Management books don’t usually set the pulse racing. From the title, you might predict that 'Delivering Public Services That Work Volume 2' would do little to disprove that rule. But reading these case histories I confess I was moved to laughter, tears (well, almost), anger and deep reflection, sometimes all in the space of one chapter.
Disclosure is in order here. I have done, and still do, editing work for Vanguard, the consultancy whose thinking the eight cases reflect. I knew several of them, or thought I did, but reading them in this context reminded me all over again why I am both excited and proud to do it.
These are the opposite of the bloodless Janet and John stories most management books use to illustrate their theories. Here are real managers – real policemen, care workers, fire and rescue staff, food safety inspectors, care workers, town planners – wrestling with real issues in their daily work, issues that lead them to pose, and struggle to answer, the most important questions in management: What is our purpose? What are we here to do? How well are we doing it? How can we do it better, in ways that make people's lives easier?
Although they all reference the ‘Vanguard Method’, this being real life each case is quite different from all the others. Each journey starts from scratch and entails real choices. There are no single right answers and plenty of compromises. Not one is easy or the result of applying an off-the-peg formula. Unexpected constraints – not only government targets and specifications, though these often loom large – obtrude and frustrate; people brought up on different management assumptions misinterpret or find it hard to adapt to new ones; there are false starts and setbacks.
Yet what they share at the end is the learning that improving service brings real benefits: halved costs of stroke care in Plymouth, dented crime figures in a tough sector of Wolverhampton, better development at lower cost in Rugby planning office, improved food safety in Great Yarmouth, slashed red tape and wasted effort at Staffordshire Fire and Rescue, halved advice costs in Nottingham, lives of vulnerable and elderly in Somerset radically improved and the number of missing persons reports in Cheshire reduced by 75 per cent.
Although improvement was obviously anticipated, none of these outcomes could have been predicted in advance. It is the result of intellectual curiosity, as rewarding to read (and write) about, let alone to do, as to solve a detective story. This is how real change happens – emergent, full of unexpected twists and turns, the fruit of the hard yards of repeated experiment and learning. It can’t be planned – it emerges from the learning. By opposition, the stories here demonstrate with blinding clarity the arrogance of planned top-down change like that currently being visited on the NHS. How can you plan a new destination if you don’t know what direction and how fast you’re currently travelling? Every case in this book demonstrates how little managers commonly know about their organsations. They have no idea how poor their service is from the customer's point of view. Like referred pain, the presenting problem often disguises a quite different one underneath. Having lost sight of their purpose, they have little understanding of their costs.
One criticism of systems thinking is that its acknowledgement of complexity makes it hard to know where to start unpicking it. But what these cases – and indeed all Vanguard interventions – have in common is that they begin with an analysis of demand. In a thought-provoking chapter in part two of the book, Vanguard's Richard Davis explains why this has to be so. For most managers demand is unproblematic – it's what comes in through the door or, more likely, call centre. But as Davis shows, when demand is assessed against purpose – 'what we are here to do' – a very different picture emerges. Half or more of the 'demand' is likely to be 'preventable' – the result of not doing something or not doing it in a way that solves the problem in the first place. If you can get rid of this 'failure demand', there's an immediate uplift in capacity, a hallmark of all the cases in the book.
Establishing 'the problem that we want to solve' is the critical first step from which everything else follows. But it is not always obvious. For example, when one council looked closely at its apparently insatiable demand for social housing, it found that in 70 per cent of applications, the problem was one that going on the housing list wouldn't solve ('The garden's too big and I need help', 'it's an insurance policy for when I'm old and alone', 'my kids are grown up and I want them out – give them a house', 'I'm homeless'). Writes Davis: 'As a nation, we think we have a shortage of social housing. It's possible that we do, but we currently don't know.'
The book concludes with two more general chapters: a complementary piece by John Seddon on why the opposite, mass-production approach to services favoured by the conventional wisdom ineluctably makes them worse and drives cost up, and a final summing up by Charlotte Pell that pulls together the two most important messages of the book, both of them counterintuitive to those brought up on traditional management thinking: it's cheaper to do it properly, and the only way to do it properly is to put people using professional judgment back in charge. As becomes crystal clear from these cases, when you understand the organisation as a system, improving service starts with a leap of fact, not faith.