22 June 2007
Consumer satisfaction is one vital area of public services that is not getting the attention it deserves. The solution is to measure improvements against criteria that put users right at the heart of provision
If anyone doubts that public services are still feeling the winds of change, they should look at the volume of reform being proposed, discussed and carried out.
A more mixed economy of provision is part of this landscape. Although the pace is slower than expected, it is set to continue, with government programmes including Compact, ChangeUp and Future Builders focused on supporting the third sector to provide public services. And, as part of the place-shaping agenda, local authorities are now expected to take on a stronger commissioning role to work with local partners and providers.
The third sector is a vital partner and brings a well-established reputation for responsiveness, innovation and flexibility into the mix. But while few would challenge the basis of this reputation, there is a lack of robust data to support it. The National Consumer Council's new research into public service delivery, Delivering public services: service users' experiences of the third sector, is one of the few quantitative studies and the first to focus on user experiences.
Our starting point was the voice of consumers, and what they tell us counts. We examined whether services measured up against a set of user-focused criteria, including: sorting out their problems properly; acting on their comments; and treating them with dignity. We focused on more personal services — employment, domiciliary care for older people and social housing in the public, private and third sectors.
One of our main findings was that the third sector is not a cure-all, neither did it always provide best practice. In fact, it is impossible to generalise about third-sector delivery.
But when it comes to niche services, including employment services to meet specific needs, it shines above the rest. Almost 90% of users of these services believed that the organisations could be trusted and said that staff went out of their way to help out. One user said: 'If you ask for employment they'll ask how's your health, do you need anything else, your financial situation and everything.'
Private providers do better in domiciliary care for older people — more than 90% of these service users said that staff were friendly and treated them with respect.
In social housing — where there is little to differentiate the public from the third sector in terms of delivering user-led criteria — the picture is bleak, with less than half of those polled feeling positive about their services.
Another finding was that there is a gap between what consumers want and what they get — and they don't ask for much in the first place. They want, but don't always get, a decent basic service. They want providers who do what they say they will, and who solve problems when they arise. They care deeply about how services are delivered, about the quality and attitude of the staff they have to deal with and about being treated with respect and dignity.
These soft skills are critical but are often overlooked in performance measurement systems. One domiciliary service user told us: 'Staff are friendly and understanding. They don't talk down to you. You don't feel like you're putting them out.'
Two-way communication is a relatively weak area across the board. People want to be listened to but most service providers are much better at providing information than responding to users.
This study shows that there is huge potential for cross-service and cross-sector learning about how to deliver responsive services. Why are mechanisms to share best practice not in place? Without effective processes for learning, continuous improvement to public services will be seriously impeded.
The findings are significant for service providers, commissioners and regulators. Proficiency and technical competence are important, but so are the skills and professionalism of individual staff, and these, too, need to be taken into account.
This poses a challenge to service commissioners, who need to better understand the complexities of the marketplace for service delivery, and the different strengths and weaknesses of potential providers.
More time needs to be dedicated to planning services to identify exactly what needs to be commissioned and to ensure that user-led criteria are built into the process. Strategic planning and a service-user perspective are critical to getting such intelligent commissioning right.
Service providers have an equally important role. In addition to instilling good practice in their organisation and sharing it more widely, they need to build user requirements and satisfaction measures into service design and evaluation.
Hearing directly from users about their experiences of public services has given us a stronger impetus to campaign for change. Consumers need services that are organised for their benefit, not for the convenience of providers. And commissioners will need to sharpen up their act if they are to deliver on this.
Ed Mayo is the chief executive of the National Consumer Council. The NCC report was published on June 20