The challenge of reform in an age of austerity

Regular readers will know that I have written before on the work we are leading in Salford on complex families, or, as the government now calls them, ‘troubled families’.

This work has caught the attention of several ministers, and the recent announcement by the prime minister recognises that councils have been working with these families already – since long before the summer riots – and have led the way on co-ordinating support so that families only have to deal with a single case worker rather than 28 different agencies.

The government has pledged 40% of the cost of tackling these families. The problem here is councils cannot afford the other 60% of the cost on their own and at a time when we have been asked to make massive budget cuts, and while this money is welcome there are serious issues in relation to the impact of the cuts on local services for young people (Connexions, youth services etc) which are vital part of the process.

It is great news that the money is going to build on existing work locally, rather than some new, separate initiative being bolted on. It is important that we get the scheme right. Our ‘bottom up’ work in Salford has been especially successful in clearly illustrating that the risks of collective failure are high for our residents and communities but also for the state in financial terms. It is also clear that we need to get to the root of the problem in two ways – tackling the drivers of poverty and disadvantage, and tackling the causes of a highly fragmented public service investment and delivery system.

In practice our work has generated a new paradigm of integrated investment and delivery arrangements. The centrepieces of this reform work are a joint commissioning hub (being led by Salford’s director of public health) and a joint prevention and early intervention delivery model at neighbourhood level.

Central to this work is a major shift towards intelligence-led investment, focusing on the crucial risks. A key driver of integration is the use of person and family-centred planning – used in some areas of delivery now (learning disability, children’s services) but not across agencies as extensively as it could be to deal with the risks I outlined earlier. This shift is significant and can ensure we are focused on the assets of individuals and families rather than just their deficits, placing clear responsibilities and ownership with residents for their role in improving outcomes.

There are many challenges with this work, not least the need to ensure that the overall ambition for the city is supported in the process of empowerment and devolution, and ensuring that it does genuinely strengthen accountability rather than just organise services at a different spatial level.

We know that there is potential beyond our current plans – for example by exploring opportunities to tighten joint investment and delivery on these crucial issues through the use of a mutual or co-op model. We also know that government wants to explore how payment by results could contribute to the collective action that is required for work in complex cases, and that there is potential for philanthropic investment through social impact bonds.

Introducing these dynamics or new models may help but they will not in themselves produce integrated, customer focused delivery at scale. There have to be strong foundations of common interest in place first – an urgent job but one which I believe requires thought and care – not always two things that go together when times are tough.