Entitled “Opportunity knocks: a briefing on devolution and multiple needs in England”, the report argues that devolution can be a useful tool for joining up local services to better support people with multiple needs.
Where is devolution happening?
In the current round of devolution agreements, twelve deals have been announced, following an open application process. Most of the deals cover urban and suburban areas, and many involve the creation of ‘combined authorities’ which bring together existing councils in a locality, usually with the requirement that a new Mayor is elected to provide democratic representation. The MEAM report reproduces a helpful list from the Local Government Association:
Devolution and multiple needs
So far, devolution in England has focused largely on issues such as economic development, skills and employment and transport (although Greater Manchester of course has been pioneering a devolved approach to health and social care and criminal justice). Just 2 of the 12 devolution deals agreed – the West Midlands Combined Authority and the North East Combined Authority – explicitly mention multiple needs.
Nearly all the deals, though, include some powers that would affect people with multiple needs and the services that work with them. For instance, all of the deals agreed so far include provisions on employment support, committing local areas to work with the Department of Work and Pensions to design better services for the ‘hardest-to-help’. In many cases, this will mean people who are unemployed as a result of their multiple needs.
In May 2017, a range of areas will elect new Mayors – who in some cases will also take on the responsibilities of the Police and Crime Commissioner – making the next year a crucial period to influence the devolution process. As local areas look to implement devolution deals and redesign their approach to public service delivery, there is an opportunity to ensure that more people with multiple needs get the flexible and coordinated support they require.
MEAM consistently argues in all its work (quite rightly) that locally co-ordinated commissioning can improve outcomes for individuals and communities, and reduce costs.
The paper highlights three key factors (advanced by Dr Henry Kippin, of Collaborate) which mean that devolution is an opportunity for this client group:
- An underlying principle of devolution is that economic ‘deal-making’ can lay the groundwork for radically different ways of organising public services. The long term goal is that economic growth and public service reform become mutually reinforcing. More holistic public services provide the ’social spine’ for future growth, and increased economic activity enables social investment. All of this depends on a changed relationship between Whitehall and localities, and a more co-productive relationship between citizens and state.
- Those monitoring the language of devolution will have noticed the interest in ‘inclusive growth’: the RSA has launched a commission on the topic, and a number of commentators have argued that inclusion should be central to our thinking about how growth and social change happen. This is particularly important in the context of multiple needs, which disproportionately affect deprived communities in the north and on the coast of England. Collaborative ways of addressing multiple needs can provide a route in to working with those
furthest from the labour market, and least likely to gain from the proceeds of growth. It may be true that the best way to reduce welfare spending is for people to be in work, but the way to get them there is surely through holistic support that is sustainable and meaningful.
- Successful devolution depends on a better relationship between and across the voluntary, statutory and private sectors. It must both be more collaborative (between providers and across the commissioner-provider divide) and more self-critical, asking whether behaviours are really being driven by the need for a different relationship with the citizen.
MEAM acknowledges that devolution is also a risk for this client group — that, again, the voices of people experiencing multiple needs will not be heard and their interests not taken into account.
However, MEAM is lobbying hard, both for a national strategy on multiple needs and on a local level to make sure that where devolution is taking place, the opportunity is taken to co-ordinate commissioning and service delivery in the interest of people with multiple needs.
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