John Seddon on the future of social care

Professor John Seddon

I’ve always been a fan of Private Eye. Forty years ago I worked for the BOC Group. The chairman Sir Leslie Smith would say he’d read the Financial Times to find out what’s happened and he’d read Private Eye to find out what was going to happen. Private Eye does a better job of scrutiny than many of our institutions.

It was a small item in a recent issue of Private Eye that got my attention; I learned that Brendan Martin, the man who runs Buurtzorg UK, had withdrawn his support for what was described as a Blueprint for social care. I like Brendan; he’s a good man with worthy intent. I also rate Buurtzorg – a Dutch care-service organisation – as amazing, a true innovation. Private Eye reported Martin withdrew his support because the Blueprint proposed a structural change whereas he believed the reform of care services must start with the needs of the care recipients. He’s right.

So I got hold of a copy of the Blueprint. It was authored by Josh MacAlister, CEO of Frontline, an organisation funded by public money to recruit and train social workers, in conjunction with Boston Consulting Group. The Blueprint has Buurtzorg all over it; representing the UK pilots of Buurtzorg as successes. Absolute rubbish; they were shocking failures. So I did a podcast to argue that compared to Buurtzorg in the Netherlands, the UK pilot results were, at best, pathetic and I described the reasons for Buurtzorg’s success which, in short, began with the leader realising that the problem was the system; I also described how Vanguard’s clients in care services had learned the same that the starting-point for designing a better system is understanding what’s wrong with the current system.

Then I wrote to the people listed as interviewees for the Blueprint, sharing the transcript of the podcast with them. What astonished me was that everyone who replied – and bear in mind these were all significant people in the care-services world – told me they did not concur with the Blueprint’s plan of action. One or two were even quite cross to have been cited. One would have thought that this lack of consensus and, as the Blueprint places such heavy emphasis on Buurtzorg, whose leader had withdrawn support, the whole thing should have been re-written, shelved or at least paused for reflection.

But then I think about what I’ve learned about policy-making in Whitehall. It’s like this: you have an idea; then you get other people in the Whitehall bubble to enthuse about your idea and once you have a body of people onside you stand a good chance of the idea becoming policy. There is neither desire nor means to base policy on evidence. In that crazy world you’d want to list lots of people in any proposal to give the impression that your idea is widely supported and you’d want to ignore the inconvenience of the main argument being torpedoed by its representative in the UK.

So I began to take the view that this Blueprint is a pitch; a pitch for public money. According to Private Eye MacAlister’s organisation has already received £72m over recent years for social-worker training. That too was a plausible pitch. We have a problem… turnover of social workers is too high… it must be a training problem… that’s how Ed Balls saw it when he was the minister. It wasn’t a training problem then and it isn’t a training problem now. Social workers leave because the system is rotten. Did the £72m have any impact?

Clearly not, the Blueprint reports that as many as 55% of social workers have had enough and are planning to leave. You might have thought that Josh MacAlister would have reflected on that as his organisation was set up on the basis that training would solve the morale problem.

The Blueprint uses the word system but shows no understanding of how the system needs to change. For example, it acknowledges the current problems of bureaucracy, form-filling, mistrust, overbearing reporting to regulators and low morale and yet, again astonishingly, it asserts that the plan will adhere to all existing regulatory frameworks. Forgive my cynicism but this is either a ploy to avoid any opposition amongst the consensus-builders or MacAlister hasn’t got a clue about work as a system.

Perhaps he thinks his proposed structure represents a different system. His plan is to create a series of self-managed teams. A family-facing team that does the social work, a referral team that allocates work, an enabler team that helps the family-facing team by handling administration, an insight team that helps family-facing teams do best practice and a strategy team that guards the culture and ensures the teams are empowered.

Really? This is Big-Consultancy speak; lots of words with indistinct meaning. But then, eventually, I find out where it is going. You have to plough on to the end of the huge document, which has abundant repetition and is a tiring read, to find this: To deliver the plan in an initial 12-month phase for 2 family-facing teams the cost estimate is between one and one-and-a-half million pounds. What is delivered for this eye-watering fee? The 2 family-facing teams get 5 initial training days and 2 monthly training days in their first year.

Forgive me. But all I can say is: ‘F*** me’. What a rip off. The estimate for a complete transformation of each local authority’s children’s service is 5 to 7 million.

Now here’s the thing: we have helped leaders of care services transform their services into systems that have results on a par with Buurtzorg for tens of thousands of pounds, with results in months, not years.

Camilla Cavendish, who is working for the minister on the future of care services and chairs the Frontline organisation – in other words is a collaborator with MacAlister – came across one of our clients and was impressed. My team introduced her to another client who’d taken even further strides; they sent her my Podcast on Buurtzorg as she too was a fan and had eulogised about Buurtzorg as a journalist. She replied to say she’d read the script in one gulp. Maybe it gave her indigestion. She arranged for us to speak but on the day she was busy and instead sent an American student, who is working with her, to interview me. It was a bloody awful experience. Her questions showed she either couldn’t listen or had no ability to grasp what I was talking about; I gained the impression she’d been tasked with asking me some questions Cavendish wanted answers to which, given what I’d been saying, were neither good nor useful questions.

My central argument concerned the way regulation is the fundamental cause of sub-optimisation of these services. The bureaucracy MacAlister describes demands reports up the hierarchy, and many of them. Failure to report and reporting poor results both risk damage to reputation. I have published many examples of adherence to referral, assessment and care-plan targets, a focus on budget management and the methods of commissioning, all causing sub-optimisation and the signal that things are awry is the volume of failure demand hitting care services – often over 80% of all demand.  Yet managers of these systems get the green light from regulators. Boxes ticked.

Ofsted is the primary regulator of children’s services; many of the measures that drive the bureaucracy are questions you would want to ask if you want to know the extent of what’s going on with children in need. You can understand why governments might at least want to know the extent of the problem. The regulator asks: How many assessments are occurring? Are children referred and assessed in a timely manner? Do the children have care plans in place within defined timescales? Is there evidence these are reviewed? How many children are be labelled as ‘Looked-after Child’ (LAC) and ‘Child in Need’ (CIN)? How many are there in terms of percentages per 10,000 of the population? And the like. These controls help no one understand or improve the system; instead they work against any such understanding and frequently can serve to make performance worse. But adherence to these controls protects reputation. Yes, you can have a lousy service and a good rating from the regulator. The controls focus leaders on activity at the expense of purpose. So it matters that activity targets are met rather than each and every child in need being understood.

The questions you would ask if you wanted to know how we are actually doing with helping children in need would be related to purpose, not activity. I shall return to this. But first something that came to my desk recently.

A manuscript of what I hope will be published as a book, describing one family’s experience of children’s services. It began with a tragic event: A family happily agreed to take in their friend’s three children for a couple of weeks when she was admitted to hospital. She deteriorated rapidly and unexpectedly died. What began as a two-week arrangement became extended and tragic. The family wanted to take the children in and the children wanted the same but there were two issues: the family had limited resources, so funding would be necessary, and the children had an estranged father who have been sent back to his home country, Latvia, for criminal behaviour.

The protection of children is, quite rightly, governed by law. In such circumstances the law provides for our statutory services to appoint the family as connected foster carers immediately, then later as Special Guardians, leaving more formal matters of suitability to later and to offer discretionary payment. It could have been very normal very quickly. But that didn’t happen. The motivation for the book was to share the horror of that result taking 18 months.

A hierarchy of social-work actors delayed, failed to act as agreed, told lies, threatened the family with taking the children away, contravened a judge’s direction, only to, eventually, do what mattered. It illustrates how the social work hierarchy sought to avoid bad news, for fear of personal and corporate liability. The book shows how mistakes and lies couldn’t be admitted; instead were denied, and further lies were generated to cover up; it being impossible to acknowledge the truth.

So you have to ask why. How can these people, who joined a vocational service, act this way? It’s how you survive; it’s how you climb the tree. Adherence to regulation, adherence to budget, avoidance of bad news – we have seen how scandals have driven up the number of children taken in to care, simply because it avoids loss of reputation.

Ofsted’s web site proclaims its regulatory function is insuring that services help children in need. It asserts that prerequisites for leadership, note that, prerequisites – you’d better have them – include a vision and values statement, a statement of philosophy, documentation for the structure of teams, controls on how cases move through the system, descriptions of how social work practice will be carried out, arrangements for the provision of help, protection and care for children, what the thresholds for providing services are, what services are expected to do and how services are monitored for quality and effectiveness.

And this is where regulation gets into deep water. One way to deal with all the above is to have documentation for everything, in spades. Regulators like documentation. But what constitutes ‘good’ in any of the above edicts is open to subjective judgement. Much of what is promulgated as ‘good’ isn’t good at all. Misjudgements, conflict, stress, staff turnover and claims for retribution are inevitable consequences.

It is the primary fault in our system of regulation: regulators bring theory. So adherence to their theory is the route to a good reputation. But their theory is wrong. Any of us can point to vision and values statements that are meaningless and not lived by. How cases move through the system encourages an industrial, specialised, cost-controlled design; specifying how work will be carried out impedes the system’s ability to absorb the variety of demand, the very idea of thresholds is to misunderstand how value is created for care recipients, and effective monitoring depends entirely on the measures in use; activity and budget measures do nothing to help us understand effectiveness.

Ofsted also publishes examples of good practice on its web site. In its view these things are good: Being child-centred, ensuring stable relationships (continuity) with social workers, co-producing plans with families, ensuring children grow up in their own families or extended families where possible, having a relationship with the whole family.

Well blow me down, who’d have thought? Having published this insightful list of the bleeding obvious, and despite publishing its view on prerequisites, Ofsted is at pains to point out that it favours no particular method.

And neither should it. In fact Ofsted – and all regulators of public services – should have NOTHING to say about how services should be run.

What we need is a complete re-think of our philosophy and method of regulation. We can only justify regulations if the controls they disseminate are economically and socially advantageous.  The way we regulate today fails both tests. Regulation today amounts to a plethora of specifications inspected for compliance. The specifications amount to opinion; the ideas ministers, administrators and regulators like. Instead of regulation by specification and compliance we need a regulatory system that drives innovation.

There is a systemic relationship between purpose, measures and method. To say it is systemic is to assert that it exists in all organisations for good or ill. When regulators specify measures and methods they create a culture of compliance (usually with bad ideas). Regulators need to limit their edicts to statements of purpose. The leaders of services must be free to choose how to work to achieve that purpose, determining for themselves what measures and methods they will employ. When inspection comes around inspectors need only to ask what choices of measures and methods have been made, and the inspector should go see for themselves how well it is working. The consequences are that transparency will increase (the usual hiding places are removed) and the reliability and validity of inspection reports will increase. Moreover it lays the foundation for innovation. It is to change the locus of control from the centre to those who are paid to run the services.

As I said many UK local authorities have adopted the Vanguard Method to improve care services despite having issues with regulators. But regulators can’t argue with the results: significant improvements in capacity – they provide better help for more people – improvements in service – they learn to give only what is required to meet the needs of care recipients – and significant reductions in the cost of service provision. These services have been subjected to scrutiny by local scrutiny panels. But there is an example of our work that has been subjected to external scrutiny by a number of bodies including the OECD; and that’s the youth service in Amsterdam. (An easier-to-read version, written as a case study is here.) Academics who are critical of the Blueprint for its lack of evidence, among other issues, argue in a recent article that this is the example from the Netherlands that MacAlister should have paid attention to, as it is more akin to children’s services than Buurtzorg.

And here are the results: Overall savings of 30m Euros across the Youth Protection system in Amsterdam; a 50% reduction in the number of families under care; a 61% reduction in protective measures; a 53% reduction in the number of out-of-home placements; a 46% reduction in youth parole measures; a 16% reduction in child custody; a 28% reduction in referrals to youth care providers; a 75% reduction in unnecessary administration. And, of course, many more lives more quickly back on the rails.

All achieved because the service focussed on doing what matters for each and every child. They changed the whole system to respond effectively and efficiently to the children’s needs. There’s the thing: high-quality services are always lower cost. Efficiency comes from effectiveness. All of the New Public Management paraphernalia went, thrown away, by leaders who learned how irrelevant and harmful it was to performance; supported by a government that had given up on New Public Management.

My current copy of Private Eye reports that the Department for Education insists that any recommendations in the “independent” review of children’s social care – chaired, would you believe, by MacAlister – requiring funding must include ‘as robust and detailed an evidence base as possible to demonstrate how, and over what period, this would be offset by savings’. So you might assume that MacAlister’s Blueprint is dead in the water. I wouldn’t bank on it; Big Consultancies are adept at creating fictitious spread-sheets and equally adept at avoiding blame when the savings don’t transpire.

But here we are, us who never went to school with anyone in government, with an evidence base that is as robust as anyone could want, with a method that any leader can follow, that results in far better services at much lower costs, and, in services where children can be separated from families, far fewer separations and thus much lower costs across the whole system. And, in every example, demand for services falls. Happier people and communities, isn’t that the purpose of public services?

Ours is delivered, MacAlister’s is entirely speculative.

The best thing we can do with the Blueprint is chuck it in the bin.

Notes:

The academic article arguing our work in Amsterdam should have been MacAlister’s model can be purchased here: Dismantling the Blueprint: Buurtzorg in English child protection social work: European Journal of Social Work: Vol 0, No 0 (tandfonline.com)

One of the authors has agreed to provide free copies; contact joe.hanley@open.ac.uk

The OECD report that includes the Amsterdam work is here.

An easier read of the case study in Amsterdam is here.

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McKinsey extols the benefits of digital public services; wise advice or costly folly?

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Transcript of a podcast, John Seddon, October 2020

In July this year McKinsey published a report entitled Digital Public Services: How to achieve fast transformation at scale.

These are the arguments in the report:

  • The private sector has raised the bar on customer experience,
  • Better public services will increase trust in governments,
  • Digital services will improve the customer experience, decrease costs and boost productivity,
  • The means to going digital are Agile and smart programme management,
  • And people see no reason why public services should be more complicated than shopping online.

I imagine the report is aimed at politicians, for they hold the purse strings for what will be a multi-million, even multi-billion, investment. The arguments are plausible, but what do politicians know about service-organisation design?

I am eternally grateful to the late Nick Georgiades, the man who taught me during my MSc in occupational psychology back in the Seventies. He installed in me what he called a ‘crap detector’, a preparedness to question assumptions and seek evidence that either confirms or denies propositions. When I read the McKinsey report my crap detector went off the scale. So in this podcast I’m going to discuss the McKinsey arguments and describe what it takes to design truly effective public services.

Let’s start with the private sector has raised the bar on customer experience.

Oh no they haven’t! While it is true that the private sector has invested heavily in digital services, the impact on customer experience has been pretty dreadful. In our recent book Beyond Command and Control, we devoted four chapters to explaining how digital services have worsened the customer experience and raised costs. In an earlier podcast, I described how insurance claims organisations adopting McKinsey’s ideas about ‘best practice’ in digital services digitised non-value activity – the activities you’d design out if you knew what you were doing. If you think adopting new roles and rituals, dreaming things up – in other words doing Agile – and forcing customers down new digital channels through smart programme management is the route to effective services you need your head examined. Of course the big selling point with digital services is lower transaction costs but what actually happens is the number of transactions increases, provided, of course, customers stick around to get what they want. Many don’t. The reason for this failure is, simply put, that computers work on rules and rules prevent the system from absorbing the variety of customer demand. So while digital protagonists may crow about the increase in digital transactions, costs rise and the customer experience worsens.

As an aside, in this report McKinsey repeats the mantra of standardising services. Wrong, wrong, wrong. If you standardise services you inhibit the system’s ability to absorb variety so costs can only rise.

But let’s move on to the evidence that McKinsey offers on how digital services will improve the customer experience, decrease costs and boost productivity.

The McKinsey report cites examples of governments that, to the reader, would appear to already be gaining the benefits of going down the digital track. According to the report Australia has created a new agency, Services Australia, to “improve the digital user experience for many federal government services”. So I got in touch with a colleague in Australia.

He replied, saying Services Australia is a rebrand of the old Department of Human Services. Amongst their remit are services delivered via Centrelink, essentially benefit payments. This service introduced a digital means – using an algorithm – to claw back overpayments of benefits – they called it Robodebt – with disastrous consequences. In short, he described Robodebt as a great example of a digital cluster f***. Apologies for the language, they speak plainly down under.

Citizens identified as over claiming benefits were bombarded with computer-generated demands. The government hired debt collectors, made appeals difficult, imposed travel restrictions for citizens alleged to be in debt and changed the statute of limitations on debt collection. Bombarded with calls from desperate citizens who couldn’t get through, Centrelink outsourced this failure demand to the private sector. These are, by definition, vulnerable people; some were so distressed they took their own lives. Despite many complaints of false debts, government refused to change course. The chief executive of the digital agency resigned in disgust and opposition politicians called for a royal commission to investigate this shocking debacle.

So, no evidence of improving the customer experience, decreasing costs and boosting productivity there then. According to one commentator the public money spent on Robodebt almost matches the amount government originally claimed it would claw back. Given the government has now committed to reimburse half a million claimants we can only assume this early foray into digital services was an extremely expensive mistake.

Despite this disaster the Australian government is committed to plough on with more digitisation in Services Australia, with McKinsey’s help.

All of the players would have been better advised to learn from the debacle. What we know from working with benefits services in various countries is that overpayments are frequently due to errors in the benefits service rather than citizens being fraudulent. If they’d studied what was going on they’d have learned how rules – set in an algorithm – fail to absorb the variety of demand. And the only way to get the service working effectively would be to start the process with a human interaction.

Let’s move on to Denmark. According to the McKinsey report Denmark has national portals for resident and business services. It is mandatory to use a service called Digital Post to communicate with government. So I called a colleague in Denmark. He confirmed that it is mandatory to use digital means to communicate with government. Danes have to sign in to see if they have any mail but, naturally, a lot of people don’t bother or forget to sign in and so miss communications from government (himself included – and he’s  young, computer-literate person). As he puts it:

“The problem is that you get a text notification saying ‘you’ve got mail in the portal’ but then you have to sign in, and you can’t always do that, and so you forget”.  

If people fail to respond (to something they often haven’t seen) a reminder is sent and a financial penalty is applied. Apparently quite a few young Danes who don’t see their call-up letter instructing them to start military service get picked up by the police. He tells me many older people and vulnerable families have to get help from carers or friends to use the digital system. Also some local municipalities have created teams to help people use the digital portal.

No doubt the digital protagonists argue this will work out eventually, with a bit of nudging and coercion and one day every Danish citizen will conform and comply. Even if that is the case (and I doubt it) the next hurdle is: does this digital means actually work as part of a service?

It turns out my Danish colleague was able to answer that question for one service – planning applications. And the answer was a resounding no. If Danes want planning permission the digital portal requires them to fill out a standard form. The consequence is a bucket-load of failure demand. He said that in summary the digital platform did NOT facilitate a swift and easy to use process, did NOT secure relevant information to the application and did NOT create  better resource utilisation – all of which were claims made at the outset. Once again people who don’t give up because they want a service have to get help, so they have to pay agents who are used to navigating the system.

He went on to describe the results of studying a series of planning applications. Inevitably applications had missing information, even missing attachments (lost in the digital ether). In short the digital solution resulted in too much, too little or wrong information. Working with a local municipality they set up a conversation with applicants, designed to ensure the municipality got the right, relevant information. This more effective way of working puts the digital platform in a different place. In essence it becomes no more than a first point of contact that is unable to do any value work. Danish municipalities are obliged by central government to pay through the nose for this. It reminds me of an example in our early work in housing. A housing organisation in Leeds was obliged (by central government) to use a central call centre, run by the city council, for reporting repairs. When the leaders studied what was going on they learned that, similarly, no value work could be done – all the call centre could do was pass a record of the call on – so they were paying a quarter of a million pounds a year for nothing.

We’ve seen much the same with planning services in the UK. One of the first services to be digitised, central government mandated the installation of an IT system called ‘One-app’. To command and control thinkers it was a wet dream. Adherence to activity targets could be monitored, the responsibility for making a correct application was pushed on to residents, planning staff could game the system and, quite naturally, ordinary folk who wanted to build an extension or whatever were driven to use agents, as in Denmark, at a cost.

I should say that there are planning services that have followed our method, putting the IT solution to one side, and they start as our colleague did in Denmark: having a conversation with the applicant so that from there the service can just focus on doing what matters. These services are loved by residents and developers – in fact developers, who interact with many planning departments, couldn’t believe how good the service could be. One app has the same problems as I just described in Denmark. I remember speaking to John Swinney, when he was finance minister in Scotland. He told me Scotland was thinking of introducing a software platform for planning services. I asked if it was the same as one app. He confirmed it was, I suggested he should not go down that road as we had seen what a mistake it was in England. But he did, even though a Scottish council on the western isles had applied our method with extraordinary results. It illustrates the power of a plausible narrative. Evidence doesn’t trump narrative.

Another country cited in the McKinsey report is Germany. In this case, the report includes a series of numbers as evidencing the potential for improving the customer experience, decreasing costs and boosting productivity. So I asked my head of research to look into it. I said my bet was these so-called results were speculative rather than delivered. This is what he had to say:

“Yes, you were right: it’s all extrapolated from projected, not actual, figures; lots of ‘could save’ or ‘would save’ statements; nothing that’s been delivered. The source that McKinsey have extracted these figures from is referenced as being published by the German National Regulatory Control Council in October 2017.”

He went on to say:

“Having looked at the German language version, guess who the report was actually originally written by? Yep, although commissioned by the German National Regulatory Control Council, the report itself was created by McKinsey, who have their logo on the front cover. I think that’s quite cheeky, don’t you?”.

No, I don’t think it’s cheeky, I think it’s outrageous.

It’s time to turn to the problem and the solution. I’m going to do this by reference to a book entitled A New City Operating System. The authors have, without doubt, drunk the digital Kool-Aid. Like McKinsey, they base their argument on the need to restore trust in governments. They also assert that this lack of trust has only been amplified by the new social media – people use social media to make a lot of noise about governments’ failures. And they assert that the technological changes that contribute to heightened cynicism can also power the very transformation of government that will turn that cynicism into trust. Really?

This so-called new operating system is tech-heavy. Mobile and cloud computing, GPS, Big Data, data mining, data analysis, digital platforms, artificial intelligence, internet of things, omni-channel services and so on. It makes me wonder how much money will be spent building this operating system before you learn whether it works.

The book poses examples: A housebuilder who uses the same plans for the houses he builds; who has a family that needs their home built within 6 months. But he faces long waits for planning permissions. A mother of two with a part-time job who qualifies for benefits but has to take time off to apply and has to provide the same information to different departments as the benefits services are specialised. A woman who is opening a restaurant with funding from friends who finds herself paying rent on the premises while waiting for approvals and inspections in order to open for business. And so on.

The authors, to put it bluntly, speculate that information technology will speed up solutions to these problems by getting the right information to the right people at the right time, will also ensure that routine work will be done by machines (for example chatbots answering routine questions), will speed up analysis, will eliminate repetitive form-filling and so on.

Really?

In essence the problem we have is that services are specialised, functionalised and fragmented. Their argument – which I should remind you is speculative – is that IT will bring it together. It reminds me of the conversation I had with Jeremy Hunt when he was our minister for health. I said the problem we have with our health service is that it is fragmented and provides no continuity for patients, so people find it hard to get what they need; and what we should do is redesign it to provide continuity and ensure that services provided match people’s needs exactly. His response was that he agreed with my analysis but disagreed with the solution. In his view integration would be better achieved by an IT system. Well, we’re still waiting.

The better solution – and a solution that costs beans compared to massive IT investments – is to firstly gain knowledge of demand in citizen terms. This knowledge is then used to create the right expertise at the first point of transaction, whose job it is to firstly establish with absolute clarity what we call the citizen’s nominal value – the thing that matters to them. From there you focus on doing only the value work – delivering the things that actually matter and when you’re building such a design you build the information technology last because it is at that stage that you know exactly what you need. That’s how you design services to absorb the variety of customer demand. The consequences are reductions in end-to-end time, dramatic reductions in costs, astonishing improvements in service and much less expenditure on information technology. And these improvements are real, delivered, not speculative.

And so to McKinsey’s argument that people see no reason why public services should be more complicated than shopping online

We are not stupid. We don’t imagine that getting planning permission or claiming on insurance should be a simple one-click process, like buying something from a retailer. Of course we do expect things like renewing a driving licence or paying a toll charge should be so, but these are simple, predictable and repeatable demands and IT is good at those. But as demands increase in variety – think benefits – IT, because it is based on rules, fails to absorb variety. Just think about the multi-millions wasted on Universal Credit in the UK, a service mandated to be digital by default, which still doesn’t work, has escalated in cost and will never work via digital means.

What actually matters to citizens is that public services work, not that they can be accessed on their smart phone.

And so we turn to the problem of trust. Why McKinsey and the authors of A New City Operating System think improvements in public services will increase trust in government is beyond me. We certainly do have a problem with trust on governments. Rutger Bregman, author of Human Kind puts it this way:

“Democracies around the world are afflicted by at least seven plagues. Parties eroding. Citizens who no longer trust one another. Minorities being excluded. Voters losing interest. Politicians who turn out to be corrupt. The rich getting out of paying taxes. And the growing realisation that our modern democracy is steeped in inequality.”

Note: no plague called distrust of public services.

We citizens are perfectly able to distinguish, for example, between our views on the National Health Service and our politicians’ management of the Covid 19 crisis. Similarly, the fact that many politicians have a pecuniary interest in privatising health services may lead us to distrust them but not distrust the service. Likewise we can hold quite different views of our teachers and schools compared to our views of our politicians’ use of an algorithm to assess student grades.

In fact the path that governments are travelling on – persisting in digitising all public services – will only serve to increase distrust. As people become frustrated with trying to access services, as they become aware of the public money being wasted, the damage to people’s lives and the revolving doors where consultants move to senior roles in the civil service and politicians and senior civil servants move to consultancies, people are bound to become more cynical.

McKinsey claims its report to be a tried and true formula. I don’t think so.

There are three things we all need to know:

  • Digital services only work when demand is simple, predictable and repeatable.
  • As the variety of demand rises, if we use digital channels, we will see a rise in failure demand, so costs rise and capacity is reduced.
  • When we learn to design public services against citizen demands and make IT the last thing to do the cost of transformation falls, services improve, and the cost of services falls – and each of these results is dramatic.

I hope you’ve noticed a pattern. In the past we drove services into call centres, today we drive them into what we call digital channels. The motivation for both is to achieve lower transaction costs. When these services face high-variety demands they don’t work, driving up failure demand. The remedy is to provide a human interaction as the first step in designing an effective service, then we realise the first point of contact isn’t necessary, then we ponder… how much money did we waste creating it?

To access the McKinsey report: https://www.mckinsey.com/industries/public-and-social-sector/our-insights/digital-public-services-how-to-achieve-fast-transformation-at-scale

For more on the follies of digital services in the private sector, listen to this podcast on digital services.

For more on the follies of digital services, read chapters 8 to 11 In Beyond Command and Control.

Studying demand remotely

photography of woman using laptop

In normal times, we are on site with our clients. An important part of the Vanguard Method is studying demand. This usually means listening to live phone calls, sitting in face-to-face meetings and looking at case files across multiple IT systems. A Vanguard expert is typically with you when you start doing this work. Some of this isn’t possible at the moment, so can we help you remotely? And how does it work?

We weren’t sure how it would work when lockdown started but we have learned that it’s not only possible, but it’s also very effective. Most organisations record phone calls, and this verbatim demand is a great source of learning. Some organisations even have the functionality for more than person to plug into a live call. With a Vanguard expert present, 4 or 5 people can listen to demand together on a video call and discuss whether the call is value or failure demand. The learning is richer as a group with an expert present. Once everyone is familiar with understanding whether a call is value or failure, teams can go off and listen to more calls, either recorded or live, to get a picture of the type and frequency of demand. We find that clients enjoy working at a pace that suits them, pulling for help when they need it, and coming back as a team with a Vanguard expert when they have more data.

In People Centred Systems, for example, in social care services, seeing someone in person helps you to understand more about their context and situation. There are non-verbal clues when you are with someone that you simply don’t get from a phone call. So, if you aren’t able to see people face-to-face at the moment, your listening and understanding skills need to be even more refined. This is an excellent opportunity to practise and develop your intervention skills and apply Egan’s model of the Skilled Helper.

We are on site with some clients in some circumstances, but we will certainly be continuing to help you study demand remotely when we know it will add value for you.

An interview with John Seddon

Adrian Swinscoe, author of Punk CX, interviews John Seddon on the Punk CX podcast.  You can hear the episode here.  Adrian and John discuss the difference between organisations talking ‘outside in’ and being designed ‘outside in’.

What’s the one thing missing from Agile?

In this 3-part series for Modern Analyst, John Seddon asks what’s missing from Agile, explains why knowledge is the prerequisite for profound change and why you should always do IT last, not first.

1: https://www.modernanalyst.com/Resources/Articles/tabid/115/ID/5462/Whats-Missing-from-Agile.aspx

2: https://www.modernanalyst.com/Resources/Articles/tabid/115/ID/5476/Knowledge-The-Prerequisite-for-Profound-Change.aspx

3: https://www.modernanalyst.com/Resources/Articles/tabid/115/ID/5528/Knowledge-First-IT-Last.aspx