How can you make better decisions in #complexity?

What is one thing you’d like to offer to adult social care commissioners to help them decide their approach?

How can you make better decisions in #complexity?

How do we ensure a better #future for citizens, communities – and ourselves?

How can we encourage #innovation in an over-pressurised and partly broken system?

Adult social care #commissioning is a fantastic space to explore these issues, as we’ve been doing for the last few weeks on an interesting project, and for years before that!

Commissioning in adult social care means shaping a complex system to get better outcomes for people with learning disabilities, physical disabilities or physical or mental health issues.

It can be as narrow (but challenging) as ‘procuring organisations to provide homecare’, and as wide and messy as ‘shaping a community where everyone can thrive’.

As a commissioner, you have varying levels of power, authority, capability, respect, and understanding in your organisation.

…you have to constantly respond to crises (most of them caused by ‘austerity’): a provider of care collapsing; problems recruiting and retaining workforce because they’re paid less than Amazon; 30% of carers off sick with COVID; an urgent need for particular specialist mental health services (say).

…and you have to work in a place, with all its complexities:

– do the chief executives of the council and the hospital trust get along, or can they not be trusted to be in the same room together?

– do our providers trust us, or are they still hurting because we clumsily tried to reduce their fees three years ago?

– do the community organisations agree with our ideas about ‘coproduction’, or do they see it as foisting the costs of care on to them?

What we’re doing is trying to produce a tool to help people doing this messy, complex job to assess their context, and:

1- put together a commissioning development plan to get more ability to influence the system of health and care in their place (or, even, the system of wellbeing)

2- decide which of twelve ‘commissioning approaches’ fits their place and their needs best

We’ve been running this as a #workoutloud process – so if you fancy diving in and contributing, you’re welcome! There’s an open Mural board and an open meeting on Wednesday 20 April at 2:30pm (links below).

Or you can give us a quick comment here:

What is one thing you’d like to offer to adult social care commissioners to help them decide their approach?

As well as the slides (scroll to the bottom), the draft working documents are on a Mural board for comment, at

Mural Board

And there’s a final meeting of our open group for anybody who wants to comment on Wednesday 20th 2:30-3:45pm which you are welcome to attend – registration needed at

About this work:

The Public Service Transformation Academy has been commissioned by the LGA (the Care and Health Improvement Programme, jointly run with DHSC and ADASS) to produce a tool for adult social care commissioners to go through strategic options appraisal – i.e. to assess their place and decide the best approach to commissioning.

The slides in PDF:

The Great Leap Forward

A blog post from RedQuadrant’s digital government lead Gerald Power

I had an interesting couple of meetings this week with a delegation from the Chinese Government. It also allowed me to listen in on a presentation from Matthew Cain of Hackney on their excellent digital work in a borough that has both the ‘silicone roundabout’ and some serious challenges with deprivation. It was a group of officials from the Chinese equivalent of local government wanting to learn about transformation and digital service delivery in the UK. I hope that I was able to give some insights into the journey the UK has taken from the turn of the millennium cool Britannia ‘e-is good’, when people thought posting a pdf. was an e-service, through to the age of smartphone service delivery and musing on ‘govtech’, ‘fintech’ and block chain.

However, a lot of the learning was on my part as I considered would it all have worked better if we had been able to take a strict top down centralised approach as the Chinese can.

No division between local government layers, no pandering to free markets and the ability to apply strict central control. Would that have made things much easier?

Having spent several years in Cabinet Office trying to herd the big fat cats of central departments and more varied cats of local government on digital transformation; being able to ‘tell’ people what to do was something that was initially very appealing.

It might have been possible to standardise much more of what local government does on line and offer much more in terms of common transactional platforms rather than issuing guides to best practice and a few digital building blocks from We might dispense with the slightly Alice in Wonderland process of 4G and 5G licence auctions and the strange way we fund our fibre backbone. God forbid we might join things up across layers of government!

However, by the end of the two days I came to believe that it was this kind of ‘telling’ people how to do digital – and in particular politicians telling people about technology and technologists telling people about user experience- that caused some of our biggest digital failures.

Not because of what the Chinese delegates said, my Mandarin is not exactly fluent and they were asking not telling, it was more about me describing our success and failure to them. I had lots of time to think about what I had said as it was translated. Talking about failed or troubled high profile programmes like the National Programme for IT in the NHS and the currently struggling Universal Credit. And talking about really effective services like online tax self-assessment, car tax and driving licences, that sort of sneaked the ball into the back of the net with little fanfare. Talking about the diversity of transformation in Health and Local Government.

It all made me think of my experience of big centrally and politically driven projects and how often they go wrong. If you ‘tell’ someone how to do digital transformation you had better really know how to do it and be able to communicate and manage that change at a really detailed level. Similarly if you let a huge project to industry you really do need to understand what you and they are doing. Because if you can’t you create a lot of momentum with very little control of direction or sense of ownership and that is very dangerous.
In reality transformative change is messy, dirty, complicated, amazing, satisfying and can only really be evaluated as a success by those using and delivering the services. The more cutting-edge, the more you have to learn as you go and the less well a rigid top down approach works. Standards, visions and five year plans are great to help guide transformative change, but ultimately you need intelligent, passionate and empowered people testing and learning. Like the coders in Hackney literally going into the street to watch applications being used by residents.

So my conclusion was that there is no easy answer to digital transformation, we just have to embrace the complexity learn to love learning and accept failing sometimes as part of that learning. It also has to be a dialogue that focusses on outcomes not dogma or technology.

The great leap forward will probably have to be a lot of small but significant steps.

One thing we did all agree on was that there was no sensible explanation for why nobody ever faced any sanctions over the fiasco of the National Programme for IT in the NHS.

I am certain that in China they would have sent someone to prison for a long time; not necessarily the guilty party, but definitely someone.

#DigitalServiceDelivery #DigitalTransformation #Technology #Complexity #ITSolutions #eGovernment

#digital-service-delivery, #digital-transformation, #it-solutions