Enabling collective action
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Shared results have supported collective action and impact
A results approach can support collective action in future
The Forum has led four Better Public Services Result Areas:
- Reducing long-term welfare dependency
- Increasing participation in early childhood education
- Increasing infant immunisation rates and reducing the incidence of rheumatic fever
- Reducing the number of assaults on children.
A focus on a small set of shared results has supported the social sector to be clear about our shared objectives and transparent in measuring and reporting achievements. It has also supported agencies to work in new ways and join up across agency boundaries, including by using data more effectively to target interventions or inform choices.
The Forum’s experience with using shared results has been that they are an essential tool for collective action and we continue to support this as an approach.
It is important that results are not changed too frequently and are given time to work. It takes time for a results focus to shift behaviours and the design and delivery of services and supports. There is still work to be done to embed our practices into business as usual and strengthen a whole-of-sector approach, rather than individual agency responses.
We should begin to consider how we refresh results and targets
The existing results and targets have supported the social sector to work collectively on issues of real importance. While the end date for the existing targets is 2017 (or the end of 2016 with respect to the target for early childhood participation), we should begin to consider future results and targets for the social sector. Work on new results and targets could start as early as 2015, or immediately in the case of the already announced policy on reducing working-age benefit numbers by 25% or 75,000 by June 2017. MSD is preparing advice for the Minister for Social Development on options to achieve this target.
There is a broad range of social sector problems worthy of investigation. Areas for focus could be selected on the basis that they support the social sector to work together and that they:
- concern a shared population, or place, or problem
- require collective action to address
- are a matter of sufficient importance
- are able to be measured
- are amenable to actions that can deliver on the results (we know enough about what works for these problems to introduce actions to improve them).
In addition, we should ensure the process engages front-line services and the wider community to achieve their buy-in and commitment. Our experience with the current approach is that this is essential if we are to realise the full potential of a results approach.
We would welcome the opportunity to discuss with you how shared results have supported our collective action and the potential for improvements, as well as how we refresh the results and potential new result areas that could be investigated.
Integrated approaches are critical when facing complex problems
Social services can find it difficult to engage people, especially those with complex needs. Vulnerable people can be ‘hard to reach’ or the available services can be unattractive to them. Once engaged, some people with complex needs require additional help to find effective support. There are also gaps in services and differences between communities in what is available.
There is variation across the social sector in the degree to which services are decentralised or devolved (child protection and welfare are mostly centralised, while schooling and health care are largely devolved to regions or communities with their own boards). The sector is also characterised by a high degree of outsourcing, with some delivery highly reliant on non-government organisations (NGOs), and by a limited ability for agencies to influence other decision-makers’ allocation or service decisions.
Integrated approaches are beneficial when agencies are working with common clients or addressing interconnected social issues. Done well, integrated models can improve the focus on clients and results, improve engagement with and access to services, and reduce unnecessary visiting and assessment. There is, however, more limited evidence of the impact of these approaches on longer-term outcomes and the transaction costs of co-ordination and integration can be high. Care is therefore needed when deciding which problems, populations or needs require an integrated approach and how best to achieve integration.
In addition, integration needs to be designed and delivered sustainably. Change needs to be led and success sometimes depends on particular agencies or workers.
There is more than one way to integrate – we are testing several models
Different models of integration have been introduced in New Zealand. Some are nationally focused, while others are aimed at specific communities, families/whānau or individuals. These models broadly cover:
Planning and decision-making
- Integrated or collaborative services planning and decision-making (eg, at a national level – Youth Crime Action Plan (YCAP), Prime Minister’s Youth Mental Health Project, Family Violence, and at a local level – Social Sector Trials, Children’s Action Plan Local Governance Groups, and the Hutt Valley Innovation Project).
Integrated case management and/or services for children, young people and families with more complex needs
- Integrated case management approaches with a single referral gateway (eg, Children’s Teams)
- Co-ordinated or integrated case management with multiple referral gateways (eg, Strengthening Families Case Management, Whānau Ora, and wraparound case management initiatives for youth)
- Integration that supports individuals to have greater choice over the services and supports they receive (eg, Enabling Good Lives Demonstration).
Co-located services to improve access and engagement
- Co-located community-based service hubs (eg, Early Years Hubs, youth service hubs developed in Social Sector Trials sites, Family Service Centres, Victory School in Nelson, and other school-based services).
Local leadership of decision-making has been introduced to enable services to reflect local conditions and encourage innovation
In some circumstances, decision-making in the social sector is located away from central government. The schooling and health sectors are the largest examples.
Locally-led decision-making processes have been introduced to address complex and interrelated social policy problems. Local stakeholders have a better understanding of local challenges, resources and opportunities and greater knowledge of what is likely to work for that community. Locally-based, flexible approaches also have the potential to encourage innovation.
In each model of integration, it is possible to place decision-making closer to, or further from, the front line. While local decision-making is an essential element of some integration models, community involvement in shaping services can also be achieved through other means, including consultation, engagement or collaboration with communities, providers and other local players (eg, local government). Strong local leadership and engagement are important success factors in any approach.
We need to continue testing current models of integration – while addressing issues such as ‘product clutter’
There is a strong case to continue integrated strategy and planning approaches for complex problems. As well as cross-agency action, we need to ensure sufficient local consultation and engagement and the potential to be more structured in our approach.
Integrated case management/wraparound services are intensive and high cost. They are suited to populations or problems where this approach is necessary and justified. Given this, they should be used selectively. Co-located services are useful in engaging children, young people and families in services and can be an entry point to more intensive help. There is also scope to think more about social service hubs in future infrastructure builds.
In some communities and for some populations there is overlap in integration models. The potential for clutter has increased as new models are introduced or the coverage of existing models has widened. For example, a higher-needs community could have a Social Sector Trial, Whānau Ora, a Youth Offending Team, a Youth Service, and Strengthening Families, as well as a range of co-located services. This adds to the complexity of governing and managing these initiatives both locally and nationally. Some local communities are beginning to address these challenges and take steps to reduce clutter.
Some models are in the early stages of implementation and testing and we do not have sufficient evidence to be definitive about which models work best. We are not yet in a position to address clutter at a national level. Over the next two years our evidence base will develop as evaluations of the more recent models, such as Children’s Teams, become available and work to improve measurement and data for the Social Sector Trials is completed. In the meantime, we could support communities to address any local clutter in ways that work best for that community.
Another key issue (perhaps most acute for wraparound case management) is the governance arrangements for these services, especially where there is local decision-making, as these arrangements are often clunky. There is an emerging case for developing a model for integration at a local level that could be used for existing and emerging local planning/services.
Work is also required to understand and develop the national level supports for effective local integration (eg, critical analytical capability at a national level that supports local integration and innovation, and governance and management mechanisms and structures that support joining up across the social sector).
We should proceed with care in further shifts of decision-making
While the community desire for more joined-up services can drive integration, integration is not necessarily about government shifting power to communities (‘devolution’). The community sector has also identified the importance of government empowering its regional and local social sector staff to lead integration locally.
There are also other issues to be worked through, including:
- how government achieves national policy objectives when decision rights are held in communities
- the scope of any decision rights over services, given a desire for consistency in objectives, access, quality, risk management, and, in some cases, delivery mechanism
- the impact on the efficiency of delivery of services
- the relationship of any community-led decision-making to that led by other bodies such as DHBs
- accountability for taxpayer funding.
Given these complex questions and ongoing testing of models of integration, we suggest continued caution on how quickly further decision-making moves to communities.
We will work with our partners in communities to deliver services to vulnerable New Zealanders
Many of the services that support vulnerable people in communities are delivered by the NGO sector. The introduction of integrated models in communities has raised questions for NGOs about their capacity to participate and meet service demands. Current initiatives to streamline contracting processes and reduce compliance costs, improve the effectiveness of purchased services, and invest in NGO capability go some way to addressing these concerns. However, we can expect continued pressure on NGO resources in a tight fiscal environment.
Initiatives to improve contracting processes can also give community partners more flexibility to innovate to meet the needs of their clients and communities more effectively. Discrete, siloed and tightly specified contracts do not always allow providers to work with others in new ways. Progress has been made on this issue, but it is an aspect of streamlining contracts that could be further strengthened.
Integration has potential to improve the effectiveness of services for vulnerable New Zealanders. We have a range of models under way and need to allow time for the evidence about their successes, or otherwise, to emerge. At that point decisions will need to be taken about the future of these models and how we integrate in ways that are both scalable and sustainable. We welcome the opportunity to discuss these issues with you further.
Integrated data and advanced analytics has significant potential
Data and analytics can support better social outcomes
There is considerable potential to improve services for people, including those with complex needs, through integration of data and the use of analytics1.
Creating integrated data sets focused on people, within agencies and across sectors, can give a better understanding of individuals and their families over time and as they move across services. The potential uses range from evaluating policy and programme impact (research), through to supporting frontline workers deliver better services to clients by providing them with an integrated view of people’s needs and the services they receive. Initiatives under way include Statistics New Zealand’s Integrated Data Infrastructure (IDI) for research and statistical purposes and the Vulnerable Kids Information System (ViKI).
The insights provided through advanced analytics can support better service targeting and funding decisions, stronger evidence, and better informed frontline services. All of these mean better services for New Zealanders. Current examples include the Welfare Investment Approach and the development of the predictive risk model to identify vulnerable children.
But there are significant challenges to work through
People’s lives do not match our data structures. Much of the current activity is ad hoc, particularly where agencies are trying to integrate data to support service delivery. Agencies will continue to work on initiatives specific to them, while we also work as a sector to bring our services together around the most vulnerable. Alongside this, we need to build stakeholder and community understanding of the potential uses of data and analytics.
Making better use of data and analytics across the social sector will require sustained effort to:
- understand and address the current privacy and permissions environment (including learning about how we best use Approved Information Sharing Agreements – AISAs)
- ensure we have the necessary infrastructure
- meet challenges of data quality and records linking
- build the necessary capability and expertise across the social sector.
We do not underestimate these challenges and recognise they are magnified when working together. However, the potential benefits to those using our services make it worth investing the time to understand and overcome these challenges and to develop proposals in this area.
We would welcome the opportunity to discuss the benefits that data and analytics offer for improving services, particularly for vulnerable people with complex needs, as well as how we can meet these challenges to make advances in data integration and analytics.
Our budget and funding processes could better support collective action
Our work to deliver on our priorities and make progress on shared results, social sector integration, and data integration and analytics illustrates the importance of aligning incentives to work together to deliver results. Increasingly, we are looking at budget, prioritisation, and funding approaches that support collective decision-making and funding of joint social sector action. Our current approaches support effective decision-making and trade-offs within agencies, but are less well suited to situations where agencies are trying to work across traditional agency boundaries on common problems, clients or populations (for example, when trying to work on shared results).
Processes that support us to take a social sector approach to prioritisation and investment decisions, rather than an agency or portfolio-by-portfolio approach, support us to work together more effectively as a sector. This is an emerging area and we would welcome the opportunity to explore new approaches to prioritising collective investment.
