How the national economy impacts local services

As we approach the Autumn Budget, the Westminster Circus can feel remote from local public sector delivery. But as we’ll see, macro decisions and mistakes in central government are having a profound effect on delivery, and the urgent need to redesign services. Here’s a graph of national GDP per capita for the top 20 countries…

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Designing early help

As the cliché goes, Early Help is the fence at the top of the cliff, instead of the ambulance at the bottom. Instinctively that feels like common sense, but when we look at public finances we see a different picture. For example, the NHS spends 95% on the ambulance and only 5% on fencing (estimates…

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Commissioning for outcomes

For commissioners, the outcome is King. It’s the discovery of outcomes that underpinned Every Child Matters, genuine co-production with families, and kindled the spark of systems thinking in children’s services. An outcome can be the tangible change or result for a child, young person or family. Or at the motherhood-and-apple-pie end of the spectrum, we…

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Mental Health is a wicked issue

There are some problems we can’t solve. For example, let’s take a big adaptive problem that needs lots of resource to solve, and coordinated national, local and community action. We call these problems wicked issues, and I think I’d put children’s mental health in this basket. Wicked So how do we solve a wicked issue?…

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