like familiar Westminster speak. But this reorganisation of services is no paper exercise. In Cornwall, for example, proposals include a wholesale transfer of the budget for adult social care from the local authority to the Clinical Commissioning Group – tying up health and social budgets care together for the first time. As the details of other ‘devo deals’ emerge there are sure to be some more new ideas.
The devolution revolution is not a temporary blip on the landscape of public service reform, and it is not something that can be unpicked easily at some point in the future. The approaches that local areas choose will change local services for a long time to come.
Manchester Centre – the hub of the Northern Powerhouse? (Credit: techmark.co.uk)
Integration for the nation: bringing together health and social care
To meet the long-term challenges of increasing demands on health care and our ageing population, everyone from politicians to doctors agree that the integration of health and social care is part of the answer. But while integration care sounds easy, nobody is yet quite sure how to do it in practice. It’s a huge intellectual and practical challenge which is causing everyone to scratch their heads.
In the recent spending review, the Treasury was clear that integration is a key goal across public services but that it would not be dogmatic on how it is achieved: ‘the ways local areas integrate will be different’, it stated.
At present the NHS seems to be taking the lead on integration. The Department of Health’s ‘integrated care organisations’ vanguards are exploring how to join up services and create smoother pathways of care for chronic conditions.
As 2016 unfolds, we expect this to increasingly draw in local authorities as integration and devolution proceed hand-in-hand. One likely consequence of this will be new organisational forms, to allow more flexible ownership and governance structures and a refocusing of services on what works.
More councils thinking differently on children’s services
Some view children’s services as the last major unreformed part of the public service landscape. In 2016 we think this is set to change.
A number of councils we know are on the front foot, exploring new models of delivering services. There is also talk of children’s services across Greater Manchester joining up as part of the ‘Devo Manc’ deal. Already up-and-running, Achieving for Children, a joint venture between two London Boroughs (Kingston and Richmond), is a great example of what can be achieved when councils work together. This model, and others like it, can allow for more innovative and flexible delivery – and better services for children and young people.
The resilience challenge for established public service providers
Successive governments have sought to develop diversity in public services by encouraging independent providers into the market to compete alongside council, the NHS and large outsourcing firms.
Many of these new entrants are social enterprises, charities, or other not-for-profit forms, and all have had to find their feet quickly.
Like any small business, they face challenges. In 2016 many of them reach a ‘crunch point’, where they must re-tender for their core contracts against stiff competition from larger for-profit providers. This applies particularly those that sprang from the first wave of the Department of Health’s Right to Request Programme.
Resilience is the watchword for these organisations. They will need robust business plans, well-developed financial systems, and a close grip on cash flow. Being able to demonstrate social value will become increasingly important as their competitors seeks to outdo them on price.
Over the last few years, a number of high-profile initiatives have been influential in nurturing this marketplace, including the Investment and Contract Readiness Fund and Big Potential, but providers will now have invest more of their own resources to plug gaps.
New approaches are already emerging to address these issues. Mutual Ventures is delighted to have been chosen by the Health and Wellbeing Partnership LLP, a group of nine social enterprises in the North West, to support them to develop and grow a model of collaboration which involves pooling their resources to increase competitiveness.
We are excited by what 2016 holds and look forward to continuing the conversation with you in the New Year.
Happy Christmas from all the team at Mutual Ventures!