Why relational services matter

Joy MacKeith shares her thoughts after the inaugural Towards Relational Public Services (TRePubS) Conference

How do you deliver public services that are relational – services that recognise and respond to the unique needs and circumstances of each individual?  That was the topic of the conference ‘Towards Relational Public Services’ that I have just had the pleasure to participate in. 

Sam Game and I gave a workshop which explored how the Outcomes Star helps to make ‘Enabling Help’ a reality in practice.  Working in a relational way is one of the six core principles of Enabling Help, Triangle’s blueprint for effective services.

Sam, who leads the implementation of the Parent and Baby Star in Health Visiting services in Warwickshire, described how using the Star has helped them work in a more relational, collaborative and strengths-based way.  Parents have responded incredibly well.  They are much clearer about the health visitor’s role and they love the way that Star helps them see what is going well as well as where they have needs.  And it isn’t just the parents.  It has also helped commissioners to understand and value the service.

Our workshop was one of more than 40 sessions which took place over two days at Newcastle Business School – part of Northumbria University. 

For me the highlight was Mark Smith’s presentation on service transformation work in Gateshead.  He described how they have implemented an approach to working with people with complex needs in which there are only two rules: ‘do no harm’ and ‘stay legal’.  In this ‘liberated method’ case workers have a low caseload and there are no limits on how long they can work with someone or what kind of support can be provided.  And case workers have budgets and the discretion to spend money to help solve pressing problems. 

What I loved about this approach was that the bureaucracy was stripped out, giving workers the chance to do simple things that could make a big difference and avert much greater problems down the line.

Mark is part of a growing movement of managers, practitioners and academics who are challenging the orthodoxies of New Public Management (sometimes described as the 3 Ms – Markets, Metrics and Management). They are making the case that outcomes emerge from many interacting factors and therefore cannot be ‘delivered’ or dictated.  In this complex environment, learning rather than prescription and control is the most effective management strategy.  And it makes more sense for commissioners to take a relational approach and to hold service providers accountable for learning rather than targets.  This new approach is called Human Learning Systems.

Toby Lowe, Visiting Professor of Public Management and the Centre for Public Impact closed the conference with a call to action – for all of us who want to see services that are more relational, responsive and effective to come together and work with a coalition of the willing to create a paradigm shift in public management.  It is an exciting vision, and one that I think the Outcomes Star, a tool with flexible, relational working at its core, can play a role in realising.

Joy MacKeith, Co-creator of Outcomes Star

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Watch Joy’s conversation with Toby Lowe about the synergies between Enabling Help and Human Learning Systems 

Find out more about Enabling Help here 

Find out more about Human Learning Systems here

 

 

Going for collaboration at the GoLab Conference

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Triangle co-founder and Outcomes Star co-author Joy MacKeith reflects on the theme of collaboration at this year’s Social Outcomes Conference and points to Human Learning Systems as an effective way to make this the norm in service delivery.

Hear Joy describe what Triangle has learnt about what works in service delivery in this podcast

Watch her conversation with HLS proponent Toby Lowe

In early September, I had a fascinating two days at the Government Outcomes Lab (GoLab) Social Outcomes Conference.

I learnt about Social Impact Bonds (SIBs) and other outcomes-based funding initiatives around the world, from France to Australia and Paraguay to Japan, but for me, the most interesting session was on the UK’s Life Chances Fund.

We heard from many of the initiatives receiving this funding, all of them doing incredible work in a range of sectors including vulnerable mothers, employment and mental health.

The strongest common theme was how this additional funding and its link to long-term outcomes drove meaningful collaboration between providers and commissioners. In these initiatives, all parties are working together to identify blocks and create an ecosystem of services that has the needs of the person being helped at the core. It was inspiring to hear about their work.

Interestingly there wasn’t very much talk about the payment mechanisms and the extent to which linking funding to the achievement of particular targets was a valuable part of the process. From behind-the-scenes conversations I have had at this conference in previous years, I know that this can be a sensitive subject. Projects can be reticent to raise this issue when funders are in the room.

There were, however, some interesting discussions about the sustainability of these programmes. Although they can demonstrate cost savings, these are not always savings to the organisation providing the funding. For example, the local authority provides the funding, but the health service makes the saving. And they are not always ‘cashable’. For example, re-offending rates are reduced, but that does not make it possible to close down a wing of that prison and thereby reduce costs, at least in the short term. This fact can threaten the sustainability of SIBs as the rationale depends on the logic of these cashable savings. Perhaps we need to look for other mechanisms to support collaboration.

I have attended this conference for the last four years. This year I sensed a growing recognition of the importance of a person-centred approach to service delivery and the need to create a collaborative service system to achieve this. And more and more people now have experience of seeing how this can deliver improvements in practice. What we need now is a way of making this way of working part of typical day-to-day practice – in commissioning and service management, rather than something that happens when there is an additional pot of money to incentivise and support it.

Here I think Human Learning Systems (HLS) has some of the answers. It is an approach with problem-solving and ‘doing what it takes’ rather than ‘doing by the book’ at its core. This was a point made at the event by Lee Whitehead of Manchester Metropole University. He studied many SIBs and found that those that followed the HLS principles were more likely to succeed.  Gary Wallace of Plymouth also talked about how they are taking the kind of relational approach that both HLS and Triangle recommend outside of the context of a SIB.

I’ve been exploring HLS and the overlaps with Triangle’s Enabling Help principles with Toby Lowe, one of its leading proponents.  You can watch our conversation here.

And for a fuller description of what Triangle has learnt from twenty years of creating and supporting the Outcomes Stars in practice, listen to this episode of Next Stage Radicals where I describe the main messages of our Enabling Help report.

Also, look out for October’s edition where Mark Smith of Gateshead Council will be talking about how they are transforming their service delivery – informed by HLS and working with the Outcomes StarTM.

I will certainly be back at GoLab in 2023. I hope there will be even more space next year to hear from people like Mark who are finding ways to implement the person-centred and collaborative approaches, that are so important to Triangle and the people who use our Outcomes Stars– with or without a SIB.

Further reading: Dr Anna Good shares her thoughts on #SOC22

Musings on the importance of trusting relationships, professionals’ emotional labour, and the desire to improve delivery through data. 

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GoLab – Social Outcomes Conference 2022

Dr Anna Good shares her thoughts on #SOC22

Last week, Triangle directors- Graham Randles, Joy MacKeith and I attended the Government Outcomes Lab annual conference #SOC22

One presentation that particularly resonated with me was from Reji Ikeda at the Ministry of Justice in Japan. Talking about ‘value measurement for offender rehabilitation’, he emphasised the importance of the quality of the relationship and the ‘emotional labour of professionals and volunteers’ on rehabilitation outcomes. He also spoke about how poor occupational well-being can negatively impact these relationships. I couldn’t resist mentioning the Justice Star as an excellent tool for developing trusting relationships and boosting staff morale in this context.

Joy’s recent report Enabling help puts human relationships at the heart of effective service delivery, so this is at the forefront of my mind when thinking about the Star. The Enabling help report highlights the problems with borrowing from approaches such as the scientific and economic paradigms in social provision. Although not focused on the Star, the innovative suite of Stars offers a better, more enabling approach. I thought of this when the keynote presenter, Julie Battliana, stated that ‘agitation is alone is not enough to make change happen, innovation is required’.

 Another theme that I noticed running throughout the conference was the desire to use data to improve service delivery. I felt this was encouraging in a conference often focused on meeting targets and payment by results. Miika Vuorinen, a Chief of Evaluation from Finland, commented that one way to know if social outcome frameworks are working is to see if they are being integrated into the decision-making processes. Closer to home, Stan Gilmour from Thames Valley Police gave a powerful presentation, emphasising ethical decisions based on using data to allocate resources and plan social impact.

It’s possible I was looking out for these positive signs, as I feel passionate about encouraging and supporting good use of Star data. By ‘good use’ of data, I mean those closest to the creation of Star data (practitioners and managers) interpreting the data and using the learning to encourage changes needed to maximise the outcomes for those being supported.

Further reading: Going for collaboration at the GoLab Conference

Triangle co-founder and Outcomes Star co-author Joy MacKeith reflects on the theme of collaboration at this year’s Social Outcomes Conference and points to Human Learning Systems as an effective way to make this the norm in service delivery.

Sign up to our quarterly newsletter for product updates, case studies, publications and news. 

New ‘How to’ guide explains how the Outcomes Star can turn Human Learning Systems principles into practice

Since the publication of our Enabling Help report last year, we have been working with Toby Lowe and colleagues at the Centre for Public Impact to articulate how the Outcomes Star can operationalise learning as a management strategy and other core components of the Human Learning Systems (HLS) paradigm.

Both HLS and Enabling help focus on moving on from the failings of New Public Management towards an alternative vision of supporting ‘human freedom and flourishing’ through creating flexible, relational, compassionate service delivery systems in which the role of measuring is to support learning for individuals, organisations and places.

The Star as a tool for turning HLS and Enabling Help principles into practice

We are delighted that the Star is one of the tools identified in the Centre for Public Impact’s recently launched guide: Human Learning Systems: A practical guide for the curious, commissioned by Healthcare Improvement Scotland and Iriss.  

 The guide highlights three different ways that the Outcomes Star can be used to put the principles of Human Learning Systems into practice:

  • Person level: the Star empowers people to take an overview of where they are, understand their life as a system, choose their goals and work out the next steps to achieve them
  • Organisation/place level: the Star enables meaningful purpose-aligned reflection and learning about what is and isn’t working within services, in order to better support those they serve
  • Connected learning cycles: the Star offers a way of collective sense-making between different actors within or across organisations, for example within a multidisciplinary team supporting an individual, or between commissioners and service providers

Read the Outcomes Star case studies included within the guide. 

The synergy between the Star and human learning systems

HLS started as an analysis of the problems within traditional approaches to public service management.  It has gone on to articulate an alternative framework and then look for practical ways of bringing that vision to life. 

The Outcomes Star, in contrast, started as a practical tool for service providers to evidence that they are making a difference in a way that really reflects and supports what they do. From there we articulated the vision of service delivery and public management that was implicit in the tool in our Enabling Help report. 

The convergence of these approaches, despite their different starting points, speaks volumes.  The time has come for this shift in thinking and practice.  We look forward to furthering collaboration with the HLS movement and others who share this vision.

Could your use of the Star inspire others?
Are you working with the Star as part of a wider HLS approach?
Please get in touch with our Research analyst, Dr Anna Good (anna@triangleconsulting.co.uk), as we are keen to create and publicise more case studies.  

How the ideas driving social provision are steering service delivery off course

Triangle, the social enterprise behind the widely used Outcomes Star tools, is calling for a paradigm shift in social provision.  In a new report to be published in September 2021, co-founder and Star co-author Joy MacKeith argues that at its heart service delivery is about meeting human needs and changing behaviour.  Everything we know about how change happens points to the importance of relationships, trust and connection.  Research also shows that services must be holistic and tailored to each person. But the ideas currently driving social provision steer the focus away from relationships and flexibility and onto procedures, markets, targets and standardisation.  They break service delivery down into parts rather than focusing on the whole system.

The report presents an alternative vision – an enabling approach to service delivery.  Called Enabling Help, this alternative puts the focus of the service delivery system on the service user, rather than the helper, the service or the intervention.  Enabling Help builds relationships, trust and hope, develops skills and capabilities, is holistic, responsive and tailored to each individual person.

It also paints a picture of what it means to make Enabling Help a reality in practice. At the front-line it means moving to a collaborative approach rather than telling and directing. For managers it means changing the emphasis from managing procedures to enabling front-line workers to deliver relationship oriented, collaborative, flexible, problem-solving services.  For commissioners it means shifting the focus from numbers to narratives – co-learning with service providers about what works. 

‘Enabling Help’ builds on Triangle’s twenty years’ experience of helping organisations to support and measure change for people receiving services.  Working with over one hundred collaborating organisations including local and national charities, housing associations, grant-making trusts, local authorities and NHS trusts, has provided a unique insight into what works when supporting change and building well-being and potential.  And training and supporting over one thousand organisations to use the Outcomes Star in practice has highlighted what can get in the way of delivering what works.  This report pulls all this learning together and identifies the real reasons why people being helped get stuck in services and the people delivering the help feel frustrated and de-motivated.

The report calls on all those involved in service delivery from front-line workers, to managers, commissioners, researchers and policy-makers to embrace this new set of ideas and put relationships, responsiveness and learning at the heart of everything they do.