John Copps looks at some of the trends that might shape public services over the next 12 months.
Douglas Adams said that predicting the future is a mug’s game - but that we need to do it because we are all going to have to live there. As we leave 2023 behind then, it’s a good time for a bit of crystal ball-gazing.
So, what can we expect to happen in public services in 2024? What trends will shape them, and what will be different in 12 months’ time? With the help of the MV team – I have picked out six things to watch out for.
A General Election
There will be no avoiding party politics in 2024. With a General Election on the horizon (May, October, January - exactly when is anybody’s guess, although a Spring Budget confirmed for 6th March has encouraged speculation about Sunak going early), there will be intense politicking around public services. The backdrop of rising demand and financial constraint now seems hard-wired in, but one thing that has shifted is public expectations of services. Evidence suggests this has fallen over the last few years, perhaps most starkly seen in the pessimism about the state of NHS and social care services in the Health Foundation’s tracker. As voting day approaches and the candidates for government make their promises, this will surely rebound.
The NHS is certain to be a battleground, but some less obvious areas may be drawn in. Local government finances are in a parlous state and it may not take too much more for them to become a concern for voters. With the 6.5% – or £4bn – rise in the recent local government settlement (including option to increase council tax), will this be enough to keep it off the front pages?
Time for ‘place leadership’
Joined up public services are something that has long been talked about. Over the last five years or so, thinking on this has coalesced around the concept of ‘place’. The maturing of Integrated Care Systems, and the increasingly realisation that whole-system working is needed to address increasingly complex and overlapping citizen needs, further weight is being thrown behind this way of organising services.
But integrated services will only become reality if the leadership is there – from councils, NHS services and from within the community.
Of course, this is wrapped up with the fate of devolution, which is an enabler for place leadership. Within the Chancellor's Autumn Statement, new deals were announced in Greater Lincolnshire, Hull and East Yorkshire, Lancashire, and Cornwall. Less coverage went to the perhaps more significant confirmation of a formal agreement with the West Midlands for a department-style single funding settlement. With money comes power, so this felt like an important moment for devolution.
The coming year will be a chance for place leadership to take the limelight. The positions of the major parties will be clarified as the election approaches. Regional inequality sits at the root of much of this but I expect to see the language of Levelling Up gradually disappear from the political lexicon. Will a new government promise something different and will it be able to avoid the instinct to centralise power?
Finding more space for prevention
Prevention is better than cure is a maxim that almost everyone in public services ascribes to. But it is far rarer to see it happen in practice, as acute needs and ‘crisis’ continues to hoover up resources.
Back in 2019, the NHS Long Term plan called for a redistribution of resource from acute to primary and community care. Instead, spending on acute care between 2021 and 2022 grew faster than any other area of spend. Similarly, the cuts to early help services over the past decade don’t suggest that children’s social care has lived up to the mantra either.
There are bright spots though. Gateshead Council’s ‘Liberated Method’ rallies against the siloed and crisis-focused mode of many public services and promotes an approach that starts with people rather than ‘services’. Leeds City Council’s relational approach, including through its child and family-focused Family Valued, offers a way of looking at support based around people’s strengths, relationships and trusting that they know best.
Making the financial case for early intervention is critical, as is better data collection and evidence of outcomes. This is a challenge rather than a prediction then: will leaders be brave enough to find a way to make progress in making prevention central to public services in 2024?
The rise of Artifical Intelligence
For the casual reader that has just stumbled across this article, this is perhaps the least surprising thing to find in a list of predictions for 2024. Since Chat GPT was launched in the second half of 2022, there's been no shortage of commentary on what the future will look like, both in terms of threats and opportunities.
Artificial Intelligence is developing at breakneck speed with what seems like the standard Silicon Valley model of 'go fast and break things'. Public service leaders know that they can't approach things that way.
2024 will need to see some serious thinking on how AI applies to public services. It is technology that can't be ignored because of its many potential benefits, but neither can it be uncritically applied because of its well-documented risks around bias and inventing truths. Public services must be accountable and, where decision have an impact, need to be transparent, explainable and challengeable.
Mutual Ventures believes that public services should start their AI journey from a basis of ethics and values. From there, leaders need to be strategic about how they want to use AI, identifying the potential use cases that would deliver the best value for users and communities. The opportunities in 2024 and beyond are great - but we must approach AI with care as well as boldness.
Regionalisation in children’s services
When Josh MacAlister’s Independent Review of Children’s Social Care was published, one of its most headline-grabbing recommendations was a proposal for Regional Care Cooperatives (RCCs), which would take responsibility for commissioning fostering, residential and secure care placements on a pan-local authority footprint. RCCs was the clearest expression of a wider inclination towards regional working expressed in the Review.
Eighteen months on and the focus on regional working has struck a chord with policy makers. In 2024, regional working in children’s services will become a lot more visible, with already-existing Regional Adoption Agencies joined by ten Fostering Recruitment Hubs and two pathfinder Regional Care Cooperatives.
Pan-local authority working will take a big step to becoming integral to how children’s services are delivered. Ambitious local authorities will see opportunity to shape this change, but no local authority will be able to ignore it.
Local government on the brink
Local government is in financial crisis. 2023 has seen four councils issue Section 114 notices – the nuclear option for FDs forced to admit that they can’t balance their books.
There have been warnings on this for years but the tone has changed. In December, the County Councils Network reported that seven out of ten of its member councils are ‘no longer confident they can balance their budget’. It is also something that we’re hearing talked about sympathetically in NHS boardrooms and other parts of the public sector, which is a new experience. 2024 will see the financial pressure on vulnerable councils intensify and a potential flurry of new 114 notices.
The consequence are local areas stripping down the to the bare essential services and fire sales of assets. This creates short term uncertainty but also longer-term implications. In the short term, local government will need to think differently and look at new models for services, including those involving cooperation with other providers and the community.
Whatever happens next year, we can be guaranteed that it won’t match these prediction. As we have learnt from the past few years, expect the unexpected. But however 2024 pans out, I’m sure it will be another year to remember.
I know I speak on behalf of everyone in MV when I say that we look forward to working with many talented public servant colleagues, familiar and new. We hope you have a happy and prosperous New Year!
For more information on any of our predictions or to speak about how MV could help your service contact john@mutualventures.co.uk.