Some public service managers think we should forget ‘personalisation’, believing it to be a luxury when budgets are being cut.
However, the ‘choice’ approach could save money as well as empowering citizens.
Prime Minister Gordon Brown and Opposition leader David Cameron have argued strongly in favour of more choice and control over services to individuals and communities.
But the Guardian has recently unearthed a new scepticism. ‘Forget personalisation’, managers at Jobcentre Plus have been quoted as saying. Personalisation is pointless in the current economic climate and unable to cope with the weight of new customers flooding through their doors, they argue.
This opens up a much wider question about public services — is this the right time for the government to seek to redesign services around the individual? With funding for all parts of the public sector tightening over the coming years, should we focus on the basics and postpone a wider radical restructuring?
The answer should be a resounding ‘no’. In fact, there is a very strong economic and business case for introducing and deepening personalisation, not only into re-employment programmes but also into health, social care and beyond. Research by the New Local Government Network suggests that, if the right approach is taken, personalisation has the potential not only to give individuals and communities more choice and control, but also to save money.
However, to bring about this change we must have a different perspective on efficiencies. Traditionally, ministers have seen this mainly as an issue of productivity.
Therefore, we have seen more block contracts; an emphasis on standardised services; efforts to remove supposedly unnecessary tiers of government; and larger, cost-focused procurement exercises based on longer and bigger contracts to drive rationalisation and economies of scale. In such a scenario, customer choice has been seen as inefficient, requiring as it does surplus provider capacity. And, although some £4bn of efficiencies have emerged from this approach, such savings are fast drying up.
Neither should the track record of central state efficiency or public sector productivity encourage us to look to Whitehall for the answer. Investment in the police service and the NHS has not so far resulted in a commensurate increase in productivity.
However, rather than being concerned with productive efficiencies, we should focus on understanding demand and what precisely should be allocated. In adult social care, individual budgets have laid bare the gross wastage of the old standardised approach. Some individuals are receiving more care than they need and the state is wasting many thousands of pounds, when these needs could be met more directly for less.
On the other hand, many vulnerable clients are receiving less than they need. Even here, efficiencies are ripe to be made. Individuals who receive stable and appropriate support are less likely to require high-intensity crisis intervention from health, homelessness or unemployment services. This is a major plank of the whole preventive policy across health — and can be provided only through personalisation.
Pilots of personalised adult social care have shown that savings of almost 7% can be unlocked by taking advantage of a more competitive market of suppliers and a better understanding of clients’ needs. Lessons from personalised health systems in both the Netherlands and Switzerland reveal the same.
But beneath these clear-cut economies lie further hidden opportunities. If we harness latent social capital in communities, personalisation can give funding to non-state enterprises, saving money further down the line. Community safety and the local environment are just two such areas where we might be able to give greater ownership to local communities to co-produce their own services. So we should devolve budgets and responsibilities to the street and neighbourhood level.
Second, unsuitable and inconvenient access to services (such as limiting choice of GPs) might disrupt people from working and thereby helping the economy. The NLGN suggests that we should take advantage of the advent of electronic patient records to allow individuals to register with more than one GP, so that commuters do not have to take time off work to visit their doctor.
So far, the economic arguments in favour of personalisation have been drowned out by more politically engaging arguments such as the need to empower citizens. These are themselves cogent motives to devolve choice and control. Yet, in an environment where we must prove the worth of everything that we do, personalisation also offers a choice way of saving money.
Nigel Keohane is senior researcher at the New Local Government Network. His report People power: how can we personalise public services? was published on March 23
