How government spending cuts can be a catalyst for radically better public services
In the fallout over the recent Budget, government spending was once again in the spotlight. But while the row centred on benefits at a national level, it’s social care managed by local authorities that is currently entering a period of intense crisis. Faced with unprecedented cuts, local government chiefs now have to find a way to conjure up spending reductions which neither impact upon jobs nor frontline services.
If this seems like an impossible task, that’s because an assumption prevails across much of the public sector (and private organisations too) that higher budgets correlate with better quality services – and that cuts, by definition, mean a choice between “salami-slicing” services or axing them altogether. That assumption is misplaced. In fact, even steep budget cuts can – and do – lead to improved public services and better outcomes for the people who use them.
The reason is that squeezed budgets can serve as a catalyst both for asking awkward, even existential, questions about practices and procedures, and taking a data-led approach to reviewing how services are designed and delivered. How, for example, would you plan a service if you were starting from scratch? Is there a better way to utilise existing resources? And, in the realm of social care specifically, what is the best way to ensure vulnerable people get the support they need?
With multiple services to deliver and growing populations, local authorities have little choice but to look afresh at the way in which services are configured, and rebuild them around the user. In adult social care, for example, the latest evidence shows that the way in which a person is supported at a time of crisis can be a crucial factor in their longer-term quality of life. Take a scenario where an elderly person is placed in a residential care bed as a temporary measure after a hospital admission. If they’re not supported to return home to live independently when ready to do so, they’re likely to remain in that bed.
By adapting that same individual’s home to allow them to live independently afterwards, and scheduling home visits from care workers and other professionals, longer-term admissions to residential care can be reduced by up to one third. This approach enables older people to live longer and more fulfilling lives – and significant cost savings too.
Data held by local authorities invariably reveal a treasure trove of missed opportunities. Many councils collect the raw numbers, perhaps using impressive technology, but more often than not do very little with evidence such as who is using a particular service, how long they have been using it, and what the outcomes are. By rigorously examining this data, critical information can be gleaned: is a service reaching the right people? Is it reaching enough of them? Could outcomes be improved? If so, how?
By reviewing data at every level, services can continually be improved. An individual’s needs will typically vary over time, and it’s important that they are consistently monitored to ensure that they don’t end up receiving more care than they actually require, potentially resulting in institutionalisation – which is not only costly, but could also decrease their chances of living independently. Holding timely and consistent care reviews can have a huge impact on that individual’s wellbeing – not to mention the cost of their care.
Similarly huge opportunities exist right across the public sector – both to transform the way services are delivered and, by using data, to deploy existing resources more efficiently. Enabling local authorities to examine processes and decision-making to ensure that the right services are being made available (and how, when, or even if, the correct decisions are being made) is key to improving both services and outcomes.
Self-disruption – revolution from within – is hard. Over the years, systems become entrenched and, within organisations, old habits die hard. But it needn’t be expensive; councils don’t need to invest a lot of money to make this work. Instead, by equipping people within local authorities with the skills, knowledge and support to enable them to tap into the power of the data they’re gathering anyway, frontline services can and should be enhanced, despite budgetary constraints.