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Do we need a movement to get early action trending?

April 24th, 2015

The Community Links led Early Action Task Force has just published a new book One Hundred Days for Early Action: Time for Government to put prevention first: A collection of essays by a respected group of leading experts and thinkers with decades of experience of Government – as, civil servants, senior advisers or respected commentators.

The latest of our posts serialising the essays between now and the General Election considers whether Early Action needs to generate a popular movement to get it “trending” . Contribution by Ray Shoastak , International Adviser, former Head of the Prime Ministers Delivery Unit and Director General, Performance HM Treasury.

Download the book.

 

And can you imagine fifty people a day? I said fifty people a day…Walkin’ in, singin’ a bar of “Alice’s Restaurant” and walkin’ out?  Friends, They may think it’s a MOVEMENT, and that’s what it is…

ARLO GUTHRIE Alice’s Restaurant lyrics

For me early action is when a health visitor sees that if a family doesn’t get help they are storing up problems (and costs) further down the line – and does something (either themselves or through referral) that turns the situation around. Or when a pre-school or GP sees that a child may not be ‘school ready’ and helps the family address the issues.

Or when a teacher sees the early signs of a student’s behaviour impacting on learning – and sorts some help with either the child or the family to stop it getting worse. Or when a local worker in a community based charity acts quickly so a young person doesn’t find themselves on a downward cycle of problems with substance abuse.

These are the actions of the people we know who make a difference – the frontline of nurses, social workers police officers, doctors, teachers – who work directly with children, young people and families. Each day they work tirelessly on behalf of children and families and do what they can to help, to find someone else to help, or to intervene in a way that is outside their normal response. I find them everywhere I go and they are passionate about helping those in our communities to make the most of their lives and reach their potential. Unfortunately, far too often I also find them frustrated in trying to make the siloed bureaucracies join-up. And too often the required thresholds essentially say: “go away and get worse and then we can help”.

So a new Government should quickly ask ‘what can we do that is more enabling for frontline practitioners?’ I am not suggesting that Government should avoid issues such as poor performance, unresponsive services or provider capture. But it needs to do its business recognising that frontline services are delivered at the frontline and that our public services will never be better than the skills, attitudes and behaviours of those that do the job. Given their role in creating the legislative, financial and policy context for services, it is critical that Government looks at the things which can make services more difficult to deliver, including:

  • poorly constructed legislation,
  • funding regimes that force silos,
  • poorly designed approaches to inspection,
  • micro-guidance
  • the balance struck between the rights and responsibilities of citizens.

There now seems to be a consensus that the individual social costs and financial consequences of late action are too great a price to pay – the common sense case for early action has been made. The good work of many local partnerships, local authorities, the Early Action Task Force, the Allen Reports and the Early Intervention Foundation have all played their part in both raising the issues and finding new ways of managing the challenge of meeting acute needs and at the same time acting earlier. But it is not enough and often the work is at the level of “the system”. At a time of restricted resources and more complicated lives it is even more critical we break the cycle at the level of “the individual”.

I have been thinking recently that Government focus on the complexity of integrated working, attributing financial benefits, accountabilities and coordination (all of which matter and are important) may be the wrong place to start. I have been wondering if there is a danger that we are making early action too complicated and starting in the wrong place. Maybe what we need is a movement that starts with citizens and the frontline.

I am not suggesting that the new Government doesn’t need to prioritise early action spend as it will save us money in the long term. The Treasury also needs to play a more active role in both creating a framework which will support cross-department planning and coordination – and figuring out how savings in prison and benefit costs can be reallocated to social workers. Certainly there is a need for Local Authorities, other commissioners and providers to increase investment in evidence-based programmes; and local partnerships to integrate their services. But what I am really reflecting is that given I find that the people in the system – politicians, civil servants, local government officers, commissioners, frontline folk – all care deeply about helping the people they serve more quickly it is odd that we are finding this so difficult. We continue to invest when it is far too late. Maybe we need to readjust our thinking to recognise it is only people on the frontline who can spot the need for early action. And it is only the frontline that can take the early action; we should build our systems from that staring point.

So my proposition for the new Government is that instead of thinking about new legislation or new initiative they should focus on ensuring the system supports the early action judgements of frontline practitioners and citizens. How about a movement of frontline practitioners to get early action trending, because movements start with people working together to advance their shared ideas and maybe we are not paying enough attention to them.

What would happen if the Government focused more on giving the frontline greater voice? Finding ways in which we could amplify the strength of their judgements about what needs to be done to help the people they see each day. Finding ways of empowering them to act decisively when early action is the right response to the day-to-day challenges faced by the children and families they work with. What would be the consequences if the Government really focused on unblocking what gets in their way rather than the bigger ‘systems’ issues. After all, they are the people who identify the practical, often small, changes in behaviour that can begin the process of changing the reality for children and families. They see it and do it every day.

If they did have an enhanced voice would it be so loud that the system would begin to change? At a time when ‘austerity’ is impacting on frontline numbers and the nature of our universal services (let alone the more targeted ones) will the reality of what is at stake become clearer? If we give voice to the people who are applying the thresholds and witnessing the consequences would we get the change we are after?

If we enable them to speak out will they be seen as whingers, disrupters or activists? The danger of movements is that it becomes disruptive and focuses on blaming others. That would be a disaster. Is it possible to magnify the reality of what frontline practitioners see in a way that frames their contribution the way it is intended – to solve problems. More importantly, can their perspective be heard in a way that leads Government to action and overcome whatever obstacles exist?

Similarly, can the Government get better at learning from what frontline folk do, as individuals in both their interventions and in the way they unblock the system to help those they work with? Could we turn this learning into system change – rather than the other way around? Do we need a movement which is not about big changes (although those are needed too) but about small practical ways to readjust the system to focus on solving the day to day problems and challenges – and get incremental improvement now?

Or maybe it is happening already. Discuss.

Early Action Policing – invitation to presentation

April 23rd, 2015

Our previous early action guest blog posted by Deputy Chief Constable Andy Rhodes on March 16th was exceptionally well received and, as Andy noted in his additional comment on March 26th, widely circulated, (as was his second blog post earlier this week)

Lots of readers asked for more information or for the opportunity to discuss the work. Dawn Austwick, CEO of the Big Lottery Fund, kindly offered to host a meeting for Andy to share his experience. It will be from 10.00 to 12.00 on June 1st in central London, venue to be confirmed.

It’s free, of course, but we expect lots of interest so please book early by clicking here.

Register now to hear about the pioneering early action work of Lancashire Constabulary from Deputy Chief Constable Andy Rhodes.

Effective Investment in Early Action

April 23rd, 2015

The Community Links led Early Action Task Force has just published a new book One Hundred Days for Early Action: Time for Government to put prevention first: A collection of essays by a respected group of leading experts and thinkers with decades of experience of Government – as, civil servants, senior advisers or respected commentators.

In the third of our posts serialising the essays between now and the General Election, Rob Whiteman, CEO of the Chartered Institute of Finance and Public Accounting discusses a growing gap between the way different generations access, and pay for, public services.

Download the book.

 

Political debate is still beset by short-term thinking and a desire to spend money we cannot afford: in particular on policies which favour older citizens, such as triple-lock pension uplifts, which leave relatively little on offer for younger generations.This inevitably results in a growing gap between generations in terms of the consumption of public resources.

The argument which follows proposes righting that bias, reprioritising investment with a view to the longer term, and having the foresight and confidence to focus resources on prevention rather than cure. All of which must be underpinned by flexible and adaptive system leadership built around the needs of communities and individuals, rather than the current structures of the state.

Health

Of course everyone was once young and chronic conditions have a long provenance, but so-called “lifestyle diseases”, such as Type 2 Diabetes from obesity or conditions related to smoking and alcohol, are rising inexorably. They are putting the NHS under unprecedented strain that is only set to worsen over the coming years.

Providers are already often under financial pressure. Despite several reorganisations – all undertaken with the best of intentions – we are left with the intractable problem that A&E departments are picking up more and more primary care activity. Bottom line evidence and financial trends suggest that the system is even more volatile following the Lansley / Hunt reorganisation; but the previous reforms are themselves tainted with questions about productivity and quality.

In England the next Government must ensure national and local system leadership to keep the NHS functioning and effectively balance priorities, pressures and prevention. System leaders must reaffirm the sustainable route to better integrated outcomes and improved public health. Politicians must avoid claiming that their party alone has the magic bullet.

If prevention is always better than the cure, it is usually also more affordable. Investing in public health campaigns will help to assuage the rate of acute healthcare pressures in the long term. Similarly, investing in areas such as mental health or urinary infections can mitigate some of the upward trends in social care costs. And investing in social care can reduce acute pressures suffered by A&E.

The point here is that all players can contribute to prevention and this desperately needs better system leadership and a relentless focus on the individual’s needs.

But now for the really controversial bit; for the tens of millions of pounds needed by the health and social care system, Governments must make a choice: tax more, introduce more charging, or create self-insurance for parts of the system. As an accountant, I am not saying which it should be, just that the sums will increasingly not add up without something being done. Cutting the rest of the state to compensate is not sustainable for the next 20 years.

In practice it can be difficult to ensure that the public pound is being effectively directed towards the hardest to reach groups; but overcoming this would have a powerful public pound multiplier effect, given that there is such a strong body of evidence showing that investing in public health measures will lower the risk of chronic conditions in the long term. Again, this needs effective system leadership (but please not another reorganisation).

For example, Action on Smoking and Health (ASH) demonstrated that tobacco control and prevention initiatives cost a maximum of £300m per year, with a net annual revenue benefit of £1.7bn – nearly six times the initial cost. For every pound spent on psychosocial treatments for dependent drinkers, the public sector saves £5. National and local systems leaders should commit to public health budget increases above inflation for every year of the next Parliament and get as firm a grip as possible on other budgets, rather than allow them to crowd out investment on prevention. No easy solutions, but relentless financial management and embedding the culture and capacity to make savings and efficiencies in all boards, layers of management and the front line.

Housing

That the local government board supervision of councils was once part of the old ministry of health before the creation of the NHS shows the synergies between housing and public health policy. In terms of delivery, before the war the London County Council (LCC) was the largest hospital provider in the world whilst also building the largest public housing estates. Which, to some extent, is why since the war joined up local policy (now called “commissioning”) and joined up local delivery (now called “integration”) have taken so many different incarnations – in order to reconcile the fact that central Government in the form of the NHS plays such a huge role in local government (in the broadest sense) without supervising local government in the more narrow sense (councils)

Housing remains an area of high public concern and a key determinant of health. Our national discourse all too often centres on the incentives for house buyers, including buy to let, without prioritising the contribution housing policy makes toward health and wellbeing. Economic growth, social stability and community are all undermined by an insufficiency of good and affordable housing.

The increasing reliance on housing benefit over the last 20 years has seen long-term housing investment replaced by short term subsidisation. This imbalance has created a vulnerability that has recently been exposed under welfare reform. Large scale partnership developments, such as Manchester Life, highlight what can be achieved with housing when it is viewed as a long term investment with a better combined financial and social outcome. The cost of failure and remedial action, in the form of housing benefit, is in the long run unsustainable, both financially and socially.

Policy makers in recent Governments have wanted to develop innovative housing solutions on an industrial scale, but a legion of obstacles has prevented this. In my own career, as CEO of a London borough, we were authorised by DCLG to pilot a local housing company with a mixture of tenures (public, shared-ownership and private), rights to step up and step down rates of ownership and community assets. Although universally praised, it foundered on the Treasury considering it “novel, contentious or repercussive”. And therein is a lesson. When building hospitals and houses during a period of global financial meltdown, LCC borrowed, raised bonds and taxed to deliver policy under more light-touch central Government supervision without the tight hand of Treasury control. Whilst Scotland, Northern Ireland and Wales will have the conditions to fund community planning, will the English regions?

Families

The Troubled Families programme was launched in 2011 to join up efforts across central and local government. Local authority budgets were increased by £448m over three years on a payment-by-results basis with the ambition to turn around the lives of 120,000 families in England. By March 2014, nearly 40,000 troubled families’ lives had been turned around across a number of indicators: improvements in antisocial behaviour, crime and education results, as well as continuous employment.

The West Sussex Think Family Partnership shows how the programme works in practice. It is led by West Sussex County Council bringing together agencies including district and borough councils, police, the voluntary sector, education and health. The partnership is helping 750 families get back on track and has implemented a number of innovative approaches.

One of these is “Think Family Neighbourhoods”, where areas of known deprivation are targeted with projects that promote neighbourhood pride and community cohesion, and build skills for work. What many early action initiatives like this demonstrate is the need for public bodies to work together, with a shared vision and shared aspirations for the local area. Traditional organisational boundaries have to been crossed and trust needs to be built between local and national bodies, and between public, private and third sectors.

Choosing the right delivery model is important. As public sector bodies work more closely together, decisions will need to be taken about the appropriate commissioning and delivery vehicles, such as a shared service, a joint venture, or a public sector owned company structure. Where a separate organisation is established, the establishing entities will need to determine the lines of accountability and – crucially – the ownership of risk.

Accountability and ownership of risk in a collaborative world is a complex issue. Traditional thinking on governance and accountability needs to be challenged, and well‐established concepts need to evolve to cope with new ways of transparently delivering public services through new structures. Good governance will underpin the success of partnership working – and while the fundamentals might remain constant – flexible, novel, accountable and transparent governance arrangements will need to be developed to overcome pre-existing hard‐wired structures and processes.

Conclusion

During 2014 CIPFA has worked with local and national agencies to create a means of aligning local public spending (ALPS) so that partnerships can better assess the totality of local resources. During 2015 we will work with a range of partners to develop tools to support and measure partnership initiatives and preventative programmes.

Healthcare, housing, social care, public health, troubled families and community budgets are all parts of the same local public service system needing leadership, analysis, financial control and new integrated solutions to optimise the use of public money. The last 70 years tell us restructures can disrupt this, and moving around the parts may not provide real and genuine systemic devolution and new delivery models. And given the scale of costs required, some hard choices on tax, weaning ourselves off universality and introducing more charging will all have to be considered in areas such as pensions and healthcare, to prioritise investment in prevention and earlier action.

An inspirational day with Jobs, Friends & Houses

April 22nd, 2015

Our previous early action guest blog posted by Deputy Chief Constable Andy Rhodes on March 16th was exceptionally well received and, as Andy noted in his additional comment on March 26th, widely circulated.

Lots of readers asked for more information or for the opportunity to discuss the work. Dawn Austwick, CEO of the Big Lottery Fund, kindly offered to host a meeting for Andy to share his experience.

It will be from 10.00 to 12.00 on June 1st in central London, venue to be confirmed. It’s free, of course, but we expect lots of interest so please book early by clicking here.

 

On April 10th I spent the afternoon visiting the Constabulary’s first Community Interest Company (CIC) – Jobs, Friends and Houses (JFH) in Blackpool. It was one of the most inspirational and humbling experiences I have ever had as a police officer. This blog post explains, hopefully quite succinctly, why this is radically different and therefore why it is achieving great things. Before I do let’s start with one of those moments where you have to really stop and ask yourself ‘did that actually happen?’

I arrive at a big Victorian property in the centre of Blackpool, a place I know well. It’s in full re-development mode having just been stripped out by the JFH team. I’m greeted by a guy who I instantly recognise, I think he recognises me and I feel quite anxious. The last time we met I’m sure he was throwing a storage heater down a staircase at me? He’s talking me through the work they are doing on the property and we get into what brought him here, his journey. When I talk later about the hundred and one things that make JFH tick – I mean the hundred and one things that are different, that are complex and need to be understood from the perspective of the individual not the perspective of the system. His insights were powerful and also should give us hope.

Jobs, Friends and Houses works on the principle that the majority of people who have committed crime have done so as a consequence of personal issues that have their origins in early life experience. Unconditional Positive Regard so to speak. It therefore approaches the problem of rehabilitation with a mind-set that is more empathetic and optimistic. As Steve the Police Sergeant who has brought this into reality despite huge cultural resistance says ‘we refuse to believe it’s ‘when’ someone re-offends it’s ‘if’ because we believe in them and we believe in what JFH can achieve’.

JFH understands that for people whose life journey leads them to addiction and crime things get very complicated very quickly. Everyone in society faces life’s challenges yet for some these become barriers that build up over time until they are impossible to unravel. Look back at your own life and take stock of the ups and downs: births, deaths, marriages, divorces and health problems. Now imagine bouncing back from all of this without family support, with no qualifications, with an addiction, with no accommodation , no job and a criminal record. The ‘system’ we all live in is pretty complex … moving house or becoming a carer for a parent with dementia reminds us of that. For some it’s so complex they end up on the outside looking in, becoming disengaged and stigmatised. All too often they turn to crime.

Now I’m a police officer and I believe that if you commit a crime you should be held to account, I’ve seen the devastating impact crime has on victims. This isn’t a call to ‘go soft on crime’ but quite the opposite JFH is an example of ‘what works’ and how radically you have to think to reduce crime, victims and the human cost of addiction and offending. Public sector partners take note: this has the potential to save you millions. Ask your local prison just one question ‘how many people are in here on breach of licence?’. My opposite number who runs a prison knows he is releasing offenders only to see them fall foul of the system that needs to provide … Jobs, Friends and Houses! So they return. Add it up it’s millions.

So what does JFH do?

JFH is a Community Interest Company run by the police. New for us, but so far not radical. It was pump-primed with a grant from the Department of Communities and Local Government, gained in partnership with Blackpool Council. The CIC buys run down properties and renovates them using fully-trained tradesmen who are employed by the CIC. It takes referrals from a variety of agencies and provides volunteer training moving to full employment in the CIC . Volunteering to accredited training to employment. The mentoring support is provided on the job and the property portfolio then rents to the workforce. Jobs, Friends and Houses – simple?

Not so simple and there are one hundred and one things that make this tick, like any great innovation it’s driven by a core of incredible characters who have been there, done it – and bought the T shirt. I spoke to some of the people working on the houses and the stories are powerful for me as a police officer. The ‘offer’ presented by JFH gives us an insight into what can be achieved by ‘integrating’ a service for a certain group of High Intensive Users – and it not only does it not cost the taxpayer a penny it is generating jobs, improving the housing stock and they are paying tax!

Now many people may read this and think this is nothing new. In policing terms we know the pathways that reduce re-offending – what JFH does is deliver them in an integrated way. Offender Management teams do their best to collaborate and ‘manage’ the problem but nobody has the time to provide the 24/7 support provided by an integrated service like this. This is strengths-based, cost effective and very personalised. It looks at the reality of what life is like, what motivates people to change and is adapting every day by learning from the client group about ‘what works’.

 

Quick Wins in the First 100 Days of a new Government

April 20th, 2015

The Community Links led Early Action Task Force has just published a new book One Hundred Days for Early Action: Time for Government to put prevention first: A collection of essays by a respected group of leading experts and thinkers with decades of experience of Government – as, civil servants, senior advisers or respected commentators.

In the collection they set out practical steps for the next Government. In the second of our posts serialising the essays between now and the General Election, this piece by Guardian Journalist  Polly Toynbee, sets out the way in which a new government could claim some quick wins.   Download the book.

 

Hit the deck running – that’s the advice given to every new prime minister. But running where, to do what?

Gordon Brown lost his blueprint somewhere  on the short walk between Number 11 and Number 10. On stepping inside, David Cameron burnt his pre-election disguise as the nice-maker of his party:  away went hoodie and husky-hugging as he embarked on his scorched earth austerity plan. But even those with a declared plan find themselves easily swamped by unforeseen events as the daily churn of minor crises overwhelms original intentions.

In the first 100 days some things need to be done fast to point the way, while other, slower things must lay down long-term foundations from the start for fundamental change. Signaling the direction of the Government, so every minister and civil servant understands the route march needs bright flags waved from early on.

Quick wins? Repair some damage first. Abolish the bedroom tax on day one to signify revival of welfare state principles: the housing crisis is not the fault of council tenants. Until the DWP chaos is sorted, automatically pay personal independence payments to all the hundreds of thousands of seriously ill and disabled people waiting for months, sometimes for over a year, for basic support: over 40% of applicants are waiting, with no help, due to DWP incompetence. Repeal Section 75 of the Health and Social Care Act to stop any more of the NHS being sold to a small cartel of private companies, some of them, Serco and G4S, already under investigation for fraud.

Start on the living wage from day one, showing how the earnings crisis is at the heart of the country’s economic instability, and the cause of soaring tax credit and housing benefit bills. Let no company bid for a Government or council contract unless they pay the living wage and pay all their taxes. Virtually every large company does Government work, so this spreads fair pay rapidly across most sectors – bringing in hefty sums from tax-avoiders. This time every company that ever hopes to earn a tax-payers’ pound has to contribute fairly to the welfare of their employees and the exchequer.

Make building homes a cornerstone of what good Government is for: families everywhere worry where their children are to live. Free local authorities immediately to borrow for investment in social housing: borrowing rates are low and they have huge assets to borrow against. Get building fast, with quotas for homes and quotas for apprentices to be taken on by every contractor using state funds.

Royal Commissions are traditionally mocked for “taking minutes and wasting  years” but they can be useful if you know what you want from them. A permanent rolling Royal Commission on Inequality could act fast to spell out the alarming current trajectory and recommend remedies: all the research is there already. What’s lacking is the nerve and the authority to act on the obvious: half the population is underpaid, dragging down the economy while property is over-valued and under-taxed, council tax is derelict for lack of revaluation while many of the older generation acquire too, much leaving the young bereft. The Commission would make recommendations for windfalls – as on utilities in 1997 – to be taken from cartels and profiteers to pay for high quality apprenticeships, jobs for the young, a revitalisation of Sure Start and universal good childcare. Extend the Low Pay Commission’s remit beyond the universal basic minimum wage to pronounce on pay rates variable according to sector, as in the old wages councils: some sectors in some areas can afford higher pay rates for their staff than every local hairdresser or sandwich shop. Let them set targets for top pay too, suggesting the Government withdraws its custom from companies that overpay executives. Most of these banks and finance houses do business with Government.

Signal that this is a Government that will put the young first, from birth to first job. No wonder young people are detached and alienated from a political process that has abandoned them: in a vicious circle they don’t vote, so
they don’t count and resources pour upwards to better off home-owning pensioners. Devote resources first to nursery, schools, FE colleges, universities and gold-standard apprenticeships, not the shoddy courses posing as a route to work – and that way young people will see that politics makes a difference to them directly: Westminster decisions matter and they should get involved.

Summon the forces’ top brass to join a Defence Commission, spelling out the colossal defence cuts Osborne has already written in (though dare not confess). Ask them to decide if they really want a Trident replacement – or
to use the limited funds for a right-shaped army, navy and air-force able to dovetail with European allies’ capabilities.

Above all, at this eleventh hour, devote every effort to halting climate change, internationally and at home. Show that green investment creates green growth and green jobs in renewable energy and insulated housing. Take on the climate deniers and declare a green growth Government: real international strength grows the more independent we become in energy over the next decades.

The first 100 days can lay out the journey to a stronger economy through greater equality when even the Governor of the Bank of England declares escalating inequality is the greatest threat to long-term economic stability.
Fairer, greener, more generous-spirited, the country needs to learn to like itself better. That means an end to divide and rule, blaming and shaming the weak, the poor or foreigners: this time “Genuinely all in it together” needs to be reclaimed from day one.

One Hundred Days for Early Action: Distilling the Wisdom

April 16th, 2015

This week the Community Links led Early Action Task Force published a new book One Hundred Days for Early Action: Time for Government to put prevention first: A collection of essays by a respected group of leading experts and thinkers with decades of experience of Government – as, civil servants, senior advisers or respected commentators. In the collection they set out practical steps for the next Government. Between now and the General Election we will be serialising the essays on this site starating with an introductory piece by Caroline Slocock – Director of Civil Exchange, member of the Early Action Task Force and (amongst other things) a former Private Secretary to the Prime Minister. In Distilling the Wisdom Caroline imagines the books contributors as an advisory group  introducing this little book to the new boss with a Private Secretarry’s first memo. Download the book.

 

 

Margaret Thatcher's last dispatch box

Prime Minister

  1. Welcome to office. You have received advice from an expert panel of advisers, with key points of agreement summarised below.

Background:

  1. There is a strong consensus from your advisers that early action should be at the heart of your future strategy. It will not only deliver greater well-being and fairness, it will also promote growth and opportunity. It will reduce the rising demand for public services and help drive public sector reform. Many of the current incentives point in the wrong direction, toward short-termism, silo working and maintaining expenditure on acute services at the expense of early action. Without decisive early action, a downward spiral will continue in which preventative spending is cut to yield short-term savings, resulting in rising demand over the medium to longer term and threatening financial sustainability.
  2. Decisive action to tackle these institutional barriers will be easier for an incoming Government: “early action to beget early action,” as Dan Corry puts it. There are precedents from earlier Governments of successful bold initiatives announced in the first few days: the New Deal, the transfer of interest rates to the Bank of England and the creation of the Office for Budget Responsibility.
  3. That said, although some institutional changes are best implemented and announced in the first 100 days, in other areas it is advised that further work is commissioned now in order to underpin well informed decisions at a later point. Analysis and discussion now are more likely to yield better results.

A Five Point Action Plan

  1. There is a five point action plan for you to consider, each of which is considered in more depth below:
  • Set early action outcomes to drive the agenda.
  • Plan for the longer term and for delivery of these outcomes.
  • Identify, protect and increase early action investment, treating it as essential investment in the future, rather like capital investment.
  • Spend and tax to deliver better outcomes, not to perpetuate existing public services and the current welfare system.
  • Increase accountability for early action.

Early action outcomes

  1. A small number of early action outcomes, which cut across institutional boundaries, should drive this agenda. Choices here are critical and should not be rushed, as they will drive everything that follows. These will set a clear direction for the reform of public services without which you will not achieve real change or make significant savings in expenditure. Existing public services have failed, for example, to tackle persistent health and education inequalities or stem rising demand.
  2. Key outcomes suggested by the advisers include reducing inequality and child poverty; investing in children and young people; increasing public health, including better mental health and well-being; improving housing and tackling global warming.
  3. Once these outcomes are identified, you may want to consider particular initiatives that will help deliver them. As you see some ideas have been put forward by your advisers including a programme of investment in Troubled Young People (building on the current Troubled Families initiative); a Good Mental Health programme, which would include preventative and remedial investment; a Schools for Life initiative, including training in resilience, a Transition to Work programme for young people; a public health promotion campaign; and an imaginative new housing strategy, including incentives to increase house sharing.

Longer term planning

Planning needs to better support the delivery of early action outcomes and to achieve this you need to tackle the culture of short-termism that pervades the public sector. The next Comprehensive Spending Review is the right place to start. Many of your advisers agree that firm plans should be set for the full fixed five year term, though most think that there must be leeway to review mid-term in the light of developments. But they would also like to build in a longer term horizon, a minimum of an additional five years, to create a “Ten Year Test” which would require the consideration of the long-term benefits and costs of all existing and new expenditure both in the spending review and when more detailed plans are made. However, your advisers warn against rushing this process in the CSR, as decisions taken in haste are rarely the best.
Investing more in early action

  1. Your advisers recommend that you commit to shifting a higher proportion of expenditure into early action year-on-year, and suggest that this should a clear goal for the next Spending Review. To deliver it expenditure on early action would need to be separately and robustly classified – the National Audit Office have already proposed how to do this and their definition has been developed by the excellent Early Action Task Force. Early action should be treated as an investment, like capital, and ring-fenced, with a “one-way valve” – acute spending can be diverted to it but the early action budget cannot be raided for short term spending.
  2. To help shift toward greater investment in early action, various ideas are put forward by your advisers for a new social investment fund or funds. One idea is to ‘top slice’ a proportion of current departmental budgets for the delivery of outcomes which cut across institutional boundaries.

Spend and tax to deliver better outcomes

  1. A focus on better outcomes, on the longer term and on investing more in early action has major implications for how the public sector currently operates. We propose that your Government commission work now to map the best way forward, leading to a publication of a ground-breaking “Delivery of Public Outcomes” White Paper. This would sit alongside thinking about greater devolution, which itself opens up new opportunities to do things differently. It would signal a move away from maintaining existing services – which are no longer fit for purpose and are crumbling under rising demand – to new models for delivering outcomes and reducing demand. These would often be developed and delivered locally and in collaboration with service users. The public sector might redefine its role from public service delivery to prevention.
  2. Various ideas and thoughts are put forward by your advisers which could be considered, including:
  • New methods for co-ordinating local delivery, building on City Deals, Health and Well-Being Boards.
  • Development of some existing models for pooling budgets and working collaboratively, such as Community Budgets and Our Place.
  • Putting power into the hands of front line staff to work in new ways.
  • Shifting financial incentives to reduce pressure on existing services (e.g. raising council tax bands to generate revenue and reduce incentives to under-occupy).
  • Shifting existing public sector contracts toward outcomes, finding ways to work with the voluntary and community sectors more effectively and moving away from big contracts.
  • Encouraging personal action such as investing in parenting skills and resilience in young people, home sharing, and encouraging better health and reducing food poverty by a public campaign to “grow your own food and reduce food waste.”
  1. Taxation and benefits are an important part of this picture but currently tend to be considered separately to spending on public services. Your root and branch review could look at how to simplify taxation and find ways to remove any hidden incentives to employers to keep wages low because of tax credits. The review should also look at an early action approach to reducing welfare costs, promoting investment in action in non-welfare budgets – such as greater investment in mental health – to tackle problems at source rather than cutting benefits in ways that may create further problems.
  2. You should look at the case for greater taxation where it can be shown to be part of a strategy for prevention. One idea is for a “polluter pays” tax, for example of the alcohol, smoking, betting and junk food industries, with revenues invested in earlier action.

Increasing accountability

  1. Do not underestimate the shift in culture that this programme will require. New institutions and tools are needed to facilitate this process.
  2. To drive a change towards an earlier action approach within Government and develop new tools, such as better methods of evaluation, it is proposed that you establish a new cross-Government unit under your direct control (but also reporting to the Chancellor).This should be established immediately. Similar units could also be set up in each Department to help re-prioritise spending. They could report to the central unit.
  3. There is a broad agreement about the need for a new external organisation or organisations to monitor progress and aid external accountability. Lord O’Donnell proposes a new Office of Taxpayer Responsibility that might clear spending proposals. Alternatively, you might extend the remit of existing bodies, particularly the Office for Budget Responsibility, which might also take on the critical task of strengthening evaluation. One technical task that must be tackled is to ensure that the definition of GDP does not inadvertently score prevention as a reduction in GDP by public services.
  1. You should also consider whether legislation is needed to facilitate and embed early action, for example through new statutory accountabilities at a local level and duties to collaborate, a duty to promote early action and apply a ten year test and a binding commitment to shift spending toward early action. You will know that the Welsh Government’s Future Generations bill has blazed a trail here. It will be important to ensure that the rest of the UK isn’t left behind

Leadership

  1. Finally, there is a need to take the public with you on this. There is great potential in early action for you to develop a more positive and optimistic framework for reducing public expenditure over time. It is proposed that you announce your strategy in your first major speech.

Thank you Prime Minister.

One Hundred Days for Early Action

April 14th, 2015

Manifestos were launched this week, with prevention clearly on the agenda for both Labour and the Conservatives. In areas such as health, crime and the environment the manifestos illustrate a commitment to prevention and include specific suggestions as to how they will achieve this.

But to what extent will this rhetoric become practical action if either party forms a government? This is an important question in a time of escalating needs and constrained resources. As Rob Whiteman, CEO of the Chartered Institute of Public Finance and Accounting, points out: “if prevention is always better than the cure, it is usually also more affordable”.

Prospective MPs would therefore do well to read our latest book, One Hundred Days for Early Action. It brings together a group of leading experts with decades of experience of government to share their thoughts on early action and its importance. Covering a wide range of issues from systemic change through to practical programmes in specific policy areas, each author offers an insight into immediate changes that could – and indeed should – be made by the next government.

Our current trajectory is unsustainable. It is not, however, inevitable. The time to put prevention first is long overdue, and the next government – whoever they may be – will have the perfect opportunity to do this.

In Defence of Welfare 2: Towards an Early Action Social Security System

April 10th, 2015

Today marks the launch of In Defence of Welfare 2, a collection of essays from academics, policy makers and journalists exploring the changing nature of welfare in the UK.

With over 50 essays, the collection covers an impressive range of issues from the impact of welfare reform to the very purpose of our welfare state. There are many common themes throughout the essays, but one is particularly striking: rather than promoting social security, the welfare system often undermines and punishes those that currently rely on it. Refreshingly, the discussion in this collection is far more constructive than you might find elsewhere. It is a very welcome contribution to a debate clouded by attacks on the so-called ‘undeserving poor’.

Our piece, Towards an Early Action Social Security System, aims to directly challenge this overly narrow and negative debate. Drawing on ideas from both our qualitative research into the impact of welfare reform in the London Borough of Newham and our more theoretical work on social security, we argue that there is a need to take a longer term approach to the social security system.

Far more detail can be found in the actual piece, but in order to revitalise the system we must re-imagine its underlying principles in a more positive light and change currently restrictive public spending rules. This would not only challenge the endemic short-termism so evident in the current system, but also lead to better social and financial outcomes for all. Rather than being seen as a ‘bill to be cut’, it can instead be framed as a crucial investment in individuals, communities, and ultimately the whole of society.

Budget 2015: Three initial thoughts – a welcome, a warning and a concern.

March 19th, 2015

The line-by-line analysis of what was included – and what was not – in George Osborne’s budget started before he had even sat down; I’d like to add three initial thoughts to the conversation: Welcoming one measure, identifying a concern and warning of a significant challenge.

First the good news. We’ve been banging on for years about early action and joined-up services. We welcome the news in a passage of the budget statement the Chancellor committed to the following:

1.87 Further savings will also be achieved by making local services work better for the people who need them. The £448 million invested in the Troubled Families programme has helped over 105,000 families to turn their lives around, the government has demonstrated its commitment to early intervention in a child’s earliest years and the £5.3 billion Better Care Fund is helping people to benefit from joined up health and social care. This is based on the principles that intervening early can prevent problems arising later on and locally joined up services can better meet the needs of vulnerable people. Building on the government’s ambitious programme of reform, the Budget announces that the government is exploring the cost-effectiveness of options to integrate spending around some of the most vulnerable groups of people, including:

  •   joining-up services for people with health and social care needs,
  • improving the links between health and employment support for people who are unable to work because of a health condition,
  • designing a more integrated, multi-agency approach to divert from custody, where appropriate, female offenders who are convicted of petty, non-violent offences

Although it is too early to understand the depth and scale of this commitment it would be perverse not to welcome  this clear recognition of the importance in invvesting in preventative initiatives. Programmes such as the Better Care Fund have the potential to make a real difference. We must continue to  interrogate the detail on this work and hold feet to the fire.

However the real proof of these commitments will be determined by adequate resourcing of the public agencies who are tasked with delivering them – as we have stated previously Early Action spending forestalls future liabilities and creates growth. Funding needs to be treated in the same way as capital investment – not raided for short term demands. It is a significant challenge to see how cash strapped councils will be able to deliver or support these measures. Back in November I wrote about a little noticed National Audit Office report on local authorities which predicted that some may go broke in the next few years. This danger still remains and further evidence of its likliehood continues to emerge. Even local authorities which just about manage to survive will only be able to do so at the expense of vital services and, possibly, some statutory duties.

Finally a concern for Community Links and colleagues in the voluntary sector who are currently picking-up the pieces when our communities struggle to cope with the cumulative challenges of low-pay, under employment, and extensive welfare reform. This budget was a missed opportunity to improve the lives of the most vulnerable; tinkering with the tax allowances has resulted in negligible and possibly negative impact for the lowest paid –whilst benefitting middle and higher earners. This budget has done nothing to reduce inequality.

Yet there is much a Chancellor of the Exchequer and a newly-elected government could put in place relatively simply and quickly to put an early action approach at the centre of their programme of work, or risk the future of important public services if they fail to seize the opportunity.

The Early Action Task Force has brought together a hugely respected group of leading experts and thinkers to set out practical steps for the next Government. Their compelling contributions  will be published next month in a series of essays: One Hundred Days For Early Action: Time for government to put prevention first

Osborne’s budget: forward thinking or the same old story?

March 18th, 2015

Cover100DaysThe past few years have been a missed opportunity for investment in early action.

In 2012 the Early Action Task Force published The Deciding Time, calling on government to prevent today or pay tomorrow. A year later the National Audit Office published their early action landscape review, highlighting how just 6% of major departmental budgets (including Health, Education and Justice) was spent on early action in 2011/12.

There has been some progress since then, though much of it has been outside of Westminster. In Wales, for example, the Well-being of Future Generations Bill makes long-term thinking a statutory requirement, thus illustrating that progress at a national scale is very much possible. At a more local level, Lancashire Constabulary have successfully begun a shift in policing towards early action.

The Budget

The Chancellor’s budget is unlikely to signal any real change in direction. Perhaps a gift or two to butter up certain parts of the electorate, like so many pre-election budgets before, but nothing that will embed an early action approach in public services.

Nevertheless, we are now at an important juncture. The next government, whatever its composition, has the opportunity to change things for the better – to start a shift towards early action, therefore yielding a triple dividend: savings to public expenditure, increased contributions to the exchequer, and thriving lives.

It is with this opportunity in mind that we will be publishing a collection of essays in early April filled with practical ideas for how the next government could put prevention first. One Hundred Days for Early Action brings together leading experts in their field, many of whom have had extensive experience in and around central government. It explores what systemic change is needed and how early action might look in a range of specific policy contexts.

Many of these things will take more than one hundred days to achieve in their entirety. However, setting them in motion and ensuring that an early action approach frames much of the government’s work over the next five years is entirely possible in those first few months.

Let’s not have another missed opportunity.