UNLOCKING POTENTIAL AFTER LOCKDOWN

In response to Covid-19 people and places across the UK are reinventing public services to help people flourish, but we need a national strategy. Here’s how to create one.

RICH WILSON • 13 JULY 2020

‘Every morning I wake up saddened by the fact we haven’t done more to make the most of every talent in our land, reproaching myself that we did not do more in children’s social care, primary schooling and secondary schooling to provide opportunities and keep young people safe’, explained Michael Gove in his Ditchley Lecture given on 27 June 2020.

As we emerge from lockdown there is consensus that we must #buildbackbetter and in particular, we must focus our efforts on the people whom we have ‘forgotten’; people who Gove suggested ‘asked to be remembered’ at the 2016 referendum.

Politicians of all stripes have been seeking to tackle inequality for decades. Just days after the 1997 election, Tony Blair made a speech on the Aylesbury Estate in South London promising: ‘there will be no forgotten people in the Britain I want to build’. And yet in the intervening 23 years, inequality has changed very little.

How could this moment be different?

The science of supporting citizens to flourish

In his speech Gove argues that ‘at the heart of our programme must be a focus on what works — what actually helps our fellow citizens to flourish’. He is absolutely right. Since 2017 myself and colleagues have been seeking to understand better the science of how we can support ‘citizens to flourish’, we call this Good Help. Good Help supports people to take control of their lives. It generates hope, agency and action. It’s based on a suite of established social science theories and techniques such as transactional analysis, self-efficacy, social learning theory and motivational theory as well as newer models such as Michie’s COM-B, persuasive technologies and digital social network theory.

Perhaps what’s most interesting about these models is that they reflect decades of grassroots best practice on how to help people take control of their lives. Practices such as health and rehabilitation coaching are now known to have the same strong evidence base as the Good Help sciences. Practice and theory have often emerged independently — but have now combined into a powerful discipline for helping people to flourish.

Of these Good Help techniques, self-efficacy is particularly important. Self-efficacy is our belief that we can do one thing or another. This could be find a job, get fit, help a neighbour, manage the park or simply cook a meal at home. Self-efficacy is a very well established metric with good data sets across all public services from schools to addiction support. And it’s the best proxy we have for whether people are flourishing or not.

Unfortunately, it’s rarely applied to mainstream public services in the UK.

Public services as engines of self-efficacy

Perhaps the primary way that government can directly address inequalities is through public services: our schools, hospitals, care homes, Job Centres etc. Unfortunately, our research suggests that much of what is delivered by public services inadvertently erodes self-efficacy, and thereby exacerbates inequalities. The cycle of action below helps us understand why this happens:

The Cycle of Action explains how our life circumstances generate our beliefs which in turn generate the actions we take. The cycle can be positive or negative. People in the positive cycle are able to take ever more control of their lives, becoming more ambitious, achieving goals — such as better work or managing mental health — and often dramatically improving their wellbeing. The negative cycle does the opposite, trapping people into difficult life circumstances and shoring up inequality, often over generations.

The cycle of action is the foundational model underpinning Good Help that helps us redesign public services to efficiently and effectively address inequalities. Over the past two years we’ve seen people and places across the UK using it to dramatic effect. One good example of this is Rochdale. The photo below shows how they are using the cycle of action to provide a coherent strategy targeted at helping people thrive.

They are not alone. York, Sheffield, North Yorkshire and others have also been developing similar strategies that have come into their own during Covid-19 response. Helen Chicot, Place Lead at Rochdale Council, explains:

‘We started developing our Good Help strategy in 2019, which meant we were much better placed to work with communities in an enabling way when lockdown hit. It’s also provided us with a shared framework for shaping the mass service redesign process we are now in. We know we’re all working towards helping people flourish and have an evidence base to draw upon.’

There is also a network of Good Help practitioners providing practical models of how to repurpose services so that they generate self-efficacy: Transform Lives in Liverpool who support people find better work; OTR in Bristol supporting people to manage mental health, Grapevine in Coventry who fuse community development and social care to create communities where people can help one another flourish, and of course many others.

Clare Wightman, CEO of Grapevine explains: ‘Good Help has helped us explain to commissioners how what we do has a strong evidence-base, and really the key ingredient for helping people lead more self-determined and fulfilling lives. The trouble is it’s still hard for us to get commissioned to do what we do best. Most commissioners don’t understand that and prefer to stick with more familiar models.’

This gets to the heart of the issue. For each of our key public services — schools, Job Centres, social care and prisons — there are providers showing us how we can explicitly target human flourishing. They have been doing it for years. Sadly, despite the weight of evidence and examples of proven practice, these approaches remain on the margins, which means millions of people are also left on the margins; ‘forgotten’ by our inability to re-purpose public services.

The costs of bad help

The homelessness charity Groundswell found their support generated a saving of £2.43 for every £1 spent. Community Catalysts reports an annual saving of £525,619 for Somerset Council in 2017. LankellyChase calculated that individuals with multiple and complex needs, such as being homeless or having problematic substance or alcohol misuse, incur an average £250,000 of service use costs, with some individuals incurring almost £1 million over their lifetime. The fact that such provision is the exception, rather than standard practice, suggests that the failure to mainstream Good Help appears to be costing vast sums the nation can ill afford to waste at this time.

What generates the savings is ensuring support is targeted at generating motivation, not dependence. For example, both Mayday Trust and Liverpool Waves of Hope have shown how to help people become much less likely to reoffend or re-start substance abuse. The projects have succeeded because they have made the interventions at all points in the cycle of action — life circumstances, beliefs and actions. By contrast, much mainstream support overlooks how our friends and family drive our behaviour, for example how peer pressure can cause people to reoffend or maintain unhealthy lifestyles. Both Mayday and Waves of Hope harness peer influence to create positive supportive structures which make flourishing more likely.

Covid-19 making us all Good Help experts

Without realising it, many of us have been on a period of accelerated learning in Good Help throughout 2020: helping our neighbours who are shielding by supporting them in whatever ways we can, building the confidence of friends and family scared of the virus or suffering from loneliness.

The only way we have been able to meet the challenge of Covid-19 is by taking action to stay safe and help those around us. This is easy to say but as we all now know, it often involves highly sensitive support where we attune to those around us who may be having a very different lockdown to us.

At the heart of this has been building people’s confidence, their self-efficacy in the face of the pandemic. This is Good Help.

But it goes wider than health. As we move out of lockdown with a likely rise in unemployment, homelessness and other societal challenges, we are going to need to ensure we do all we can to mainstream the good practice that can ensure a generation is not lost.

A national strategy for public services unlocking potential

Over the past 18 months we have spoken to hundreds of experts, practitioners and community members about how public services can become a driving force for unlocking potential. Based on this we think a national strategy for public services unlocking potential should consist of these five actions:

Commissioning Good Help: current commissioning arrangements for public services tend to preference bad help and block Good Help. This needs to be reversed. This would enable us to quickly channel resources to the existing Good Help practitioners across the country. Not only would this offer better value and service quality than mainstream alternatives, but far more money would remain in the communities as these providers tend to be community-based.

Public service experiments: working in schools, Job Centres, social care, colleges and prisons we would prototype models for delivering Good Help which can be evaluated using a mix of conventional performance measures and innovative approaches (such as measures that track self-efficacy), with successful practice scaled and spread. We have already commissioned plans for how to start mainstreaming Good Help in schools, Job Centres and prisons and could build upon this.

Local authority strategies: 25 local authorities have already put themselves forward to develop Good Help strategies. This is not a conventional service redesign programme but involves building local movements that align statutory, community sector and citizen efforts explicitly with a view to improving service quality, while building people’s self-efficacy. They should be supported and used as models for other authorities.

Local and national movement support: there is already an emerging movement of Good Help practitioners across the country, inside and outside of public services. We have started to bring this group together, but it should now be supported to become a powerful force for service transformation locally and nationally.

Human centred service reform: previous attempts at national public service transformation have been top-down, technocratic, slow, expensive and only partly successful at best. Good Help offers a different route, starting with people and ideas rather than the more machine-like elements of systems change. There is real enthusiasm among statutory and community sector practitioners for this approach, which we can now translate into a potent but practical national strategy.

Gove finished his Ditchley Lecture by saying ‘I want to ensure that whatever their background, every child has the chance to succeed, and nothing we do should hold them back. It is on that basis I make my case and on which I am happy to be judged.’

We have already seen how in Rochdale, York and Sheffield Good Help has generated new partnerships between the statutory, voluntary and community sectors which are already creating innovations many thought impossible. If these ways of working became part of a national strategy there would be a real chance of ensuring that, this time, no one is forgotten.

 

Picture: Socially distanced football training, Minchinhampton Rangers Youth Football Club (4 July 2020)