Total Place

1. Birmingham – January 2010 Total Place Lynne Haig

2. Context • From 1997 to 2007 public spending increased by 42% in real terms • Local Government saw a 39% real increase in Government grants from 1997 to 2007

3. ‘Secret doomsday plans for 20% cuts in public spending are being prepared by senior civil servants, who fear politicians are failing to confront the scale of the budget black hole. The proposals include savage cuts in funding for local authorities.’ The Sunday Times, 5 July 2009

4. Bank of England GDP projections August 2009 Largest overall six month drop in output since records began in 1955!

5. Three waves of impact Impact on local economy: 2008-9 Impact on public services: 2009-11 Impact on public revenues: 2011-19

6. “In prosperity prepare for a change; in adversity hope for one.” James Burgh

7. Wind back one year……some preparations were underway • ‘Calling Cumbria’ - the first ‘whole system’ place programme • ‘Counting Cumbria’ mapped £7.1bn of public sector expenditure flows across the place. • Similar programmes in Suffolk and Norfolk • Operational Efficiency Programme aimed to identify greater efficiencies in: • - back office and IT • collaborative procurement • asset management and sales • property • local incentives and empowerment

8. Sir Michael Bichard recommended the roll out of Total Place: • to map total public spending in a local area • identify efficiencies through local public sector collaboration • identify opportunities to redesign services around user wants and needs

9. So what is Total Place?

10. A conventional perspective on Total Place….. Ministers Sir Michael Bichard Senior Officials Board M.D. LCLG Uber Prog Director Prog Director Prog Director Prog Director Prog Director Prog Director Prog Director Prog Director Prog Director Prog Director Prog Director Prog Director Prog Director Prog Director PLACE LA LSP PSB Officers citizens

11. An alternative view of Total Place….. A once in a generation opportunity to transform the whole system public service system

12. Total Place challenges how, and how much, resource is allocated…. Total Place resource mapping reveals the total public expenditure across a local area

13. The direct cost of alcohol related diseases is over £2.7bn per year • Drink related deaths have increased by over 100% since 1990 • Smoking is estimated to cost NHS £5bn a year • Illegal drug use is estimated to cost £110 billion over the last decade. • School exclusions are extimated to cost £300,000 per child. • The average lifetime cost of NEET is £97,000

14. Meet the Johnsons • No male member of the family has worked for three generations • mum, a smoker, is diabetic and suffers from depression • petty crime and social disorder • domestic violence (mainly drink related) • children missing school. Some trouble with police. This family has had 370 face to face visits from public agencies in 18 months.

15. “80% of our expenditure was on the staff costs of the beauracracy, filling in forms, assessments and meeting with each other. Only 20% of staff time was spent actually working with the families.” Director of children’s services

16. Putting individuals and their relationships at the heart of service design…. Standard service to all. Supplier driven. Best for who? Cost Better understanding of needs. Perceived value for citizen. Still single service. Delivering service ‘to’ Identify and understand challenges with the people they affect. Co-creating solutions with people and with front line staff Delivering service ‘for’ Create solutions ‘with’ Enable self help. Support capability and resilience. Citizens trusted to make good choices for themselves. Achieved ‘by’ capable citizens Wellbeing

17. Better services: connected and co-created Lower cost: 30+% saving Confident communities: done with, not to total place is about innovation. It’s about creating ‘better for less’…..

18. It’s about challenging the relationships of power, knowledge and resources…… Whitehall Whitehall Service Place Service Place Local Local

19. Birmingham Total Place • Drug and Alcohol misuse • Gangs • Brighter Futures – early intervention • Adult Mental Health • Adults with Learning Disabilities • Poolway ‘ community demonstrator’ • Learning and Development

20. Emerging findings • local leadership • releasing innovation from the front line • changing relationships • re-thinking public services – transformation versus improvement

21. Emerging model…. Initiation Inspiration Innovation Implementation Insights Shared ambition Into own leadership New ways of leading collaborating Leadership of place Leadership Citizens and front-line Diverse group From ‘for’ to ‘with’ Citizens and front-line Engage partners Engagement Levels, gaps, overlaps Hot spots cold spots Difference in the difference Central to local Funding flows Analysis Citizens current reality journey mapping Service redesign organisation redesign Design programme Design

22. Total Place is a whole systems approach; based on place; built on trust.

23. Future challenges…. • Efficiency from current models won’t go far enough • Capacity in the third sector • Articulating value to commissioners • The crazy zone between two paradigms!