The Austerity Challenge
Bringing Kingston's Public Services Closer Together
The budget situation for all public services is not good. Even in those areas of spending which are ring-fenced against spending reductions - health and education to name two - the reality is that rising costs and a growing population will continue to make setting realistic budgets difficult.
In Kingston, we have decided to tackle this head on. On the one hand, we have shifted our budgeting methodology away from the traditional silo focused process to one which focuses on outcomes. I will write about this more once we have seen the budget published in the early part of next year. However, what I am going to discuss is what we can do with public services working together.
For some time, Councils have been sharing services. Kingston shares services with a number of other local authorities and a year ago looked at the possibility for sharing services almost entirely with Richmond. I have referred to this as vertical integration between Boroughs. This type of integration has limits because it alone will not solve our budget issues nor will it fundamentally reform the way public services are delivered. Many will have heard me speak about the need for horizontal integration where local public services come together. One reason for this is efficiency but there is also a degree to which this will make services more accessible to local people.
Our overall vision should be of public services that are much more simply accessible either through co-location or some other form of collaboration. To give you one perspective, surely it is better for a resident to be able to have a single point of contact where they can access their housing, benefits, recycling, Police and maybe even their hospital appointments. There is a need for a "Citizen's Hub" so that interacting with public services is simpler and where the frustrations of not knowing who to engage with will be less complex and much smoother running.
One example of the work we are doing on this is the Kingston Co-Ordinated Care programme. We have brought together a range of medical practitioners and those in adult social care to create a new way of removing the silos that exist between public services so that we minimise the points of contact that occur with each patient as they are passed from health to care to hospital to care and back again, in a health and social care roundabout. Each of those 'pass-offs' has a cost and often that is an unnecessary or repeat cost. This team of practitioners have been working hard on making a new system real. From testing it on 'paper patients', they are now moving to working in a live situation and the results so far have been astonishing. By breaking down the silos between public services and focusing on the patient/resident/customer we hope to create a series of local services that are truly Kingston in nature.
This is a unique and exciting programme and other Boroughs are looking on as they are far behind in organising the relationships we have brokered across the system. Yes, this might be about reducing budgets and saving money but equally this is about how lower budgets can force us to think anew and do things differently.