0048187

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Transforming Public Services –
The next phase of reform
Citizen perspectives on Transforming Public Services:
the next phase of reform
Part of the dialogue on public service reform that took place across Scotland between June
2006 and February 2007.
Published March 2007.
The views expressed in the report are those of the author(s) and do not necessarily reflect
those of the Scottish Executive or any other organisation(s) by which the author(s) is/are
employed.
The Scottish Executive is making this research report available on-line in order to provide
access to its contents for those interested in the subject. The Executive commissioned the
research but has not exercised editorial control over the report.

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PUBLIC SERVICE REFORM
CITIZEN PERSPECTIVES ON “TRANSFORMING PUBLIC
SERVICES: THE NEXT PHASE OF REFORM”
Jim McCormick, Linda Boyes, Deirdre Elrick, Andrew Harris,
Nicole Hastings and Marco Pisano
Scottish Council Foundation
Scottish Executive (2007)
Social Research Report

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ACKNOWLEDGEMENTS
Members of the Scottish Council Foundation research team would like to express our thanks
to participants in the five deliberative workshops held across Scotland in September 2006.
Their willingness to address some of the key challenges for public services across the course
of a day’s discussion is a further encouraging sign of the citizen interest in public service
reform. We would like to express out thanks, as well, to Catherine Bromley (Project
Manager) and her colleagues Pauline Davidson and Colin McKay in the Public Service
Reform Development Division (Finance and Central Services Department) of the Scottish
Executive.
December 2006

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CONTENTS
EXECUTIVE SUMMARY 6
User-focus and personalisation 6
Quality and innovation 7
Efficiency and productivity 8
Joining-up and minimising separation 8
Strengthening accountability 9
CHAPTER ONE BACKGROUND AND CONTEXT 10
Research methods 10
Format of events 12
Priority and significant themes 13
Report structure 14
CHAPTER TWO USER-FOCUS AND PERSONALISATION 15
Scottish Executive goals 15
One size fits all? Personalisation and choice in public services 15
Responses to personalised care vignettes 16
Public involvement: upstream and localised 17
The views of public service leaders 20
Summary of main points 20
CHAPTER THREE QUALITY AND INNOVATION 21
Trends and satisfaction with service standards 21
Consistently high standards between areas 25
Innovation: new and adapted services 27
Customer care and communication 28
Locating Responsibility 29
CHAPTER FOUR EFFICIENCY AND PRODUCTIVITY 31
Efficiency, priorities and assessing risk 31
Waste, value for money and focus 32
Diverse providers? 32
CHAPTER FIVE JOINING-UP AND MINIMISING SEPARATION 35
Defining joining-up 35
Responses to ‘joining-up’ vignette 35
Better sign-posting 36
Communication and planning between services 36
CHAPTER SIX STRENGTHENING ACCOUNTABILITY 39
Responsibility and responsiveness 39
Giving an account and holding to account 41
Two-way accountability 42
Independent not vested interests 43

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Authentic performance measures 44
More autonomous, more accountable? 45
Be accountable for actions not just plans 46
Accountable leaders 46
CHAPTER SEVEN CONCLUSION: TEN PROPOSITIONS ON PUBLIC SERVICE REFORM 48
Improve the quality of feedback 48
Be clear on priorities and expectations 48
Devolve powers as they are earned to strengthen accountability 48
Adapt services and skills to serve a more diverse population 49
Reforms need to connect more clearly with public concerns about reducing waste and improving
efficiency 49
How services are funded and delivered may be more important that who delivers them 49
Pursue two-way and ‘long-run’ accountability 50
Local and virtual accessibility 51
Expertise and independence 51
Move further towards joining-up and ‘single gateway’ approaches 51
REFERENCES 52
ANNEX 1 SUMMARY OF LITERATURE REVIEW 54
ANNEX 2 TABLES 58
ANNEX 3 VIGNETTE RESPONSES 62
ANNEX 4 FIELDWORK DOCUMENTS 65
Recruitment questionnaire 65
Pre- and post-event surveys 71
Thematic guide for group discussions 81
Vignettes 82

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EXECUTIVE SUMMARY
Introduction
In June 2006, the Scottish Executive published Transforming Public Services: The next phase
of reform. The report set out five fundamental principles around which reform should be
organised:
• User focus and personalisation
• Driving up quality and enhancing innovation
• Greater efficiency and productivity
• Joining up and minimising separation
• Strengthening accountability
Research Methods
To test these principles in more detail, the Scottish Executive has undertaken a number of
activities, including a series of dialogue events with public service leaders in nine areas
across Scotland. The Scottish Council Foundation designed and facilitated a smaller series of
public involvement groups in five locations across Scotland during September 2006. This
report presents the main findings of those groups.
User focus and personalisation
By ‘personalised’ services, participants tended to refer to localised face-to-face contact with
people they could identify – such as a local police station rather than a call centre – and to
associate ‘personal’ with services promoting independence and dignity, especially care
services to help elderly people stay at home for as long as possible. The idea of ‘topping-up’
as a means of limited personalisation over and above universal standards was also considered.
Where a clear view was expressed, most participants supported improving the quality of
universal services, accessible to all. Greater personalisation was considered by some to bring
a risk of favouring those with better communication skills.
Responding to case study ‘vignettes’, participants expressed a strong commitment to helping
people live independently for as long as possible, with more intensive personal support and
adapted accommodation where appropriate. Individual involvement in meetings with
advocates and family members was expected with no prior assumptions made about
individual capacity to take part in decision-making.
Greater awareness and training for frontline staff were proposed in order to enhance
professional skills and communication abilities. The need to take concerns seriously, rather
than dismissing them on the grounds that ‘the expert knows better’, was also emphasised.
Participants placed a high value on personalised response, speed, and excellent
communications skills among service providers towards users (and their families), as well as
between providers. There was a common expectation that staff and budgets would be brought
together to respond to individual needs and that individuals would be fully involved (with
extra support provided if necessary) in decisions made.

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A need for the public to play a more active role at the planning stage of decisions was
identified, rather than leaving it only to elected representatives to mediate public views.
Better systems for ‘advance warning’ were proposed, including public meetings at times
people would be willing to attend and more prominent use of local newspapers.
While there was near unanimous support for greater public involvement in all stages of
decision-making, there was much less discussion on methods of involvement that would
work best. The case for holding a referendum on major developments was made in one area
(e.g. railway extension) and the option of paying citizens for at least some public involvement
activities was suggested in another.
Quality and innovation
Participants living in diverse areas across Scotland expressed consistently positive
satisfaction ratings with most services. Nonetheless, it is notable that residents of the most
disadvantaged neighbourhood appeared to be more satisfied than those living in more settled
and affluent areas. A contrast between urban and rural areas was also evident: while residents
of one central city area rated public transport second highest in terms of satisfaction,
participants from both rural groups scored public transport lowest. And while all three urban
groups rated Maintenance services lowest, both rural groups expressed most satisfaction with
these services.
No group offered a negative rating on ‘good quality services’ delivered by their council, but
four of the five groups did so on the issue of making ‘best use of the budget’ and those in the
most disadvantaged did the same for ‘local focus on quality of life’.
Improvements to the local environment were identified as a step forward in most areas, with
participants noting it has become easier to recycle household waste than in the past.
However, deteriorating standards were identified in the three urban groups related to an
overall sense of ‘the visible signs getting worse’, especially litter, refuse/cleansing services
and road maintenance. Concerns were raised about reduced primary care coverage out-of-
hours and a clear preference was expressed for face-to-face contact rather than using NHS 24.
Potential risks to local health service availability in future were identified in both urban and
rural neighbourhoods. There was some recognition that the actual or proposed centralisation
of key services like these would lead to winners and losers in terms of accessibility.
Insufficient funding for bus routes and a restriction of early evening services was also raised
as a main concern.
In terms of increased service provision in future, participants placed a high priority on greater
policing presence especially at night, and (for towns and cities) in places where violence and
anti-social behaviour associated with binge drinking was more likely to occur. Practical ways
to extend existing services were identified, e.g. doorstep collection of household waste and
heavy goods for recycling; extended opening hours in primary care services to better meet the
diverse needs of the workforce; and greater use of Community Wardens.
In the larger cities, participants placed a high value on equity considerations as well, but they
took differing views on the nature of existing variations in standards. Residents of the most
disadvantaged neighbourhood wished to know more about service standards across the city,
with many believing better-off areas enjoyed better public services. In the most affluent area,

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residents believed some of their public services were poorer due to greater targeting of
resources in low-income neighbourhoods. In the most remote location, participants felt they
did not receive an adequate level of basic services like water/sewerage and bus links.
Most participants recognised there is currently a trade-off between high quality but uneven
public services and less good but universal services available in all places. They supported
greater consistency in quality standards across their authority, with proper monitoring and
enforcement of standards, as well as clearer comparisons between different parts of the public
sector and different authorities.
Participants expected public services to become more adaptive and responsive services as
user expectations and needs change. Participants emphasised the role of good customer care
and the importance of clear communication. They noted that migrant workers in front-line
service roles should be given language training to ensure their communication skills are good
enough.
The possible consequences of demographic trends were considered. Participants identified a
need to invest more to support ‘independent living’ and intermediate options like sheltered
housing; and supported much greater choice over when and how to retire from work and
better options for drawing upon the experience of the retired population. Some emerging
social and health needs were felt to be poorly addressed by services currently. Support for
parenting and promotion of healthy life-styles (diet and responsible drinking) was expressed.
Efficiency and productivity
Waste and duplication were considered to be a legitimate target because they prevent public
services being delivered effectively.
Participants put an emphasis on ‘wiser spending’ by setting priorities the public felt were
more in line with their own.
While replacing older buildings with fewer, modern buildings might bring important service
benefits, participants felt that options to retain the status quo (or intermediate options) might
be worth considering. Some considered that localised services with ‘less than best’
infrastructure might, occasionally, be preferred to centralised services in modern settings.
Joining-up and minimising separation
One practical consequence of participants’ views on the issue of joining-up is to consider
greater use of ‘single gateway’ models, where frontline staff act as a broker between various
other agencies on behalf of the user.
Participants in two locations identified a clear need for better communication and joint
planning across sectors, not just between public sector agencies. This was considered to be
especially important in the case of services like public transport which often combine
funding/strategic planning from the public sector with private providers operating on a
franchise basis. Participants living in the most remote area stressed that all service provision
planning needs to consider the implications of transport if services are to become more
accessible.

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Strengthening accountability
Participants in all of the public groups expressed strong support for localisation of services,
including face-to-face contact with staff who have authority to make decisions and deploy
resources. Further ‘downstream’, participants only felt able to hold decision-makers to
account if they were given a better account of why decisions have been made, especially
where the reasons appear difficult to understand, or changes are unpopular. There was
recognition in most groups that decisions might go against what the majority wants, or that
some areas may benefit more than others. The common view was that people in positions of
authority should be more willing to communicate their reasons openly and take responsibility
for their decisions.
‘Long-run accountability’ concerns the timescales for spending allocated budgets, and
making sure that they are realistic. In the case of large Public Private Partnerships where
actual costs do not become apparent for some years, participants were unclear how
councillors and service leaders could be held to account for decisions made largely by their
predecessors.
‘Two-way accountability’ describes a process of more active communication, engagement,
responsiveness and feedback between service providers and users. Possible ways to change
the ‘terms of engagement’ included ‘stakeholder citizen’ and ‘shareholder citizen’ concepts.
Linked to this is the concept of co-production between service providers and users, as
developed in areas as diverse as personal care for adults with disabilities and community
safety.
A high value was placed on independent sources of information about service performance.
This was influenced by a perceived lack of information sharing by some councils.
Participants in the two rural areas proposed a stronger role for community councils, greater
expertise through professional advisers playing a role similar to Audit Scotland locally and
the idea of ‘professional’ councillors. Participants in most groups took a sceptical view
towards a continuing role for party politics in local government.
It was felt that what gets measured and reported on may not be the most useful indicators of
service priority and standards. How we go about monitoring performance may also need to
change. Each group considered the issue of ‘vital signs’ that would persuade them significant
improvements to public services were being achieved in their area. While it was considered
important to have access to information that carried public trust, participants made clear they
would prefer to ‘see with their own eyes’ the evidence of progress.
Greater financial autonomy for local councils was proposed as a potential route to stronger
accountability. It was felt that councils deserved to have more autonomy in order to test
whether this would lead to a more genuine debate about priorities and greater local
responsibility for their decisions. Participants wanted to hold their elected representatives to
account for what they actually achieve, not good intentions expressed in strategy documents.

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CHAPTER ONE BACKGROUND AND CONTEXT
1.1 In June 2006, the Scottish Executive published Transforming Public Services: The
next phase of reform. It made the case for significant changes in public services on the basis
of five propositions:
• Public services are valued and are improving – reform is not based on an assumption
of failure.
• People expect more and better public services.
• Demographic change – affects pattern of service need/demand and implications for
the workforce.
• People want services organised around needs and aspirations.
• Technology offers an increased range of delivery options.
1.2 The report then set out five fundamental principles around which reform should be
organised:
• User focus and personalisation
• Driving up quality and enhancing innovation
• Greater efficiency and productivity
• Joining up and minimising separation
• Strengthening accountability
Research Methods
1.3 To test these principles in more detail, the Scottish Executive has undertaken a
number of activities, including a series of dialogue events with public service leaders in nine
areas across Scotland, and a written consultation based on the questions set out in
Transforming Public Services. The Scottish Council Foundation designed and facilitated a
smaller series of public involvement groups in five locations across Scotland during
September 2006. This report presents the main findings of those groups.
1.4 Neighbourhoods were selected from among those areas where the service leaders
dialogue process was already underway. The exception was a remote area of North West
Highland, chosen to reflect the distinct experiences of public service use in that setting.
Communities within each authority were identified to reflect a broad typology developed in
previous studies undertaken by the researchers (Scottish Council Foundation 2002; 2000).
These are termed the ‘four nations’ of Scotland: ‘excluded’, ‘insecure’, ‘settled’ and
‘affluent’:
• ‘Excluded’ Scotland: An area facing problems of enduring economic and social
disadvantage (Maryhill in north west Glasgow);
• ‘Insecure rural’ Scotland: An area considered to be vulnerable to economic and social
decline: (town of Galashiels, Borders);
• ‘Insecure remote’ Scotland: An area considered to be vulnerable to economic and
social decline (small town of Lochinver, Highland);

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• ‘Settled’ Scotland: An area with a mixed indigenous/commuter population, relatively
low unemployment but not necessarily affluent (Town Centre of Stirling);
• ‘Affluent Scotland’: An area with a stable and prosperous population, as indicated by
high rates of employment and home ownership (Stockbridge within the New Town of
Edinburgh);
1.5 The decision was made to recruit a cross-section of 16 adult residents from each area,
to take part in a one-day group discussion. We decided to hold in-depth discussions
(deliberative workshops) rather than shorter focus groups, enabling us to combine both open-
ended dialogue where participants could identify their own local priorities, and responses to
case study materials prepared in advance. The aim was to reduce the likely respondent bias
from using established community/voluntary sector networks. Recruitment quotas were
established using small-area Scottish Index of Multiple Deprivation (SIMD) data and local
profile data from the 2001 Census.
1.6 An independent recruitment agency (Criteria) was appointed to select a balanced
group of participants on the basis of sex, age group, household type and socio-economic
quotas reflecting as closely as possible the profile information. Incentives were offered for
participation and follow-up phone calls were made shortly before each event to check those
recruited were still intending to participate. Table 1.1 shows the age, sex, socio-economic and
ethnic composition of those attending the five groups.
1.7 In total, 69 people took part. The recruitment agency was asked to recruit minority
ethnic participants where possible. This proved to be difficult for the first three groups
recruited, due largely to the profile of the local population. The agency was asked to take
extra steps in Edinburgh (which were unsuccessful) and in Stirling. One Asian Scot
participated in Stirling, and two Polish migrants were recruited (but one of them failed to take
part). The drop-out rate varied from 1 in Borders and Highland to 4 in Edinburgh. Some of
the groups experienced ‘differential’ drop-out: in Edinburgh, for example, 2 participants aged
under 30 did not join the group. In Stirling, the three people recruited who did not attend
were aged 25-30. In Glasgow, both ‘no-shows’ were in their early 30s and of social group
DE.
1.8 There is a clear distinction to be drawn between area-based socio-economic and
demographic measures and individual-level characteristics. Social geographers have studied
the concept of ‘ecological fallacy’, in order to understand ‘neighbourhood effects’ where
individual attitudes and behaviours appear consistent with, or diverge from, expected effects
based on knowledge of area composition. The number of participants involved in this
research limit how far we can test whether experiences and attitudes ‘map’ onto what might
be expected from an area-based typology. The group composition, in four cases out of five,
was a close reflection of the quotas identified. However, the biased nature of drop-out in the
Glasgow case meant the small group composition there was a less accurate reflection of the
local profile than in the other four areas.

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Table 1.1: Composition of the groups
Edinburgh Glasgow Highland Borders Stirling Total
Age group
18-24 1 4 1 3 1 10
25-44 6 4 8 3 5 26
45-64 4 3 4 5 6 22
65+ 1 3 2 4 1 11
Sex
Male 5 6 7 8 8 34
Female 7 8 8 7 5 35
Socio-Economic Group
AB 8 2 3 3 2 18
C1 2 5 5 4 5 21
C2 1 2 2 2 2 9
DE 1 5 5 6 4 21
Ethnicity
White
Scottish/
British
12 14 15 15 11 67
Asian
Scottish
0 0 0 0 1 1
White Polish 0 0 0 0 1 1
Total 12 14 15 15 13 69
Format of Events
1.8 Two short questionnaires were designed to capture baseline data covering service
experiences and attitudes (pre-survey) and responses at the end of the day’s discussion (post-
survey). Survey findings are based on small numbers in each case, and cannot be aggregated
across the five locations in any meaningful sense. Each group was a small cross-section of the
adult population in each location. However, they offer indicative findings for further
consideration, and suggest apparent similarities and differences between people living in
these diverse neighbourhoods.
1.9 The groups spent the best part of a day deliberating on various aspects of public
services in their area. The discussion guide was informed, in part, by previous exercises
exploring quality of life priorities using similar methods. As well as the surveys, the day
combined open-ended plenary sessions, small group work to consider priority themes in more
detail, and the use of vignettes (case study materials) to generate discussion on both
individual and area-level public service scenarios. Materials for the groups were developed
following a brief literature review1
. A summary of findings from this literature review is
included in Annex 1.
Priority and significant themes
1.10 Two trends emerged in most of the discussions and can be thought of as a backdrop
for interpreting responses:
1
This was a selective review of key published sources, with the purpose of informing design of participant
surveys and informing other discussion materials, rather than a formal systematic literature review.

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• Social changes, including both parents working, less time for volunteering, loss of
community and lifestyle changes, have increased pressures on public service.
• A sense that individuality and personal/social mobility have eroded people’s
investment in their community.
1.11 Groups were asked to identify a number of significant public service issues and trends
in their area. They were encouraged to think of examples where service issues had got better,
worse or stayed the same in recent years. Through discussion in the full group, participants
then agreed a set of three priorities to consider in more detail. These were a mix of familiar
public policy challenges (e.g. community safety and the role of policing), emerging trends
(e.g. changing demography and possible consequences for public services) and over-arching
objectives (e.g. accountability; efficient use of public finances).
1.12 Priority themes across the groups are shown in Table 1.2. This shows, for example,
that Transport and Travel was identified as a significant issue in all five locations, and that
two groups selected this as a priority. This is denoted by [5 – 2] shown after the issue
descriptor. Further significant issues (i.e. those identified in the opening plenary session, but
not chosen for more detailed discussion) are highlighted in Table A1 (Annex 2).
Table 1.2: Priority themes identified in each location
Priority themes are shown by two ticks. Other significant issues are shown by *
Priority issues Edinburgh Glasgow Highland Borders Stirling
Transport and Travel,
especially bus services [5-2]
* * *
Public/Community Safety,
Policing and Crime [4-2]
* *
Funding for Public
Services/PFI; Standards and
Value for Money; local taxes
and spending; financial
allocations [3-3]
Accountability, Participation,
Public and community
involvement [3-3]
Equity between communities
across the local authority, lack
of consistency in service
quality [2-1]
*
Communication & Information,
sources of advice [2-1]
*
Planning & Coordination,
reducing waste [1-1]
Employment (regular not
seasonal or low-paid) [1-1]
Ageing population and healthy
living [1-1]

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Report structure
1.13 Rather than organising the report around these priority themes, we have used the five
fundamentals for transforming public services (as set out in the Scottish Executive’s report of
June 2006) as our framework.
1.14 We have ‘clustered’ the output from group discussions to fit. We aimed to explore
local understanding of the public service reform debate and self-identified priorities for
reform, and then analysed them through the lens of these five fundamentals. The bullet points
used to introduce each of the five principles are extracted from a presentation by the Scottish
Executive in June 2006 to aid consistent interpretation.
1.15 In addition, we have drawn selectively upon summary reports from the nine dialogue
events with public service leaders to provide an indication of how the concerns of service
providers may overlap or differ from those of the general public. This publication is one of a
number of reports related to the wider Transforming Public Services consultation process,
they are all available on the Scottish Executive website (www.scotland.gov.uk).

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CHAPTER TWO USER-FOCUS AND PERSONALISATION
Scottish Executive goals
• simpler access to public services
• a genuine voice for the public in how services are planned, delivered and
scrutinised
• greater choice in what services can be obtained, when and how they are used
• unified, easy to access complaints system
Context
User focus, personalisation and choice have emerged as key objectives in a range of public
policy areas. The debate on what kind of choice is best suited to service user needs, and to
tax-financed public services as distinct from market goods and services, is set to gather
momentum. While few are willing to stand against these objectives, evidence in Scotland/UK
on how best to extend appropriate forms of choice – within existing public service institutions
or through greater ‘contestability’ on the side of provision – remains limited. Moreover, the
debate in Scotland has been focused mainly on personalised public services rather than on
contestability and choice between providers from different sectors (which has greater
prominence in the UK Government’s recent publications on public service reform, Strategy
Unit, 2006). Although the evolution of a “British model of reform” has been identified as an
area for exploration (National School for Government, 2006), devolution is more likely to
mean that various working models, rather than a single approach, will emerge in practice.
One size fits one? Personalisation and choice in public services
2.1 There was less explicit reference to these principles in the groups than might have
been expected, before case study material was used to prompt discussion. We consider in
later sections the value participants placed on having someone responsible for dealing with a
concern, and doing it promptly; being listened to and receiving feedback; and being given a
suitable account of the reasons behind decisions. By personalised services, participants
tended to refer to localised face-to-face contact with people they could identify – such as a
local police station rather than a call centre (Borders group). The same group associated
‘personal’ with services promoting independence and dignity, especially care services to help
elderly people stay at home for as long as possible.
2.2 The Edinburgh group discussed the idea of ‘topping-up’ as a means of some
personalisation over and above universal standards. There was some recognition that trade-
offs are required within limited public resources. While some individuals may wish to pay for
enhanced services if they can afford to, others in the same group believed the public interest
was best served by pursuing higher universal standards rather than more personalisation:
‘I would rather see [services] standardised and the quality of what’s provided made
better, than see more personalisation.’ [Edinburgh, 45-54 year old woman]
‘Within standardisation, you can still have some personalisation. An example is, if
they’re refurbishing houses these days, the tenants get a choice as to what paint they

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want to use. It’s the same standard that’s being applied, but they get some choice.’
[Edinburgh, 55-64 year old man]
2.3 Under the heading of user focus and personalisation, participants in the Edinburgh
public service leaders dialogue session called for a greater commitment to direct payments
for people with disabilities and care needs.
Responses to personalised care vignettes
2.4 Case study vignettes were presented to each of the groups, introducing individuals
who had service needs with different levels of complexity: more intensive personal care for
an elderly woman to live in sheltered accommodation with possible dementia; earlier
diagnosis of illness and better communication by professionals needed for a young woman
with special needs; and support for a young man to establish a small business. Two of these
vignettes refer to service users who are among those less likely to benefit from public
services - people with disabilities and other special needs, and older, frail people (Social
Exclusion Unit, 2005) - and are discussed in this section (see boxes).
2.5 In responding to the vignettes through small group discussions, participants in all
locations highlighted the potential for many agencies to be available, or needed, to support
one person at any time (full responses to these vignettes are presented in Tables B1 and B2 in
Annex 3).
Vignette on diagnosis of illness for person with special needs (Maureen)
Maureen is in her early 20s and lives with her parents. She went to schools for pupils with special needs. She
had been experiencing severe headaches and loss of balance, so her doctor referred her to the Outpatients’
department at the local hospital. She asked her Mum to go with her to the appointment.
On arriving at the hospital, the receptionist spoke only to Maureen’s Mum to ask for Maureen’s personal details.
When they saw the consultant, he also spoke to her mother rather than to Maureen.
After three attempts to diagnose the problem, her condition was identified correctly as a brain tumour and she
underwent a course of chemotherapy. It was successful and she made a full recovery.
2.6 In the case of Maureen, participants expressed a strong commitment to treating
everyone as individuals, regardless of special needs and ability to articulate concerns.
Communication with individuals, and advocates as appropriate, was expected. This should
apply to all front-line staff, from receptionists to consultants. Greater awareness of staff, and
training to enhance professional skills and communication abilities were proposed. One group
emphasised the importance of speedy and local diagnosis/treatment, echoing a more general
principle for NHS treatment to live up to.
2.7 Participants cautioned against making prior assumptions about lack of personal
capacity. Instead, proper assessment should be carried out with family involvement, and
ideally a case worker should be assigned to help join up services and offer advocacy if
required. Specialist counselling through the treatment and recovery stages was considered
important for service users who may be less able to make use of the full range of services

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independently. It was expected that specialist support should be funded and provided by NHS
and local authority services.
Vignette on possible dementia and sheltered housing (Maggie)
Maggie is 80 years old and lives in sheltered accommodation. Recently, the resident warden service in her
building was replaced by a visiting warden service (with twice-daily checks).
After a few weeks, Maggie became increasingly confused and had almost stopped going out of her flat.
Residents were concerned because she had also started to wander at night. They were worried, as well, that she
was not eating properly and appeared to have lost weight.
When they raised concerns with the visiting wardens, they were told that Maggie seemed fine, had never
complained of feeling unwell or confused, and was always up and moving about when the wardens visited.
2.8 Responding to the case of Maggie, respondents placed a primary emphasis on family
involvement, wherever possible, as well as a range of staff at her sheltered accommodation
and primary care/social services. They focused on the need to take concerns seriously, rather
than dismissing them on the grounds that ‘the expert knows better’ (in this case, visiting
wardens). Participants also pointed to the value of ‘a compassionate and caring approach’ that
comes from good company, friends and fellowship – that is, support that cannot easily be
organised through public services. Responses were rooted in a strong commitment to helping
people like Maggie to live independently for as long as possible, with more intensive
personal support and adapted accommodation (e.g. installation of an alarm system). As with
Maureen, individual involvement in meetings with advocates and family members was
expected with no prior assumptions made about Maggie’s capacity to take part in decision-
making.
2.9 Overall, responses showed the value placed by participants on personalised response,
speed, and excellent communication skills from providers to users (and their families), as
well as between providers. There was a common expectation that staff and budgets would be
brought together to respond to individual needs and that individuals would be fully involved
(with extra support provided if necessary) in decisions made.
Public involvement: upstream and localised
2.10 One of the user focus objectives set out in Transforming Public Services (Scottish
Executive, 2006) is: ‘a genuine voice for the public in how services are planned, delivered
and scrutinised.’ While individuals and households experience the impact of these decisions
ultimately, the process by which decisions are made should involve communities of interest
(e.g. service users) as well as geographical communities.
2.11 Questions were placed on the surveys, testing the level of importance participants
placed upon various ways of involving the public in service issues, and what difference they
thought it would make if the public were more closely involved in decision-making. (Tables
2.1 and 2.2).

18
Table 2.1 Importance attached to the public being informed and involved by public
service providers.
What level of importance would you give to the following as ways of public service providers
informing / involving the public? (Post-event survey)
No. of participants saying
important or very important, by
location
EDI GLA HGH BOR STI Total
Asking for people’s views and
opinions before policies are
decided
12 11 14 13 12 62
Providing information about
policies and services
11 13 15 13 12 64
Involving people directly in the
decision making process
12 14 14 13 12 65
Asking for people’s views and
opinions when reviewing policy
decisions
12 14 15 14 12 67
Reacting to issues raised by the
public
12 13 14 14 12 65
Total 12 14 15 15 13 69
2.12 The first of the tables shows a consistently high degree of importance attached in each
location to greater information sharing and public involvement, at various stages of the
planning and decision-making process. The second table shows net ratings on how likely
participants felt various improvements would be achieved as a result. Figures are shown by
age group and although comparisons between the groups are difficult due to the large
variation in numbers, they show the relative strength of agreement with each possible
outcome within each age group.

19
Table 2.2 Net likelihood of public information/involvement approaches
making a difference.
How likely do you think it is that any of the following would happen in your area if there were more
information and involvement for the public? (post-event survey).
Net likelihood scores
by age group
16-24 25-44 45-64 65+
People will know more about how public
services work
+ 3 + 27 + 17 + 6
Public service providers will make better
decisions
+ 4 + 23 + 18 + 7
Services will focus on people’s needs + 4 + 26 + 18 + 4
Individuals and communities will have
more power over public services
+ 2 + 22 + 11 + 4
People will feel more ownership of public
services
+ 3 + 22 + 12 + 4
Public services will be better + 1 + 22 + 13 + 6
Total 10 26 22 11
2.13 Each group had much to say about the importance of what we might call ‘upstream’
accountability. First, there was a strong acceptance of the need for the public to play a more
active role at the planning stage of decisions, rather than leaving it up to elected
representatives to mediate public views (Glasgow group). The shortcomings of the current
system were identified readily. Decision-making activity is seen as weighted towards telling
the public what has been decided, or ‘rubber-stamping’ consultation on decisions that have
been made but not yet publicised:
‘It’s [currently] just a pseudo-accountability. They will come and ask people what
they think and then they just go and do what they were going to do anyway’.
[Edinburgh, 25-34year old man]
2.14 The Stirling group agreed the public should be engaged before projects are planned,
designed and money has been allocated, with follow up involvement to make sure all parties
are satisfied. The implications of various options should be discussed before decisions are
made. By increasing community consultation on how public funding is allocated, the Stirling
group felt local spending decisions would become more accountable to residents.
2.15 In the Borders group, participants talked about better systems for ‘advance warning’
including public meetings at times people would be willing to attend and more prominent use
of local newspapers.
2.16 While there was near unanimous support for greater public involvement in all stages
of decision-making, there was much less discussion on methods of involvement that would
work best. There was limited time available to discuss the critical question of how to achieve

20
this aim. Further research on this topic would help to shed light on whether the public feels
enthused about ‘other people’ getting involved rather than themselves, and on the range of
methods that might be suitable. However, two specific suggestions were made. On the
strength of the Waverley railway case (which the Borders group had felt poorly consulted
upon), the case for holding a referendum on major developments was made. In Stirling, the
option of payment for at least some public involvement activities was proposed as a means of
ensuring a wider representation of views.
The views of public service leaders
2.17 Public service leaders talked frequently about involving the public. In Ayrshire for
example, consultation was thought to be essential to successful change management with
stakeholders, service users and employees needing opportunities to input. In the Borders
session, stakeholders talked of insisting every proposal begin with a description of how it is
intended to benefit users of the service. They also wanted to engage more explicitly with the
local community around agreed outcomes. Aberdeen stakeholders talked about greater use
being made of local media and digital TV as means of local involvement. They also thought
that local stakeholder conferences could help to encourage engagement and citizenship.
2.18 A number of calls were made for teaching citizenship in schools to help young people
to be engaged and to understand their citizenship responsibilities. Stakeholders also thought
users could be involved to a greater extent in setting priorities for services, and agencies
should share feedback with the public more often. Edinburgh stakeholders thought
engagement with communities could be joined up across the public sector and that resources
should be directed to building capacity in communities. In these views, there appears to be a
strong level of agreement between participants in the public and stakeholder groups.
Summary of main points
2.19 By ‘personalised’ services, participants tended to refer to localised face-to-face
contact with people they could identify – such as a local police station rather than a call
centre – and to associate ‘personal’ with services promoting independence and dignity,
especially care services to help elderly people stay at home for as long as possible. The idea
of ‘topping-up’ as a means of limited personalisation over and above universal standards was
also considered. Where a clear view was expressed, most participants supported improving
the quality of universal services, accessible to all. Greater personalisation was considered by
some to bring a risk of favouring those with better communication skills.
2.20 Responding to case study ‘vignettes’, participants expressed a strong commitment to
helping people live independently for as long as possible, with more intensive personal
support and adapted accommodation where appropriate. Individual involvement in meetings
with advocates and family members was expected with no prior assumptions made about
individual capacity to take part in decision-making.
2.21 Greater awareness and training for frontline staff were proposed in order to enhance
professional skills and communication abilities. The need to take concerns seriously, rather
than dismissing them on the grounds that ‘the expert knows better’, was also emphasised.
2.22 Participants placed a high value on personalised response, speed, and excellent
communications skills among service providers towards users (and their families), as well as

21
between providers. There was a common expectation that staff and budgets would be brought
together to respond to individual needs and that individuals would be fully involved (with
extra support provided if necessary) in decisions made.
2.23 A need for the public to play a more active role at the planning stage of decisions was
identified, rather than leaving it only to elected representatives to mediate public views.
Better systems for ‘advance warning’ were proposed, including public meetings at times
people would be willing to attend and more prominent use of local newspapers..
2.24 While there was near unanimous support for greater public involvement in all stages
of decision-making, there was much less discussion on methods of involvement that would
work best. The case for holding a referendum on major developments was made in one area
(e.g. railway extension) and the option of paying citizens for at least some public involvement
activities was suggested in another.

22
CHAPTER THREE QUALITY AND INNOVATION
• universally high standards for all, available as locally as is possible
• better services, delivered in better ways
• strengthen leadership in public services
• more effective, streamlined performance and scrutiny regime
• foster an innovation culture, offering greater freedoms and operational autonomy,
incentives for successful implementation
Context
Assessments of satisfaction with public services tend to measure a mix of prior expectations
(some of which are untested) and experiences (some of which may not be recent). They
cannot be equated, simply, with assessments of service quality. This broader concept of
quality is multi-dimensional. It encompasses the gap between expectations and experiences,
and is informed by assessments of speed, courtesy, reliability, fit with life and work
circumstances (e.g. extended opening hours), quality of communication (including face-to-
face contact if preferred), and redress when concerns or complaints arise. In this section we
consider some of the ‘building blocks’ of service quality, including satisfaction measures, and
of innovation in terms of service extension and adaptation.
Trends and satisfaction with service standards
3.1 The Scottish Executive (2006) makes the case for transforming public services in
terms of building on an existing asset base rather than addressing deficits:
‘Public services are valued and are improving – reform is not based on an
assumption of failure.’
3.2 Summary reports from the stakeholder dialogue sessions indicate that some service
planners and providers believe, nonetheless, that the scale of reform needed is significant:
‘In order to ensure there is a sound platform for the delivery of cost-effective and
high quality services, a complete process of business change is required’. [Borders
dialogue session]
3.3 Across the five locations, common references were made to ‘good products and high
standards of customer service’ as well as ‘speed of response following customer contacts’ as
key elements of high quality service experiences.
3.4 The baseline survey asked respondents in the public groups to assess how standards in
different public services and overall economic factors had changed in recent years. Table A2
(Annex 2) presents net ‘improved’ figures (number saying ‘got better’ minus those saying’
got worse’). Of the 35 scores (7 factors across five locations), 18 are rated on balance as
having got better, 12 are rated as having got worse and a further 5 are rated as neutral. This

23
measure only shows the balance between those giving one of these two responses, and does
not include those saying ‘stayed the same’ or ‘don’t know.’
3.5 Standard of living was judged to have improved, on balance, in all groups. Health
services and public transport were viewed as having improved in all groups except in the
Borders. The Highland group provided the strongest positive assessments of all, relating to
standard of living and education, although the local economy was rated by a small margin as
having got worse. On the other hand, road maintenance received the strongest negative rating
of all, from the Edinburgh group, with all other groups also scoring this in net terms as
having got worse. Police services were viewed in each location in neutral terms or by a small
margin to have got worse.
3.6 Aggregating these net scores for each area (assuming for this purpose that each factor
could be weighted equally), locations reflecting ‘insecure remote’ (Highland), ‘excluded’
(Glasgow) and ‘settled’ (Stirling) have the most consistent positive view of recent trends.
‘Affluent’ (Edinburgh) and ‘insecure rural’ (Borders) appear to have a more ambivalent view,
rating only two of these factors on balance as having got better.
3.7 How people view recent trends may not be the same as how satisfied they feel
currently with various services. The baseline and post-event surveys then asked respondents
in the public groups to rate ten local public services on the basis of their satisfaction.
Responses are shown in Table A3 (Annex 2) as net satisfaction scores (numbers satisfied or
very satisfied minus those not very or not at all satisfied). The rank order is shown in Table
A4.
3.8 In the pre-event survey, all but two of the fifty net satisfaction ratings (10 services
across five locations) were rated as positive. Local GPs were rated in strongly positive terms
in all groups, and ranked top in four of the locations. Local hospital services and Leisure
provision also achieved high satisfaction scores in four locations, but with more modest
ratings in Edinburgh. Maintenance services were rated particularly well in the two rural
groups (though not water services in the Highland group). The only negative satisfaction
scores in net terms were found for public transport in the Highland group and housing
services in Stirling. By coincidence, Stirling Council’s proposed stock transfer of council
housing to a housing association was being rejected clearly around the time of the meeting.
3.9 In the post-event survey, little change was observed for services scoring in strongly
positive terms previously. Local GPs were ranked first or second in all groups. Leisure
services, Hospitals and Emergency services scored positive ratings in every case. However,
five ratings became negative (one service in each location). In the three cities, Maintenance
services had negative satisfaction ratings, reflecting an element of dissatisfaction with roads
and pavements in the capital city and in Stirling, while discussion of refuse collection and
cleansing services led the Glasgow group towards a slightly less positive view by the end of
the day. In Borders, Planning and environmental services were viewed least favourably,
perhaps reflecting concerns expressed about the process leading to development of the
Waverley railway line. The Highland group expressed by far the greatest dissatisfaction on
public transport (declining from a net score of – 1 to – 11 between the surveys).
3.10 Participants living in diverse areas across Scotland expressed consistently positive
satisfaction ratings with most services. Nonetheless, it is notable that residents of a low-
income Glasgow neighbourhood appeared to be more satisfied than those living in more

24
settled areas of Edinburgh and Stirling. A contrast between urban and rural areas is also
evident. While Edinburgh participants rated public transport second highest, both Highland
and Borders groups scored public transport lowest. And while all three urban groups rated
Maintenance services lowest in the post-event survey, both rural groups expressed most
satisfaction with these services.
3.11 Three statements about the local council were included in both surveys, based on
questions used in the Scottish Household Survey (Corbett et al. 2005). Responses are shown
in Table 3.1.
Table 3.1: Net agreement scores with statements by location
To what extent do you agree or disagree that your local council…
Net agreement scores Edinburgh Glasgow Highland Borders Stirling
Pre Post Pre Post Pre Post Pre Post Pre Post
…Provides high quality
services
+ 4 0 + 7 + 4 + 6 0 + 5 +11 0 + 5
…Does the best with
the money available
- 5 - 3 + 3 - 1 + 5 + 1 - 2 - 2 - 6 - 4
…Tackles key issues
affecting quality of life
in your neighbourhood
+ 1 0 + 3 - 2 + 2 0 - 1 + 7 - 6 0
3.12 For all groups, in the baseline survey, the proposition that their council provides high
quality services attracted more agreement than the other statements did, with positive ratings
in four of the five locations (and a neutral score in Stirling). Net ratings fell slightly in the
post-event survey for Edinburgh, Glasgow and in Highland, but rose in Stirling and Borders
(recording the highest agreement of all, +11).
3.13 On the value for money/efficiency prompt, that the council ‘does the best with the
money available,’ ratings were lower than the quality of services responses in every case,
though only marginally so in Highland, and were negative in Stirling, Edinburgh and
Borders. The rating in Glasgow also became negative in the post-event survey.
3.14 Finally, for focus on local quality of life, initial ratings varied just above and below
zero in Edinburgh, Glasgow and Highland on both surveys, while the assessment in both
Stirling and Borders improved from initially negative ratings. Relatively high numbers felt
unable to judge if their council tackles key quality of life issues locally in the post-event
survey.
3.15 In sum, the Glasgow and Highland groups rated their council more favourably on
these measures than the others in the baseline survey, with Stirling participants offering the
least favourable view. In the post-event survey, the Borders group expressed higher levels of
agreement (the only one to give two net positive scores out of three) while the Highland
group’s scores were more neutral. No group offered a negative rating on ‘good quality
services’, but four of the five groups did so on ‘best use of the budget’ and Glasgow did the
same for ‘local focus on quality of life’.
3.16 Turning to the initial group discussions, NHS services were widely regarded as
having improved and primary care services were considered as ‘first rate’ in the rural groups.

25
However, concerns were raised about reduced coverage out-of-hours and a clear preference
for face-to-face contact rather than using NHS 24 in both Glasgow and Borders. It was noted
that waiting times to get a primary care appointment might mean ‘speaking to a nurse rather
than a GP’. This was not necessarily seen as a poorer service response, but one that differs
from common expectations.
3.17 Concerns were expressed as well about potential risks to local health service
availability in Glasgow (possible re-organisation of hospital services leading to increased
travel times) and to emergency services in Highland following a successful campaign to
retain a local ambulance base. While participants in the Borders group were very satisfied
with the quality of hospital and emergency services, they recognised that residents of outlying
areas faced longer journey times and response times than they did living in a town. There was
some recognition that the actual or proposed centralisation of key services like these would
lead to winners and losers in terms of accessibility.
3.18 Improvements to the local environment were identified as a step forward. Participants
in two groups (Borders and Stirling) found it easier to recycle household waste than in the
past, although the Glasgow group pointed to a lack of recycling facilities.
3.19 Deteriorating standards identified in the three urban groups related to an overall sense
of ‘the visible signs getting worse’ in Edinburgh (especially litter and road maintenance) and
refuse/cleansing services ‘leaving something to be desired’ for households in the Glasgow
group and for local businesses in Stirling. Lack of care and ‘pride in the job’ was thought to
lead to rubbish strewn in back closes and a risk of vermin (Glasgow). Linked to discussion in
Stirling about the proposed housing stock transfer, concern was expressed about falling
standards:
‘It used to be that if work was done by a council worker, an inspector followed 3
days later to check it was okay.’ [Stirling, 45-64 year old man]
3.20 Insufficient funding for bus routes was raised in Borders, especially between the main
towns and outlying areas in evenings and on weekends, and for connections to Edinburgh.
The price of a return bus ticket from Galashiels to Edinburgh led participants to agree it was
cheaper to drive. The Glasgow group attributed a perceived worsening in the quality of local
bus services to privatisation, and a restriction of early evening services was identified even in
urban areas of Stirling.
3.21 In terms of increased service provision, initial discussions in each group pointed
consistently to the need for a greater policing presence especially at night, and (for towns and
cities) in places where violence and anti-social behaviour associated with binge drinking was
more likely to occur.
Consistently high standards between areas
3.22 A core aim of the Scottish Executive (2006) is to ensure public services deliver
‘universally high standards for all, as locally as is possible.’ Without prompting, a number of
the groups identified the principle of equity of service standards between areas within their
local authority as important. This is in line with other evidence pointing to the need for sub-
authority level data to monitor whether equity is being achieved between localities (Scottish
Consumer Council, 2004).

26
3.23 In Stirling, this meant a desire for consistency of services between the central urban
areas and outlying communities with their own very different needs (ranging from low-
income ex-industrial villages to more affluent rural settlements). In the larger cities,
participants placed a high value on equity considerations as well, but they took differing
views on the nature of existing variations in standards. Edinburgh participants believed that
living in a more affluent neighbourhood like theirs could mean less investment even in the
basics (e.g. school fabric), while more money is focused on poorer areas. In contrast, the
Glasgow group believed that better-off areas currently received better public services.
3.24 Equity between areas was less of an explicit theme in the rural groups, but
participants in the more remote location (Highland) felt they did not receive an adequate level
of basic services like water/sewerage and bus links, and the Borders group contrasted their
inadequate bus timetable with standards available to Edinburgh residents:
‘Why should Galashiels not have a late-night bus service?’ [Galashiels, 25-44 year
old man]
3.25 Each group agreed that minimum standards should be ensured for all, but that
definitions would vary between neighbourhoods. One Edinburgh participant noted:
‘Who decides what the standards are? One person’s idea of a clean street is different
from another’s.’ [Edinburgh, 35-44 year old woman]
3.26 The Edinburgh group pointed to a likely trade-off between high quality but uneven
public services (like bus links) and less good but universal services available in all places.
Participants agreed that a clear tension related to how high the minimum standards are set,
above which variations may be acceptable if communities are willing to make different trade-
offs. While a range of individual views were expressed across the groups, another Edinburgh
participant summed up perhaps the most common view:
‘I think it should be high standards for everybody, not just if you’re educated and able
to make your needs known.’ [Edinburgh, 45-54 year old woman]
3.27 Looking ahead, participants in the Glasgow group were keen to see consistency in
quality standards across the city monitored and enforced. In Edinburgh, participants
discussed whether a degree of competitive pressure might help to raise standards:
’If there was serious competition to the council then they would do something about it
[levels of service].’ [Edinburgh, 25-34 year old woman].
They saw this not necessarily as introducing other providers of public services, but
emphasised the value of clearer comparisons between different parts of the public sector and
different geographical authorities.
3.28 Some of these issues were raised in the public service leader dialogue sessions:
‘Simple and comprehensible performance data could be published across services on
a consistent national basis’. [Aberdeen dialogue session]

27
3.29 The introduction of ‘public service rewards’ was also suggested in the Aberdeen
dialogue session as a way of encouraging competition and as a means of driving up services
standards, as long as this was done in a sophisticated way.
Innovation: new and adapted services
3.30 There was relatively little discussion in the groups on innovation in public services.
Participants referred more commonly to maintaining existing services (i.e. minimising the
risk of re-organisation leading to reduced access) or securing improvements to basic services
they felt to be inadequate. However, each group did explore the theme of more adaptive and
responsive services as user expectations and needs change.
3.31 Practical ways to extend existing services were identified. For example, the Stirling
group saw pavement collection of household waste and heavy goods for recycling as a simple
and modest improvement that ought to have been introduced much earlier (and is still not
available to all). They posed the question: what will be the next step forward in terms of
waste recycling and reduction?
3.32 Adapted health services were also discussed in Stirling. A widely held view
concerned the need to extend coverage of primary care services to better meet the diverse
needs of the workforce. More evening and weekend surgeries were supported, rather than
only relying on NHS24. In addition, GP-initiated health check-ups were regarded as a
positive step.
3.33 To serve the goal of improved community safety, Community wardens were
welcomed by the Stirling group who supported further investment in their numbers. The need
for more localised policing, with neighbourhood offices and a visible presence was also
highlighted in the same group.
3.34 Future demographic change was a focus of discussion in the Borders group. The
ageing of the population was considered to result in greater pressure on health and care
services, and a need to invest more in ‘independent living’ and intermediate options like
sheltered housing. Moreover, the group identified the need to change how we view the ageing
of the workforce and the concept of retirement. They supported much greater choice over
when and how to retire from work (including options to continue working part-time after
retirement age) and stressed the need to draw upon the experience of the retired population,
through ‘inter-age’ apprenticeships where their skills could be passed on to younger people,
3.35 The Highland group also discussed future demographic change. They noted the
declining number of jobs over an extended period of years, particularly in the fishing
industry. They held government responsible for allowing local fishermen to be driven out by
foreign competition. The fear was also expressed that young people were moving from away
from the Highlands to settle in larger cities, where it was perceived that jobs and affordable
housing were more abundant. One participant noted:
‘They want us to keep this area populated, but we are losing jobs. This used to be a
fishing and tourism community, but now it’s just getting down to tourism.’ [Highland,
44-64 year old man]

28
3.36 In the Dundee public service leader dialogue session, participants referred to the
demographic challenge of an ageing population in Scotland and of the burden of disease upon
the health services as a trigger for speedy change. In the Borders stakeholder session, the best
way to address demographic change through public service reform was perceived to be
through multi-agency and co-located teams, with shared back office services, asset planning
across agencies (including a single national database of properties); better information
sharing and coordination of actions.
3.37 The Borders group identified, as well, emerging social and health needs they felt were
poorly addressed by services currently. In common with other groups, a number of
educational and community safety problems were traced back to parenting/family skills. They
believed strongly that Parenting courses ought to be provided, or at least co-ordinated, by
Social Work departments, and that families at risk of giving their children a poor start in life
or who presented ongoing risks should be encouraged – perhaps obliged – to take up these
services. One participant noted:
‘The situation is only going to get worse. These kids will become parents, their kids
will act worse, and it will go on.’ [Borders, 45-64 year old woman]
3.38 In addition, the Borders group believed there is an increasing need to promote the
concept of healthy life-styles, for example with accessible services to encourage healthy
eating, and an increased emphasis on domestic science (Home Economics) in school.
Customer care and communication
3.39 Consistent with recent research findings from the Scottish Consumer Council (2006),
among others, participants emphasised the role of good customer care and the importance of
clear communication.
3.39 The responsiveness of front-line staff in Glasgow Housing Association (GHA) was
compared favourably with experiences before stock transfer. The Glasgow group also felt
primary care staff did a good job of responding to their service needs. In Stirling, Local
Enterprise Company staff were thought to be particularly helpful. They were described as
‘encouraging’, ‘accessible’, and provided follow-up customer care. Migrant workers in front-
line service roles were discussed in the Borders group. Some participants called for better
English language training for employees:
‘Foreign bus drivers don’t always give the information you need’. [Borders, 45-65
year old man]
3.40 The need for clear communication was also expressed by public service leaders in the
Borders dialogue event, who talked about communication with the public being essential,
perhaps via an integrated newsletter as this could help demonstrate that there is a single
(shared) gateway for the public for services from the various agencies. Aberdeen stakeholders
put forward the idea of a ‘tell us what you think’ day, where polling could be conducted on
the subject of public services. The opportunity could be used to engage and to explain service
priorities at a local level.

29
3.41 Public service leaders in Inverness thought communication with the public about
competing priorities and needs in delivering public services should be improved. They
believed effective communication would enable the public to think about public services in a
‘whole system’ way, and be less likely to make unrealistic demands. The same group
proposed the idea of a ‘single regional public engagement point for complaints, dispute
resolution, consultation and communications.’ This could provide the critical mass to enable
these functions to be carried out well. It was also suggested that methods of gathering public
satisfaction information should be standardised. A further proposal came from leaders in
Stirling, where it was felt that there could be greater harnessing across the board of user
complaints and suggestions. One practical suggestion was to have a moderated on-line
conferencing interface to focus upon user interest and to keep a dialogue going.
Locating responsibility
3.42 Finally, central to achieving high quality public services, was the need for greater
acceptance of shared responsibility between individuals/families, the community and public
service providers. Sustained improvements were considered to depend not just on higher
levels of investment or staffing, but improved communication, education to raise awareness
(not only in schools but through community learning and development), closer public
involvement in decision-making, and more responsive and directly accountable public service
provision. (See also Chapter Six on Strengthening Accountability).
3.43 Participants living in diverse areas across Scotland expressed consistently positive
satisfaction ratings with most services. Nonetheless, it is notable that residents of the most
disadvantaged neighbourhood appeared to be more satisfied than those living in more settled
and affluent areas. A contrast between urban and rural areas was also evident: while residents
of one central city area rated public transport second highest in terms of satisfaction,
participants from both rural groups scored public transport lowest. And while all three urban
groups rated Maintenance services lowest, both rural groups expressed most satisfaction with
these services.
3.44 No group offered a negative rating on ‘good quality services’ delivered by their
council, but four of the five groups did so on the issue of making ‘best use of the budget’ and
those in the most disadvantaged did the same for ‘local focus on quality of life’.
3.45 Improvements to the local environment were identified as a step forward in most
areas, with participants noting it has become easier to recycle household waste than in the
past.
3.46 However, deteriorating standards were identified in the three urban groups related to
an overall sense of ‘the visible signs getting worse’, especially litter, refuse/cleansing services
and road maintenance. Concerns were raised about reduced primary care coverage out-of-
hours and a clear preference was expressed for face-to-face contact rather than using NHS24.
Potential risks to local health service availability in future were identified in both urban and
rural neighbourhoods. There was some recognition that the actual or proposed centralisation
of key services like these would lead to winners and losers in terms of accessibility.
Insufficient funding for bus routes and a restriction of early evening services was also raised
as a main concern.

30
3.47 In terms of increased service provision in future, greater policing presence especially
at night, and (for towns and cities) in places where violence and anti-social behaviour
associated with binge drinking was more likely to occur. Practical ways to extend existing
services were identified, e.g. doorstep collection of household waste and heavy goods for
recycling; extended opening hours in primary care services to better meet the diverse needs of
the workforce; and greater use of Community Wardens.
3.48 In the larger cities, participants placed a high value on equity considerations as well,
but they took differing views on the nature of existing variations in standards. Residents of
the most disadvantaged neighbourhood wished to know more about service standards across
the city, with many believing better-off areas enjoyed better public services. In the most
affluent area, residents believed some of their public services were poorer due to greater
targeting of resources in low-income neighbourhoods. In the most remote location,
participants felt they did not receive an adequate level of basic services like water/sewerage
and bus links,
3.49 Most participants recognised there is currently a trade-off between high quality but
uneven public services and less good but universal services available in all places. They
supported greater consistency in quality standards across their authority, with proper
monitoring and enforcement of standards, as well as clearer comparisons between different
parts of the public sector and different authorities.
3.50 Participants expected public services to become more adaptive and responsive
services as user expectations and needs change. Participants emphasised the role of good
customer care and the importance of clear communication. They noted that migrant workers
in front-line service roles should be given language training to ensure their communication
skills are good enough.
3.51 The possible consequences of demographic trends were considered. Participants
identified a need to invest more to support ‘independent living’ and intermediate options like
sheltered housing; and supported much greater choice over when and how to retire from work
and better options for drawing upon the experience of the retired population. Some emerging
social and health needs were felt to be poorly addressed by services currently. Support for
parenting and promotion of healthy life-styles (diet and responsible drinking) was expressed.

31
CHAPTER FOUR EFFICIENCY AND PRODUCTIVITY
• More resources for front-line delivery through the Efficient Government
programme
• More streamlined and simplified performance reporting and scrutiny
• Scottish Executive to become more proportionate in its monitoring
• Fundamental review of inspection, regulation and audit arrangements
Context
The Scottish Executive ‘Efficient Government Initiative’ sets targets for efficiency savings
across the devolved government, local authorities and health boards. In the tighter fiscal
climate emerging, the need to achieve such savings for reinvestment in front-line service
delivery has been recognised increasingly. Public service providers are being encouraged to
collaborate in managing ‘back office functions’ as part of the drive towards ‘Shared
Services’. In addition, more efficient approaches to reporting on service performance, and to
the audit and inspection of service regimes, are viewed as necessary to enable service
providers to achieve their objectives. Relatively less emphasis has been placed, to date, on
improving workforce productivity in Scottish public services although steps to manage sick
leave more actively have been taken widely. Improved productivity is likely to become a
more prominent feature of the debate.
Efficiency, priorities and assessing risk
4.1 Participants identified various examples of lack of efficiency in public services. These
were not the same issues that tend to be reflected in policy and media debate: workforce
productivity, staffing levels or indeed the overall size of the public sector. Instead, there was
an emphasis on ‘wiser spending’ by setting priorities the public felt were more in line with
their own. For example, in the Borders group, one participant called for:
‘Less waste on useless and unnecessary things like digging holes in the road, and
more money for hospital services’ [Borders, 25-34 year old man]
4.2 In the Stirling group, participants drew attention to what they saw as ‘pointless tasks’
such as constantly doing the pavement in the town centre.
4.3 Public-Private Partnerships have been used to roll forward significant amounts of
investment for capital-intensive projects, and to spread repayments over a number of years.
The case for doing so is made on the grounds of ensuring schools, hospitals and transport
infrastructure are modernised on a timescale in keeping with public expectations, and without
significant increases in public borrowing. However, questions were raised in a number of the
groups about the real need for at least some of the new hospitals (Stirling) and school
developments (e.g. the Glasgow group questioned the benefits of closing four local schools
and merging into one large new build school).
4.4 While replacing older buildings with fewer, modern buildings might bring important
service benefits, participants felt that options to retain the status quo might be worth

32
considering in some cases. Localised services with poorer infrastructure might, occasionally,
be preferred to centralised services in modern settings. In the Borders group, most
participants questioned the value of developing the Waverley railway line because of
unknown cost, expected lack of use by existing residents compared with a bias towards new
commuters and an uncertain liability on Council Tax payers for cost over-runs:
‘How can we be sure that the risk is being passed to private firms?’ [Borders, 45-54
year old man]
Waste, value for money and focus
4.5 The argument that we need more efficient public services because of waste and
inefficiency was made mainly by the Edinburgh group, with some references made in Stirling
and Borders. Waste and duplication were considered to be a legitimate target because they
prevent public services being delivered properly. In Edinburgh, participants discussed at
length their concern that the lack of focus on value for money and clear priority-setting harms
services in the long-term, as well as leading to higher Council Tax than actually required:
‘There’s wastage everywhere. You have to cut the fat away, and channel the money to
where it’s really needed…Public services should only do the things that they can do
well – or they should stop doing them. Get the people with the right skills to do the
right things.’ [Edinburgh, 55-64 year old man]
‘I’d like reviews of: the need for the council to do care in the community; economic
development; the need for police and fire boards, bearing in mind that councillors sit
on the boards anyway; co-ordination of transport.’ [Edinburgh, 55-64 year old man]
4.6 In discussing how they would judge whether public services were improving, one
participant in the Borders group expected to see Council Taxes frozen in real terms and
services improved through efficiency savings. Others in the same group felt additional
revenue could be raised from a development levy on new homes being built to attract
commuters. As this would contribute to house price inflation above the means of average
earners in the area, participants felt it was equitable to invest some of the proceeds from
economic growth to benefit public services.
4.7 As noted earlier, there was little direct reference to traditional stereotypes about
workforce productivity, such as ‘over-manning.’ However, some participants did refer to
additional legislation and too much administration stopping front-line efficiency in policing.
The Borders group spoke of local authority office hours being too short to meet the needs of
working people, while in Stirling participants admitted to feeling unclear about what council
staff do these days, ‘apart from developing strategies’.
Diverse providers?
4.8 Public services are provided through public funding but not necessarily by the public
sector. The case for commissioning voluntary sector providers of public services has been
made, frequently, on the grounds of user focus and innovation, while some private providers
are considered to offer improved efficiency or productivity.

33
4.9 In Stirling, a range of different views was expressed, with general agreement that
using others to deliver public services should happen only if it made services demonstrably
better. Where voluntary organisations took on service delivery roles, participants were
concerned that it might change their ethos towards profit. They stressed as well the need to
ensure that services became more accountable not less so: even where services went out to
tender, the local authority should retain a strong monitoring role, the ability to adapt or end
contracts, and have powers to put in managers where contracts were not succeeding.
4.10 Related to a discussion on accountability in Edinburgh, the Borders group proposed
that clearer comparisons were needed between private and public services. As an example,
waiting times to have calls answered by the gas company might turn out to be worse than for
the local council.
4.11 The post-event survey included a question on who might provide public services
locally. Responses are shown in Table 4.1.
Table 4.1: Net comfort scores with other providers by location
How would you feel about public services being delivered by the voluntary or private sector?
Net scores:
Comfortable/
Concerned
Edinburgh Glasgow Highland Borders Stirling
Voluntary Sector - 2 (1) + 10 (2) + 4 (1) +4 (4) + 5 (3)
Private Sector 0 (3) + 1 (6) + 8 (2) 0 (6) + 1 (4)
4.12 The table shows net scores derived as the difference between those feeling
‘comfortable’ and those feeling ‘concerned’. The combined number who answered ‘Neither’,
‘It depends’ or ‘Don’t know’ is shown in brackets. Of the 10 scores (voluntary and private
sectors rated in five locations), 7 have net comfortable scores, 2 had neutral responses and 1
had a net concerned rating.
4.13 For the voluntary sector, the Glasgow group felt most comfortable about its potential
role in delivering public services, while the Edinburgh group was the only one to express
more concern than comfort. Comfort ratings with the private sector were lower than with the
voluntary sector in three locations (Glasgow, Borders and Stirling), scoring close to zero in
these groups as well as in the Edinburgh group. This ambivalent response contrasts with the
Highland group, which expressed the most comfort with private providers of public services.
This appears surprising, given participants’ clear dissatisfaction with at least one service
delivered by regulated private operators (public transport). In addition, the scope for the
private sector to run public services is likely to be least in remote rural communities.
4.14 Among the Edinburgh stakeholders, calls were made for greater capacity building
with new providers or in new areas of service provision, and for improved learning between
voluntary organisations. In Stirling, the advantages of looking for partners outwith the usual
set of service-providers were discussed. A clear view of the role of the voluntary sector was

34
called for. Simplified and outcome-focused grant agreements were suggested for the
voluntary and not-for-profit sectors.
4.15 Dundee stakeholders talked about ‘recruiting talent’ from both the private and
voluntary sectors, as well as working closely with and expanding current links with both
sectors to build capacity in public services. It was thought necessary to look globally at
currently available models, and to work towards ‘blending’ the best of each sector to arrive at
the best solutions for public service delivery.
4.16 Waste and duplication were considered to be a legitimate target because they prevent
public services being delivered effectively.
4.17 Participants put an emphasis on ‘wiser spending’ by setting priorities the public felt
were more in line with their own.
4.18 While replacing older buildings with fewer, modern buildings might bring important
service benefits, participants felt that options to retain the status quo (or intermediate options)
might be worth considering. Some considered that localised services with ‘less than best’
infrastructure might, occasionally, be preferred to centralised services in modern settings.
4.19 The view was expressed consistently that voluntary and public service agencies
should only be used to deliver public services if this made services demonstrably better.
Where voluntary organisations took on service delivery roles, some participants were
concerned that their ethos might change towards profit-making. They stressed as well the
need to ensure that services became more accountable in future: even where services are
tendered, participants felt the local authority should retain a strong monitoring role, the
ability to adapt or end contracts, and have powers to put in managers where contracts were
not succeeding.

35
CHAPTER FIVE JOINING UP AND MINIMISING SEPARATION
• Achieving real outcomes against the priorities set by the people of Scotland
• Reform pathfinders to demonstrate new ways to integrate service delivery
• Ensure community knowledge of, and involvement in, the Community Planning
process.
Context
The concept of joining-up services is not new. In the 1990s, notions of ‘reinventing
government’ and ‘holistic government’ proved influential in US and UK governments. In
Scotland, Community Planning Partnerships provide a consistent local focus for joint strategy
and delivery of more services, building on the various models of closer planning between
separate agencies (notably the Joint Futures initiative between health and social work
agencies and now Community Health Partnerships).
Defining joining-up
5.1 A definition offered by one Edinburgh group participant was:
‘Joining-up is about efficiency, saving money, but it’s also about improving the
quality of contact.’ [Edinburgh, 55-64 year old man]
5.2 Joining the gaps between policy intentions and outcomes was also identified as a goal.
An example of this closer linkage was given in the Stirling group:
‘Employment is not the council’s responsibility but they are always training
youngsters and ditching them when they’re qualified’. [Stirling, 45-64 year old man]
Responses to ‘joining-up’ vignette
5.3 A third vignette, or case study, was presented to group participants, detailing a young
man aiming to establish a small business (see box). A summary of responses from each
location is shown in Table B3, Annex 3.
Vignette on small business start-up (Jamie)
Jamie is 23 years old and wants to set up his own car repair business. He has the skills and a lot of useful
contacts, so he thinks this could be a viable business. He lives at home with his parents in their council house, so
isn’t worried about the cost of living while he gets his business up and running. But he has only £500 saved
towards getting his business started.
None of his family members has any experience of being self-employed. He is keen to make the right decisions,
but isn’t sure what he needs to know, and where he can best find out what he should do to ensure his business
will be successful. He wants to be able to reply upon a steady income. He is keen to make sure that he builds up
the business, but also knows he needs to plan for the future.

36
5.4 Across the locations, participants showed a relatively high level of awareness about
information sources available. They referred to regulatory matters (e.g. tax), public sector
support through enterprise bodies (with references made to Business Gateway) and voluntary
sector support from Citizens Advice. In addition, a number of groups highlighted the
importance of informal support from other experienced people. Numerous references were
made to the importance of ‘independent’ sources of advice, available free of charge to the
user.
5.5 Recognising the diversity of information and advice services, two groups emphasised
the need for a ‘one stop shop’ approach or use of the Council Service Point to sign-post the
user to the most relevant services. In addition to joined-up information, there was an
expectation that different agencies should collaborate with each other. A diverse range of
service providers was not considered necessarily to be a negative feature. However, a
practical consequence of participants’ views is to consider greater use of the ‘single gateway’
model, where frontline staff could act as a broker between agencies on behalf of the user.
Each group advised Jamie to use internet sources, suggesting that more of the joining-up can
be done on-line. One group raised questions about the feasibility of Jamie’s plan because he
had no assets to help secure a loan.
5.6 Participants also posed a number of questions to service providers, including how
rules on regeneration funding could be changed to nurture an environment for small business
start-ups. The Edinburgh group called for clarity on who should be the lead agency to
promote local economic development.
Better sign-posting
5.7 According to the group participants, good communication skills and information from
trusted sources would help citizens to do some joining-up more easily. Sign-posting to
appropriate sources of advice might offer, in some cases, a good alternative to the harder task
of achieving service integration:
‘I don’t know if it’s actually about joining everything up. I know that if I go to a
department, it wouldn’t necessarily have to be joined up as long as they were able to
help me and gave me the right number – that would be helpful. But just to say that
‘this is nothing to do with me’ and leave you, isn’t right.’ [Edinburgh, 45-54 year old
woman].
Communication and planning between sectors
5.8 Joining-up should apply not only to public sector bodies like the council, health
board, local enterprise company and emergency services. Participants in two locations
identified a clear need for better communication and joint planning across sectors, especially
in the case of services like public transport which often span funding and strategic planning
from the public sector and private providers operating on a franchise basis. Stirling
participants felt closing the perceived communication gap between councils and bus
companies should be a priority.

37
5.9 The Highland group took this theme further. They reported that communication
between public services, e.g. hospitals and schools, and public transport providers does not
appear to take place. They proposed that all service provision covering remote rural areas
should consider the implications of transport if services are to become more accessible.
Examples were given of children being unable to take part in after-school activities, and
adults having difficulty arranging hospital appointments, due to limited public transport
provision at inconvenient times. In addition, labour market opportunities were restricted.
5.10 Joined up thinking around the provision of public services was identified as central to
developing high quality services by Highland participants. For them, this meant thinking
about roads, land prices and ‘red tape’ when aiming to encourage new businesses; linking
social housing to land reform; raising staff awareness of travel time and transport links when
services are not provided locally; and investing in school education on the basis of children’s
needs. Concerns were raised that teacher: pupil ratios should not be set on the same basis as
in larger settlements.
5.11 Turning to the public service leaders dialogue sessions, participants in Aberdeen
suggested greater use of Joint Boards across services, for example covering police fire and
health, overseeing implementation and operations. In Dundee, the use of shared services to
‘provide a local joint emergency contact centre for police, fire, rescue, council, health and
voluntary sectors’ was offered as a way forward. They believed that, as a matter of urgency,
legal barriers to joint working and the delivery of shared services should be removed. They
called for joint health and social service drop-in clinics in the evenings and at weekends.
Customers would be at the centre of the delivery mechanism, and wherever relevant, there
would be continuity and a seamless tie-up between public and privately-delivered elements of
services, such as in the social care of the elderly and disabled.
5.12 In Stirling it was suggested that responsibility for joining up is often passed up to the
higher levels rather than remaining with the practitioners themselves. Where a member of the
public accesses the wrong service, frontline staff should not simply advise the user that they
are at the wrong place, but help them to locate the right service.
5.13 Public service leaders in Edinburgh referred to the case for greater co-terminosity,
with the suggestion of sharing boundaries for the health board, police, fire, and local
authorities. There were also familiar calls under a number of headings to focus on ‘whole
system thinking’ rather than a silo approach. It was considered essential to clarify what
should be delivered nationally and regionally, such as policing services, and what should be
delivered locally,
5.14 In Lanarkshire, it was suggested that rationalising Health Board boundaries could
improve co-ordination of services with partnerships. The Borders group also proposed
moving towards multi-agency, co-located teams, combining health and care issues as one
package to the end user.
5.15 Finally, in Inverness, one workshop participant called for the abolition of island
councils and health boards, and to merge the two sectors across the three island authorities
(Orkney, Shetland and Western Isles). An intermediate view was to merge health and local

38
authorities within each island would be preferable, while others believed the way forward was
through multi-skilled workers from a single agency providing health and social care services
in the same location.
5.16 One practical consequence of participants’ views on the issue of joining-up is to
consider greater use of ‘single gateway’ models, where frontline staff act as a broker between
various other agencies on behalf of the user.
5.17 Participants in two locations identified a clear need for better communication and
joint planning across sectors, not just between public sector agencies. This was considered to
be especially important in the case of services like public transport which often combine
funding/strategic planning from the public sector with private providers operating on a
franchise basis. Participants living in the most remote area stressed that all service provision
planning needs to consider the implications of transport if services are to become more
accessible.

39
CHAPTER SIX STRENGTHENING ACCOUNTABILITY
• Strengthen democratic accountability
• Ensuring that user experiences and views drive performance improvement
• Simple, quick and effective redress when something goes wrong.
• Providing focussed, appropriate, balanced and consistent information about
services, performance and people.
• Strengthen accountability of senior officers.
Context
Public group participants explored strengthening accountability of public services in various
ways, reflecting the multiple forms of accountability facing service leaders and providers.
While there has been considerable discussion of how to improve turnout levels in elections,
there appears to be more enthusiasm for improved forms of ‘everyday’ accountability. This
spans closer involvement in the early stages of strategic decision-making through to better
ways of leaders giving an account of their decisions; and to speedy, clear forms of redress
when service users express concern or make complaints. In this way, strengthening
accountability appears to be as much about ongoing processes of giving an account and
holding to account as the public assessing performance in elections.
Responsibility and responsiveness
6.1 Improved accountability as a key goal of public service reform was identified as a
priority theme in three groups – Edinburgh, Highland and Stirling – and viewed as an
objective running through all discussions in Borders. Accountability was explored in
Highland and Stirling as a two-way process, involving better feedback from decision-makers
and service providers and closer public involvement in scrutiny of decisions.
6.2 The overall sense of the Edinburgh group, which focused mainly upon the
responsibility of leaders and decision-makers, was that accountability has declined. They
thought this was marked by a general sense of no-one being willing to accept responsibility
for what happens, especially mistakes and failures:
‘Everybody says ‘It’s not my fault’. It starts with Tony Blair and goes all the way
down.’ [Edinburgh, 55-64 year old man]
6.3 This view was echoed in other groups, with various references to changing beliefs
about the motivation, honesty and integrity of leaders.
6.4 Turning to the issue of expressing concerns and making complaints, evidence from
the literature points to service user satisfaction arising from good information about services
and standards; accessibility; listening to consumers; and professional staff attitudes (Scottish
Consumer Council, 2006). Redress – or putting things right when they go wrong - is also an
important part of the equation. In the baseline survey, we asked participants how confident
they would be in receiving a satisfactory response (see also Scottish Consumer Council 2006;
Scottish Council Foundation/Volunteer Development Scotland, 2006). Responses are shown

40
in Table 6.1 as net confidence scores (i.e. the number saying ‘confident’ or ‘very confident’
minus those saying ‘not very’ or ‘not at all’ confident).
Table 6.1. Net confidence scores in having a concern or complaint resolved well by
location.
If you had a concern or complaint with these public services in your area, how confident would you
be in receiving a satisfactory response?
Net Confident
scores
Edinburgh Glasgow Highland Borders Stirling
Local GP + 8 (2) + 11 (3) + 11 (0) + 11 (2) + 8 (1)
Local hospital + 4 (4) + 13 (1) + 3 (2) + 10 (3) + 6 (1)
Emergency + 4 (4) + 12 (2) + 9 (2) + 8 (3) + 2 (5)
Public
transport
+ 3 (1) 0 (3) - 2 (5) + 1 (4) + 2 (5)
Leisure + 2 (6) +11 (3) + 6 (4) + 5 (4) + 8 (2)
Housing + 1 (9) + 4 (5) - 5 (4) + 3 (8) - 1 (6)
Maintenance 0 (2) + 6 (4) + 5 (5) + 3 (2) + 5 (4)
Social Work 0 (9) + 2 (8) + 4 (5) + 1 (8) + 1 (6)
Education 0 (7) + 6 (8) + 3 (4) + 4 (7) + 2 (5)
Planning and
Environmental
-1 (6) + 2 (12) + 1 (8) 0 (7) - 3 (8)
6.5 Similar to the satisfaction ratings discussed earlier, five of a possible 50 net
confidence ratings were negative while a further five scored zero. Respondents felt more
confident that a concern or complaint would be handled well by local GPs, hospitals and/or
Emergency services, though scores were relatively lower for hospital services in Edinburgh
and Highland, and for emergency services in Edinburgh and Stirling. Leisure services were
rated positively in this regard as well in most groups. In Glasgow and Borders, all confidence
scores were positive or neutral. In contrast, the lowest degree of confidence was expressed in
housing services by the Highland group, which also rated public transport in negative terms.
In both Edinburgh and Stirling, least confidence was placed in planning/environmental
services, while the Stirling group also gave housing a negative rating.
6.6 It is worth noting that the negative confidence ratings are relatively modest.
Moreover, the number of respondents who either didn’t know or expressed neither
confidence nor a lack of confidence (shown in the table in brackets) varied significantly. This
reflects patterns of service use and knowledge. For example, more than half of participants in
Edinburgh and in Borders were in this category for Housing, while Social Work,
Planning/Environmental and (in two locations) Education also drew relatively high numbers
of uncommitted responses.

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