While 3D printing is becoming more widely used in general engineering the use of 3D printing in the medical and allied sectors such as dentistry has only just begun.
Digital must be the enabler, not the driver, of reform. Eddie Copeland, director of Government Innovation at Nesta, explains why real innovation starts with people
For the best part of the last decade, ‘digital’ has been the watchword of local government reform. Councils have embraced the idea that online technologies can provide services that are cheaper to deliver and easier for citizens to use.
Many councils have started by improving the way they publish information, making their websites easier to navigate and use on different devices. Next, they have focused on improving or creating new ways to access services online, from reporting missing bin collections to paying council tax. Much of this work is aimed at channel shift: encouraging people to engage online rather than by mail or in-person visits, which are more expensive. Progress has been good. According to the Better Connected survey by Socitm, 54 per cent of all 416 council websites now provide a ‘good’ or ‘very good’ service in 2016-17.
This is welcome news. But there is a risk that such digital change is more cosmetic than transformative. Having well-designed websites is all well and good. However, they will change little if they are just a new digital front face for the same old processes behind the scenes. Indeed, rather than lowering costs, channel shift can perversely increase costs in some service areas by making it easier for citizens to report problems in the first place.
Furthermore, in their drive to make more ‘user-centric’ services, some organisations miss the fact that their own staff are also users. While creating a modern digital experience for their residents, too many councils still expect their staff to work with antiquated technology or paper records.
Smart councils are therefore adopting cloud-based tools that not only integrate with their websites, but also enable smarter back-end processes. Such tools can enable staff to access the information they need wherever they are, whether in the office or out on frontline duties. This is good for breaking down silos, and can also reduce costs compared with running and supporting software and hardware in-house. For many councils, this is as far as digital transform goes. That is unfortunate, as it misses the biggest challenge and the biggest opportunity.
The £5.8 billion question
First, the challenge. Councils today are facing unprecedented pressure to deliver more and better with less. Thanks to growing and ageing populations, demand for many services has soared. At the same time, budgets have been dramatically cut, with the local government sector experiencing a 40 per cent reduction in its central government grant since 2010. According to the Local Government Association’s Future Funding Outlook, local authorities in England alone face a £5.8 billion shortfall by 2020.
If digital is to speak to this challenge, it is not enough merely to increase the efficiency of transactional services. Councils must urgently address expensive and complex service areas such as social care, which are not about optimising the flow of information, but are based on human interactions supporting complex needs. In these service areas, while we have seen exponential improvements in the technologies available, there has been little innovation in the structures and processes they are applied to.
Before they consider what role digital will play, service managers should therefore first answer the question: ‘How do we want to work?’. Might there be a fundamentally better way of addressing a given social need rather than merely optimising the existing way of doing things? At Nesta, we believe the answer is ‘yes’. And the big opportunity starts with people, not technology.
Where do good ideas come from?
Innovation starts with good ideas. The people who best understand the problems to be addressed and the opportunities to do things differently are often those working at the coalface of their particular field. In the case of local government, this will be council staff and especially frontline workers. The difficulty is that these people often lack the time, resources and permission to try new approaches, or even to show they have a good idea in the first place. Local authorities wishing to innovate should therefore seek to tap into the knowledge and ideas of these in-house experts.
This is part of the rationale for Nesta’s collaboration with the Welsh government on a programme called Innovate to Save (I2S). I2S is a £5.8 million initiative that provides grant funding and non-financial support for public and third sector staff who wish to propose and test new ideas that can improve services and deliver cashable savings in their area of work. Ideas that prove successful in practice are then issued with more significant funding and support to scale up in the form of a loan.
In its first round, more than 120 public and third sector employees took part, and 50 ideas were put forward, highlighting the willingness of public sector staff to offer ideas if only they are given the means to do so. The programme also recognises an important truth: councils cannot expect to determine what will succeed a priori. They need to run experiments in the real world. They should enable those closest to the problem to trial those new ways of working for themselves.
Councils should also ask whether they can use technology to involve people in different ways, including those outside local government. In a search for inspiration for alternative operating models for public services, they could do worse than observe the characteristics of some of the leading and most disruptive digital companies.
The defining feature of the internet era is the platform business model. Companies using platform models have been ripping up the rule book in areas as diverse as how we connect and communicate (Facebook, Twitter, LinkedIn), shop (Amazon, eBay); and how we exchange our time and skills (TaskRabbit, Uber), money (Crowdfunder, Seedrs), space (AirBnB) and assets (Peerby, Streetbank).
Though some platforms have been criticised for the terms under which they operate, they have other, separable, characteristics that are of direct relevance to public services. To name just a few: platforms represent the most efficient mechanisms ever conceived to unearth new, and then match supply and demand of people, time, assets, space, or money. They are highly scalable. They have low operating costs. These are precisely the features that many local authorities are seeking for their own operations.
It would be wrong to suggest that all problems could be solved if only we had ‘Uber for social care’. However, approached thoughtfully, the benefits of the platform model need not be confined to the private sector. That’s the thinking that underpins Nesta’s ShareLab Fund, which supports early stage organisations to develop and apply collaborative digital platforms to tackle real world challenges.
In our first round, launched in 2016, Nesta awarded grant funding and mentorship to eight UK-based organisations. Among these were Social Value Exchange, which brings together suppliers who need to create community benefits (due to the provisions of the Social Value Act) with community-based organisations who already are - but who lack resources. Meanwhile, TrustonTap connects older people and their families directly with carers, avoiding the need for traditional agencies. This allows customers to pay substantially less for their care, and also enables carers to earn substantially more than they would through agencies.
Many of these platforms will operate entirely outside of local government, but in a way that may relieve pressure on public services. However, platforms can also be run or commissioned by councils themselves, or plug directly into traditional public service models. The former idea is neatly demonstrated by Casserole Club, a peer-to-peer alternative to meals on wheels, created by FutureGov, specialists in designing public services for the digital age.
The latter is demonstrated by GoodSAM. When somebody calls the emergency services to report that an individual has had a cardiac arrest, as well as dispatching an ambulance, many ambulance trusts are now able to send out an alert to GoodSAM. The GoodSAM app alerts qualified first aiders in the vicinity of the victim, highlighting their location and that of the nearest defibrillator so they can hurry to the scene. When every second counts, those volunteers can make the difference between life and death. Indeed, they have already been proven to do so.
In both cases, the websites and apps are not just bolted on to the same old operating models. Instead, they use technology to augment the capacity of public services by tapping into volunteer networks.
Man and machine
All these examples speak to a broader point about how local authorities need to think about digital. Quite simply, councils need a much bigger vision for the role of people: shifting from a focus on creating user-centric services, to one that prioritises tapping into the best ideas of their own staff and redesigning the models in which people are engaged. Digital must be recognised for what it is: the enabler, not the driver, of reform. Real innovation starts with people.