Total Place: London’s public spending

1. Total Place:London’s public spending Urban & Regional Economics Lent Term Seminars LSE London 25th January 2010 Dick Sorabji Corporate Director Policy & Public Affairs

2. What is Total Place? • CLG sponsored pilots • HMT & Cabinet Office support • 13 pilots • April 2009 to April 2010 • A whole area approach • Doing better with less • 70~ informal pilots • Individual authorities • London mapping • Strands • Counting • Culture • Customer insight Trying to go beyond SRB, LAA and MAA

3. Total Places: what & where Total Places • Birmingham • Bradford • Coventry, Solihull, Warwickshire • Croydon • Dorset, Poole, Bournemouth • Durham • Kent • Leicester & Leicestershire • Lewisham • Luton & Central Bedfordshire • Manchester city region & Warrington • South Tyneside, Gateshead, Sunderland • Worcestershire Policy Themes • Alcohol & drugs • Health & social care • Children • Crime • High cost communities • Young people & employment Targeting wicked problems in diverse communities

4. Total Place : in its place • Technology & public services • Streamline central government • Senior Civil Service • Sharper delivery • Government efficiency • Including re-location • Total Place & Performance • Central local frameworks Competing to be a priority in government response to public finance pressures

5. Total Place: drivers & destinations • Driven by: • Weaknesses in silo delivery • Public finance squeeze • Method: • Looks at all public service in a place • Identifies overlap and duplication • Redesigns to improve service & efficiency • Goals: • Operational outcomes • Service transformation plans • Early efficiencies • Understanding multi-organisation delivery • Strategic outcomes • Creating incentives to innovate locally • Changing central government Total Place is a theory as well as a national initiative

6. London Councils’ local audit:PwC thinking with numbers • New perspectives • By policy area • By organisational crowding • Deeper investigation • Managing chronic care • Obstacles to work • Whole system approach to youth offending • Different focus to Total Place pilots • Central government reform • Local solutions to national problems • Organisational evidence for London policy proposals Focusing on the conditions for success more any one success

7. Total State spending in London

8. London locally managed spending

9. London public spending 2008/09

10. London spend viewed from Whitehall 2008/9 figures

11. NDPB London spending 2008/9 figures

12. Players in one policy area:Economic Affairs 2008/9 figures

13. Hidden ideas in Total Place • Reorganisation • Not practical • Collaboration: • Aligns delivery • Supports person focus • Unlocks new delivery chains • Accelerates innovation • Major influences on public services • The national policy environment • Lack of local incentives Total Place as a critique of the traditional Whitehall approach

14. From efficiency to innovation Efficiency savings • More tasks per hour • Bulk purchase savings • ‘Invasive’ control systems • More ticket machines • Doing things better Process improvements • Eliminate tasks • Different purchases • ‘Automatic’ control systems • Oyster Card • Doing better things Thinking differently delivers more than squeezing harder

15. London Councils’ Strategic Themes • Devolution– because we believe devolution to our boroughs ensures better results for Londoners • Partnership – because we believe our partnership expertise delivers local feel and London scale; so driving innovation and efficiency • Democracy and trust – because we believe clear accountability and real engagement with Londoners happens best at borough level. London boroughs aim to be every Londoner’s first choice for a fair hearing and a fair deal • Resources and risks – because we believe London boroughs have the confidence and talent to take on challenges and the associated risks that others are too remote to handle. Total Place can help map out our vision of a new relationship between central and local government

16. Managing chronic care • 1.3m registered cases • 900,000 with 3+ conditions • 72% hospital bed days • 65% out patient appointments • Costs in London £5 billion • £3 billion NHS, £2 billion social services

17. New approaches to chronic care • New approaches • Prevention & early intervention • Self directed care • Joint service design • Diabetes £590m • Projected saving £100m • All chronic care extrapolated • Saving £880m, 18%

18. Anti social behaviour • Cost to London public services £500m • Local authority costs £330m • Youth Offending Teams • £150m related costs • Economic costs • Lifetime truancy extrapolated costs £500m • Londoners in prison costs £900m • 18,000 adult Londoners in prison

19. New approaches to ASB • 16 types of public service organisation • New approaches • Personalised interventions • Early action • Systems joined up locally • Projected savings to the state £85m • Economic & social savings uncosted

20. Obstacles to work • Cost of worklessness £5 billion • New approaches • Jointly designed • Devolve to integrate systems • Integrated case managers • Retain central system • Incentives for individuals & organisations • Projected savings £630m • Increased tax £440m

21. Implications of PwC research • Drivers of better with less • Early intervention • Life stage gap identification • Personalisation • Self direction – guided & unguided • Designed by and around the person • Integrated case management • Not re-organisation but: • Devolve • Integrate funding streams • Outcomes of better for less • £10.65 billion analysed • Projected £1.6 billion saving – 15% • If could apply to all state spending in London saving ~ £11 billion

22. Total Place In context

23. Total Place: changing public service? • Delivery chains • Process improvement • Citizen driven • Networks • Common values • Common outcome targets • Relational markets • Commissioning driven • Scale to influence suppliers • Personalisation close to the customer • Market platforms integrating the two: • eBay Routes to collaboration without permanent merger

24. Customer focus is efficiency focus Processes often designed for a structure that was replaced long ago Between departments Within departments IT provides management controls that do not obstruct delivery Front line staff usually know how a process could be improved The hard part is getting them to tell you Middle managers have the hardest time First steps in process improvement Redesigning delivery chains around the customer exposes ineffective delivery

25. A process model of local government Local Authority 3rd Sector Private Contract Private Contract 3rd Sector Citizen (internal customers)

26. Delivering through networks • Understanding others’ business models • Bringing common values to surface • Communication across all levels • Co-ordination not control • Education as influence • Become the network hub • Strengthen the network Both more flexible and more fragile than hierarchies

27. Traditional local government:Hierarchies and contracts PCT Private Contractor 3rd Sector Contractor

28. Emerging local government:Hubs and networks Public Private 3rd Public children elders LA LA 3rd Public LA Exec LA 3rd LA Public safety Private Public Private economy 3rd

29. Place based public service pressures Organisational listening Neighbourhood flexibility Strategic scrutiny Leadership & mobilisation Shared service management Partnership building Multi agency accountability Pro-active economic development Market development Performance management Financial management Risk management Closer to citizens Delivery through networks Managing uncertainty Place based public service requires new skills locally and new thinking nationally

30. What next for Total Place? • Government decisions • in Budget? • Conservative party consideration • In first 100 days? • Locally driven proposals • Kent: Bold steps for radical reform • London Councils’ • Manifesto for Londoners

31. End