A report from the UK Cabinet (Excellence and fairness: Achieving world class public services) charts a new course for reform of, and to achieve excellence in, providing public services in the UK. The vision is based upon three principles: citizen empowerment, a new professionalism in the public workforce and strategic leadership from government. For me, the timing is useful as one context for shaping the US public health objectives for the next decade. For readers who aren't familiar with Healthy People, it is the US government's vehicle for developing, adopting and then acting on public health priorities for the next decade. You can go here for an overview of the Healthy People 2020 process or to the Healthy People 2010 objectives to get an idea of their scope.
The section on citizen empowerment is useful to those of us who are social marketers and claim an audience-centric approach as one of our guiding principles (so do they!). Citizen empowerment is also a core feature for those who see social media and mobile technologies as enabling philosophies and tools. Below are some excerpts from the report that may inspire both your imagination and intention to become involved in opportunities to contribute to national policy development. I'll note here that the original document concerns ALL public services and not just health, though these are the focus of what I extracted. The promises of social marketing and applications of new media are not restricted to just health issues!
Here is the nut of their approach: The best systems in the world treat each citizen as a unique individual, with his or her own family’s distinct needs, and then tailor the service to meet these personalised requirements. No centrally driven or centrally accountable system can operate in this fine-grained way…
'The underlying quality of public services is better than ever before. The challenge now is to ensure the development of more personalised and responsive, as well as fair and equitable services. Alongside the extension of choice in health and other services, there must be a deepening of user involvement through new forms of individual and community control. The exact mechanism will vary from service to service, but the aspiration will be the same: enabling more personalised services by giving citizens the information and power to shape services around their needs and aspirations, rather than by assuming that someone in the Government knows best.' (my emphasis throughout)
Some of their recommendations to empower citizens include:
For many services, empowerment starts when people are able to make real choices about which services are best suited to them – their lifestyles and their needs. Enhancing and extending the opportunities people have to make choices empowers citizens. It also creates pressure for improvement by rewarding services that offer what people want…in a range of sectors from childcare to primary health, alternative education, probation and employment services.
The whole agenda of reform will rest on improved transparency of information about public services and their performance, as well as transparency about the standards that citizens should be able to expect. Effective empowerment rests on good information…Central government is therefore committed to ensuring that, as a matter of course, public services make non-personal information available for re-use. This will include the provision of frequent, comparative and tailored performance data about services at a local level.
In addition to encouraging collaboration between service users and professionals, networks of users can also provide personalised and ongoing support to an extent which would be impossible if provided by professionals alone. For example, the Expert Patients Programme in the UK enables people with personal experience of managing long term conditions to share their knowledge and expertise with others. [Ed Note: and here’s a social network site 'specifically designed for organizing helpers, where everyone can pitch in with meals delivery, rides, and other tasks necessary for life to run smoothly during times of medical crisis, end-of-life caring, or family caregiver exhaustion.' Just a thought...]
The Government will therefore extend opportunities for people to become directly involved in making decisions about the treatment and service they receive – the parent, student, patient, tenant or victim of crime becoming a genuine partner in deciding on the best approach. Parents, for example, will be able to influence and support the education of their children through regular interaction with their school via email and text message, as well as regular parents’ meetings and reports...The internet has given a powerful voice to consumers to give feedback on private sector services – that feedback is now spreading to public services and must be embraced. NHS Choices is a large scale example of the public sector soliciting feedback on health care, building on the example of websites such as patientopinion.com. The challenge for public service providers is to listen to and work with websites that provide a rich seam of feedback, even if that feedback makes for uncomfortable reading.
A deeper form of user engagement involves transferring control of resources to the service user. For example, individual budgets in social care have shown that when people are given control over the funds to be spent on them, they often make changes that significantly improve the care they receive: bringing support closer to home; fitting services more closely around the needs and resources of their family; and getting better value for money in the services they buy.
And the finale -
As the Government seeks to move the public services forward, the next stage of our reform programme must put power directly into the hands of citizens, driving services to become more responsive and personalised to each individual’s needs and aspirations – and provide a strong set of incentives for the system to innovate and improve. As a consequence:
Services should reflect people’s aspirations and lifestyles to offer users the increased personal control they demand, and adapt to meet new demands such as more flexible opening hours or better online access.
Services must be designed around people’s complex and interrelated needs, for instance providing those with long term health conditions with greater continuity of care between their home and hospital.
- A stronger
relationship needs to be created between the citizen and public service
professionals. Only when citizens are treated as equal partners do they bring
their knowledge, time and energy to address challenges such as preventing
If these excerpts captured your fancy, stay tuned as I will have guest bloggers over the next several weeks posting here to inspire a conversation with you and others about how health communications, social marketing and health information technologies can contribute to our public health goals for the Year 2020. We will also be posting some pages at the Social Marketing wiki for more extensive discussions and debates. Pass the word along and join us.