Radical Redesign: URGENT

The news keeps on coming about continued pressure on local government finances.  In the article, “LGA warns councils could face ‘financial meltdown‘”, we see that the Local Government Association suggest an expected “black hole” of around 15% of the required budgets for 2015/16.

Sir Merrick Cockell, LGA Chair is quoted,

Over the past three years [councils] have worked tirelessly to deliver new efficiencies through measures such as sharing services, restructuring the workforce and reducing senior pay

All good I guess (some really excellent work has been done), but in light of the ongoing pressure, he goes on to say,

Ultimately the only way of maintaining public services in the face of proposed long-term cuts is a radical redesign of the way public services are provided and paid for

Service Design

Councils, in concert with other public service agencies in localities simply have to start to look at the challenges of the future in a different way.  This different way is simple and radical and therefore I think it’s unclear how it can emerge very easily from within current structures.

A design approach to problems seeks to really understand how people experience public services.  It does this through research, often including ethnographic work and certainly plenty of time spent with services users and the front line staff operating the service.  The radical part is that a service user’s experience will often cross departmental and even organisational boundaries, and this can feel like service user perspectives will only over-complicate matters!  But the truth is that when we look at things from the service user’s perspective, we see that it is us who have over-complicated things.  Hugely.  We can start to see how things can be radically simplified.  We can start to see how the service we think must surely work, just doesn’t very well.  It is really not the only way to do it.

I had a really interesting couple of pints with a friend who is a product designer last night.  He’s a very clever engineer (he’s building his own plane to give you a sense of it).  He has led several product innovation units in some big private firms and talked to me compellingly about user-centred product design.  In one example he talked about how his team invented a new kind of inhaler for orally dispensing medication.  They produced a prototype and sat behind mirrors watching people interact with the device.  They conducted detailed research on different types of patient – people who always followed the doctor’s instructions, people who never did, and so on.  They sought to understand how to tailor how they needed to support use of the device to suit these different types.  They realised that they should avoid calling it an inhaler, because people know how to use a traditional inhaler and would bring those assumptions and ‘suck then click’ on the new device, even though they were clearly told this new device required ‘click then suck’.  They also looked at how they might encourage people to stick to their medication routines and monitor this.  They had a stick on chest patch (electronic gizmo) that would register a swallowed pill as it passed by.  Problem was, user testing showed that patients weren’t at all good with keeping the patch in place.  Idea binned early and with minimum cost and no reputational damage.

Too often public services have just piled in and implemented their own “chest patch” services, which makes sense to them and appear to be “obviously” helpful.  But what they don’t see is that services often don’t fit at all well with the way people *are* or *are becoming*.  Rather than services being living, changing things based on continuous iteration, guided by service user feedback, they are implemented fully formed – you might say “imposed” – and are run until there’s no money left to fund them any more.  Generally they are not de-commissioned because there is not enough work done to develop alternatives.  Of course there are many examples of great services that are responsive and adaptable – but you get my basic drift.  They are very often not like that, right?

Some of my tweets will make me look like I’m a technology nut.  I pretty much am!  I do think most re-design thinking is going to be powered by the possibilities of new technology.  I even bang on about “cloud computing” in a seemingly abstract, IT guy kind of way.  But actually what drives my thinking and interests me most is how we develop user-centred services and tools.  How we negotiate around existing assumptions and structures.  How we push for radical simplification.  How we come to accept that service delivery will probably be highly distributed (lots of different types of provision and co-production) but strongly networked, with the users at centre stage.

This is not something that will just happen.  We all need to learn about service design, think about ways to start making it happen.

Find a problem, start small.  Get a mixed group of people in the room.  Generate ideas.  Get out and speak to some service users.  Build a prototype, test it, change it.  Don’t wait for it to be fully formed, get it out there.  Start designing the future.


2 thoughts on “Radical Redesign: URGENT

  1. Great article, and I love the emphasis on putting service users at the centre. It just makes sense! This enhanced participation or coproduction as it seems to being rebranded these days, is really essential if services are to stop second guessing what people really need and start designing services that are better at meeting needs. Have you read the Nesta / innovation unit stuff on Radical Efficiency? It provides a more detailed model, with some inspiring examples, such as ‘patient hotels’. Definitely worth a look.

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