Mike Attwood, Programme Director, Total Place Coventry talks about whole area approaches to providing public services at The King's Fund Annual Conference 2010.

1. BETTER FOR LESS.........OUR JOURNEY MIKE ATTWOOD PROGRAMME DIRECTOR FOR COLLABORATION

2. ‘Pain is inevitable... suffering is optional.’ M. Kathleen Casey

3. What we said in 2009 ...‘The time is right – a special combination of factors...’ crisis for public sector leadership and a will to re-connect the scale of the challenge is beyond any single organisation emotional and practical understanding that the old ways don’t work the clock is ticking... the uncertainty and concern is at all levels of the system – and is pushing collaboration enough leaders willing to ‘let go’? partnerships are at a crossroads – marginal to mainstream new relationship between local and central – less projection of problems between us cross-political statements about localism and shift from targets to outcomes.

5. Diverse: urban/rural, younger/older, ethnicity

6. Centre of road and rail network

7. Existing partnership working

8. Strongest performing economic sub- region within the West Midlands

9. 49 Super Output Areas within the 10% most deprived nationally, two thirds of these are in Coventry

10. 88 Super Output Areas in the 10% least deprived nationally

11. 1 unitary, 1 met. borough, 1 county, 5 districts – 2 LEPs

12. 2 PCTs, 1 Care Trust, 2 Police/Fire orgsThe Place

13. ‘Geography has made us neighbours. History has made us friends. Economics has made us partners…and necessity has made us allies...‘Those whom nature hath so joined together, let no man put asunder...‘This is a partnership, not an empire.’ John F. Kennedy

15. The scale of spending Overall spend in the sub-region (population of 1,046,000) of around £6.5 billion Around 50% is by national agencies Around £1 billion spent on education and children; £1.6 billion on health Two axes of spend ‘deep dive’: - Front-line ‘horizontal’ – children, older people, waste - Back of house ‘vertical’ – procurement, HR, strategic planning, emergency planning

16. What some of the wicked challenges look like: type 1 diabetes in children is rising by 3% per year (NHS Confederation) pupils who had truanted were 11 % more likely to report taking drugs at least once a month (HSCIC 2009) the public want more police on the street – but the evidence for effectiveness is mixed we need less hospitals but the public, local and national politicians are in denial about this – 50% estate occupancy? challenging families are less likely to work, more likely to commit crime and don’t tend to engage with services professional boundaries and identities are hard to shift we need macro, cross-system solutions in a time of growth in micro organisations 4% per year needed at least – double thatof high-performing public sector organisations.

17. Getting clear about the programme – Keith Grint and wicked problems Critical problems need command: just do it (it doesn’t matter what you think) Tame problems need management: déjà vu (I’ve seen this problem before; I know what process will solve it) Wicked problems need leadership: vu jàdé (I’ve never seen this problem before; I need to get a collective view on what to do about this)

18. The Programme

19. What helps and hinders?

20. Tricky issues and learning: How to engage meaningfully across the public sector – not just local authorities? Democratic deficit vs. local authority perceived control by partners Organic or deliberate? Managing transition – decommissioning and double-running It will take time – traditional savings still required meanwhile Where do savings accrue? – How to risk share What about local localism?! – Schools, GPs... A public sector savings scrum or more money in local people’s pockets? The compact with local people Impact on jobs – honesty with staff and TUs National political flux and nerve – how will it look? Sustainability Turkeys voting for Christmas – supportive change management and neutralising the blockers who won’t change Front-line education and development...new staff for a new world Leadership development

21. It’s about keeping the culture and the counting together F. Scott Fitzgerald‘The test of a first rate intelligence is the ability to hold two opposing ideas in mind at the same time and still retain the ability function. One should, for example, be able to see that things are hopeless, yet be determined to make them otherwise.’ King John or Thomas Jefferson? Forced in to a decision/change against your will OR Make the decision to BE THE CHANGE YOU WANT TO SEE

22. ‘With less than half our productive capacity the Soviet Union has at least equalled us in several crucial areas of military science and technology.’ John F. Kennedy