Creating an Effective Public Sector

Mike Bourne, Pippa Bourne

• Publisher: Routledge
• Year: 2022
• ISBN:
  9781000549102
• Edition: 1
• Topic: Business
• Subtopic: Government & Business
• Index: Business

This book offers an in-depth look at developing effectiveness in the public sector and how to achieve the best possible outcomes for people rather than just good or efficient outputs.

In 15 comprehensive chapters, the authors present structured ideas and practical approaches for achieving a more effective public sector. The book sets out a framework for visualising success in complex situations with multiple stakeholders. Topics include how you stimulate change and influence people to adopt changes, how you manage politics, set targets and standards, and measure them, and how you create a culture of high performance with a focus on getting the right things done. Effectiveness does not arise from excellence in one area alone and the book weaves together ideas on leadership, managing expectations, and keeping focus on the longer term.

Creating an Effective Public Sector will be of interest to decision makers in the public sector, project managers working on central and local government projects, and senior civil servants. It will also be invaluable for advanced undergraduate and post-graduate students studying in the fields of government, project management, and public-sector management.

Part 1 Creating the environment for change

DOI: 10.4324/9781003099895-2

If the ladder is not leaning against the right wall, every step we take just gets us to the wrong place faster.

~ Stephen Covey

The change needed to embed a culture of achieving effective outcomes is profound. It requires a major shift in thinking, the managing of expectations and changes in the way people operate. Unless new ways of working and thinking become embedded habits, we tend to go back to our old ways of dealing with matters when we are under pressure (Markman, 2013). We search for the comfort of certainty in the measurements and numbers that show we are doing what is required of us. Those to whom we report do the same. Often, we know what should be done. We read books, go on courses, and talk to people, and yet when it comes down to doing the right thing, we are side-tracked and the end result is satisfactory but not as good as it might have been.

In this section, we will look at why effectiveness is so important and examine some of the pressures that force people into shorter term thinking which mitigates against achieving an effective outcome. We will highlight the skills needed to create an environment for change, starting with aspects of leadership which support the creation of an effective organisation. In the following chapters, we will present some tools to help you embed that change and explain how they can be used to best effect.

Reference

• Markman, A. (2013), “Both good and bad habits are boosted in times of stress,” Psychology Today, June, https://www.psychologytoday.com/us/blog/ulterior-motives/201306/both-good-and-bad-habits-are-boosted-in-times-stress

Chapter 1What are the challenges?

DOI: 10.4324/9781003099895-3

To make improvements one must understand where the weaknesses lie and have an idea of how they have arisen. In this chapter, we will highlight some of the challenges, tensions, and contradictions encountered when aiming for effectiveness. Most people will recognise at least some of these because they are woven into the fabric of our daily lives, whether as readers of the news, policy makers or as employees trying to fulfil our objectives. To some extent, we accept them as “just how things are” and work with or round them, but if changes are to be made, we need to put a spotlight on them and see them for what they are. But first, let’s start by explaining why effectiveness matters.

Why is effectiveness so important?

Business guru Peter Drucker once said: “Efficiency is doing things right: effectiveness is doing the right things.” Consider the building of a road. It may have been completed within time and within budget, but if people do not use it and it fails to deliver the expected benefits the fact it has been constructed in an efficient way will be entirely irrelevant. The money spent on it will have been wasted.

It is easy to see the importance of concentrating on effectiveness rather than just efficiency in this simple example of a visible construction project, but the principle holds true for all projects and actions. A case study of projects in NHS Digital (provider of information, data, and IT systems for those involved the National Health Service) showed that even when an application had been well designed and efficiently created and there was a good rationale for its implementation, benefits were not always fully realised within the expected time scale because users were slow or unwilling to change the way they worked (Williams et al. 2019). Without buy-in from stakeholders, systems will not work, no matter how obvious the benefits appear to the designer of the system, or how efficiently they have been created. This was well understood in NHS Digital and they took steps to consult and involve stakeholders from the outset and throughout the lifecycle of the project in order to ensure the outcomes were effective, rather than focussing primarily on efficiency in the way they created the new system, even if this did take some time.

In most situations there is still a strong focus on efficiency and, we would argue, this is often at the expense of effectiveness. In the case of projects, the same study found that the realisation of benefits (which could be equated to the effectiveness of a project) was in focus at the beginning of a project (used in order to justify the business case) but waned considerably as the project progressed and emphasis switched away from benefits and outcomes towards ensuring there was no overspend and timescales were on track. This was true of public sector projects in all the countries studied. (And, incidentally, it is true in the private sector, too.) You would expect there to be a focus on completing a project on time and within budget, especially as public money is involved. Of course that’s important, but the reduction of focus on the effectiveness of the end result is of concern. Having spent money and resources and put a great deal of emotion, effort, and expectation into the running of the project, it is important to establish whether it is finally delivering benefits and to learn from what actually happened, and to do this in a transparent manner which is not overly time consuming. This is not to say reviews don’t happen. They do, but we question whether enough is learnt from them in terms of establishing effectiveness (Bourne et al. 2020).

So, why is there such a focus on efficiency? There are many reasons, but it is essentially the result of a mixture of internal and external pressures. Efficiency is relatively easy to understand and measure. Money spent, progress made, and time taken can be calculated and reported with comparative ease. Effectiveness is less easy to define and measure.

The percentage of patients treated within emergency departments within four hours has been a long-standing target in the NHS, although at the time of writing it is currently under review. On the face of it, it is clear and easy to understand, and it can be measured and reported on. The public can relate to waiting times because they experience them personally, as anyone who has been to a large A & E department on a Saturday night can testify. There is no doubt that waiting times affect people and make them unhappy. However, important though they are, what is the purpose of A&E? It is not to ensure patients have the shortest possible waiting times, but to ensure people receive the best possible timely treatment and recover from accidents and illnesses as soon as they can. In practical terms, this will mean people with less serious injuries will wait longer than others and that when there is a major incident with many grave injuries, or a particularly virulent flu season, waiting time targets will be broken. So, on one hand, A&E waiting times are a good measure. Everyone wants them to be as short as possible and having a target should help motivate hospitals to improve their processes to make this happen. On the other hand, do they encourage the wrong behaviour? There have been reports of people being kept in ambulances to delay the ticking of the waiting time clock, and people being admitted to wards to stop the clock ticking. Perhaps the point here is that everyone knows it is sensible to have a target for waiting times, but we also need to recognise that it should not be cast in stone. Sometimes it will be broken for very good reason. That reason is to ensure the ultimate aim is achieved: so that people receive timely treatment and make the quickest possible recovery.

Another reason for measurement is the need to provide good news, to show progress. “Crime rate down 20%” is an attention-grabbing headline. But as one interviewee from the police service related to us, media headlines are only sound bites without the full context. One would have to consider the relative seriousness of a crime. Is the theft of a mobile phone the same as a serious sexual assault? Clearly not. So, to understand whether the police force in an area was being more effective or not is a far more complex issue than simply looking at headline figures.

Developing an effective police force should indeed result in lowering the crime rate. We know that one means of creating a sustainable reduction in crime rate is for the police and other agencies to work with troubled families to improve peoples’ lives and tackle the underlying causes of crime. However, this takes a long time, and it is hard to measure. In the meantime, the media and the public want to see progress. Senior police officers want to be able to provide evidence of their success and want it to be recognised to support promotion in their own careers and for the benefit of those reporting to them. Politicians want the public to see they are being tough on crime so they can be re-elected. Naturally, this is not confined to the police force and all these motivations are entirely understandable, but whether we like it or not, they feed the desire to concentrate on shorter-term measures of efficiency.

Then you have the issue of different agencies competing for funding. Governments are more likely to provide funds to organisations which have a good track record of success as judged by their performance metrics, so it is in the interests of the leaders of that organisation or department to ensure they meet or exceed their targets.

As you can see, one of the big challenges to creating an effective public sector is the tension between the culture of society expecting measures of efficiency for reasons we have highlighted above and focussing on what really matters – a beneficial final outcome.

In summary, what we are saying is that it is important to keep the ultimate aim in mind at all times and find ways of measuring and tracking progress that also encourage thinking about longer term outcomes. Whilst most of us may believe we are doing that, in practice there are various tensions and pressures that can blow us off course and force us into shorter-term thinking.

The relationship between efficiency and effectiveness

There is a strong focus on performance in the public sector – not just in the United Kingdom but worldwide. Resources are always tight because the number of possible outputs from the public sector is virtually endless and users of services, in developed countries at least, have come to expect they will receive whatever they need as a matter of course. [Incidentally, we are using the term “output” to mean an immediate product or service created from an activity whereas an “outcome” is the medium or longer-term result of the activity – the benefit arising from it.] With healthcare, for example, there is ever more that can be done to improve the well-being of the population and support those who fall ill. So, there is always a pressure to do more with less. Paul Winter, Deputy Director of Corporate Governance, Compliance and Data Protection, NHS Staffordshire, and Stoke-on-Trent CCGs had a lovely expression: “If the culture demands a Rolls Royce level of effectiveness and you have a Trabant level of investment. There is a problem.”

Whilst you cannot always afford to increase the level of resources, you can make better use of what you have by being more efficient. However, there is a limit to how efficient you can be. Over time, the gains become smaller and smaller whilst the pressure on employees grows until it begins to have an adverse effect on performance. Nobody can work at full stretch with limited resources over a long period of time and deliver the same high-level results. Effectiveness on the other hand provides a different perspective by examining the actions that will provide the greatest impact.

Being effective is paramount but that doesn’t mean to say that efficiency doesn’t matter at all. It’s obvious that it does matter to an extent, and you could argue that efficiency is part of effectiveness. You can be efficient without being effective, but you probably can’t be effective without considering efficiency, too. Throwing seemingly endless resources at a problem, as has happened in some countries whilst combatting the effects of the coronavirus pandemic, is a judgement call and the pandemic was potentially such a catastrophic event that extreme measures were justified. However, efficient use of resources is also important because they are not infinite and what you spend in one place you cannot spend in another. There was certainly a debate to be had about whether normal processes to ensure efficiency (such as value for money in procurement, for example) would be appropriate in the emergency situation, and there is a line under which they probably wouldn’t be appropriate. Planning in advance should result in establishing a mechanism for what happens in an emergency so people having to make decisions at least have a guide, but ultimately the test is whether resources are being spent on something that will be effective in solving the problem. Let us take an example. The idea of having a track and trace system to reduce the number of people infected with the virus circulating in the population and infecting others would appear to be an effective approach to limiting the spread of the virus. Ultimately, money spent on a track and trace system that is run efficiently should result in an outcome of fewer cases of illness, fewer hospitalisations, and fewer deaths. But the system must be efficient at identifying infected individuals within a given time period and encouraging them to self-isolate, otherwise the desired outcomes will not be realised.

Here is an example from the private sector. Clive Jeans, former Chief Executive of Milliken in Europe told the story of their “samples” operation. Milliken were manufacturers of carpets for hotels, conference centres, and large venues. Previously they had taken the approach of responding to enquiries and despatching samples by courier from their central warehouse. However, when they analysed their customer base and their customer needs, they discovered that a very large percentage of the product specifiers were architects based in central London. Having realised this, they decided to substantially improve their customer response time. They fitted out a van with a wide selection of samples and every day the van toured the centre of London receiving requests for samples and delivering them directly to the architects’ offices. So, a specifier could request a sample in the morning and be happily surprised to receive that sample when they returned from lunch. Cost wise this may not have been the cheapest operation, but it was extremely effective in getting their products specified.

So, efficiency and effectiveness go hand in hand. You need to be clear about the ultimate outcomes you want but, rather like a chain, there are links of individual decisions and actions each of which has an element of effectiveness and efficiency within it. John Spence CBE, formerly director of retail distribution for Lloyds Bank and now a County Councillor (amongst many other things) has a wonderful expression. “Keep your eyes focussed on the horizon, but don’t fall over the steppingstones or you won’t reach your Nirvana.” Bear in mind, you also need to ensure you don’t follow the steppingstones without checking they are going in the right direction. You may inadvertently be heading for hell.

Clarifying the pressures

We have pointed out some of the pressures that lead people to concentrate on setting goals and measurements that focus on the shorter term and to concentrate on individual aspects of performance rather than on the whole, both of which work against the idea of achieving the most effective outcome. Efficiency is easy to measure as you go along, whereas effectiveness can only be seen at the end. Efficiency is easy to see in individual elements of a project or initiative, whereas effectiveness is achieved in bringing those elements together in the best possible way.

But the pressures are real and cannot be ignored. Stakeholders want and need to see progress and success. Individuals and teams need to be motivated. You need shorter-term measurements of performance to know what is working and to check you are on track. If you are measured against progress towards a goal, that is where your efforts will be focused. Yet in working towards these shorter-term goals, you may be overlooking the bigger picture. As the saying goes: “You can’t see the wood for the trees.”

This prompts a number of questions. How can these two seemingly opposing forces be reconciled? How can you focus both on the longer-term outcome and also on the efficiency of the process used to achieve it? How can you manage stakeholder expectations when stakeholders are not in possession of all the evidence? How can you avoid being blown off course by unexpected events to which stakeholders will expect a response?

There is no simple answer to these questions. Understanding the conflict between pressure for efficient working and effectiveness and between long- and short-term focus is a good start, but working effectively, holding up a picture of the successful outcome and keeping eyes focussed on that, requires a change in culture and expectations which takes time to achieve.

Producing plans and charts showing the actions needed to achieve a successful outcome is common practice, but producing an honest analysis of the pressures, internal, and external, which will need to be managed is less common. For example: what objections are stakeholders likely to have? What performance measures will they expect to see? What behaviour will those measures encourage? What will the consequences be? These issues may be raised in a risk analysis, but it is important that they are considered thoroughly, not in a formulaic way, and that there is an open and honest debate about them (Figures 1.1 and 1.2).

FIGURE 1.1 Questions to ask when examining...