Scottish Government

EXECUTIVE SUMMARY

BACKGROUND

The Integrated Service Delivery and Governance Modelling project (the modelling project) aimed to test the most viable and appropriate models of integrated public service delivery. The project ran for 12 months from August 2005 to August 2006. It was co-funded by the Executive, COSLA, SOLACE and the Improvement Service.

The Modelling project formed part of a series of Public Service Reform discussion events where senior leaders from a range of public service organisations were brought together and given the time and space to consider how they might develop and enable new and innovative ways of working.

The modelling project was designed around facilitated workshop discussions with participants from frontline public services:

• examining the potential for further integration of Scotland's front line public services
• exploring the conditions under which innovations in sustainable integration might flourish
• encouraging public service practitioners to develop relevant ideas for service integration.

Discussion focused on barriers and enablers to better public service integration and a better understanding was reached of how constraints on deepened collaboration could be reduced or removed. Project participants generated ideas based on their knowledge and experience and investigated the governance implications of emerging models, which were tested for viability and validity against the five agreed principles of public service reform (Scottish Executive, 2006) ¹.

The project was originally intended to comprise 3 rounds of data collection:

• Round 1 - 25 facilitated workshops at which participants considered the principles of effective integration and barriers and enablers to integration
• Round 2 - 18 facilitated workshops at which participants were asked to generate potential service innovations. This round focused primarily on the managerial, organisational and delivery systems and implications for further front line service integration.
• Round 3 - was to have consisted of a further round of workshops exploring governance implications for front line service integration. However, this round of data collection did not take place as governance issues are now being discussed at the Public Service Reform Dialogue events currently taking place across Scotland and are also being considered at a strategic level, by a number of other policy areas in the Executive.

The summary below therefore relates to data from the first two rounds of the modelling project, generated through 43 facilitated workshops with over 150 leadership level participants from a broad cross section of Scotland's public services, central and local government and agencies. Participants represented the wide composition of Scotland's local authorities, with representatives from cities, from larger and smaller local authorities and from rural areas and the islands.

Since the modelling project was initiated, the Reform Support Team ² has been established within the Public Service Reform and Efficiency Group within the Scottish Executive. The team will provide support to local authorities, and other public sector organisations, who are in the process of devising innovative projects and finding new ways of working that seek to effect a transformational change to service delivery by making a significant contribution to the five key principles of public service reform outlined in Transforming Public Services: The Next Phase of Reform (Scottish Executive, 2006).

KEY FINDINGS

Broad conclusions

• Key drivers for further integration of public service delivery are the political imperative to reform; the public desire for the maximised use of public resources and the necessity of getting the maximum value for every public pound.
• Across Scotland's core public services there is a strong willingness to develop and deliver innovative approaches to the integration of services, planning and delivery.
• There is a widely held belief amongst those delivering public service that if done well, service integration has the potential to create a virtuous cycle of effective public service delivery and increasing user and consumer satisfaction. However, if done badly it will be a significant waste of time and will damage the image of public services.
• Participants felt that if the Scottish Executive is to effectively support and enable public service reform, it needs to change its processes and responses to service delivery partners and agencies to reflect new configurations of services. This would involve streamlining bureaucracy and rationalising funding and scrutiny arrangements.
• Sufficient pump priming to fund integration was identified as a prerequisite for the delivery of the reform agenda.
• Community Planning processes and relationships are thought to have significantly increased levels of trust and partnership in many localities, however, these relationships need to be built on to deliver wider and deeper integration of services.

Note: Many of the barriers identified by the project were the converse of the enablers and vice versa. Consequently, rather than repeating the same points, particular barriers and enablers have been highlighted, to reflect the weight afforded them by project participants.

Barriers to delivering integrated public services

• The imprecise use of language and concepts in the debate about the integration of public services adds to confusion amongst service delivery staff expected to deliver reform. In particular, workshops identified multiple interpretations and confusion about the terms "partnership working", "joint working", "amalgamation", "collaboration", and "cooperation".
• The creation of new structures and processes, instead of maximising the potential of existing operating contexts and practices such as Community Planning and Best Value, were felt to inhibit rather than help service delivery.
• Professional barriers to sharing data, knowledge and intelligence across partner agencies were highlighted as having a constraining effect on delivery of integrated services.
• Physical, geographic, organisational, statutory and funding boundaries were also emphasised as impediments to integration.
• The Scottish Executive was itself perceived as inhibiting reform through policy divergence, competing objectives and expectations, the practice of ring fencing funding for a multiplicity of new initiatives many of which require specific reporting mechanisms. There was also a perception that the Executive was insensitivity to service priorities particularly at local levels and had a tendency towards centralisation.
• Overly bureaucratic and over inspected operating environment were thought to reduce opportunities for reform.
• The current risk averse public sector climate compounded by a litigious environment reduces opportunities for innovation, as does the lack of a shared public sector approach to risk management operating across silos and between professions.
• A lack of project management, implementation and evaluation skills was also identified as an inhibitor of reform within the Public Sector.
• Political, professional and to an extent union, parochialism was considered to act counter to joint service delivery.
• Divergent business practices were also felt to prohibit reform as the public sector retains non-compatible ICT legacy systems and conflicting budgetary and planning cycles.
• Prevailing uncertainties about the national reform agenda were also thought to stifle innovation.

Enablers to delivering public services

• A common shared purpose agreed by delivery agents, which is subject to regular review.
• Trust, openness and transparency across partner organisations, facilitated through excellent communication.
• Shared data, knowledge and management information systems which are closely linked to user needs.
• The Scottish Executive enabling those who know most about front line service delivery to innovate, rather than creating a steering group or board to oversee the integration and reform of public services.
• Pooled or shared funding and a rationalisation of associated reporting requirements.
• Improved geographic co-terminosity.
• A clear definition of governance geography.
• Clear performance and audit regimes which are appropriate to integrated service delivery process.
• Strong and effective leadership informed by political, managerial, professional, organisational and unionised perspectives and a commitment to deliver change.
• The use of ICT to create virtual organisations and single contact point service delivery outside physical or organisational geographies.
• A growing recognition across the public service that increased integration will result in greater efficiency and productivity and allow partners to respond more effectively to cross-cutting policy. This was thought to be particularly important at a time of changing funding patterns and the possible decrease of available resources.

TENTATIVE RECOMMENDATIONS

Specific actions which would remove barriers and enhance enablers to greater integration of public service delivery

• Integrate service delivery around an agreed shared purpose.
• Design services around the needs of users and customers.
• Foster supportive leadership.
• Reform Scottish Executive to reflect external changes to public service delivery. Change policy demarcation, funding streams and statutory environments which currently prevent integration.
• Develop good practice information about how to identify and deal with common problems associated with the most frequently integrated services.
• Develop better, clearer definitions of governance geography for integration based on the development of clear shared governance and accountability systems for integrated service outcomes.
• Set realistic and achievable timescales for successful implementation of individual integration initiatives and ensure the correct sequencing of resources for the reconfiguration of front line service delivery and accountability mechanisms.
• Get sign-up from senior leadership especially politicians at national level to actively support and exemplify successful integration of front line services and to minimise / eliminate competing or conflicting expectations and demands on service delivery systems.
• Nurture a learning environment through sharing good practice and learning points from failed attempts at integrating service delivery.
• Mainstream integration principles into new Scottish Executive initiatives making sure that new initiatives fit into improved service delivery planning, scrutiny and audit processes.

Further work to enable specific actions to be undertaken

• Establish an evidence-based business case for wider and deeper integration of public services in Scotland.
• Clarify which services are and which are not being considered for integration based on a detailed consideration of the evidence.
• Investigate the ways in which integrated service delivery will affect the modes of support services required and reconfigure support to reflect these findings.
• Establish an appropriate and commonly shared language for Scottish public service integration which makes it clear that integration means more than 'partnership plus' and better collaboration.
• Consider what changes the Executive must make to reconfigure its operating culture and approach to supporting service delivery organisations in user focused service delivery.
• Consider how existing processes such as Community Planning and Best Value principles might be more appropriately and effectively used to support integrated front line service delivery.

POTENTIAL SERVICE INTEGRATION PROJECTS

During the second round of workshops participants identified a number of potential service integration projects, these are listed below under 4 broad category headings. Further information on these projects are included in the full report.

A single public service:

• West Dunbartonshire public sector agency - proposed by West Dunbartonshire
• Ayrshire Shared Services - proposed by North, South and East Ayrshire
• One for all connected services approach- proposed by Dumfries and Galloway
• Fife incorporated - proposed by Fife
• Western Isles Plc. - proposed by Western Isles

Shared resources:

• Shared local authority and NHS assets; integrated asset management - proposed by Scottish Borders
• Shared resource management - proposed by Clackmannanshire
• Argyll and Bute single customer access point- proposed by Argyll and Bute
• Single change management approach - Aberdeen and Aberdeenshire
• Problem identification and solving intelligence partnership - proposed by East Dunbartonshire

Integrated service delivery for specific user groups:

• Integrated community learning disability service - proposed by Perth and Kinross
• An Integrated children's service - proposed by Moray

Integrated service delivery on a specific issue:

• Economic development - proposed by Stirling
• Health Care in East Renfrewshire - proposed by East Renfrewshire
• Joint delivery of social work services between city of Aberdeen and Aberdeenshire Council - proposed by City of Aberdeen and Aberdeenshire
• Public services response to antisocial behaviour - proposed by Falkirk