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Public Service Innovation - 2011 version


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2011 version of my presentation in the MIoIR [MBS] MSc seminar series, module on Service Innovation

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Public Service Innovation - 2011 version

  1. 1. Service Innovation Course Innovation in public services Manchester Institute of Innovation Research IAN MILES [email_address] MIoIR, University of Manchester
  2. 2. Why is this important? <ul><li>Public sector is a huge area of expenditure, employment, etc. – and under heavy political pressure and facing challenges of social change (e.g. ageing). Innovation is vital for increasing efficiency , for delivering new and better quality services </li></ul><ul><li>Important market for innovative products (goods and services) from across economy – impact of public procurement on innovation systems </li></ul><ul><li>Important demonstrator of scope for new services, infrastructures and standards </li></ul>Manchester Institute of Innovation Research
  3. 3. But what are public services? <ul><li>Not necessarily ownership, but Governance. Not market- or third sector- led. Structured through state financing/control by state employees, or through “public service industry” or outsourcing to charities. </li></ul><ul><li>Funds from taxation/national insurance/government revenue </li></ul><ul><li>Different levels of governance – national, (regional), local. </li></ul><ul><li>Varies a lot across countries </li></ul><ul><li>Typical services include... </li></ul>Manchester Institute of Innovation Research
  4. 4. <ul><li>Education (all levels) </li></ul><ul><li>Health </li></ul><ul><li>Social care, community services, social and employment services </li></ul><ul><li>Criminal justice </li></ul><ul><li>Emergency services </li></ul><ul><li>Sanitation, waste disposal </li></ul><ul><li>Business support services </li></ul><ul><li>Public administration </li></ul><ul><li>Defence </li></ul>What are public services? - 2 <ul><li>EU employment shares, 2000 </li></ul><ul><ul><li>Public administration, defence; compulsory Social Security 11.4% </li></ul></ul><ul><ul><li>[Other community, social and personal service activities 7.0%] </li></ul></ul><ul><ul><li>NACE1 sections L to O – ACTIVITY (not governance) groups </li></ul></ul>Manchester Institute of Innovation Research Huge employers <ul><ul><li>Education 10.0% </li></ul></ul><ul><ul><li>Health and social work 14.3% </li></ul></ul>
  5. 5. Services Innovation Manchester Institute of Innovation Research <ul><ul><li>Intangibility (issues of transport, storage, coterminality) </li></ul></ul><ul><ul><li>Interactivity (Production and consumption often intertwined) </li></ul></ul><ul><ul><li>Information-intensity (Much specificity as to service, client) </li></ul></ul><ul><li>Need to relate service product and production process to service client – often extended affair, degree to which individual details involve specialised or customised production varies immensely. Affects scope for innovation of various kinds. </li></ul><ul><li>Public services have to confront the variety of human characteristics with the dictates of large systems and bureaucratic rationality . </li></ul>
  6. 6. Manchester Institute of Innovation Research Drawing on (and other MIoIR work) Specific Research on PSI is limited, though many studies of, e.g. New technology in hospitals, local gvt.
  7. 7. Confronting the received wisdom: Geoff Mulgan Manchester Institute of Innovation Research
  8. 8. “ Public Sector Modernisation” Manchester Institute of Innovation Research
  9. 9. Public sector IT project failures Manchester Institute of Innovation Research Government IT projects July 2003 Report 200 “• Difficulties with IT delivery occur in both the public and private sectors. ... the public sector has specific issues to address, including long procurement timescales, high publicity, the need for accountability and the political environment. • ... some factors ... lead to particular problems with IT, such as rapidly changing technology, difficulties in defining requirements and high complexity. • Much government IT is now delivered by external suppliers, so government needs to be an intelligent client. Departments require a range of skills to scrutinise bids, keep up to date with technology, be realistic about what systems are likely to deliver, understand commercial drivers and actively manage suppliers. • Breaking projects down into smaller parts increases the chances of success and makes contingency planning easier, but requires considerable time and effort. • It is important to include the final users in project development and provide time and resources for training.”
  10. 10. Public Service Innovation <ul><li>There can be ambitious innovation programmes (e.g. Current NHS IT programme) </li></ul><ul><li>There can be substantial problems (this applies to all sectors)... </li></ul><ul><li>.. these can become highly politicised and debated in media (less common, though not unknown, in private services). </li></ul><ul><li>Governments target public sector – though whether this is really innovation is at issue </li></ul><ul><li>Many commentators conclude that public services face particular problems. </li></ul>Manchester Institute of Innovation Research
  11. 11. Private / Public Services Contrasted Manchester Institute of Innovation Research
  12. 12. Private / Public Services Contrast 2 Manchester Institute of Innovation Research
  13. 13. <ul><li>Key Assumption (here): </li></ul><ul><li>competition drives innovation </li></ul><ul><ul><li>Threats and rewards -> doing better </li></ul></ul><ul><ul><li>Individuals will be motivated </li></ul></ul><ul><ul><li>Organisations will be motivated </li></ul></ul><ul><ul><ul><li>Use instruments like IPR </li></ul></ul></ul><ul><li>Solution: make PS more like private sector: </li></ul><ul><li>“ New public management” </li></ul><ul><ul><li>Features: quasi-markets </li></ul></ul><ul><ul><li>Indicators and targets </li></ul></ul><ul><ul><li>Performance measurement [Acted upon!] </li></ul></ul><ul><ul><li>Outsourcing </li></ul></ul>Thus a Prevalent Approach to Public Sector Reform Manchester Institute of Innovation Research
  14. 14. But...Is Reform enough? <ul><li>Reform without considering impacts on innovation may be problematic. </li></ul><ul><li>Thus we see various efforts to stimulate innovation in new ways alongside general reform and modernisation efforts. </li></ul><ul><li>E.g. NHS Institute for Innovation and Improvement </li></ul>Manchester Institute of Innovation Research
  15. 15. (earlier) NHS Modernisation Agency <ul><li>Est. 2001 to support NHS and partner organisations in modernising services and improving experiences and outcomes for patients. </li></ul><ul><li>Focused on four areas: </li></ul><ul><ul><li>improving access, </li></ul></ul><ul><ul><li>increasing local support, </li></ul></ul><ul><ul><li>raising standards of care, </li></ul></ul><ul><ul><li>capturing and sharing knowledge widely. </li></ul></ul><ul><li>“ 10 high impact changes”: </li></ul><ul><ul><li>Treat day surgery as the norm for elective surgery </li></ul></ul><ul><ul><li>Improve access to key diagnostic tests </li></ul></ul><ul><ul><li>Manage variation in patient discharge </li></ul></ul><ul><ul><li>Manage variation in patient admission </li></ul></ul><ul><ul><li>Avoid unnecessary follow-ups </li></ul></ul><ul><ul><li>Increase the reliability of performing therapeutic interventions through a Care Bundle approach </li></ul></ul><ul><ul><li>Apply a systematic approach to care for people with long-term conditions </li></ul></ul><ul><ul><li>Improve patient access by reducing the number of queues </li></ul></ul><ul><ul><li>Optimise patient flow using process templates </li></ul></ul><ul><ul><li>Redesign and extend roles </li></ul></ul>Manchester Institute of Innovation Research
  16. 16. What do we know? <ul><li>Numerous essays on why public services might have an innovation problem… </li></ul><ul><li>On why the solution might lie in introducing new public management and/or market principles </li></ul><ul><li>Various studies of public service innovation start off from this perspective </li></ul><ul><li>Even PUBLIN only examined public services </li></ul><ul><li>But there is one comparative study, which tells a different story.. </li></ul>Manchester Institute of Innovation Research
  17. 17. and: is the Public Sector really less innovative? Manchester Institute of Innovation Research <ul><li>Earl, L. (2004) An historical comparison of technological change, 1998-2000 </li></ul><ul><li>and 2000-2002, in the private and public sectors Ottawa: Statistics Canada (also see Earl 2002) </li></ul><ul><li>Can you find any other comparisons? </li></ul><ul><li>- EC is trying to develop a public sector equivalent of CIS </li></ul>Education Healthn
  18. 18. Different types (or levels) of Innovation: <ul><li>PUBLIN differentiated between innovations involving: </li></ul><ul><li>changes in characteristics and design of service </li></ul><ul><li>products and production processes – including development, use and adaptation of relevant technologies, </li></ul><ul><li>delivery innovations – involving new or altered ways of solving tasks, delivering services or otherwise interacting with clients for the purpose of supplying specific services, </li></ul><ul><li>administrative and organizational innovations – involving new or altered ways of organizing activities within the supplier organization, </li></ul><ul><li>conceptual innovations – in the sense of introducing new missions, new worldviews, objectives, strategies and rationales (particularly important to institutions operating under social or public objectives, linking the social objectives of the policy and institution and the operational and economic goals and functions of the agency) </li></ul><ul><li>system interaction innovations – new or improved ways of interacting with other organisations and knowledge bases. </li></ul>Manchester Institute of Innovation Research
  19. 19. Some examples of innovation in health services <ul><li>Genetic screening </li></ul><ul><li>Intraocular lenses </li></ul><ul><li>Health informatics </li></ul><ul><li>Electronic patient records system – huge scale, clear benefits (and professional risk perception) </li></ul><ul><li>NHS Direct: “most radical innovation in recent history of health service” </li></ul><ul><li>NICE </li></ul><ul><li>Tier Two – reduced waiting lists through appropriate secondary care rather than using hospitals </li></ul><ul><li>Creation of new mental health trust – specialisation </li></ul><ul><li>Pilot “out of hours” link with Aus/NZ consultants </li></ul><ul><li>Modernisation Agency </li></ul><ul><li>[and now organisational change –GP commissioning - is this innovation? ] </li></ul>Manchester Institute of Innovation Research
  20. 20. Exercise <ul><li>Each group is providing a online and/or phone-based interface to a public service. </li></ul><ul><li>What are the design features of this innovation? (what does it provide, to whom, when and how? What does this mean in terms of ease of use by different population groups? Availability of platforms?) – 10 mins </li></ul><ul><li>What stakeholders need to be engaged (public, professionals, telecomms, private services, etc.?) How can alliances and partnerships be built? 10 mins </li></ul><ul><li>What skills and training are required? 10 mins </li></ul>Manchester Institute of Innovation Research
  21. 21. Results Manchester Institute of Innovation Research
  22. 22. Mulgan : sources of innovation Manchester Institute of Innovation Research
  23. 23. Mulgan again: innovation checklist Manchester Institute of Innovation Research
  24. 24. Public Sector Opportunities? <ul><li>High level of staff expertise, creativity, problem solving </li></ul><ul><li>Strong public spirit ethos, motivations beyond personal financial rewards </li></ul><ul><li>Controversial shifts underway (e.g. competitive framework of Foundation hospitals) believed by proponents to increase innovation by: </li></ul><ul><ul><li>Allowing for flexibility and experimentation within target culture and common standards </li></ul></ul><ul><ul><li>Incentivise staff (and management) financially, status-wise, and through improved service quality </li></ul></ul><ul><ul><li>Improve patient choice (will drive resources as money follows patients) aand “consumer” feedback into innovation process </li></ul></ul><ul><ul><li>Management draws on external sources for “directed creativity” and organisational innovation and knowledge mananagement… </li></ul></ul><ul><li>Conscious efforts at innovation management (under various guises) </li></ul>Manchester Institute of Innovation Research
  25. 25. Policy Challenges Manchester Institute of Innovation Research <ul><li>Research Policy – bringing in the public sector where it is absent, taking better account of it where it is present… </li></ul><ul><li>Public sector policy – governance, regulatory reform, efficiency, modernisation… Building innovation into public policy… Assessing innovation processes and impacts to guide policy, validate expenditure </li></ul>
  26. 26. Implications for Research <ul><li>Many commonalities – many ideas and instruments can be borrowed – can we use innovation models (PLC etc)? </li></ul><ul><li>Different selection processes internally and externally. Processes of diversity generation too. </li></ul><ul><li>Much is public-private mixture (many kinds) </li></ul><ul><li>Public services highlight areas where innovation studies are weak </li></ul><ul><li>Explore new innovation strategies </li></ul><ul><li>Some </li></ul><ul><li>efforts </li></ul><ul><li>underway </li></ul>Manchester Institute of Innovation Research
  27. 27. Public Service Innovation… <ul><li>… is a topic crying out for research </li></ul><ul><li>Policymakers desperately want good knowledge </li></ul><ul><li>Innovation studies themselves can benefit from looking at this </li></ul><ul><li>Its important for public expenditure, social well-being, and innovation across the economy… </li></ul><ul><li>Must not be a ghetto! </li></ul>Manchester Institute of Innovation Research
  28. 28. End of presentation - extra slides from previous years follow – see also my presentations at Manchester Institute of Innovation Research
  30. 30. Manchester PUBLIN (health) results <ul><li>Concept of innovation recognised and people can work with it (to some extent) in interviews, but the actual term “innovation” often was not employed – many other terms used. </li></ul><ul><li>“ Innovation” often seen as fashionable jargon – or as ‘new technology’ or problem-solving </li></ul><ul><li>Or as a matter of adoption of top-down guidelines, meeting targets (important procedural innovation). </li></ul><ul><li>Often incremental developments, often hard to establish boundaries between innovation and replication. </li></ul><ul><li>Huge number and range of developments, not subject to much direct recording/compilation in databases… Though some recording through incentive schemes, and through efforts to impose IPR models… </li></ul>Manchester Institute of Innovation Research
  31. 31. Specific/Stronger Obstacles to Innovation? - from PUBLIN Health <ul><li>Internal diffusion / roll-out repeatedly a major issue - much effort now being spent on identifying, codifying and spreading good practice, new procedures. Lack of structures and mechanisms for organisational learning seen as major issue – efforts being made here. But… </li></ul><ul><li>Initiatives to diffuse good practice seen as “short-lived” – reorganisations lead to loss of corporate memory </li></ul><ul><li>Infrastructural and procedural/occupational heritage and legacy, entrenched practice and procedures are commonly experienced. </li></ul><ul><li>‘ Professionalised’ resistance – e.g. clinicians, ambulance service form “disconnected hierarchies”, some self-governing professionals, others “quasi-military” forces. Lack of common command and control structures – conflict with established roles, politics, “empires” </li></ul><ul><li>In particular lack of commitment to consumer orientation was often cited as a major issue (mirroring political rhetoric in UK). </li></ul><ul><li>Public resistance to reorganisation – though public seem very open to new ways of operating </li></ul><ul><li>Lack of “ownership” of innovation – top-down initiatives – </li></ul><ul><li>… and IP issues </li></ul>Manchester Institute of Innovation Research
  32. 32. Specific/Stronger Obstacles to Innovation? - more <ul><li>Resistance to ‘out of the box’ thinking plus risk aversion (generic issue in public sector – related to nature of service (large-scale and severe risks) and to political cycles. High public/political profile plus blame culture, accountability and risk of litigation (but US?). </li></ul><ul><li>Pace and scale of change (NHS in particular) – shifting targets and absence of opportunity to reflect/asses consequences </li></ul><ul><li>Very complex organisation – composed of multiple tiered interlinked systems with - Huge staff numbers; Many occupations; Many organisational arrangements; Many service processes </li></ul><ul><li>Lack of “patient information connectivity” between actors in system </li></ul><ul><li>Lack of dedicated budgets for innovation at relevant (local, Trust) level. </li></ul><ul><li>Some areas (mental health) not high profile priority for investment (cf. surgery) </li></ul><ul><li>Requirement to consult, lack of clear picture of all eventual effects </li></ul>Manchester Institute of Innovation Research
  33. 33. In our studies, the innovations exciting management were: <ul><li>Those more at the strategic/management level </li></ul><ul><li>Organisational: governance relation changes, new agencies, etc </li></ul><ul><li>New roles, responsibilities, new ways of operating (need for knowledge management capacity), role in training </li></ul><ul><li>Technical and technological (huge) – some systemic, esp.IT-based, </li></ul><ul><li>New specific practices e.g. round pharmaceuticals, clinical practice, techniques, devices, etc. Huge range of artefacts involved. Again, much IT impact. </li></ul><ul><li>Often technological innovation closely tied to further organisational/process change/innovation </li></ul>Manchester Institute of Innovation Research
  34. 34. SOME SLIDES ON INNOVATION POLICIES AND INITIATIVES FOR PUBLIC SERVICES - Manchester Institute of Innovation Research The present crisis and government worldview means that many of these activities are now very different (if they exist)
  35. 35. Many major initiatives with innovation implications Manchester Institute of Innovation Research <ul><li>Could we have innovation audits? We have yet to measure public service innovation and impacts systematically (several partial attempts)! </li></ul><ul><li>Can we do better in assessing costs and benefits of attempts to impose certain “private sector models” on the public sector – are there other elements of innovation management that should be engaged with (first?) </li></ul>
  36. 36. Discussion and Exchange Manchester Institute of Innovation Research
  37. 37. Policy for innovation? Manchester Institute of Innovation Research
  38. 38. Innovation Unit <ul><li>Research, Consultancy, facilitation for gvt, local gvt, CSOs, etc. </li></ul><ul><li>Esp. education </li></ul>Manchester Institute of Innovation Research
  39. 39. Manchester Institute of Innovation Research But the effort seems to be diminished with the new government and its focus on top-down reforms (of the sort the parties promised not to make before coming to power). Thus this BIS activity now seems stalled.
  40. 40. EFFORTS TO MEASURE PUBLIC SERVICE INNOVATION Manchester Institute of Innovation Research
  41. 41. MePIn – Copenhagen Manual <ul><li>Working Party of National Experts on S&T Indicators (NESTI): methodological guidelines for measuring S&T activities (Frascati, Oslo Manuals) Task Force </li></ul><ul><li>Centre for Educational Research and Innovation (CERI) measuring innovation in education and training </li></ul><ul><li>OECD Public Governance and Territorial Development Directorate Government at a Glance (2009 and 2011) + various activities on innovation in public governance </li></ul><ul><li>OECD Health Division performance indicators for health systems, ICTs in health </li></ul>Manchester Institute of Innovation Research