Buying Quality Performance

In this special guest blog, we hear from Bill Wells in response to Richard’s recent piece on changing the way children’s services are commissioned. Bill Wells worked in DWP, BIS, and its labour market predecessors, for over 35 years. As a labour market economist he has a national and international reputation. During this time he had responsibility for devising the target structure for Jobcentre Plus and also determining the levels at which the targets should be set. He suggests how lessons from his work there might be applied to children’s services.

(We invite guest bloggers to submit articles and we actively seek more open discussion on all the questions raised on this site. Please note that the views of any guest author do not necessarily reflect our own.)

THE AIM SHOULD BE TO SERVE THE PUBLIC AND KEEP THEM ON THE STRAIGHT AND NARROW. NOT SOLVE THEIR PROBLEMS AND TELL THEM WHAT TO DO.

Richard Johnson in ‘Think of the children’ https://buyingqp.com/2016/07/18/think-of-the-children/ highlights some of the terrible outcomes that children in care suffer and suggests a commissioning strategy to improve it. I’m not sure, however, that his strategy is completely aligned with his stricture to ‘Think of the Children.’

Below I suggest an approach based on the target structure that I helped to devise for Jobcentre Plus in delivering their Welfare to Work programme (which could be seen as a commissioning strategy in the public sector). It also starts with an identification of what the important outcomes are but adds to it by setting out the minimum levels of customer service each individual can expect and also how to get the best value for money for the public sector – increasing the level of service that can be provided.

MOST DESIRED OUTCOMES OCCUR WHEN THE CHILDREN HAVE LEFT CARE. SO THE HELP NEEDS TO FOLLOW THE CHILD OUT INTO THE WORLD.

Much of the discussion is about the quality of care whilst the child is in care. However, most of the poor outcomes – high levels of NEETs, self-harm, imprisonment – occur after they have left care. Responsibility for the child in care cannot, therefore, stop at the door of the care home. There needs to be an infrastructure to follow the child so that all of them make a successful transition from care into (say) housing; a job or education; and continued access to Information, Advice and Guidance – preferably from someone who knows them – to act as their advocate but also as their policemen – to keep them on the straight and narrow.

The person responsible for the child’s care need not be (and is probably not best placed to be) the person who ensures that the child in care makes a smooth transition onwards. However, they should have the responsibility to ensure that the child is safely passed to the appropriate authorities and do not fall through the cracks.

PUBLIC SERVANTS ARE THERE TO SERVE THE PUBLIC. NOT VICE VERSA.

The service that the children receive whilst in care should be specified in terms of minimum service levels e.g. all of them will receive three meals a day, a bedroom etc. However, it needs to cover not just the ‘nice’ things but also the ‘nasty’ things. The organisation has the responsibility for ensuring, for example, that all those in care, do their homework, do not become a persistent truant or get in trouble with the law.

The public also all deserve courtesy and civility and, as representative of the people, the Government should require this of providers. These requirements should not be regarded as exceptional or excessive. Dealing with difficult customers is not exclusive to the public sector. The cliché of the rowdy (or worse) group visiting the curry house after the pub is a cliché because it contains an element of truth.

IF AT FIRST YOU DON’T SUCCEED THEN TRY, TRY AGAIN – YOU CAN DO IT, WE CAN HELP.

It is the behaviour of the individual that delivers success not the actions of the public sector or the providers. Success, therefore, depends not primarily on an intervention – the social equivalent of a doctor treating a patient – but rather on an intervention regime – the social equivalent of an MOT system or 6 month check-ups at the dentist. These social MOTs both check to see whether the individual is sticking to the straight and narrow, and also reviews whether the individual is carrying out their part of the contract to improve their life. If they are and it is still not working there may need to be a case for reviewing their plan and changing it.

If over time success doesn’t happen, it indicates that the state or provider should provide more help to supplement the behaviour of the individual. This could be more frequent contact or the provider working closely with the individual to remove the barriers preventing success.

This intervention regime is particularly important once the child has left care. It may be that the local authority passes the child on to, say the housing department and Jobcentre Plus, but they still retain the responsibility for ensuring those organisations deliver.

REACH FOR THE CHILD’S DREAMS AND DELIVER FOR EVERYONE

Aiming at what the child wants to do not what the state thinks they should do should be central to the customer-based service that should be delivered. A key part of the service – specified in the commission – therefore, should be an agreed plan which sets out what the individual wants to achieve and how they might do it. The plans should include the agreed intervention regime that both need to sign up to. These plans need to be regularly reviewed and if they are unsuccessful then, as stated above, the state should provide more help.

Outcomes are, of course, important and depend on the quality of the interventions. Many talk about how great teachers have inspired them and were central to their hard work and ambition that led to their success. But it doesn’t matter how great they are if you never meet them. Any success is more likely the more regular and often that you see them.

AND FINALLY THE STATE SHOULD DRIVE A VERY HARD BARGAIN, CHARGING FOR ANY UNSUCCESSFUL CUSTOMERS RETURNED TO THEM.

Where commissioning from outside the public sector differs from inside is that management targets talk within the public sector and money talks outside. In both, however, the state should press to get more for less. For Jobcentre Plus the target was to reduce the cost of the service by x % per year. That might also be a feature of any private sector commissioning.

The other difference is that in the public sector at the end of a period the state retains responsibility for unsuccessful customers. In the private sector such unsuccessful customers are passed back to the state. This provides an incentive to ‘cream & park’ – focus on the easiest to help and garage the real nuisances until you can give them back. Charging for these unsuccessful clients who are returned not only reduces these incentives but also provides some money as a contribution to the rehabilitation of these children.

Bill Wells