How well are you being served? Trends and issues in European social services innovation
Jeremy Millard (Danish Technological Institute) and Anna Davies (Young Foundation) report back from the INNOSERV international workshop on innovation in social services, 17 May 2013, Brussels
INNOSERV describes itself more as a social platform on innovative social services than a social innovation research project. It is designed as a meeting place for academics, policy-makers, practitioners and users in the field of social services. The project has the objective of “delivering a research agenda to evaluate innovation in the field of social services which will help define future research activities”. On Friday, the INNOSERV team held a workshop to present and get feedback on a set of videos that showcase selected examples of social services innovation in education, health and welfare, prepared by the project over the past year.
The workshop kicked-off with a perspective on the current state of social services in a crisis-ridden Europe from Connie Reuter, the Director General of SOLIDAR (a European network of NGOs working to advance social justice in Europe and worldwide). In a time of dramatically increasing poverty, unemployment, worsening working conditions and strained social services, how can we continue to keep ‘social need’ and the European social model centre stage in order to find the best response despite these distractions? Connie argued that we shouldn’t be focusing on cuts and austerity but on where to invest in social infrastructures, particularly how this is financed, and how to integrate new technology and develop new forms of cooperation. We clearly need to innovate, but innovation itself is not the goal.
Models and guiding principles
Simon Günter, of the Hamburg University of Applied Sciences (DE), outlined a model relating the drivers of innovation to the resultant emerging patterns and mediated by a number of agents of change. Drivers include ageing and demographic change, Europe’s increasingly diverse society, the powerful promise of new technology, budget cuts and system insufficiencies. Understanding who the change agents are in this process, and how they operate, is critical to understanding the patterns emerging. Evidence from the cases indicates there are three main types: first, non-profit alliances for example of NGOs, often in the welfare sector; second, professional advocacy alliances, typically in the education sector; and third public initiatives which tend to characterise the health sector.
In this context, preliminary results of INNOSERV’s twenty case studies show a number of emerging patterns of social services in Europe. There seem to be four guiding principles reflected in the cases: inclusion, individualisation, informalisation and the influence of public openness (the “four Is”). Further, a number of clear innovation characteristics emerge: new/better services for existing needs; new services for new needs; new forms of governance (how services are organised and managed), new types of resource (such as volunteers, self-help, etc.); and new ways to evaluate (e.g. by the users themselves). Close inspection shows that none of these is radically new, but they are all clearly innovative, and in most cases it is the form of delivery rather than a completely new service which constitutes the innovation. Another clear feature is that most of the cases tend to blur professional and organisational boundaries, often through networks rather than a single organisation.
Some important observations arise from these findings, such as the legitimacy or otherwise of innovation as a guiding principle – is change always ‘good’? – and the clear observation that most results are context dependent. There appears often to be a trade-off between ‘efficiency’ and ‘empowerment’, although this depends on how these concepts are defined and measured. Other issues include the sometimes paradoxical effect revealed in the cases on the funding and regulatory framework;, for example if users and/or their intermediaries are empowered to do more for themselves they may receive less funding as a result. There is also a tendency towards the de-professionalisation of service delivery when self-help and volunteers become more prominent, with resulting implications for training and perhaps a new ‘re-professionalisation’ to cope with the changed landscape.
Preliminary results from INNOSERV’s research
As a group we had the opportunity to see four out of the 20 videos INNOSERV have developed. While the short videos (5-6 minutes each) do not attempt to convey all the complexity and detail of the cases they represent, they provide an excellent and really engaging introduction to innovations in services across Europe. Each video ends with an invitation to the viewer to consider what new ideas they have seen in the case. We saw videos looking at:
• A Sure Start Centre (Biztos KezdetGyermekház) in the village of Katymár in Southern Hungary, which is focused on early child development amongst disadvantaged families.
• Ammerudhjemmet in Oslo – a nursing home with an open model which has become a cultural centre and meeting point for the whole community
• Place de bleu – a social enterprise in Denmark room employing marginalised immigrant women to produce home interiors and accessories.
• Light Residential in Milan – a housing project ensuring a gradual transition to independent living and inclusion in the community for people with mental health problems
After watching the sample of four videos, Chris Hawker from the University of Southampton (UK), presented some results from a preliminary analysis of all twenty videos by examining the main parameters of change illustrated by the cases. Chris suggested that the videos convey a number of key shifts we are seeing within social service provision:
- Underlying value systems seem to be changing so that, for example, safety and security concerns are giving way to some extent to a focus on greater independence and risk management.
- Management by professionals is being complemented by increased user control and management of service delivery.
- Traditional centralised service provision is being replaced by increasing local and community management approaches, for example through self-help and personal budgets.
- Public sector roles are changing to focus more on creating enabling environments with diverse support offers rather than the traditional ‘total support service’.
- There is a move away from single focus interventions towards multi-focused service packages such as integrating housing and care where, for example, housing is seen as the main route towards providing care.
- Staffing is moving towards multiple role integration, or at least combination, across organisational and professional boundaries.
- We are seeing a shift in service locations, for example from specialist facilities towards peoples’ own homes, or using existing community resources.
- We are also seeing changes in resource provision from the traditional centralised single funding model towards multiple sourcing including personal budgets and civil and enterprise funding, in addition to public funding.
A number of important issues arise from this preliminary analysis, not least that despite the above changes, regulatory and inspection regimes remain tied to earlier service values, but that pressure is building for change and to move away from the ‘formal’ understanding of service quality towards a more fluid approach. It is also clear that there is no single or simple origin of ‘innovation’, nor of how innovations can be stimulated, and that the transferability of solutions can often be hindered by local service structures and, not least, the mindsets that underpin them. An important challenge is that, in the midst of the increasing diversity and greater focus on self-help and more loosely managed solutions, there is a strong need to continue to ensure that appropriate supports and formal and fundamental care services remain in place for those who are unable or unwilling to make their own decisions or manage services for themselves. For example, the promotion of independent living might also lead to increased isolation and deprivation, especially as many vulnerable individuals face not just one but a range of interrelated problems.
The role of family, networks and community is increasing in social service provision, with the accompanying flexing of service boundaries to encompass this. Yet, at the same time, the dependency on individuals and on interpersonal relationships is also increasing. Much of this is starting to be enabled by new technology, and especially the Internet and smart mobile phones. These can both dramatically extend the range of information, advice and tools available to service users, as well as provide back office efficiencies and savings if intelligently deployed. In all this, however, the elephant in the room is often the context of cost reduction and the need almost everywhere in the public sector to make budgetary savings. There may be interesting spin-off benefits to this, however, through a greater awareness of ‘value’ creation and how this is captured – i.e. what really matters and what is actually valuable to service users.
Feedback from workshop participants
Following these stimulating presentations, workshop participants discussed their impressions and conclusions in a round table session. All were agreed that an underlying characteristic of current trends in European social services was the move towards greater integration across traditional functional ‘silos’ in the public sector, including with other non-public providers, in an attempt to put the user in the centre and treat their needs holistically. Much of this is also based on strong moves towards stressing the importance of personal relationships between all the actors involved, and this reflects the “empowerment of society at large to become involved”. This is seen through new forms of volunteering and the emerging role of social platforms, especially through increasingly complex systems of community. Social services are thus becoming ‘permeable’ and open to community, both ‘inside-out’ as well as ‘outside-in, as amply demonstrated by the Ammerudhjemmet old peoples’ nursing home in Norway. Here the facilities have become a social centre for all groups in the local community to mix together and enjoy common facilities and activities. Such an approach also enables people who receive support to give support to others in return.
Examples like this might also be the key to possible scaling and dissemination elsewhere. It’s clear that local conditions mitigate against the transfer of solutions because of incompatibility with local service structures, but principles like being open to the community can stimulate adaptions in many highly diverse local situations. Another such principle might be not to see the changing relationship between the professional and the volunteer or non-professional as necessarily leading to a ‘zero-sum’ outcome. Instead, however, we should move towards a ‘win-win’ development which enhances both at the same time in a new partnership relation which values and exploits their different but complementary contributions. This, in turn, points to one possible new form of ‘re-professionalism’ hinted at above.
It is also clear that all the examples considered demonstrate incremental rather than disruptive innovation, although cumulatively and over time the impacts can be significant. Changes and adaptions are made almost daily to align with actual experience and changing needs often at the micro level. Here, for instance, what staff and users do informally to solve concrete problems is not held in check by the ‘formal’ rule book of accepted practice. This enables ‘emergent’ innovations to take place, for example resulting from ‘testing at the boundaries’ of different roles and situations. It is here that a new approach to risk is demonstrated which accepts that it is necessary but is, in most situations, confined to small scale experimentation which if unsuccessful is unlikely to damage or undermine service provision.
The INNOSERV examples are, however, in stark contrast to much traditional social services provision where a big barrier to innovation is that the public sector typically finds it difficult to take too many risks because failure can be catastrophic if it leads to service breakdown, a situation which is rare in the private sector. In order to support the move to more acceptable forms of risk, as in the videos prepared by the INNOSERV project, we should establish platforms of innovation, probably with EU support, which for example might specify the particular quality outcomes required whilst leaving the process (how to achieve the outcomes) to open innovation. Of course, definitions of quality outcomes and their measurement need strong focus, but this should also perhaps move towards more open and self-assessment frameworks in which all actors can be involved in the setting and measurement of achievements.
Another key theme of discussion was the role of the EU in supporting social service innovation. What could the EU do to help encourage ‘active theft’ so that proven ideas can travel better across the continent? Participants made some practical suggestions around the way the EU currently sponsors research. A more coordinated approach might help to ensure that various platforms to share innovations that are developed as part of Framework projects (e.g. FP7) work together, and are funded for a longer term so that they can be kept active beyond the life of individual projects. Related to research medium, several participants commented that the videos represent a very interesting new form of dissemination which the EU should track closely and consider integrating more widely. All of INNOSERV’s videos can be seen on their website and they are encouraging viewers to fill out an online questionnaire to help them gather impressions and responses.
Many thanks to the whole INNOSERV team for a really interesting day of presentations and reflections, and especially Elsa Laino at Solidar for her work in co-ordinating the workshop.