House of Commons Public Administration Select

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House of Commons

Public Administration Select Committee Public services: putting people first

Written Evidence

This is a volume of submissions , relevant to the inquiry Putting People First, which have been reported to the House but not yet approved for publication in final form. Any public use of, or reference to, the contents should make clear that it is not yet an approved final record of the written evidence received by the Committee.

List of written evidence

Page

1The Audit Commission Ev 3 2Tetlow Associates Ev 14 3The Work Foundation and Research Republic Ev 23 4Time Banks UK Ev 33 5Northgate Information Solutions Ev 36 6Diabetes UK Ev 45 7Worcestershire Hub Customer Services Managers Ev 51 8Picker Institute Ev 54 9Healthcare Commission Ev 67 10Southwark Patients Forum for Primary Care Ev 86 11CBI Ev 93 12Metropolitan Police Authority Ev 98 13Sophia Parker Ev 109 14Parliamentary and Health Service Ombudsman Ev 122 15Trevor Gash Ev 130 16General Teaching Council Ev 132 17Peter Bebb Ev 142 18Communities and Local Government Ev 144 19NHS Confederation Ev 157 20Professor Andrew Gray Ev 166 21New Economics Foundation Ev 172 22TaxAid Ev 197 23Breakthrough Breast Cancer Ev 203 24British Medical Association Patient Liaison Group Ev 208

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Memorandum by the Audit Commission

1The Audit Commission welcomes the focus of the Committee on user voice and citizen engagement with public services and is pleased to submit evidence to this inquiry.

2International comparisons and learning from other sectors are and should be a vital part of public service design and delivery. Much can be learned from the experience of other countries and other sectors. Policy ideas and practices can, however, be

difficult to translate between different settings.

3Where minimum standards for public services are set, they would need to be universal and ensure equitable access. However, the Commission would recommend that minimum standards should be used sparingly. While standards should be

nationally consistent for issues such as education and health and safety, for most local services it is important to take account of local complexities and differences. We must accept that some areas will take longer to meet the standards required due to local circumstances or their historical starting points. There are cost implications that should be recognised but may be difficult to assess.

4Measures of customer satisfaction have an important role in assessing the standards of public services. However, surveys are only one source of information and cannot provide the whole picture. Views of users, particularly those who are vulnerable, should be monitored and acted upon at a local level by public service agencies.

Independent statutory agencies such as the Commission have a role to examine

whether local public bodies take steps to know their communities and view services from the perspective of those who use them.

5Users and citizens should be directly involved in service delivery. There is a fundamental distinction to be drawn between individual and group involvement in service delivery. There is evidence from across the public sector that user involvement has led to improvement in public services while empowering citizens. There is good practice across the public sector in this area but progress is still patchy.

6Local authorities can only be truly effective if they know their communities, and are willing and equipped to engage with them and respond to their needs in a meaningful way. Effective consultation, as part of wider citizen engagement and outreach

activities, is therefore vital to help improve decision-making and service quality for diverse communities.

7There are examples where good, timely consultation has led to improved services and outcomes. But there are also examples where authorities have failed to consult with sections of their communities, have failed to provide feedback and have failed to translate consultation into action.

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Detailed response

Introduction

8The Commission's submission to this inquiry is based on our knowledge and expertise in understanding user voice and citizen engagement. One of the

Commission's five strategic objectives is focused on encouraging 'continual

improvement in public services so they meet the changing needs of diverse

communities and provide fair access for all.' Our current comprehensive performance assessment (CPA) and corporate assessments of local councils assess whether

councils understand and meet the needs of their diverse communities. We have also managed the 2006 Best Value Performance user1 satisfaction surveys of council

residents and service users, which is a statutory requirement for English local

authorities. These surveys, undertaken on a triennial basis, explore residents' views of services in addition to priorities and quality of life issues. Our housing inspectorate employs tenants as inspection advisers to support the inspection process.

9We have developed a range of tools for local public bodies that focus on improving services for users. This includes Knowing Your Communities toolkit2 that contains notable practice and was developed in conjunction with a range of external

stakeholders including the Commission for Racial Equality (CRE). Our work on Area Profiles provides a wide ranging picture of the quality of life and public services in a local area.

10On public consultations, our comments are based on information from our and others' guidance and research on good consultation practice and from our

comprehensive performance assessment (CPA) of all single tier, county and district councils in England. Building on this, case studies, covering user focus and diversity issues, are published as part of Learning from CPA web tool3. We also carry out

inspection of local authorities under best value legislation, principally the Local

Government Act 1999, which requires local authorities to consult when conducting best value reviews.

11Similarly, in our audit work, our Code of Audit Practice is focused on ensuring that 'services meet the needs of users and taxpayers'. Appointed auditors are required by the Code to report their conclusions on an audited body's arrangements for securing economy, efficiency and effectiveness in its use of resources.

1This forms part of the Best Value Performance Indicators are a national measure of performance, set by central government. For further information on BVPIs, 7d4d193131126edb6f1a104d.

2Further information is available from 7d4d193131126edb6f1a104d/KycHome.aspx. 3Further information is available from 7d4d193131126edb6f1a104d/cpa/stcc/lfcpa/index.asp.

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12We have published a number of national studies that contain evidence of authorities and others' understanding of user focus. All these national studies are available at our website 7d4d193131126edb6f1a104d and include:

?Listen up! effective community consultation - 1999

?Connecting with Users and Citizens - January 2003

?Journey to Race Equality - January 2004

?Choice in public services - Sep 2004

?Housing: im proving services through resident involvemen t - June 2004

?Choosing well: Analysing the costs and benefits of choice in local public services - May 2006

?Learning from CPA in 2005/06 - August 2006

?Innovation in local government - Forthcoming, early 2007

13Evidence in this response draws on the research in all these studies and from our audit and inspection work with local authorities, NHS bodies, police authorities and housing associations in England. The Committee's specific questions are addressed in our response below.

Questions

1) Can public services learn from the way that either non-public sector organisations or overseas governments make use of user experience in service delivery and design?

14Bodies delivering public services, like those in other sectors, should establish themselves as learning organisations, looking to international comparisons and other sectors to improve their activities and outputs. This should include learning from others' engagement with users to improve service design and delivery.

15The Commission has already done much work to help public bodies benchmark their processes and services against others. Our publication World Class Financial

Management provides private sector and international good practice in financial

management from which local public bodies could learn. In addition, we use

international comparisons in our national studies programme on issues as diverse as waste management and recycling, policing and performance management.

16The public sector can learn from the private sector on issues such as choice, which can empower users. Choice can be an effective driver of quality and value for money when consumers can choose from a number of competing suppliers or from different options about service delivery. It is important to understand the circumstances in

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which choice can operate as a force for improvement in public services, while also guarding against expanding choice into areas where it would undermine wider

objectives, such as community benefit, social justice or value for money. A key

difference exists between the private and the public sector. In the private sector, the relationship between paying and using a service is closely aligned. This is not

necessarily so in the public sector where increased consumption can lead to financial deficit and higher taxes rather than to shareholder profit.

17Choice in public services can only truly be available to individuals or groups where they have the ability to make decisions. Without that decision-making power,

individuals and groups can only make their voice heard, in effect lobbying other

decision-makers.

18Policy ideas and practices can, however, be difficult to transfer between settings.

Significant cultural differences between nations, language barriers, different political and institutional designs, and distinct regulatory environments make international comparisons and policy transfer complex. Findings, therefore, should be viewed in context. Our recent research on innovation in local government, which we anticipate publishing in March 2007, sets out how important it is for organisations to learn from others and to adapt good practice to suit their own circumstances.

2) Is it possible to set minimum standards for public services? If so, how is this best done?

19Where national minimum standards for public services are set, they should in principle be universal and ensure equitable access, taking full account of the needs of citizens and service users. However, while it is possible to set minimum standards, we would recommend that minimum standards are used sparingly.

20While there are some areas where standards for public services should be nationally consistent, for example in education, local complexities and differences mean that minimum standards could and should be different for many services. In most cases standards relating to local services and priorities, such as access to green spaces,

should be set locally and rely on service providers agreeing what standards should be in practice, in consultation with citizens and users.

21Some areas will take longer and require more resources to meet standards due to local circumstances or their historical starting point. For example, public agencies

operating in deprived communities may require more time and resources to achieve minimum national standards, compared with less deprived areas. Where local factors, such as deprivation, impact on the delivery of national priorities, these should be

reflected in any locally-agreed improvement targets set against the relevant

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indicators. A balance needs to be achieved at a local level between national minimum standards and local improvement targets.

22Standards in public services can in many cases be regulated and enforced voluntarily by the providers themselves. The public also has a part to play. Effective complaints and redress systems could lead to local self-regulation without the need for heavy

external intervention.

23As an independent regulator, the Commission has experience in measuring and assessing the delivery of national outcomes at the local area level against agreed

criteria. Our role as a regulator provides an independent assurance framework to ensure that standards are met. These include the following:

?measuring performance to provide the baseline against which improvement can be assessed, and to verify any improvement against the baseline;

?challenging services to improve, through audit and inspection locally and through national reports to draw attention to issues of wider concern;

?supporting choice by helping service users and taxpayers to provide their own challenge and exercise choice where it is available;

?sharing knowledge by working with others to spread good practice, both within and across sectors; and

?supporting public service managers through seminars, workshops, and self-assessment tools.

3) What role do measures of customer satisfaction have in assessing the standards of public services? How should user views be monitored? How can the cost-effectiveness of user surveys and feedback mechanisms be assessed?

24Measures of customer satisfaction have an important role in assessing the standards of public services, although these should be complemented by a wider range of

assessments of the services, such as through audit and inspection.

25Views of users, particularly those who are vulnerable, should be monitored and acted upon at a local level by public service agencies. This should be a continuous process and not only part of an annual survey. The Commission's current inspection

framework, whilst not prescriptive about how public bodies should monitor the views of users, seeks evidence of an effective system. We have strengthened our corporate assessments under CPA – the harder test by considering the quality and robustness of councils’ own customer surveys, citizens’ panels and other consultation methods. We examine whether local public bodies take steps to know their communities and view services from the perspective of those who use them. We also monitor the impact of

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local public bodies' decisions and assess whether they are responsive to citizen

engagement and participation.

26The Commission collects data from Best Value Performance Indicators (BVPIs), including user survey of council residents and service users, as part of our inspection process. Data from the surveys provide knowledge about citizens’ and service users’ experience, perceptions and expectations of a range of council services and of the council as an organisation. The latest BVPI user survey is currently underway and the Department of Communities and Local Government (CLG) will be publishing the results early in 2007.

27Surveys of this kind are only one source of information that can be used to capture people's experience and perception of their local services. They can also help inform citizens and users about the services being delivered and their performance, and they can provide information to facilitate engagement and information on levels of

satisfaction with local services. However, they should not be used on their own to provide the whole picture of local servic es.

28There are limitations to customer satisfaction surveys that should be taken into account. Surveys do not necessarily capture the whole spectrum of opinions. For

example, surveys may become unrepresentative if they fail to capture the views of hard-to-reach groups and non-users of services.Some service users who are surveyed may fundamentally disagree with policy decisions for example, they may not be

entitled to free access, and would therefore not be unbiased in their opinion about the quality of the service.

4) What constitutes best practice in responding to complaints about public services?

29Our knowledge in this area is based on local inspection reports that specifically deal with how local public bodies handle complaints. The Commission's key lines of

enquiry4 (KLOEs) seek evidence of a ‘well-publicised, user-friendly and supportive system for service users to submit compliments, complaints, grievances,

representations and suggestions; its response to these is positive and timely and the results are used to help improve services.’ We describe what the ideal service should look like and we seek evidence of this in our work but we are not prescriptive about the complaints process. Effective complaints and redress systems are key elements of

a transparent and accountable service. The process should at least have the following

guiding principles:

4 KLOEs are detailed questions that help to inform our inspection judgements in all of our inspections,

including our corporate assessments of local authorities and in housing, and our cross-cutting

inspections on regeneration and community safety.

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?an embedded culture of learning from complaints;

?clear aims and objectives that are guided by a complaints strategy;

?integrated and effective systems to monitor complaints;

? a monitoring system to identify whether the complaints service meets the needs of diverse communities;

? a system to identifies the wider costs of handling complaints across the public body; and

?regular reporting to managers, users of services and those who are part of the governance framework, including councillors and the board of governors.

6) Should users be more directly involved in service delivery? If so, how can this be achieved?

30It is of vital importance that users should be directly involved in service delivery. . For example, the best outcomes in increasing educational attainment can be derived from

a combination of support from parents and carers, the local community as well as

from teachers. The same principal of co-production5 can apply to managing chronic conditions or improving community safety. We should make a distinction between co-production of services by individual users and engagement in decision-making by local communities or groups such as through participatory budg eting.

31Government and policy-makers have acknowledged that direct involvement can lead to improvement in public services whilst empowering citizens. There are examples of good practice across the public sector. In housing, the joint Audit Commission and Housing Corporation national report Improving Services Through Resident

Involvement examined the benefits of more direct involvement. Housing associations found that involving residents in refurbishing an estate helped to reduce empty

properties, tenancy turnover and improved local community involvement. The last of these can have a wider-reaching impact in terms of stabilising communities and

helping to ensure their sustainability.

32Elsewhere participatory budgeting has given people a say in how their council's budget is spent in the local area. A number of pilots have been undertaken across England including in Salford, Bradford and Newcastle that are co-ordinated by the Community Pride Initiative (CPI) with support from CLG and the Neighbourhood

5The concept has been used, particularly in the USA but also in the UK, to mean direct user involvement in public services. The extent and nature of this involvement varies between programmes and

countries.

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Renewal Unit (NRU), as well as the more ambitious Open Budget project in Harrow, which is coordinated by the Power Enquiry.

33There is evidence that direct involvement in service delivery and design can also be cost-effective. The Wanless Report estimates that investment in public health and public engagement can save the NHS ￡30 billion per year by 2022, which is around half of the current budget of the NHS.

34However, direct involvement is not widespread and the evidence from our corporate assessments of local authorities found that consultation is often better developed than participation and involvement. The current position needs to be improved in order to meet the aspirations of the Local Government White Paper, which proposes an

enhanced Best Value duty to ‘inform, consult, involve and devolve’ that will require local services to secure the participation of citizens in the delivery of local services.

The White Paper also sets out a clear role for the Commission, as part of its future annual risk assessment and in inspections, to consider evidence such as citizen

perspectives, including those of the most vulnerable, as well as a local authority’s

compliance with the new duty. The Commission’s consideration of a local authority’s compliance with the new duty may examine whether opportunities to participate are available and will enable bottom-up pressure to improve services.

35Regulators also have a role in ensuring that there is probity and good governance in local services. Public participation increases risks; for example, the transfer of assets to communities may lead to inappropriate use or wasteful use of public resources, and adequate safeguards should be built in.

7) Are there certain types of decision which are more suited to consultation than others?

8)Do official consultations typically manage to capture the views of the right people? What kinds of consultation are most effective in engaging with the appropriate people?

36Consulting with the public and service users is a statutory duty for many local public services. For local authorities, these include broad duties in the Local Government Act 2000. Housing associations, police authorities and Primary Care Trusts have a statutory duty to consult with citizens and service users. It is also an important aspect of community engagement.

37The Commission has published reviews of how well local authorities consult. A management paper in 1999, Listen up! Effective community consultation, gave

guidance when Best Value was introduced, including the obligation to consult when reviewing services. In 2003, we published Connecting with Users and Citizens that

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provided an update on the issue and outlined case studies of good practice on

consultation.

38The research underpinning Listen up! found a mixed picture:

?local authorities did not use consultation appropriately;

?consultation was of inconsistent quality; and

?it was not always evaluated effectively.

39Listen up! also found evidence of good practice that demonstrated:

?strong links between consultation and decision-making;

? a strategic approach to consultation;

?that high standards were applied;

?that all sections of the community were involved; and

?feedback was provided.

40Our 2003 study provides case studies to illustrate good practice in engaging and consulting with users. There were issues identified including: lack of responsibility and meaningful involvement; poor feedback on outcomes of the consultation; and reluctance to hand over control and ownership of the consultation process.

41More recently, our corporate assessments in 2005-06 found that good progress has been made by local authorities in consulting with the public when setting its

ambitions for their local areas. Councils seek citizens’ views through a wide range of consultation processes, such as citizens’ panels and targeted consultation with specific groups. We found that better performing local authorities have well co-ordinated

approaches to consultation and share information with partners. While all councils have ways of consulting with representative groups, all face difficulties engaging with specific minority groups. Many also fail to report the results of consultations to young people.

42The drivers and audiences for consultation will vary, as well as the methods. Local authorities and other public bodies will prope rly take a different approach when

consulting users about a directly-provided service compared with a service delivered in partnership with or wholly by another organisation.

43Evidence from our studies and corporate assessments of local authorities found that some consultation techniques may not be suitable for tackling issues where strong feelings already exist in potential consultees’ minds. Holding a public meeting about the siting of a bail hostel or a travellers' site may be essential to give local people a chance to let off steam, and to convince them that those making the proposal are

willing to hear people’s concerns. Local people have a right to be informed, but there is also a responsibility for national and local decision-makers to meet the needs of the

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population at large, and for the needs of vulnerable and minority groups to be

balanced against others'. Some consultation mechanisms, such as neighbourhood forums or public meetings, are much more likely to be dominated by an

unrepresentative minority than others. While these do have a valuable role to play, their results need to be used with care and effort made to ensure that these

consultations are inclusive.

44We have identified a number of principles to ensure effective consultation, including:?commitment and culture: prioritising users must be part of organisational culture. There needs to be commitment beyond the statutory duty of local public

services to consult with service users, and this should be made pivotal to service

design and delivery;

?support and structure: leadership and collaboration between organisations is important, as is the need for a strategic approach to long and short-term

consultation;

?access to information: in order to ensure meaningful responses, consultees must be provided with relevant and accurate information;

?engaging with all users: it is important to distinguish between service users and citizens who do not, or cannot, use the service. Good practice would take both of

these into account. For example, new technology can reach wider and more

diverse audiences. Local public services need to be wary of treating consultation

with representatives and stakeholders as being the same as consultation directly

with users;

?handing over control: service users should be involved in consultation design;

?learning from experience: previous good practice and regular evaluation should be built in. We have developed Knowing Your Communities toolkit to help local

public services assess their progress on consultation and citizen engagement; and ?real results: consultation needs to be timely in order to influence decision-making, and the results need to be visible and communicated well to those taking part.

45The Local Government White Paper sets out measures for informing, consulting, involving and empowering local communities, devolving responsibility, extending choice and giving local people a say in running of services. While this has yet to come into force, it is imperative that all public bodies have an effective consultation process that takes into account the needs of its diverse communities.

12) Are there situations where the views and experiences of service users are irrelevant?

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46Views and the experience of service users should always be taken into consideration in the design and delivery of public services. However, this is not the same as

suggesting that these views should be the only relevant factor when making decisions about public services. There are instances where the views of service users should not be directly acted upon. For example, consultations can produce results that do not represent the views of local people as a whole or lead to suggestions that are not

financially sustainable or which conflict with statutory obligations. In some cases, the scale of an issue and the potential impact of the findings may require resources that are disproportionate or do not provide value for money. Each case should therefore be carefully considered.

47There is always a risk that articulate, well-educated people will be better able to use consultation mechanisms than other sections of the community. Often the voices that particularly need to be heard are those most likely to be unrepresented. For example, depending on the objectives of the consultation, particular efforts may be necessary to access the views of groups such as rural populations, disabled people and Black and Minority Ethnic (BME) communities.

48Problems arise when local public bodies use consultation mechanisms that allow a minority of people to dominate the process, do not take steps to ensure that a wide range of people participate, or use unrepresentative samples. The questions asked or the methods employed to consult can also have an impact on responses and findings.

It is therefore essential to ensure that consultation is objective and open to a wide range of responses and opinions.

January 2007

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Memorandum by Tetlow Associates

This memorandum represents the response of Tetlow Associates to the issues raised in the Issues and Questions Paper: ‘Public Services: putting p eople first?’

It follows a research project we have undertaken recently on behalf of the Local Government Association and National Consumer Council on Developing Customer Satisfaction Measures for Local Government Services. A summary of this report is given as an appendix to this memorandum.

We provide responses below to your questions 1,2,3, 8 and 10.

Question 1: Can public services learn from the way that either non public sector organisations or overseas governments make use of user experience in service delivery and design?

A: learning from the private sector

This is not only possible but essential. The context in which people experience public services is framed by the offerings of all the organisations with which we interact including the private sector, and this influences our expectations. The fact that supermarkets are now open 24 hours a day, or that many services are available on-line inevitably frames expectations about the way the world can be experienced and puts pressure on public services to learn from such examples if they are to avoid a public perception that they are anachronistic and outdated.

The techniques used by the private sector have much to offer to public services. Specific techniques designed to enhance customer insight (e.g. segmentation, techniques for understanding the nature of the customer experience and the relative importance to the customer of aspects of products and services) have informed many of the developments of commercial products and services of recent years and have given leading companies significant competitive edge.

Some of these techniques are being applied to public services but they are hampered by the fact that there is no generally accepted standard and practice is diverse. Thus wisdom derived from research about the responses of some groups in society to one service is rarely used in the design of others. The use of basic sociodemographic categories in customer research on public services is widespread but sophisticated segmentation methodologies as an essential element in service design is not. Very few public service surveys seek to understand the reasons why people feel pleased or displeased with the service they receive. Most rely on answers to simple satisfaction questions which give a

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general impression but do not help pinpoint the precise nature of improvement customers might welcome.

In order to deepen understanding, many public services use qualitative techniques

including deliberative forums, focus groups, citizens’ juries and other methodologies which give people greater freedom to express their views in depth and discuss their

experience than is possible using quantitative surveys. Many of these techniques are based on private sector examples and are extremely useful. However, their use i s patchy and only a small population can be involved, so the use of surveys with greater rigour is also required.

A related key area where public services can learn from the private sector is in the use to which the data, once gathered, is put. Public service organisations are often not structured in a way which allows the information which is known about customer responses to change the way they work. The results of surveys often do not transparently inform crucial decision making processes and are not part of the essential management information which boards draw on in making strategic decisions. Examples of the ways private companies have changed processes to respond directly to customer preferences are common. This is less evident in public services.

B. Learning from other countries

International best practice has useful lessons. The best known example is that of Canada, where there are national standards for measuring the drivers of satisfaction with services and regular national surveys (‘Citizens First’). The key lessons for the UK from the Canadian example are:

?Rigorous focus on understanding the reasons for people’s satisfaction and dissatisfaction has produced an overall significant increase in satisfaction with

services.

?The use of rigorous, standardised methodologies for understanding customers across services has proved successful for a wide range of services at all

jurisdictional levels.

?Achieving good results has not been costly and many Canadian officials believe that money has been saved.

Further information about the Canadian example is available from the Institute of Citizen Centred Service. (7d4d193131126edb6f1a104d).

Other examples worth looking at include the US American Customer Satisfaction Index, itself the basis for the European Customer Satisfaction Index which has been used on a small scale in Scandinavia. These examples provide an interesting example of a

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standardised way of managing data about customers but the results in terms of driving change are less clear than is the case in Canada.

Question 2. Is it possible to set minimum standards for public services? If so, how is this best done?

There are risks in setting minimum standards, especially those related to customer satisfaction or which depend on perceptions. Satisfaction is influenced by many issues which may not be directly related to the quality of the service received. (there is evidence, for example, that satisfaction with services varies between sociodemographic groups). Thus achieving, say, a standard for customer satisfaction of 65% satisfied or very satisfied may be relatively easy to achieve in one area but very challenging in another, and the difference may be explained largely by differences in the populations of the two areas.

More effective are minimum standards for improving people’s experience based on previous survey evidence. This approach was taken in Canada – each service was set a target of a 5% improvement in satisfaction over a 5 year period, and this was achieved by 2005.

Setting minimum standards for performance other than customer satisfaction or measures of customer experience is widespread. The effect of these on people’s relationship to services depends on the extent to which the standard relates to what people want and need from the service. Proxy targets are often used in this area – for example waiting time targets setting minimum standards in the NHS. Proxy targets carry risks – whilst it may be reasonable, provided there is robust supporting evidence, to assume that improvement in the target will improve the customer experience, organisations tend to focus on the content of the target or minimum standard rather than the spirit, especially if there are financial or reputational issues for the organisation in meeting the minimum standard. This produces perverse incentives and runs risks of damaging the customer experience when, for example, hospitals focus on ensuring that no-one waits more than 4 hours in A and E as their first priority and pays less attention to the actual experience of the patient, who may simply find themselves waiting in another part of the hospital instead, with a possible resulting adverse effect on their overall experience of their treatment.

Setting standards needs to be based on current, specific information about the issues which matter to people. Whilst there may be widespread evidence that people value being treated with dignity and respect, simple questions of social care customers such as ‘were you treated with dignity and respect’ may produce a ‘yes/no’ answer which could produce a result that a certain percentage of customers felt they were treated with dignity and respect. However, we know that elderly people are more likely to answer ‘yes’ to this question than young ones, and thus the answer may not tell us a great deal about the

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service itself but is more likely to be a reflection of social attitudes to authority. More effective are specific question derived from the detail of the experience, such as ‘Did staff talk about you as if you were not there’. Using measures built around such questions can be used to derive a meaningful overall score for the customer experience, and measuring

this over time could form a useful minimum standard for services.

Question 3A: What role do measures of customer satisfaction have in assessing the standard of public services?

Overall measures of customer satisfaction do have a role in assessing the standard of public services. However, taken on its own there are difficulties with this concept:

(a)Policy goals may not be consistent with high levels of customer satisfaction. For

example, we do not necessarily wish to prioritise simple satisfaction with higher

education – students may be satisfied with undemanding coursework, if asked,

but their longer term interests and that of society more widely are better served by sacrificing simple immediate satisfaction for greater challenge.

(b)Satisfaction levels vary by sociodemographic groups, with, for example, older

women very much more satisfied than younger men. Simple satisfaction scores

need to be understood carefully, and the underlying detail explored. Measures of the extent to which organisations focus on their customers as part of their day to day processes may be more helpful. For example, the extent to which they gather data about the user experience and use it to drive processes, alongside evidence that satisfaction scores and rating of specific service experiences are improving, may be more meaningful.

Question 3B: How should user views be monitored?

A variety of techniques are appropriate for understanding user views and experience.

‘Views’ – which may be a matter largely of opinion can be a different concept from

‘experience’. Thus a user may hold a view that a particular service is not the way he or she might ideally like it to be – for example he or she may dislike the building or the style of a publication, but nonetheless the service experience is satisfactory because he/she was dealt with expertly by staff. It is probably useful to measure both, but important to be clear which is being investigated.

The most important aspect of the user/customer relationship with the service to measure is the direct experience. Qualitative work is necessary to develop a detailed understanding of the nature of the experience and the issues and details which matter to people. This can then be used as a basis for general surveying using qualitative and/or quantitative

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techniques. If similar instruments are used on a widespread basis, and repeated over time, important trends can be tracked which can be used to inform policy development at local and national levels. This is not possible at present and requires improvement.

Question 3C: How can the cost effectiveness of user surveys and feedback be assessed?

The issue of the cost effectiveness of understanding customers is often raised. During our research for the Local Government Association and National Consumer Council we found evidence that local authorities gather a great deal of data at currently unquantified expense (estimating the actual cost may be the subject of further research) much of which is little used to drive their processes.

Additionally, some processes undertaken by public service organisations in the belief that they are a necessary part of delivering a good customer service may prove, on the basis of sound evidence, to be unnecessary.

We believe strongly that simply looking at this issue from the perspective that additional survey work represents an extra ‘cost’ to organisations is mistaken. Experts in Canada involved in managing the Citizens’ First initiative and the use of their ‘Common Measurements Tool’ believe that this initiative has at worst been cost neutral and have anecdotal evidence that individual institutions have saved money as a result.

Private companies regard the cost of understanding customers as an essential element of their business and crucial to their survival. We believe that effective public service organisations need to give this issue similar priority if their democratic mandate is to be honoured. It is not to be regarded as an optional ‘extra’ in addition to other aspects of strategic management – strategic management is impossible to undertake effectively without it.

Assessment of cost effectiveness may include measurement of the achievement of desired policy outcomes. These are often behavioural – for example reducing crime, encouraging environmental responsibility or healthy living. These depend on effective communication with customers which can only be based on detailed understanding of them and their experience. Thus even in areas where direct service experience is less relevant measurement of the extent of behavioural change may be an indication of the cost effectiveness of customer insight. Similarly, satisfied public service customers, especially those for personal services such as social services, are likely in some cases to be helped to manage their lives effectively and perhaps reduce their dependence on acute health services.

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Question 8. Do official consultations typically manage to capture the views of the right people? What kinds of consultation are most effective in engaging with the appropriate people?

The simple answer to this question is no. Engagement with many forms of consultation requires social capital which many people simply do not have – the language of documents and the processes to be engaged with are inaccessible to many and poorly advertised. Only those people familiar with such processes are inclined to engage, producing the ‘usual suspects’ syndrome and the sense that consultation has become a ritual which passes for real public engagement but is in fact a poor substitute.

This requires further work. There are many techniques available for understanding peoples’ perspectives on policy issues, many of which are in widespread use in the market research industry. Government has much to learn from these techniques and their use might make for more effective policy making and easier acceptance of policy announcements and legislation.

This problem exists at national and local level, and the capacity of some individuals to be heard can lead to an understandable perception by politicians that they are in touch with public opinion, when in fact they are simply hearing the loudest voices. It is essential that rigorous research, geared especially to ensure true representation of the population, forms part of the policy engagement process.

Question 10: How does user influence relate to wider issues of democratic accountability? This issue is of critical importance where services are intensively used but only by a minority of people – for example looked after children. Many people will have opinions about such services, especially when they are the subject of press coverage, but few will have close first hand knowledge and it is difficult for politicians to determine the extent to which widespread public opinion should influence decision making rather than knowledge of the user experience, which may be rather different. This situation is made worse when good data about the actual performance of the service in the eyes of its users is not readily available.

It is essential that sound democratic processes of engagement are supported by good data about customer experiences, so that public opinion can be balanced alongside real evidence about the way services are performing in the eyes of their customers.

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Appendix

Developing Customer Satisfaction Measures for Local Government Services

A report prepared for the Local Government Association and National Consumer Council, October 2006

Summary of key findings and recommendations

1.Local government needs a new, integrated way of understanding its customers

which reflects the new and future context its work. In particular, it needs to

support growing local accountability and the increasing role of local authorities as ‘place shapers’. Current systems for understanding customers are ill – co-

ordinated and lack the sophistication needed to respond to new opportunities and position the sector poorly to engage with current and fut ure challenges. A new

integrated model for understanding customer satisfaction and experience

throughout the sector is urgently needed.

2.The new system should integrate a range of data covering a broad scope of service

experience provided by local authorities and also their partners so that a new,

holistic view of the way local people experience services can emerge. If this is

structured carefully it will provide a rich source of insight on local experience

more widely and facilitate much deeper understanding of specific groups.

3.The new system needs to provide local authorities with the means to understand

different segments of their communities and the factors in their experience of

services which drive their satisfaction. It also needs to show how the pattern

changes over time.

4.If understanding is based on the factors described at (3) above and this

understanding is used to drive authorities’ processes, and if authorities are seen to deliver their services with equity and consistency, the research evidence suggests

that greater trust and enhanced reputation may result.

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5.There is evidence of much good practice by individual local authorities but the

picture is patchy and the opportunities for integration and learning from others is currently small. The new system should rectify this.

6.There are several shortcomings with the BVPI general survey in understanding

customers. It should be replaced with a new general survey which places greater emphasis on understanding the customer experience and which could form a

major element of a new co-ordinated system.

7.There are already in existence several surveys of specific areas of service, at

national and local level. There are greater problems using existing data effectively than there are gaps requiring new surveys to be commissioned.

8.There is often a conflict between the data needed for service improvement locally

and that required by regulators for performance assessment, producing a

tendency for authorities to focus their efforts on satisfying regulators sometimes at the expense of developing greater local responsiveness. In future, performance assessment should focus on ensuring that local authorities are collecting,

analysing and exploiting data and above all engaging with customers and

communities effectively and that people’s experience of public services is

improving. Authorities need much richer data for their own purposes and need to provide evidence that they are using it effectively.

9.Current systems for understanding the customer experience are needlessly

expensive because they duplicate effort and the results are frequently underused.

10.Any new system for sharing data needs to belong and respond to the needs of the

sector itself as a first priority. It therefore needs to be flexible, easy to use and

informative and directly helpful in the local context.

11.Customer experience data needs to be transparent to local communities,

providing them with insight which enables them to play a much better informed role in engaging with their locality and the council and as users of services.

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