Consultancy in Public Services: Empowerment and Transformation 9781847429445

Table of contents :
Consultancy in public services
Contents
1. Introducing consultancy: an empowerment approach
What is consultancy?
Starting points: preparing for consultancy
Mapping the territory of public services consultancy
Developing consultancy: the empowerment approach
Nature and principles of an empowerment approach to consultancy
Conclusion
2. Negotiating
Beginnings
Working with people: working with citizens or ‘publics’
First meeting with the client
Identifying potential areas, problems, tasks and planning
Challenges to empowering consultancy
Conclusion
3. Contracting
Importance of the contract
Developing our resources as critical and self-critical consultants
Components of critical thinking
Techniques to stimulate creative thinking
Completing the contract
Anticipating complexities
Conclusion
4. Engaging
Engaging with change
Engaging with citizens, managers and professionals
Making the contract work, baselining and translating the contract into a work schedule
Engaging with leadership and management
Building relationships
Dealing with challenging situations
Engaging with issues or problems identified by the individual
Conclusion
5. Empowering
What empowerment entails
Aspects of the process of empowering consultancy
Working in different domains: a consultant’s notebook
Conclusion
6. Disengaging
Various ways of disengaging
Evaluation
Conclusion
7. Reflecting on contexts for consultancy
Problematic and diverse: changing nature of consultancy
Conclusion
8. Reflecting on perspectives on consultancy
Different perspectives on consultancy and the organisation
Empowerment approach to consultancy in practice
Ways of viewing consultancy
Using imagery to interpret consultancy in action
General reflections on the relations between consultant and client
Doing consultancy: action research and empowerment
Conclusion
9. Doing consultancy and transforming public services
The transformative agenda in public services
Transforming organisations: innovation rather than adaptation
From technical and knowledge-based to imaginative culture
The imaginative organisation
A value-driven future
Transforming organisations
Changing the culture of public services organisations
Social entrepreneurs and social enterprise
Conclusion
References
Appendix 1: Glossary of terms associated with consultancy
Appendix 2: List of abbreviations
Appendix 3: Intellectual property rights
Index

Citation preview

Consultancy in public services Empowerment and transformation

Robert Adams and Wade Tovey

Consultancy in public services Empowerment and transformation Robert Adams and Wade Tovey

First published in Great Britain in 2012 by The Policy Press University of Bristol Fourth Floor Beacon House Queen’s Road Bristol BS8 1QU UK Tel +44 (0)117 331 4054 Fax +44 (0)117 331 4093 e-mail [email protected] www.policypress.co.uk North American office: The Policy Press c/o The University of Chicago Press 1427 East 60th Street Chicago, IL 60637, USA t: +1 773 702 7700 f: +1 773-702-9756 e:[email protected] www.press.uchicago.edu © The Policy Press 2012 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. Library of Congress Cataloging-in-Publication Data A catalog record for this book has been requested. ISBN 978 1 84742 468 6 paperback The right of Robert Adams and Wade Tovey to be identified as authors of this work has been asserted by them in accordance with the 1988 Copyright, Designs and Patents Act. All rights reserved: no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior permission of The Policy Press. The statements and opinions contained within this publication are solely those of the authors and not of The University of Bristol or The Policy Press. The University of Bristol and The Policy Press disclaim responsibility for any injury to persons or property resulting from any material published in this publication. The Policy Press works to counter discrimination on grounds of gender, race, disability, age and sexuality. Cover design by Qube Design Associates Front cover: image kindly supplied by istock Printed and bound in Great Britain by Hobbs, Southampton The Policy Press uses environmentally responsible print partners

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This book is dedicated to Len Wyres (18 November 1941–13 October 2011) and his colleagues in the North East Social Care Advisors and Hartlepool Partners. They work as volunteers to ensure that the voices of service users, carers and patients are heard; we have been privileged to work with them and have been inspired by them in recent years.

Contents Introduction vii Part 1: Setting the scene one Introducing consultancy: an empowerment approach

1 3

Part 2: Doing consultancy 35 two Negotiating 37 three

Contracting 53

four

Engaging 73

five

Empowering 111

six

Disengaging 149

Part 3: Reflections seven Reflecting on contexts for consultancy

159 161

eight

Reflecting on perspectives on consultancy

173

nine

Doing consultancy and transforming public services

195

References 217 Appendix 1: Glossary of terms associated with consultancy Appendix 2: List of abbreviations Appendix 3: Intellectual property rights

225 229 231

Index 233

v

Introduction This book has grown from our consultancy in public services carried out over the past 25 years. It challenges the traditional view that consultants exist to be brought in as experts. Instead, it develops a new way of thinking about and doing consultancy with public services, which resonates with the current direction of policy and practice in that it empowers people already in the workforce and those patients, service users, carers and members of the public who work with them and want to engage in delivering high quality services. While we admit unashamedly that this book is the unplanned outcome of our experiences, we would like to share with the reader our growing conviction that we have developed a systematic approach, which we call an empowerment approach to consultancy. In reaching this point, we have reflected on our practice and have delved into the literature on consultancy to help us to understand what has been happening as we have journeyed. We recognise, of course, that our approach is only one that has evolved from our practice and which suits us. It is only one of many possible approaches – it is an empowerment approach and not the empowerment approach. We believe that this has not only produced this very practical handbook, well illustrated from our practice, but has stimulated us to reconsider our ideas and perspectives on public services in general and on organisations such as hospitals and social services in particular, as part of our search for understanding of our practice, working from practical experience through reflection to a consistent pattern of theories and ideas. However, the book is not just about ideas, but is also concerned with engagement in practice and, crucially, with practical implementation. It deals with all stages of consultancy, from thinking about doing it, to the early stages of negotiating and entering it, through implementation and out at the far end of disengagement. It is concerned not only with consultancy processes but also with outcomes. It is about theories and ideas that are grounded in and grow out of practice. The book began as a conventional text, with the usual structure, leading from context, theories and perspectives in Part 1 through to Part 2 that engaged with actual practice. As the project progressed, we became aware that this neat and rather mechanical layout did not do justice to the process of our thinking and practice. We were aware that this structure obscured rather than conveyed the potential of consultancy to transform public services. So we did what consultants sometimes invite their clients to do – we set out to re-write and vii

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re-sequence the content. A further note on the sequence of the material comes to mind, in the words of Primo Levi. We feel that he is encouraging creativity and innovation, when in his book If this is a man (2000) he states that he has written the chapters not in order of logical succession but in order of urgency. In our experience this seems an important principle. Therefore, we have restructured this book with practice first (Parts 1 and 2) and reflections subsequently (Part 3), so as to prioritise what is distinctive about the application of our particular approach to consultancy to transforming public services. This does not mean that our reflections are segregated from the actual day-to-day ‘doing’ of consultancy; in practice, the two have always been woven together. Our view of consultancy is guided by our understanding of empowerment.This means that we encourage the use of a wide range of techniques, since consultancy for us is a generic term for a broad range of approaches rather than a specialist area of practice. Consultants should be inclusive rather than exclusive, creative rather than working well within safe limits, opportunistic rather than regimented and innovative rather than rule following. It is aimed at anybody who wants to read about consultancy – including clients, patients and members of the public, as well as consultants and would-be consultants, of course. Last but by no means least, we hope professionals and managers might read it. We have already had some debates with a few colleagues and former colleagues and, needless to say, have confirmed our view that there is no agreement about these matters. In fact, we could say that the purpose of this book is to stir up debate and incite some controversy about consultancy and those who practise it. While our purpose is to ask questions rather than to provide answers, whatever else, we hope you will find the book stimulating.

Who are we? Our biographies as consultants We have both worked in different capacities in public services, and we bring to this book our own experiences. Robert Adams I have written elsewhere (Adams, 2010, pp 55-6) of the influences that first brought me into contact with innovative practice, in the public services and in the voluntary sector. In a real sense, although not acknowledged by me at the time, my first encounter with consultancy as a radically new and empowering approach was when working as viii

Introduction

assistant governor (1968–72) in a young offenders’ institution in the UK Prison Service. The governor, Roger Dauncey, whom I knew was attached to the Grubb Institute (www.grubb.org.uk) at the time, developed in association with Peter Shapland, regional psychologist in the Midland Region of the Prison Service, an approach to changing the management of the institution which engaged all the staff in meeting and working together to reach consensus about strategies and day-to-day working. Although I did not realise it at the time, John Bazalgette, whose groups I had helped with when I worked as a prison officer at HMP Pentonville, and whose project led to his book Freedom, authority and the young adult (Bazalgette, 1971), was also attached to the Grubb Institute, where he now runs the Master’s in Organisational Analysis. In the early 1980s, in the wake of the Brixton and Toxteth riots, I carried out consultancy with the West Yorkshire and Northumbria Police on aspects of public order. From the late 1980s I was strongly influenced by sociological perspectives and also by ideas about community activism and empowerment, notably by the work of Paulo Freire (1972, 1973). It was not until the early 1990s that my ideas about consultancy moved forward again. At that time, I was commissioned by The Open University and Department of Health to carry out several consultancy projects on the use of open and flexible learning to promote management development in the health and social services. From the mid-1990s I began to work with Wade Tovey at Teesside University and we carried out consultancy in many fields. Wade Tovey I have, to many, a curious background, having a chemistry degree, but I went on to be a social worker with a Master’s in Social Research. Empirical evidence and experimentation were watchwords but could not always explain everything, even in the test tube, especially when working with people of such infinite varieties that the word ‘type’, so often misused, becomes so inadequate. I learned so much about people by listening and observing, and so began an interest in qualitative research, almost the opposite of where I started. I came to the conclusion that these almost polar opposites of research had much to offer each other if I was to work ever more effectively with people. I was in the Probation Service when the ‘what works’ debate came to the fore after Robert Martinson had maintained that nothing worked in treatment or rehabilitation in the 1960s and 1970s, but by ix

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the 1980s meta analysis and studies took the strong view that some things worked for some people much of the time. Here was a melding of the qualitative and quantitative that stills holds sway. Oddly, to some, I was a social worker, and then a probation officer, when I also became a member of the Territorial Army (TA or Reserve Forces). Here was another contradiction. This opened up for me the novel territory of different forms of power and how they were exercised differently in working with people in many different settings. Interestingly, by no means all the authority-laden and more authoritarian uses of power were in the most likely setting – the army. Many army officers used a range of ‘soft’ and disarming techniques in demonstrating effective decision-making and leadership. As a social worker I dealt with crisis situations where training and experience, and some calm, were all required, but above all, an ability to work and to communicate effectively with people with whom I hoped I had established some trust and mutual respect. Despite all of these factors and even careful planning, difficult decisions had to be made and sometimes quickly, although I often hoped for more room for circumspection. Fortunately, in the military situation, I was never on operations but faced similar ‘operational’ situations in highly challenging training.The parallels of working with people and facing challenges is clear, and again, as a scientist or social researcher, supposed opposites can have more in common than at first sight. This background was invaluable in preparing me for so many consultancy projects from the 1990s with criminal justice, drugs, social care, children and the many different types of organisation involved, sometimes with several involved together. In turn, my learning from these projects fed back into my work as an adviser/consultant in three different roles in the TA, where innovative solutions were always being sought, and new ways of working were vital in dealing with civil disasters, sometimes in work with the police, fire services and ambulance services.

Purpose of the book This book provides a handbook for the development of the empowering consultancy approach, as a means of transforming public services, although it is not a simple toolkit – there are plenty of these already in the consultancy field. It shares our experience of consultancy, which has changed the way we work with other people, and as part of this has led us to this approach. It has grown out of our experience as consultants over the past decades. The argument we develop is that x

Introduction

the empowering consultancy approach, far from being a relatively small and specialist activity by professional consultants brought in from outside organisations and agencies, can be developed by staff, patients, service users, carers and members of the public working together in those settings, and used to develop, change, innovate and ultimately transform services.

Terminology used in the book Our commitment to empowering as many staff and patients, service users and members of the public as possible to engage in what, traditionally, is only carried out by ‘expert’ consultants, means that we do use terms such as ‘consultant’ and ‘client’ with the aim of them being interpreted rather flexibly. In a care home, for instance, where all staff and residents are encouraged to act as co-consultants to each other, the word ‘client’ can refer to any staff member or any resident. We do not believe this is confusing. On the contrary, we regard it as exciting, creative and empowering.

Structure of the book The book falls into three main parts. Part 1 introduces what we mean by empowering consultancy, and considers the ideas that inform consultants’ preparations for an empowerment approach to consultancy. In Part 2 we deal with the practice of an empowering consultancy approach. Chapter Two begins the process with the pre-contract negotiations. Chapter Three moves on to the contracting phase. Chapter Four discusses how people become engaged in consultancy activities. Chapter Five considers how people are empowered through consultancy. Chapter Six explores how consultants disengage from the consultancy. In Part 3, Chapter Seven considers the contexts for consultancy in public services. Chapter Eight explores different perspectives on consultancy. Chapter Nine looks at the contribution of consultancy to transforming public services. The book concludes with Appendices containing a glossary of useful terms, a list of abbreviations and a note on intellectual property rights.

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Focus of the book The subject of the book is public services, but inevitably the balance of the selections of material reflects our own interests and consultancy activities over the past decades. There are some references to public services as a whole, but many of the illustrations come from health and social services.We make no apology for this, since health and care forms a huge slice of the UK’s economy. In fact, the health and social care workforce is the largest in the public services, and that of the UK, approaching two million, is one of the largest workforces in Europe; if we include informal carers and service users in its coverage, it extends its services to the vast majority of people in the population. One way or another it plays a hugely important part in most people’s lives. It makes sense, therefore, to focus on how we work as consultants with health and social care managers and practitioners.

How to use the book We, as two practitioner consultants, wrote this book, using the process of reflection and writing that we have developed over our work together for more than a decade. It is rooted in experience and therefore proceeds through experience first, before moving on in Part 3 to our attempts to relate this to the literature. It is important to bear in mind that this means that Part 2 contains a lot of ‘raw’ examples, in which we simply describe and present our experiences, while Part 3 is at one remove from this experience and is more academic in style. Part 3 does not attempt to conduct a full literature search and discussion of the field of consultancy, however.To do this would fill the entire book, and would lose the diversity and richness of the examples highlighted. In order to make full use of this book, it is important to free ourselves as readers and practitioners from the straightjacket of regarding our own particular organisation and profession as unique, which means that we only pay attention to those sentences in the book that specifically mention it.To this end, we use examples not just from one service, but from across all those public service organisations of which we have direct experience. These include the NHS, social work, social care, youth and community work, teaching, pre-school education, prison and other custodial institutions, the police and other uniformed services. We would like to thank John Bazalgette, Chris Durkin, Mike Lauerman and the many other people with whom we have worked on consultancies for the help they have given us in so many ways. Prominent among these are the groups of carers and service users whom xii

Introduction

we have grown to know so well over the past decade in particular. In some cases, we have asked colleagues to comment on material and they have given us much useful advice. In other cases, we have learned a great deal from working with them and have drawn on discussions with them freely in thinking about how to prepare this book.We thank Chris Walker for realising the figures in the book. It goes without saying that we have sole authorship of the book, however, which means that these and many other people are in no way responsible for any mistakes we may have made. It only remains for us to invite you to join us in revisiting our journey as consultants.We have tried to give a sufficient sample of the literature on consultancy to encourage you to read around the subject and to continue to reflect critically on your practice. Finally, we hope that you will find illustrative and reflective material that will encourage you to more creative and innovative consultancy with practitioners and citizens in the future, and that you will find this as rewarding as we continue to do.

xiii

Part 1 Setting the scene In this part, we contextualise the empowerment approach to agency, show how we came upon this approach and introduce the rest of the book, indicating briefly how the empowerment approach to consultancy has changed our view of what consultancy offers public service organisations.

1

one

Introducing consultancy: an empowerment approach In the 21st century, consultants are an increasingly prominent ingredient in public services. Sometimes they attract critical comment, as though they are merely parasites, exploiting rather than contributing to these services. Yet consultants are often sought by the agencies providing services. People who work in public services are likely to encounter consultants occupying roles formerly carried out by full-time employees of central or local government. We arrived at one local authority to find that the position of director of children’s services was occupied, temporarily, by a full-time consultant, recruited on a medium term contract and paid for by the local authority. Consultants, therefore, have become integral to the workforce of public services. Yet there is a need to understand better what the nature of consultancy is and, from the viewpoint of consultants, how it is carried out. Also, there is increasingly in the 21st century a need to understand how consultancy can be directed towards meeting the needs, and satisfying the wishes and demands, of citizens. The rhetoric of government policy, after all, is that public services should be person-centred, and, in many senses, person-led, patient-led, user-led, carer-led, or as we would call it in this book spanning public services as a whole, citizen-led. As we reflected on more than 25 years’ work, much of it together, as consultants across many areas of public services – from the criminal justice system to health and social services, in different sectors of education and training, from colleges to universities including The Open University, and in government agencies – we discovered a major gap in the literature on consultancy, which seems on the whole to be geared towards the requirements of private industry and commerce rather than towards public services. Perhaps more significant, we became increasingly aware that the way we work – ‘with’ citizens rather than ‘on’ them or ‘on their behalf ’ – goes against the grain of much of the literature on consultancy that assumes that by virtue of employing consultants agencies, organisations and groups acknowledge that in their field the consultants know best, and that it is not for service users, carers, patients, consumers of public services or indeed any other members of the public to challenge them. Furthermore, we developed the strong 3

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view that, even where consultants may be challenged by the people who receive public services, the entire model of developing and delivering consultancy in public services needs to be turned upside down, so that the consultants are driven by the experiences and wishes of the citizen. In other words, we started to spell out what an empowerment approach to consultancy means to us. It is sometimes helpful to try to sum up the core argument of a book in one sentence.We probably would resist this, using the familiar complaint of authors that this would cheapen the complex message of the book. However, we have been challenging each other to do this while writing the book, and have arrived at the following statement: The paradoxical message of empowering consultancy for change in public services is that its purpose should be to contradict the consultants’ identities as ‘experts,’ by empowering staff and citizens so that ultimately it is not necessary to bring in people from outside, because those already involved can bring about the changes themselves. This first chapter provides the foundation and context for this statement.We shall return to restate it in a slightly more elaborate way later in the chapter, but first need to lay some foundations.

What is consultancy? Consultancy has become a profession in its own right, staffed by consultants, who spread their interests throughout the rest of the workforce of the public, private, independent and informal sectors of the developed and developing world. Consultancy is the term used to refer to the activity of providing specialist, expert or professional advice, help or support. At one extreme, consultants work in the informal sector of developing countries, facilitating grant aid and equipping societies in the process of industrialising to deliver services. At the other extreme, texts on specific aspects of consultancy, such as management consultancy, tend to mirror the concerns of the client group that constitutes their market. Burtonshaw-Gunn (2010), for instance, spends Chapter 1 of his book on management consultancy considering the profession of management consultancy itself: the types of consultants, clients, the role and governance of consultancy and the ethics of its practice (Burtonshaw-Gunn, 2010, p 1). The fact that consultancy is so widely used throughout the workforce is reflected in the development of a plethora of approaches and methods of practising it. Yet a common thread runs through this diversity – namely, the fact that consultancy entails people working with people. The term ‘consultancy’ carries particular meanings in different areas of public services. For instance, in the NHS, the higher grades of 4

Introducing consultancy: an empowerment approach

medical professional are given the title of consultant, senior consultant or principal consultant. In social work, some practitioners are given the title of consultant social workers. A consultant social worker with children and families in local authority X manages the caseload of the professional staff in his or her team, chairs weekly team meetings, supervises social workers and children’s practitioners in the team and ensures that collaborative work with family members and other agencies is carried out effectively. Cockman, Evans and Reynolds (1999) use social work approaches in their approach to consultancy. Consultancy and social work share the fundamental feature of both entailing working with people, invariably with a particular focus – on bringing about change, often in challenging circumstances. This is not universal or inevitable, but it is a recurrent theme in both of these activities. What do we mean by public services? Public services can be defined as those services funded through taxation. They can also be defined as those services delivering public, including social, policies. Furthermore, they can be defined as central government services delivered to citizens through public, private, voluntary or independent means. For the purposes of this book, we avoid the complexities of these different ways of defining public services and state that they include health services delivered by the NHS and community, criminal justice, education, fire, housing, leisure, policing, social work and social care, social security (including pensions) and youth services delivered by central government and local authorities, as well as uniformed armed services provided by central government. We draw on our own experience in the examples selected for this book, which means that we focus on some of these areas more than others. We give further details of our experience later in this chapter. Although most of the literature on consultancy focuses on commerce and industry, the fact remains that public services are huge and of paramount importance to the lives of many, probably most, citizens. Annual total spending on public services in 2010 was estimated at £661 billion, which equates to three quarters of all expenditure by central government and one quarter by local government (excluding uniformed armed services). Of this, £105 billion was spent on welfare, £86 billion on education and £120 billion (18 per cent of total spending) on health. An investigation by The Guardian newspaper (Hopkins, 2011, p 31) found that while formal spending on management consultants fell between 2006–07 and 2010–11 by 5

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about £100 million, spending on FATS arrangements (Framework Agreements for Technical Support – arrangements to buy in outside technical experts, or consultants by another name) increased from about £6 million in 2006 to almost £300 million in 2009–10, a total spend on consultants and FATS between 2006 and 2011 of about £790 million. Statistics apart, some idea of the size of public services can be gathered by appreciating that the health service in the UK is not only the largest organisation in Europe, but, apart from the Chinese army, Walmart in the US and the Indian railways, probably has the largest workforce in the world (www.ukpublicspending.co.uk/). Changing role of the citizen This is not a book about theory. However, it is theoretical in the sense that as we have reflected on our experiences as consultants, we have reached into other branches of our activities in public services, and in particular into the literature rooted in the social sciences, to help us to make sense of what is going on. Our observations, therefore, are embedded in ideas and perspectives that are rooted in social policy, politics and, in particular, sociology. Whether or not we acknowledge it on a day-to-day basis, these perspectives and assumptions shape and give meaning to our perceptions and interpretations. To illustrate this, we take this notional and seemingly abstract person who figures so largely in our practice and in our discussions of it – the citizen. The empowering approach we have developed to this person – often referred to as the patient or the service user in literature and practice concerning health and social services – leads us back repeatedly to the current conceptualisation of this individual.Yet, a growing body of sociologically informed and social policy-based literature exists on the involvement of the service user in public services (McPhail, 2008; McLaughlin, 2009), and critical commentators in social policy have established that the identities of this person have changed markedly over the past few decades (Clarke et al, 2007; Newman and Clarke, 2009). We do not have enough space to analyse this here, but Clarke et al (2007, pp 9-26) deal with theoretical perspectives on the citizen – and in particular the citizen as consumer of public services – and examine the increasing importance given to the citizen as consumer since the 1980s (Clarke et al, 2007, pp 27-46). In the process, we discover that there is not one agreed set of assumptions about what constitutes the identity of the citizen as consumer of public services.There are, in effect, different ‘publics’ for different services that change through time, and the identities of citizens are not singular but plural, and are correspondingly 6

Introducing consultancy: an empowerment approach

complicated by this complexity. (There is more discussion of this notion of publics in Chapter Seven, this volume.) It will be important to bear this point in mind, as the approach to consultancy we develop cannot be a simple toolkit, but has to be flexible, in order to accommodate the variety of citizens’ identities, experiences and demands encountered in the different areas of public services. Let us return now to the main thread of this discussion, by posing the question as to why consultancy in public services is important enough to require our attention. Why is consultancy important? There is probably no part of the world that has not been affected since the late 20th century by the activities of consultants. Clark and Fincham (2002, p 1) state:‘Few people, whether in their roles as employees or as citizens, will have avoided the effects of some kind of consultancy-led initiative’. The growth of consultancy over the past 50 years has taken place in all sectors of the economy of industrialised countries. It is not the case, however, that consultants have only been active in ‘developed’ countries. Consultancy is as much an international activity, crossing geographical boundaries with the additional challenges of cultural differences. Behind much international aid and social development in the ‘developing’ countries there are consultants guiding donors and recipients, and in front of the grants and initiatives there are more consultants engaged in implementation. In short, consultancy occupies key locations and stages in the processes of international activity, in different countries. What relevance has consultancy to the work of the public services? Statutory agencies providing public services are funded directly from the Treasury (the government’s ‘purse’), while voluntary agencies providing statutory services such as healthcare or child protection are funded indirectly from central or local government, and private agencies such as companies providing residential care may receive some government funding, provided they meet criteria for judging value for money and fitness for purpose. However, since the 1980s, in the UK there has been a trend towards public services formerly provided, in effect, by a monopoly of central and local government being contracted out to service providers in the independent or third sectors, comprising voluntary, community and private groups, organisations and agencies. The Labour government (1997–2010) emphasised the importance 7

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of empowering the citizen and, although not from a New Labour perspective, the subsequent Coalition government (2010 onwards) is continuing this trend in the White Paper on the future provision of public services (HM Government, 2011) (discussed further in Chapter Seven, this volume). Among the principles proposed by the Coalition government are the desirability of decentralising control of public services as far towards the individual citizen as possible, and increasing the variety of providers outside the public sector. The recurrence of these trends reflects not only their desirability but also the lack of a fresh approach to achieve their aspirations. Two main consequences follow from these trends: • there is an enhanced role to be played by individuals, groups and organisations, as facilitators and consultants, in moving public services towards this more mixed, and hence complex, pattern of provision; • whatever the mode of provision of public services, the person who uses services as well as the citizen are intended by government to be more central than hitherto in their development, management and delivery. The empowerment approach developed in this book is entirely consistent with this statement. According to the joint statement of best practice by the Management Consultancies Association (MCA), Institute of Management Consultancy (IMC) and the Office of Government Commerce (OGC) (2009), more than £600 million is spent every year on consultancy by central government. A journalist, Gerri Peey (2010), claims that government expenditure published by the Treasury (Combined Online Information System – COINS) reveals that, in total, the government spent three times this amount – £1.8 billion – on consultancy in a single year, over £500 million of this being in the Department of Health, followed by £288 million by the Department for International Development. Looking back over the past decade, Owen and Brady (2010) quote totals about a quarter of these, but arrive at a grand total not too different from that of Peey, noting that more than £20 billion was paid by the UK government for the services of consultants; in 2009 the National Audit Office stated that the government had spent about £3 billion on consultants. Regardless of the detailed accuracy or inaccuracy of these figures, it is undeniable that consultants consume significant funding, and hence make a significant contribution to the work of public services. What is surprising, perhaps, is the little public acknowledgement of the importance of this contribution. The different ways in which this 8

Introducing consultancy: an empowerment approach

contribution is made reflect the multifaceted work of typical public services organisations. Public service organisations are complex in that their senior managers have to demonstrate that they are fit for purpose and that they can deliver services according to their budget, safely and to meet people’s needs. There are inevitable tensions between different providers of services and tensions within each organisation, too, as top managers, middle managers, team leaders and front-line professionals deal with the particular requirements and demands of their respective jobs. Top managers have to maintain a strategic view of the organisation and negotiate with others outside the organisation. Competing demands on public services are common, resources are often scarcer than is necessary to meet these demands and they need to be balanced according to the respective expectations of political representatives and of managerial and professional colleagues. Middle managers need to balance the requirements of top managers against what administrative staff and teams of professionals and other front-line staff can achieve. Teams of professionals and others in the front line of interaction with the public have to balance personal, professional and organisational demands on them. In public services, there are often situations where the demands on the service exceed what can be provided, and also where the expectations of different citizens conflict, or because of the complexity, and changing nature of their needs, cannot be met fully. In these ways, public service organisations provide challenges that are not present in private commercial organisations that are purely concerned with developing and producing a product. Authorities responsible for delivering public services employ consultants in three main ways: Ensuring that public services meet requirements for inspection and assessment: the Conservative government (1979-97) introduced measures to inspect and audit public services from the creation of the Audit Commission in 1983 to the development of many measures to set standards of performance and to monitor the quality of public services. Under Labour, the Local Government Act 1999 required local authorities, fire and rescue authorities and some parish councils to establish continuous improvement systems known as ‘Best Value’. Annual and three-year cycles of inspection, assessment and audit were established in the UK, which were more or less harmonised in England, Northern Ireland, Scotland and Wales. In the early 21st century, arrangements for the inspection of services continue to be subject to review and reorganisation. Two noteworthy features of these inspections are their 9

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reliance on National Performance Indicators and the incorporation in assessments of corporate activity and service delivery of the views of people who use services. A Commission for Patient and Public Involvement in Health was established in 2003 and was replaced under the Local Government and Public Involvement in Health Act 2007 by Local Involvement Networks (LINks) to enable independent individuals and groups to have a stronger say in how their health and social care/social work services were to be delivered. The quality of adult social care services was registered under the NHS and Community Care Act 1990 and regulated and inspected under the Care Standards Act 2000. The Care Quality Commission (CQC) was created under the Health and Social Care Act 2008, and is responsible for regulating health and adult social care. Police services were regulated by legislation such as the Police Act 1996, the Police (Scotland) Act 1967 and the Police (Northern Ireland) Act 2000. The Fire and Rescue Services Act 2004 extended the duties of local authority fire services to include rescue. Ensuring that services meet legislative requirements for health and safety, equality and non-discrimination: health and safety and anti-discriminatory practice are two areas in which health and local authority services have been particularly concerned to ensure their compliance with legislation. Directives in the European Union (EU) that are binding on member countries including the UK constitute an additional layer of legislative requirements. Campaigns by pressure groups including activist groups such as the Disability Movement and the Patients Association have contributed to anti-discrimination and equality-based legislation such as the Equality Acts (2006 and 2010). Ensuring that services match the values of professionals and citizens: the professional values of public services include respecting and safeguarding people and ensuring justice, inclusiveness and equality of treatment. We have to recognise that in any historical period certain ideas are predominant in social policy and in public services.Those involved will often take these for granted. In the 21st century, for instance, there is an enhanced emphasis on personalisation – enabling people to choose and manage their own services, rather than these being professionally directed and delivered (see Chapter Two for more discussion of personalisation, and an example given in Chapter Five on p 134). In fact, the goals of empowering citizens and personalising services could be better met in some circumstances by not using consultants and thereby saving money and enabling service users to play enhanced roles 10

Introducing consultancy: an empowerment approach

in service development.What we recognise as consultants is that some of the initiatives offered as consultancies by clients reflect ideologies – they are driven by the values and beliefs dominant at the time. By ideology, we mean a way of thinking and perceiving that is often based on beliefs, assumptions and principles of a moral or political nature. Particular ideologies are not necessarily ‘bad’, but they are part of the ideology of the day rather than aspects of some essential ‘truth’ about society, social policy and the nature of public services. In other words, the policies and practices in which consultancies take place are ideologically driven, and consultants need to retain an awareness of this and include this in critical reflection on action as it proceeds. An enhanced role for consultants in enabling public bodies to assure quality The linking theme in the above three roles of consultants is quality assurance. Quality has been a concern of governments since the early 1980s, specifically in relation to public services when the Audit Commission was set up in 1983 with a brief to judge the probity of spending of public funds, a role which shifted gradually towards monitoring services themselves. Since the early 1980s the responsibility for governance of quality assurance has been more overtly assumed by central government, for instance, through the Local Government Act 1999, which granted the Audit Commission enhanced powers of inspection over local councils. From 2000, the Audit Commission began to inspect local public services, and in 2002 Comprehensive Performance Assessment (CPA) was set up to monitor the corporate activity of local authority councils and to carry out annual service assessments and resource assessments as well as assessments of the direction of travel of future policy. A new framework for inspection of local public services began to function from 2009, and new legislation in different public services was introduced. For instance, in health and social services, the Health and Social Care Act 2008 ensured that previous rather disparate arrangements were replaced by a single integrated CQC with a brief to register services and regulate and inspect them. Two noteworthy features emerge from this brief account, namely, the great breadth and pace of change amplified by the introduction of arrangements for independent organisations to be contracted to deliver services, and the increasing emphasis on accountability of public services, to central government and to the general public. This places additional responsibilities on organisations responsible 11

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for commissioning, procuring, managing and delivering local public services and enhances the potential benefit of contracting consultants to help public bodies carry out their responsibilities. Debates about the propriety of consultancy In the light of what we have just written, it is surprising, perhaps, that consultants are not taken for granted as making a useful contribution to the work of public services. In fact, not all parties view the ground on which consultancy takes place as level and neutral. There is a growing literature on the alleged improprieties of the consultancy industry, portraying it as a parasitic means of profiteering at the expense of the organisations on which it feeds. Craig (2005, p 1) critically examines the growth of the consultancy industry, referring to the ‘management consultancy industry’ as worth about £60 billion worldwide and nearly £8 billion in the UK (Craig, 2005, p 3). Consultants are blamed for the ills of industry, including the rapidly increasing level of boardroom remuneration since the late 1990s (Hosking, 2010). It is undeniable that even if only a small part of the criticisms of consultancy to which we have referred above is true, then we should regard the activities of consultants with scepticism. Craig (2005, p 3) poses the question why many organisations are in the business sector, ‘and major hospitals and leading government departments in countries all over the world apparently unable to find the skills they need amongst their many hundreds of thousands of employees – each one of whom is often more qualified than the consultants they use and paid enormously less per year than each of their consultants cost for just a few weeks’ work?’. Craig (2005, p  3) continues: ‘Are all consultants brilliant? – Unfortunately not. Are they all superb communicators? – If only. Do they all have an arm’s length of qualifications from the world’s greatest centres of learning? – Not by a long shot. Some consultants are, of course, highly qualified and very talented, but very many are not.’ While consultants are hired, to an extent, to bring new thinking into organisations, there is a need to recognise that consultancy is an extremely complex activity that cannot be reduced to formulaic statements, or indeed to a book of new tricks to solve old problems. What is needed in the consultant’s repertoire of skills is a balanced approach, resting partly on a properly theorised understanding of organisations in public services and partly derived from ideas developed through working with them as consultants and practising in them themselves. 12

Introducing consultancy: an empowerment approach

Consultancy and change The crucial argument we put forward is that this consultancy approach can be undertaken by the current workforce of the organisation working with those citizens who are involved with it. If we had to portray the nature of consultancy in a phrase, it would be ‘change and challenge’. Consultants are employed to bring about change. Change is the business of all employees and others in their networks as it is intended to bring about positive benefits for the organisation, its employers, funders and customers. It has systemic goals, aiming to bring about positive benefits, not only for the organisation through its managers and professionals working in it, but also for citizens in contact with it. This innovative approach has two main advantages: • it puts back in the hands of the employees, volunteers and citizens connected with services the power to act to challenge the status quo and to facilitate and nurture change; • it provides a strategy to tackle the argument that consultants are at best not helping and at worst are parasites cheating the organisation. Turning the consulting industry on its head: we can all be consultants now! The simple but dramatic message of this book is that we can achieve most, if not all, of what consultants can achieve by empowering the existing workforce of most organisations and the citizens who are engaged with them. Consultancy, as we envisage it and as we have increasingly developed and carried it out, is a long way from mystifying the client and pulling the wool over their eyes and entails a participatory and empowering approach leading to the position where, potentially, we can all be consultants. We are not arguing that no public service organisation should employ external consultants, however. On the contrary, we argue that the notion of ‘who the consultants are’ should be expanded, potentially to include the entire workforce and all those citizens with whom they interact.We view this as not just compatible with the direction of travel of policy, which puts the citizen at the centre of choosing, directing and using services, but as the logical conclusion of empowering the worker and the citizen. This book is largely taken up with the task of expanding on this viewpoint.The remainder of this chapter explores briefly the character of the approach to consultancy we have developed over the past 13

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decades. In subsequent chapters, we go through the consultancy process, illustrating and discussing each phase in more detail.

Starting points: preparing for consultancy Consultants must equip themselves to carry out consultancy. In part, consultants need to be acquainted with the field in which they are carrying out consultancy. In part also, they need to have the relevant skills to be able to reflect critically and apply creative thinking to their field of practice. We have drawn eclectically on a wide range of ideas, ranging from writers on organisations, such as the psychologists George Kelly and Edward de Bono, who invite boundary crossing between disciplines and creative thinking. At the heart of what consultants do is the activity of thinking around the setting and the problems with which they are presented.We discuss the sources of these ideas in more detail later, in Chapter Three. At this point, it is helpful to map the general territory of consultancy in public services, to give some illustrations of the kinds of consultancy with which we are concerned and to give an insight into how we work as consultants.

Mapping the territory of public services consultancy It is important to bear in mind that consultants are outsiders working inside public services.The management of the balance between being outside and working inside requires firmness, tact and sensitivity. Speaking the truth is necessary, rather than supplying little that is genuinely new and creative, in exchange for a hefty fee. Being an outsider gives the consultant a certain independence and enhances the capacity to be critical. At the same time, working inside grants access to understanding the situation from the vantage point of its regular and more permanent participants – patients, service users, members of the general public, professionals and other staff. For example some outsiders, such as members of the Boards of Visitors of penal establishments, occupy a very powerful position as critical ‘outsiders inside’, and carry out official duties monitoring the quality of public services (Adams, 1981).There is something of this in the role of typical consultants. They bring a degree of independence of judgement with them into the public service contracting them, notwithstanding the fact that they are contracted to carry out a particular piece of work. There is, therefore, an inherently problematic reality of the situation and role of public service consultants.

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The wider perspective of some consultancy derives from this ‘outsider inside’ perspective. Consultants by their nature have experience of many settings.They often work at different points in a particular public service and in many different services. They may have experience of different levels, or domains, of a service, from local practice through to local, regional or central government work. They may specialise in work in the organisational, management, workforce domains of the particular service or organisation, in professional service delivery, or they may focus on the interface between service deliverers and citizens. These different locations can be viewed as different communities, each with its own groups of staff and its own notion of its ‘public’ of service users, patients, carers or citizens. Consultants may work with social enterprises and their social entrepreneurs – they may actually function as both entrepreneurs and consultants. Their roles may be mixed, and they may work individually or in teams. Organisational development: strategic aspects Consultants in public services have multiple opportunities to focus on strategic aspects of organisational development (illustrated further in Chapter Five).Typical topics for consultancy include helping agencies in the public, private, voluntary and independent – or third – sector in engaging in change. Public services quite commonly engage consultants in pursuit of concerns about the quality of services and remedying particular shortcomings.This is in the context of the wider preoccupations of central and local government with transforming public services. The transformation agenda of policy makers and managers may entail, on the positive side, developing leadership issues and champions to promote innovation and to bring about change. On the negative side, it may necessitate tackling weaknesses in services and, perhaps, protecting the territory of whistleblowers and developing measures to safeguard their interests. Change is also a preoccupation in individual organisations working with members of the public, across a wide range of settings varying from proactive services such as policing, to walk-in services such as housing offices and consumer advice centres, through day services, to services providing various intensities and specialities of residential provision such as hospitals, care and nursing homes. In their different ways, all of these individual settings are potential beneficiaries of consultancy, to improve aspects of their working. We now use some illustrations to put flesh on the general discussion above. 15

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Example: Identifying and tackling obstacles to change Public services engaged in the process of change may employ consultants to facilitate this. A focus for such consultancy is making change happen. In the process, consultants may help the service in identifying and tackling barriers to change. A common complaint of people working in public services may be that over a long period of time they seem to waste time reinventing the wheel. The point often made is that practice seems not to progress beyond a specific point. Instead of achieving real change, staff repeatedly go round the same cycle. In such a situation, the consultants may be employed with two aims in mind: • to identify the obstacles to change; • to enable staff to tackle obstacles to change and empower them to surmount these. The consultants at one point reflect together on the need to move from analysis to action. One of them has been reading the book by Pascale et al and recalls them quoting the Vietnamese proverb (2010, p 46) that ‘a thousand seeings aren’t worth one doing’. With this in mind, they discuss the obstacles they have identified, which include: • numerous local authorities working separately rather than in collaboration, not sharing ideas and practices and on occasions even competing with each other; • problems of compartmentalisation rather than sharing innovative ideas and developing seamless services; • prioritising individual profit rather than corporate, and associated service user, benefits. The consultants develop two particular strategies for tackling the obstacles to change: foresighting, based on work they have done previously, and, following some discussion of the book by Pascale et al (2010), the positive deviance approach.

Developing foresighting as an instrument for change This involves two aspects: • Enabling staff and citizens to identify the benefits of foresighting. This entails staff and citizens gaining control of the future by trying to understand it and shape it. • Empowering staff to use foresighting. This entails asking staff and citizens involved with them developing ideas on how they would like the future to be. They are encouraged to try this first, and then shape what the organisation can offer or do to bring about these visions of the future. At the same time as engaging in these two approaches, those involved are encouraged to identify aspects not currently being developed. They may find it difficult to look ahead; nevertheless, the consultants encourage them to develop

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Introducing consultancy: an empowerment approach visions of what is not being tackled and to explore what resources could be brought to bear on these areas. It is emphasised by the consultants that no set of visions will be perfect, and much change will be incremental and continuous rather than achieved at a point in time. Further, of a dozen themes identified for change, several are likely to fail abjectly, several more may be implemented in a mediocre fashion and only one or two may be significant or even groundbreaking. However, the feeling of achievement and empowerment at these one or two areas of progress may be sufficient to take the service and engaged people forward in the continuing process of change.

Developing a positive deviance approach Positive deviance, the approach developed by Pascale et al (2010), involves not turning to the recognised experts inside or outside the organisation, but pursuing the somewhat unexpected thought that somebody as yet unidentified in the organisation has probably already tackled the problem and may even have solved it. Positive deviance model outcomes for scales are best applied in one organisation vertically, rather than transferring outcomes horizontally.According to this, there are likely to be many different individuals, or groups, that, faced with very similar problems, have developed a way of succeeding, and in identifying these it is possible to encourage others to adopt their deviance from the norm to achieve positive outcomes.

Example: Developing organisations led by the wishes and needs of all citizens and not only staff Consultants may be employed in any public services setting to improve the extent to which a specific service is led by the wishes and needs of citizens. In health and social care settings, this may include hospitals, residential care homes and nursing homes. In doing the work, the consultants may draw on the literature on democratisation of hospitals and work organisations, from the therapeutic community on the one hand, to the democratised commercial organisation or factory on the other hand, perhaps referring to settings where there is joint ownership or a cooperative organisation.

The above examples give some indication of the territory in which we operate as consultants. We continue by giving an insight into how we work. How we work as consultants: reflecting together When on a project with other colleagues, usually just as a pair, and sometimes with people who receive different public services, we (the authors) meet regularly when engaged in a particular piece of 17

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consultancy, alternating our meetings between two very different hotels in Yorkshire.We have come to label these by the names of their hotels, which for simplicity I shall refer to here as the York Hotel and the Beverley Hotel. The atmosphere at York is more lively and the pace quicker, more consistent with getting the job done as speedily as possible. The York Hotel is larger, busier and from choice we do not hire a room but sit in the busy foyer, ordering pots of coffee and tea and a snack lunch as the day proceeds. The Beverley Hotel is quiet, always unhurried and the atmosphere is conducive to reflection. We occupy the corner of one of the sitting rooms, in sedate surroundings. We set a starting time but no finishing time for these meetings, beyond that imposed sometimes by other commitments elsewhere. These meetings are outside of our regular work and independent of the stream of consultancy contracts which have occupied us, sometimes jointly and with other people and sometimes separately, over the past 25 years.We have met this way, not particularly frequently but regularly, and we have come to recognise that these occasions provide the neutral territory that is a counterpoint to our everyday practice. Before these meetings we share some ideas in writing. We each read through what the other has written. On the day, we have evolved a structure, but it is a surprisingly unstructured structure. By the end of the meeting, each of us takes something away. It may be a problem identified, a problem tackled or a series of ideas about strategies. Often there is a sense of progress, perhaps relief at an issue shared. We both agree the time is never wasted. We have come to call this our thinking time, creative time, innovative space. It is a journey into the unknown, yet in the process something on the edge of our consciousness, individually and collectively, becomes known. What is going on when we have a York or Beverley Hotel meeting? Whether we meet at York or Beverley depends on how we are feeling at the time. It is not always clear-cut when we have that telephone call or face-to-face conversation when we decide where to meet. To be frank, there is a ritual element in this and probably we could achieve a similar result in many other ways. We might go fishing, play a game of golf or sit in a corner of the local bar. The important thing is that we are aware of the prime importance of balancing engaging with the action of the consultancy and locating ourselves outside it, and reflecting on what is going on. There is, naturally, a balance to be struck between ignoring what is happening and refusing to analyse it and over-analysing it to the point where it becomes a romanticised 18

Introducing consultancy: an empowerment approach

reification of something that never was all those things.We have reached a mid-point in our understanding of these conversations. The point about the meeting away from the pressures of everyday work is that they make a space where critical reflection and creative thinking can begin to happen. Wherever we meet, there is a relationship in these occasions between three components: offloading, critical analysis and creative thinking (see Figure 1.1). Offloading generally takes place, usually as a starting point, but sometimes continuing in bursts throughout the meeting.This is where we unburden ourselves of whatever is at the top of our minds. It benefits from the meeting being unplanned, with no agenda. It needs, of course, to be controlled by the listener, to prevent it swamping other business. It happens in the way a hiker lands in a place of refreshment after a long haul and spends time taking off a rucksack and other impedimenta, hanging up a coat to dry, taking maps and other items from pockets and setting them out on the table and recalling the most immediate and dramatic incidents of the journey. Offloading entails divesting oneself, but it is important that the other person is in listening mode. It does not work as well when both are offloading together. The pairing of offloader and listener enables the other person to act as co-consultant. The roles can reverse then, or the emphasis can simply be on one person offloading. In our experience, it does not matter. Critical analysis is the useful but by no means inevitable sequel to offloading. This is where the listener needs consultancy skills, because he or she has to be in the mode of interpreting what is going on and to give feedback to this effect, to the person offloading. Critical analysis also entails contextualising the material offloaded. It is partly an account from the listener of ‘what I think is going on here’ and partly Figure 1.1: Dynamics of the York Hotel/Beverley Hotel meetings

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both of the parties working to relate it to various contexts. There is the context of ‘what is going on at work’, which is probably the main one, but there are other contexts which may be relevant, including ‘what organisational, psychological and sociological theorists have to say about this aspect of human experience’ as well as ‘what is going on elsewhere is my life’. Creative thinking is the essential, but again by no means inevitable, next stage. The York or Beverley Hotel meetings are only worth the effort if they leave us with some of what the accountants call ‘added value’. There has to be a residue of useful outcomes among our scribbled notes when we travel back all those miles to our respective homes. In our case, we can report that this happens.

Developing consultancy: the empowerment approach We have explored the general context of consultancy and have given a flavour of how we meet, reflect and draw on various techniques as an aid to creative thinking. We now turn to consider more directly what we mean by an empowerment approach in consultancy. The goal of public services, in general terms, could be said to be improving public health, happiness and well-being. How do we understand these ideas? In our everyday work in public services, we engage with individual colleagues, with work groups inside the workplace and with individuals and groups in other settings, including organisations. Our work sometimes involves us having to take on a task involving change, for individuals, perhaps for groups and perhaps on occasions, for organisations as well. The individuals, groups and organisations involved in any particular change in public services are likely to form a complex picture of resources that they bring to the situation, needs and wants. Needs of people The needs of individuals, groups and organisations have been conceptualised by social scientists – psychologists, sociologists, anthropologists and economists – from the early 20th century onwards, in a multifaceted accumulation, expressed in their best-known form in the hierarchy set out by the psychologist Abraham Maslow (1908–70). Maslow (1943) based his hierarchy of needs, in its best-known form, on the notion of a pyramid of five levels, from the most basic biological needs to the maximisation of human potential. However, in the 1960s, he added three more levels, but did not set these out in one particular 20

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publication (Adams, 2008c), so it is uncertain how he arrived at them (Maslow, 1999). These eight levels are as follows: • biological and physiological needs, for air, food, drink, sleep, shelter, warmth and sex; • safety needs, for protection and security boundaries; • affection and belonging needs, for loving relationships in the family and satisfaction at work; • esteem needs, for appreciation by others, status, reputation and recognition of achievements; • self-actualisation needs, for personal development and fulfilment; • cognitive needs, for knowledge and understanding; • aesthetic needs, to create or appreciate beauty and harmony; • transcendence needs, enabling other people to achieve self-actualisation. Maslow’s work is important because it draws not only on psychological but also anthropological and ‘social’ ideas of what needs people have and how they could be met. For instance, he built on the ideas of the anthropologist Ruth Benedict, about how the notion of synergy may be applied in organisations, specifically where cooperation between people is rewarded by management, with the result that people become more motivated, they function better and output increases. Maslow was optimistic about people and he applied his humanistic ideas about how to meet people’s needs to the circumstances of commerce, and a well-known management theorist, Douglas McGregor (1960), used his thinking in developing the notion that there are two prevailing and contrasting managerial theories concerning human nature – theory X, that people are fundamentally lazy and selfish and meet their needs at work by doing as little as possible; and theory Y, that people are fundamentally cooperative, hardworking and productive and meet their needs at work, ideally, and when encouraged, by helping each other and throwing themselves into the task with enthusiasm. Managers making theory X assumptions tend to reward workers with money and run out of incentives beyond this. Managers making theory Y assumptions tend to develop more holistic and far-reaching ways of investing in the human potential of staff and so build a more creative and productive work environment. Dennis Saleeby (2002) has developed a so-called strengths perspective based on the holistic assessment of the person’s needs as a whole and taking into account the entire ‘ecological’ world of their background – family, neighbourhood and social environment – in responding to their needs. It is important to be aware that the 21

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maximisation of human potential rests not in the simplistic assumption that people’s outward appearance counts, but in the realisation that their experience and the meaning they give to it is equally important. In among this, of course, is their own capacity and resilience and building services around these. We can draw from this brief discussion the importance of developing an approach to consultancy work that recognises people’s potential, their capacity and the available resources, and enables them to meet not only their lower level but also their higher level needs through work. Before setting out these different components of a working model of consultancy practice, we proceed through some of the key components, beginning with the importance of the person who works with the citizen – the consultant. What is it about the capacity of the consultant that makes him or her a useful person on whose resources to draw? What makes a capable consultant? We have noted the following, in our own work and in work with other consultants, as qualities and skills of the consultant with relevant expertise. The capable consultant: • • • • • • • • • • • • •

is a good team player; is flexible, open to new ideas and able to learn continuously; is able to use leadership skills; demonstrates enthusiasm for knowledge about the subject; demonstrates intellectual persistence (seeing the job through); is a good planner and organiser and meets deadlines; thrives on challenges and responds positively to problems; copes with a rollercoaster of emotions; is a good budget manager; demonstrates ethical practice, dedication and professional integrity; is a good communicator; can sell ideas; thinks on his or her feet.

Above all, the capable consultant practises ethically, which puts at the centre of this practice the interests of the client and the citizen rather than the income of the consultant from the consultancy! The consultant also has to be able to reflect critically on his or her work and this entails being self-critical. But what do we actually mean by being critical and self-critical? 22

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Nature and principles of an empowerment approach to consultancy In the final part of this chapter we set out what an empowerment approach to consultancy means to us. It is important to say that for us this is work in progress rather than a finished statement. We regard it as integral to the approach that our thoughts and reflections on our current practice feed into what we write.The empowerment approach influences, and is influenced by, them. As we shall see in later chapters – particularly Chapter Five – it relies a good deal on an action research strategy. Nature of empowering consultancy We went through a period of regarding empowering consultancy as critical consultancy or as generic or universal consultancy. We shifted over time from labelling it as ‘critical’, because although the approach shares some basic principles and practices associated with criticality and critical social theories, it relates to a variety of conceptual frameworks. We decided that the concept of empowerment relates closely to critical social theories and ideas about critical practice. It makes sense, therefore, to adopt empowerment as the core notion of our approach to consultancy, since it is based on the principle that all individuals and groups engaged in the work of public service organisations are empowered, so that they are able to identify where they would like to be in terms of goals and how they tackle them, and work towards achieving them. In this sense, the empowerment approach to consultancy is inherently challenging and this becomes even more pronounced when it is associated with the transformation of services. In the public sector many, if not most, of these services are not self-transformative. That is, some staff – perhaps a majority of staff – do not hold transformation of the organisation as a priority purpose. Also, of course, many of the changes require a significant shift in power relations between professionals and citizens, in favour of the latter. Consultants People who take on the empowerment approach to consultancy, in theory, could be external to the organisation, or any member of staff, or any citizen in contact with the organisation providing a public service. Let us state straight away that this emphasis on the contribution of 23

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the citizen-consultant is fundamental to the empowerment approach. Citizen-consultant is the term used to refer to a citizen with the dual identity of citizen and consultant, who works collaboratively and on an equal basis with other consultants. This aspect is similar to the citizen-centred leader programme advocated by The Improvement Consultancy (2006) (see Chapter Nine). This approach is challenging in that it introduces quite an extraordinary dynamic, setting out to develop work with organisations from the outside in, rather than more conventionally working on the inside with them.We refer to a similar approach below, using the term ‘critical outsider’. It is also challenging because it entails being open to recruiting any citizen as a consultant, alongside staff in the client organisation. We either take this seriously or we indulge in tokenism and operate a secretive policy that, in effect, includes some potential consultants and excludes others. We are committed to not working in a tokenistic way and to working inclusively. Here is an example of how this has worked for us in practice. Example We worked for more than two years on a consultancy, as part of which we set up a partnership between the university involved and groups of service users and carers in the north east of England.We had a core group of three consultants from the university and three service users and carers, and a wider network comprising at least two groups, one of service users and the other of carers, which met in different activities throughout the consultancy. In addition, the ‘client’ organisation had two formally constituted ‘task and finish’ groups, one including service users and the other including carers, as representatives. The groups included people representing the interests of older people, people with disabilities, people with mental health problems and other people using adult care services. Among the people with disabilities, for instance, were blind people and people with learning disabilities and physical impairments. Some people attended meetings with their personal assistants. Some used Braille during meetings and required materials translated into Braille. Some required the meeting to be suspended while they consulted with their personal assistants. Meetings needed to be preceded by informal social meetings so that newcomers could adjust and participate on an equal basis with each other. Meetings had breaks and time limits were imposed on their overall length to accommodate people whose participation was restricted in terms of concentration span or impairment. Red, yellow and green cards were supplied to all participants, so that they could signal to interrupt the business or create space to make a contribution.

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Principles of empowerment approach to consultancy We now consider an empowerment approach to consultancy in more detail. In one sense, of course, the field of management consultancy has already moved towards this position. Czerniawska (2002, p  95) acknowledges that there is less distance between consultants and clients, for example, than there has ever been before. However, we propose that all citizens engaged in public services should potentially be empowered to contribute to their management and development, which, of course, is what consultants do. Fundamentally, the empowering approach to consultancy entails promoting the inclusive view that every citizen is potentially a consultant. In any other context than the public services this statement might not carry the significance it does in the area of personalised community, education, health, housing, justice, social, youth and community, police and other uniformed services. From the vantage point of politicians and top managers in public services, what they deliver needs to express four elements. Services should be: • • • •

meaningful achievable measurable empowering.

Taking each public services organisation as a whole, the purpose should be reflected in the approach to consultancy.The extended discussion in the field of community development set out by Ledwith and Springett (2010, pp 22-7) can be applied across public services and is reflected in the empowerment approach to consultancy.These can be summarised in the following five statements: • • • • •

working for social justice working for self-determination working and learning together developing sustainable services working for empowerment and participation.

We now put these principles alongside the statement of best principles in the joint statement of best practice by the MCA et al (2009, p 2): Be truthful and constructive to, and easily contactable by, consultants and other stakeholders. 25

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Do not be defensive.The consultants are there to assist your organisation. Do not be afraid of providing too much information. Consultants would much prefer this to a lack of detail. In general, ensure that risk lies with the entity with the greatest ability to manage that risk. We maintain that an empowerment-based approach to public services consultancy relies on the consultants not exploiting their clients but practising on the basis of a value-driven approach. In public services, it is common to encounter variants of the following list of values: InDividuality CommunIcating DiGnity UnderstaNding PatIence RespecT PrivacY

D I G N I T Y

Combining these different statements produces the following composite statement of six principles: • practising honestly; • being committed to social justice for all staff – managers, professionals and others – and citizens; • working for self-determination by staff and citizens; • working openly, not defensively, and learning together with staff and citizens; • developing sustainable services; • working for empowerment and participation. Practice of empowerment approach to consultancy Chapters Two to Six go through the process of the empowerment approach in more detail. For the present, there are two points to make. The first is simply that the empowerment approach avoids the problem of the consultant as expert and develops a model of consultant as facilitator or co-consultant or colleague or all three of these (see Figure 1.2). It is important to note that while the employers, managers and professionals may see themselves as the main clients of the consultants, 26

Introducing consultancy: an empowerment approach Figure 1.2: Illustration of power relations between consultant and client

the consultants will only be able to engage citizens meaningfully in empowerment by focusing on their circumstances and needs. Thus, either the clients will need to engage them as stakeholders in public services, or the consultants will need to engage them as co-consultants. Durkin and Gunn (2010, p 51) note that in any setting where service users are the main ultimate customers, it is important to involve them in the design, delivery and management of services. However, it is necessary to appreciate the reality that any consultancy setting out to work with citizens in an empowering way is attempting the very challenging task of engaging the most fragmented and least powerful group of people – service users, patients and carers – in bringing about changes in services. In the human services, especially in social work, there is a case for the proper expectation that education and continuing professional development will equip consultants to be consultants to themselves, to colleagues and to the organisation. Three key ingredients of the empowerment approach: motivation, supports and capacity The empowerment approach does not use the language of ‘problems’ and ‘solutions’, but identifies ‘issues’ and seeks ‘opportunities’ for ‘change’. In the process, it makes use of the three linked concepts of motivation, supports and capacity.The relative importance of these will vary in any given situation (see Figure 1.3). The triangle represents three key facets of the organisations we have dealt with. We believe that all are essential to the process of creating effective change to transform the organisation and the individuals within it. Just like the three sides of a triangle, the balance of the forces can change the shape of the triangle, but if the forces are not balanced, the triangle becomes weak and unstable. We have experienced many 27

Consultancy in public services Figure 1.3: Ingredients of analysis of key factors in organisational change

organisations where this hypothesis has been demonstrated and as consultants it was rewarding to see changes in the balance, resulting in a more empowered organisation, and more sustainable change. Equally we have talked to many individuals where the same hypothesis applies. Critically, we may observe that just as there is not just one ‘public’ in receipt of services, so the identities of ‘service user’, ‘carer’ or ‘patient’ are problematic. In the first place, it is not clear-cut between the person who receives services and the manager or professional. Many people move in and out of these different identities, in their roles as employees, parents, sons, daughters, healthy person, person with an illness or condition, and so on. This is why we are committed to empowering consultancy that implies, wherever possible, working with service users, carers, patients and other citizens involved in public services.Working with citizen consultants is demanding. It requires us to be alert to ways in which professionals exclude ‘lay’ people from power and access to means of bringing about change (Adams, 2008a). Organisational change The reason clients employ consultants is essentially that their motivation for change has increased as they reflect on the fact that their own efforts have been ineffective. Motivation, however, especially 28

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if it is not shared in the organisation, is simply not enough, but it can be increased by sharing a vision of the rewards if change is effected, and indeed there may be rewards from greater job satisfaction through to better pay and conditions of service. There must be the capacity for change, which we believe encompasses that all-important factor of time, as well as the intellectual and emotional capacity of the organisation through its people. Time must be made available for people to engage in and reflect on the process of change on the journey to transformation. Equally, and closely linked, staff must understand the process at their level and it must be managed to have them ‘sign up to it’, an expression often used in this context. So many public services are reorganised in spite of staff, and at great speed, with little justification being given for the reorganisation. This does not generally involve them in the process and certainly does not empower them.Without justification the entire process risks removing their motivation as it suggests that their sense of achievement in the past was poor and their performance helped make it even more so. Supports are necessary for the process of change. These supports can take many forms, from staff training through resources like office space and equipment through to supervision time for staff as they adjust. How often do we hear that supervision, personal development reviews and appraisals should take place but are postponed, and then even on realisation are tokenistic and rarely applied beyond the completion of the necessary paperwork? This process must be effective to be supportive of the transformation process. Individuals and change Individuals need motivation too, and supports and capacity, to play their most effective part in transforming the organisation. It can be argued that unless at least most of the individual staff are not so engaged, then the process will be ineffective. Staff need motivation that preferably needs to centre on their morale, which is about the culture in the organisation, as well as pay and conditions of service. One organisation we encountered worked with challenging adult offenders. The most senior manager took the view, it seemed, that there was no such thing as staff morale, only doing the job or not doing it. In referring to individuals’ annual personal development reviews and appraisals, a further issue is that of the aspiration of these processes.As it is an annual process, the plans made centre on what has been achieved in the past year and what will be achieved in the coming year. We would argue that most, if not all, staff in a transforming organisation, 29

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should be encouraged to look back over more than the past year to consider where they were and where they are now. Equally they should be encouraged to look way beyond the next year to consider where they would wish to be in, say, five years’ time. The process becomes more meaningful for them as many would not necessarily wish to be doing exactly the same job in five years’ time. The very least is that they would wish for the organisation to be more successful and that they share in that success, but for most they will want to move sideways to try something different, on a path to see if they can play a bigger part in the organisation through promotion. Some may reflect that while promotion may bring rewards in pay it also brings extra responsibility, even pressure, something that they may not wish to take on.This process as a whole engages staff more meaningfully in the future and has the potential to transform the organisation. Example A new director reviewed the organisation and decided change was needed.This decision was based on the perception that the organisation was not performing well enough. A new structure was devised, with limited consultation, if any took place at all, and staff were required to apply for jobs in the new structure. This process destabilised the organisation as staff were understandably fearful that they could lose ‘their’ job, but of course, the vast majority of staff emerged from this painful process with the same type of work and the same limited resources and support that had existed beforehand. Some managers missed out and some gained under the new regime. This type of process was referred to by one person as ‘motivated through fear’ and in recognition that it had not provided the supports and capacity to effect real change.

Recapping the process of the empowerment approach to consultancy As consultants, we begin with assessing the contribution we can bring and our limitations. This enables us to clarify the resources from other people that we need to bring into the consultancy from the outset. Central to this is the balancing of our own experience, learning, knowledge and skills against those of clients, patients, carers and members of the public or citizens. Then there are five key stages in a process which, in practice, is more fluid and in which each stage may overlap with those around it: • negotiating – the preliminary stage of first encounters between the consultant and client;

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Introducing consultancy: an empowerment approach

• contracting – the stage of generating a formal understanding or agreement about the work to be done; • engaging – making connections with people and with the tasks to be done; • empowering – facilitating people gaining power and adopting a critical, self-critical and evaluative approach to practice; • disengaging – going through the process of ending the work and making arrangements for continuing work where appropriate. These emerge as major components of the consultancy approach we are exploring. We shall be dealing with each of them in the chapters that follow in the next part of the book.

Conclusion In this chapter we identified the key features of the empowerment approach to consultancy. It is necessary to appreciate that empowering consultancy as we conceive it is a creative process rather than a merely technical accomplishment. It is deliberately transparent in that the consultants work openly and thereby make themselves vulnerable to others with whom they work.This transparency makes the consultancy more rather than less demanding.There is an element of performance in consultancy and sometimes this can go badly rather than well. Consultants share this characteristic of their work with others who claim to be professionals. However, we set out to engage citizens as consultants wherever possible, and in so doing threaten the power base of the traditional consultant. In including citizen consultants, we invite those members of the public who traditionally occupy relatively powerless positions as dispersed interests to join the relatively concentrated power base of managers and professionals and to take part in the consultancy (an idea to which we return in Chapter Eight). Consultancy, in these terms, is not about the consultants retaining and holding to themselves their expert knowledge, but about sharing it inclusively as widely as possible, in recognition that their wisdom is alongside, rather than superior to, that of other citizens whose main stake in public services is as consumers. With a view to encouraging this transparency and empowerment, we attempt in the main body of this book to explore the nature of empowering consultancy without theorising or using jargon unnecessarily.With this in mind, in Part 2, we go through the five key stages in the process of consultancy: negotiating, contracting, engaging, empowering and disengaging.

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Further reading Clark,T. and Fincham, R. (eds) (2002) Critical consulting: New perspectives on the management advice industry, Oxford: Blackwell Business. [A book that explores the nature of management consultancy and advice and sets out a critical approach to consultancy.] Horton, S. and Farnham, D. (eds) (1999) Public management in Britain, Basingstoke: Palgrave. [A good introduction to the management of public services in the UK.] Kipping, M. and Engwall, L. (eds) (2002) Management consulting: Emergence and dynamics of a knowledge industry, Oxford: Oxford University Press. [Much detailed analysis of the contexts of, and perspectives on, consultancy.] Weiss, A. (2009) Getting started in consulting (3rd edn), Hoboken, NJ: John Wiley. [A book that does what it says on the cover – it introduces the reader to the basics of consultancy.]

Website resources Carers UK, a well-established organisation for supporting informal carers: www.carersuk.org/ Mind Tools, resources for management and leadership development: www.mindtools.com National Council for Voluntary Organisations (NCVO), an organisation based in the UK that coordinates information, activities and information in the voluntary sector: www.ncvo-vol.org.uk Patient Concern, an organisation concerned with campaigning for patients’ interests and funded and run independently of any public or state bodies concerned with healthcare: www.patientconcern.org.uk/ The Patients Association, an organisation campaigning on behalf of people who use health and social services, with a view to raising standards of services: www.patients-association.com/ Social Innovator, a collaborative arrangement between The Young Foundation and the National Endowment for Sciences, Technology and the Arts (NESTA), to make connections between people, new ideas and unmet human needs: www.socialinnovator.info/

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Website for people’s feedback on health services: www.institute.nhs. uk/commissioning/tackling_tough_choices/patient_and_public_ involvement.html NHS Patient Surveys: www.nhssurveys.org/ The GP Patient Survey: www.gp-patient.co.uk/ Quality Health, a company providing surveys commercially for the NHS: www.quality-health.co.uk/surveys/patient-survey NHS patient complaints service website: www.nhs.uk/choiceintheNHS/ Rightsandpledges/complaints/Pages/NHScomplaints.aspx

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Part 2 Doing consultancy In this part of the book, we go through the process of consultancy, from the earliest stage of considering possible areas to work on, to looking back afterwards and reflecting critically on the work done. In one sense, the process was already begun in Chapter One, where we went through the debate about whether to title that chapter ‘starting out’ or ‘preparing to do consultancy’. As professionals with experience of working with a variety of individuals, groups and organisations in public services, we have noted over the decades some recurrent similarities shared by these services. For instance, we repeatedly encounter in them a concern with delivering to the citizen a high quality service. This often begins with a notion of relating to the citizen in a professional manner. Often, too, this is associated with the principle of developing a positive style of interaction with the citizen, as customer, consumer, client, patient, service user, carer or whatever term we use.The common element we identify in all of these is that they are all based on the idea of a relationship between the service provider and the person who receives or uses the service; it is, as is commonly said, a relationship-based service. In commerce and industry, the main goal has been, and always will be, to make a profit; in public services, the main goal is to satisfy the citizen by providing a relationship-based service. Businesses carry out market research in anticipation, so that they are able to match the product as nearly as possible to the needs and expectations of the target market. It is clear when the customer likes the product or service, as they buy it and, perhaps, come back for more. Businesses may be able to improve the product to promote higher take-up of it – the bottom line is whether the customer buys the product. In public services there is not a similar bottom line, and the task of assessing customer satisfaction is more complex. Levels of service usage are a crude measure in that they only quantify the number of times the service is delivered, rather than giving feedback from the service user or citizen. Surveys and questionnaires at the point of service delivery, or soon afterwards, are not always representative of the quality of people’s experience and perceptions, and in any case are expensive in both time and resources.

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Example Consultants concerned to improve the knowledge of the service provider about citizen satisfaction were motivated by anecdotal evidence that people who perceived hospital and housing services in a locality either as indifferent or as poor lacked any interest in completing customer satisfaction surveys some time later. The consultants – who included citizen-consultants feeding in their views as consumers of public services – designed an internet application so that people using health, housing and other public services could use their mobiles to give immediate feedback at the point of service delivery. They built on the example of the service users’ guide prepared by The Good Care Group (www.thegoodcaregroup.com), and built two further stages into the process: • a quick summation of the views of citizens using a particular service; • follow-up, tackling the question ‘What are we going to do about this result?’.

Relationship-based services and relationship-based consultancy It follows that the consultancy approach in public services should also be relationship-based.This division, however, has become increasingly blurred. It is worth noting that businesses have become much more relationship-based as the discerning customer nowadays wants a product but feels that they should also expect better service too, whether it is in buying a care service or eating in a restaurant. Good service brings the customer back. In public services, however, where it is just that, a public service, the growth of targets has links to expectations in business. This comparison only serves to reinforce the view that a relationship-based approach to working with people and organisations generates the five main stages of the process of consultancy which we follow in this second part of this book: negotiating, contracting, engaging, empowering and disengaging. Having set this structure out, true to the spirit as a questioning and self-critical consultancy, we now warn against accepting Chapters Two to Six as a logical sequence to follow. In reality, they are interwoven, and in practice, one stage may run into the next, or may even be revisited later in the sequence. It is not unknown for contracts to be revisited and even renegotiated during the latter stages of the consultancy.

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two

Negotiating We deal in this chapter with what is often called the pre-contract phase of consultancy. It is, by definition, preliminary, and is characterised by the activity of negotiation.We do not imply, however, that negotiation only happens at the start. On the contrary, negotiation is likely to continue throughout the entire life of the consultancy, but from our experience it is likely to be heightened during this early period.

Beginnings We have already acknowledged that a consultancy starts its life before birth, at the preparation stage. However, there is a more visible beginning, at the point where the consultants and clients begin negotiating. This is often referred to as the ‘pre-contract phase’. Consultancies begin in different ways, affected substantially by their size and degree of formality. The larger and more formally developed consultancies are generated at senior level in central and local government, an in the NHS, are advertised and go through a process of tendering. There are smaller consultancies that lead to local, but still formal, agreements between consultants and clients.There are also some consultancy arrangements that are informal, where a fee probably changes hands without much being written down apart from the invoice from the consultant and the receipt when the fee is received. What is significant, however, is that consultancy is a process, and every consultancy goes through its own unique life course, from beginning to end. Sometimes it is impossible to specify when the beginning actually begins and when the end takes place, since the work may grow out of previous work and may lead on to other projects. Another reason for the lack of clarity about boundaries is the tendency for consultancies to involve a lot of meetings, discussions and correspondence about possibilities for action, and quite often only some of these will be translated into action. Finally, of course, this lack of clarity resides in the reality that the consultancy involves relationships between people and these, necessarily, entail a degree of complexity and uncertainty. Whatever the extent of complexity and uncertainty surrounding the beginning of the consultancy process, we can say that it entails some form of negotiation between the consultants and the clients. 37

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Negotiating is distinctive in two ways: • it occupies the pre-contract phase; • it involves not stating a position emphatically, but drawing out different positions and through interaction with clients, bringing them closer to each other. Consultants are likely to be negotiating with agencies that are themselves undergoing changes, whether in the public, private or third sectors, adding another dimension to the negotiation process. Negotiating with public sector bodies Public sector changes provide the backcloth against which their negotiations with potential consultants take place. These changes are led primarily by political as well as financial factors, and are likely to lead to two trends in local authorities: • recasting responsibilities of public sector bodies; • divestment – meaning reductions – of resources. Negotiating with groups and organisations in the private, voluntary and independent (public) sectors A consequence of changes in the structure and roles of public sector organisations is the trend towards the distribution of many of their functions to a range of private, voluntary and independent groups, bodies and organisations. The Coalition government is currently encouraging ‘third sector’ (that is, not-for-profit) cooperatives and mutual organisations in particular to take on responsibility for developing, managing and delivering public services. Cooperatives and mutuals are, so to speak, symbolic of this trend, which also includes private sector (profit-based) organisations. A report by the Association for Public Service Excellence (APSE, 2011) details the findings of research into the ways in which cooperatives and mutuals benefit each other in the third sector of public services. Regardless of the consultancy’s specific starting point, it is founded on the relationship with the client, whether an individual, a group of people, an organisation or a combination of these.

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Working with people: working with citizens or ‘publics’ We live and work in a social policy context in which public services are being personalised.The move towards making the service user and the carer central to the delivery of services became visible in social policy in the UK at the time of the introduction of direct payments under the Community Care (Direct Payments) Act 1996. Direct payments are payments made in cash to people to enable them to buy and manage their own care. Labour (1997-2010) and Coalition (2010 onwards) governments since 2000 have been increasingly preoccupied with promoting means by which people can choose and decide on the individualised or personalised care budgets that they anticipate will appropriately meet their needs. Durkin and Gunn (2010, p 48) note that such personalised approaches are inherently participatory, in the sense that the citizen as the person who uses the services is at the centre of decisions about the process, rather than being on the receiving end of services designed and delivered by managers and professionals. ‘Ultimately users are seen as playing a crucial role in developing services, emphasising a “bottom-up” approach in contrast to the top-down hierarchical approach of a state system’ (Durkin and Gunn, 2010, p 48). This is entirely consistent with the approach to empowering consultancy developed in this book. However, the development of personalisation further complicates, rather than simplifies, the process of modernising health and social services that has formed part of broader changes in the delivery of public services in the UK since the Conservative government (1979­–97) introduced compulsory competitive tendering (CCT) by local authorities for the delivery of a significant proportion of services. The complexity of these arrangements should not be underestimated. Newman and Clarke (2009, p 91) use the term ‘hybridity’ to refer not just to this complexity of new organisational forms, where ‘direct privatisations exist alongside internal markets; public–private partnerships alongside social enterprises; large “third sector” or voluntary organisations involved in major contract service delivery operate alongside the service user managing their own individual budget to buy care’. It also refers to different forms of power existing alongside each other:‘state power, corporate power, managerial power and, in some cases, power derived from “civil society”, communities and citizens – in uneasy alignments’ (Newman and Clarke, 2009, p 91). Thus, the boundaries between the public governance of public services, private authority and participation by citizens in partnerships of different kinds to deliver and manage 39

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public services are shifting, blurring and in some cases even being removed or altogether reconfigured. Since 2000, personalisation has become an increasingly prominent aspect of social policy, especially in health and social care. Personalisation is the term used to refer to policies and practices concerned with giving the individual more choice and control over the design and delivery of the services to meet their needs.The move towards individualised budgets was heralded in government policy documents from 2005 (DH, 2005, 2006, 2008), among which the common element shared was person-centred planning, which we define as the process of developing a holistic approach to making a lifelong plan to meet the needs of adults who are vulnerable or experiencing conditions such as impairments or complex, multiple problems. The Department of Health publication (DH, 2008) set out an holistic and collaborative approach to the transformation of social care. Key to this were the twin ideas of self-directed and personalised support. This implies significantly reshaping systems of social care so that people who traditionally have been fairly passive recipients of health and social services can control them far more than hitherto. The three keywords associated with these innovations are independence, choice and control by service users, patients and carers. Some local authorities link these developments with a broader context of community development and a strategy for developing healthier communities associated with an improved quality of life for vulnerable people. Personalisation as a social policy initiative in the 21st century is not a straightforward utopia about to be implemented in a perfect fashion. The think tank Demos published a critical report (Wood, 2011) identifying several problems associated with implementation, including meeting the requirements of people in residential settings which are the collective responsibility of health and social care – such as at the end of people’s lives – where sensitive leadership and practice is required at the interface between systems of health and social care. The skills of negotiating are fundamentally those underlying the entire consultancy – working with people. Empowering consultancy entails identifying the particular groups of citizens or ‘publics’ forming part of the client organisation and ensuring that citizens forming these publics are able to contribute, as appropriate. It is not possible to specify all conditions that are likely to apply in all circumstances, but the consultants need to be alert to strategies by which agencies exclude different publics from their work, while maintaining tokenistic commitment to principles of openness, democratic participation and inclusion, and should take measures to promote these principles.

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All consultancy involves work with people, perhaps more so in work with public services. While this seems a statement of the obvious, it is important that consultants have a good grasp of what is entailed in working with people. This means the good consultant will have an understanding of the factors contributing to effective interaction, between individuals and with and within groups. Working with individuals entails being sensitive to other people’s feelings and using a range of techniques to enable them to make the most of their qualities, skills, learning and experience in tackling work-based issues. Working with groups entails understanding how being in a group may affect a person, both positively and negatively. Groups are a powerful source of support for individuals in promoting empowerment and other changes, but they can pressure and even coerce people and act as a barrier to organisational development. Consultants need to have techniques of working with people at their fingertips. At the outset, working with a new client entails engendering a productive working relationship with the client, from scratch. In the first place, we need to establish what brings the client to us. The reasons that the client comes to us can vary enormously. In larger contracts, EU regulations affect public services in particular, so consultants are sought indirectly through a procurement process that involves a great deal of documentation and may involve additional stages before or after a tender is submitted. Adverts may be placed in newspapers, on websites, emails sent, or sometimes a range of organisations is made aware through tendering portals. Initial stages will often, but not always, involve expressions of interest (EOI) that involve potential bidders lodging, usually through email, that they are interested in making a bid (although expressing such does not create any expectations). Those parties having expressed their interest will be supplied with further information, again by email, although many use an online log-in system, in order to provide information for the people who potentially may tender for the work. Sometimes there will be a stage that involves a pre-qualification questionnaire (PQQ) being completed, either on paper, or by email, or again through a website portal. The larger the potential contract then the greater the interest is, so the greater the filtering process needs to be. This stage is really a first stage of filtering those who may tender as it establishes the credibility of those who will be invited to tender, with those failing to do so being filtered out.The parameters for so doing are varied but generally involve insurance cover, financial probity, equal opportunities policies or similar, and track record, reinforced by details of referees 41

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who will confirm previous work records. In addition, criminal record of fraud or the like would disqualify potential applicants and often in the public sector the requirements include Criminal Records Bureau (CRB) and Independent Safeguarding Agency (ISA) clearances for staff who would work on a project. Increasingly standards such as Investors in People, Customer First or one of the International Standards Organisation (ISO) standards must be in place for the consultants to be considered. ISO 9001 is a group of standards for quality management systems, administered by accreditation and certification bodies, which certifies that a company has business processes including: • • • •

a set of procedures that cover all its key processes; monitoring processes to ensure that these processes are effective; adequate records are kept; output is checked for defects, with appropriate and corrective action where necessary (originally, these standards were for manufacturing companies but are now much more widely used); • individual processes and the quality system itself are regularly reviewed for effectiveness; and • continual improvement is actively sought. Some of these standards are extensive, and as a result are costly to achieve, thus tending to eliminate smaller firms from such tenders. Many organisations at this stage will use a scoring procedure that a panel uses under the guidance of a procurement officer or procurement department, to determine which parties they will then ask to submit an invitation to tender (ITT). The actual tender process varies in complexity depending again on the potential value of the work, and the panel selects on the basis of a more complex scoring system perhaps, as well as a potential interview and or presentation by a shortlist of the best tender organisations. By this stage, (a) consultant(s) will have completed a substantial amount of work that will be of no benefit whatsoever if they are ultimately not successful. The client organisation will, however, meet the EU requirements and try to get best value, but will also benefit from seeing the creative ideas and comparative capacity of many organisations.This latter benefit can sometimes benefit the project and the consultant if new ideas are picked up, effectively at no charge. Against this background, as clients are generally seeking best value or value for money, then price will be a key factor, although the cheapest may well not be the most cost-effective. With unknown consultants 42

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bidding, the risks are rather higher than knowing a consultant through previous work.The tension potentially increases in this decision-making process for both parties, setting the scene for future work. In a sense the client wants as much as possible for as little money while in some ways the consultant will want to do as little as possible for the maximum money. If the EOI or ITT do not set out a guideline figure, then the whole scope of the work may be wrong, that is, the work done on the tender document and the price quoted may be well beyond the resources that the client knows is available.Thankfully, more clients are setting out guidance amounts to save wasting the time of both parties. Here is another conundrum for the client, however – if a guidance figure is given, then probably potential consultants will bid for that figure or just below it, possibly making the decision even more difficult, at least on price. In some cases, especially where the work concerned is of relatively low value, that is, less than, say, £5,000, then consultants may be sought out based on reputation or previously completed work, but a quotation of price is required.We have found that for smaller amounts, and more direct approaches form clients, based on our reputation, that a more mutually honest discussion is needed, and then if agreement is reached, the working relationship is much more productive. In essence some trust has to be established, so if the consultant may say, ‘How much money is available?’, then, using daily rates of staff, and likely smaller costs such as travel, the consultants can indicate how many days of work can be done, giving a closer idea of what can be achieved, and if necessary, in what stages. Sometimes the use of milestones builds confidence that progress is being made, the project is on track and will be completed satisfactorily.This open and honest approach usually leads to a productive working relationship.

First meeting with the client Example The consultants were working with a government agency. The selection process in this example of work with a sector Skills Council involved meeting a committee, called a task and finish group, in order to win the contract.The group comprised more than 10 people, so all had views, some of which differed. Service users and carers were present at this meeting, representing the range of citizens whose needs were being tackled by this particular public service. Some were older; some had mental health issues; some were disabled, for instance, through sight or hearing impairments; some had learning disabilities.The meeting was structured

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Consultancy in public services and paced accordingly, and the contributions of those attending presented in audio, print and Braille form, so that they could all take part on as equal a basis as possible. For instance, members could indicate when the meeting needed to be ‘paused’ so that individuals could check their papers, consult with personal assistants and raise questions for clarification and discussion. In many ways they all had to be satisfied, as the consultants would be working to them, but in reality, the consultants had to handle the general process while ensuring that the key decision maker (and in most cases there is one) had all their questions answered satisfactorily, as most contact with the organisation would be through this person.

The first meeting with the client can take many forms. It may in fact be a form of interview as a result of a shortlisting process. And this process can also be quite variable. It might be an interview (possibly following a presentation) with one or two people who will manage the project, a committee or panel, and may involve lay people, including service users or patients or even young people or children (clearly, with previous CRB checks and so on having been made). On this basis the first meeting sets a power relationship where the consultant must ‘defer’ in some ways, at least, to the client if they want to win the work, something that can set a tone for the whole contract. If there is no interview process the first meeting is equally important in terms of preparation and establishing a basis for the ongoing relationship. Again, at this early stage, it is unlikely that the consultant will wish to challenge the client for fear of the contract not being confirmed, although equally the client may well not inform the consultant that they are the only ‘applicant’, because they may not wish to give the consultant any concerns that will make them wish to withdraw. The general approach should be for the consultant to: • establish some rapport with the client but not to befriend them as this relationship will be a business one, in which each party may have to make tough decisions, for example, termination, withdrawal or other limitations on the work; • clarify any areas of ambiguity or concern in the client’s requirements, as previously informed; • establish some ground rules about keeping information flowing both ways at agreed intervals; • confirm the scope of the projects and establish the limits that will require additional time and therefore funding.

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Preparing for the first meeting • Read through the contract and note any contradictions, points for clarification, especially time scales, editorial controls and payment processes. • Prepare a list of questions. • Set out a list of points which are the limits of what are acceptable to the consultant, for example, some editing of the report in terms of presentation and so on, but no alteration of findings. • Ensure that the methodology proposed is workable and costed correctly, but noting parameters on how much further the consultant can go before further funding is essential.

Making sure the first meeting reaches its goals • Have an agenda and reasonable time scale, preferably agreed by both parties beforehand. • Keep to both of these but always allow additional time in case extra issues arise. • Try to ensure that the agenda is focused and prioritised so it is achievable in the time set aside (with further meetings for less important issues as required). • Ensure somebody, preferably not involved in the meeting content, can take notes.

Identifying the shape of the potential • Based on the contract or project objectives provided, ask questions – if something is set out, ask yourself ‘So what?’. • Keep asking until you fully appreciate what is involved. So, for example, if the project is due to be completed by 30 March, ask ‘So what if it isn’t for some reason?’. Either party can cause delays by commission, omission or simply by bad luck, such as staff sickness.

Ascertaining the expectations of the client and citizens It is vital as early as possible in the consultancy that the consultant finds out what the client expects.The wishes of service users as citizens may be forgotten or underestimated by clients, and it is important to include them adequately in the consultants’ considerations. Example A police force had been able to obtain substantial funding to look at drugs and crime issues. The funding was time-limited and there had been delays that

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Consultancy in public services exacerbated the shortage of time and the officers involved had literally been ringing around to find somebody who had the capacity to undertake the project. The client had wholly unrealistic expectations as there had not been a tender process due to time factors, and the requirements were not clearly set out. They wanted a review of crime-related drug intervention projects – crime as you would expect from the police – but in fact they also wanted a review of the state of all drugs projects current at the time. In this case the decision maker was one person, although a committee was purportedly involved. It is certainly true that the more people are involved the more complex become the expectations and the greater those expectations are too. The consultants in this case were flattered to be asked to undertake a significant project, but the expectations were heightened by a desire to see positive outcomes too, which can often be the case. The views of the public should have been taken into account at all stages and, where appropriate, should have changed the nature and process of the negotiations.

What are the questions to ask? The following is a list of typical questions, to each of which the consultant should endeavour to find an answer: • Citizens: What measures need to be taken to ensure that citizens’ experiences and wishes are fully considered and responded to? • Process: What process do you want carried out, is it up to the consultants, or should we discuss the most effective ‘do-able’ approach? • Time: What are your time frames, with any necessary milestones along the way? What are your expectations of the consultants’ time? Do you expect frequent contact, and if so, in what form? • Resources and funding: What resources are available and are these limited in any way? Do you want to pay in stages, or on full completion, or do you want to pay up front for budgetary reasons? • Motivation: For what purpose is the consultancy being carried out? Is there an expectation of a ‘positive’ report or is a ‘warts and all’ report desirable or acceptable? • Products: What kinds of product are required? Is it sufficient that the consultant feeds advice into a process or are other products required, such as a report? • Report: If a report is required, what format is required? Are drafts required and how will the draft be edited?

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Responding to the expectations of the client and citizens Once the consultant has found out the initial expectations of the client and citizens, a process of negotiation usually follows. Costing the consultancy An essential component of consultancy is the amount of time the consultants spend on a particular project and the amount they charge for this work. Costing is not simply a mechanical and arithmetic business; it is an aspect of negotiation.To illustrate this, take the following example of the work of one of the authors’ consultant associates. Example A well-established consultant in the UK public services describes her threefold approach to costing her work as follows: Free: she carries out some projects free as pro bono work, that is, work carried out for no financial or equivalent payment. These include citizen-led initiatives and fall generally into two main categories: • those initiatives she judges as high in personal and social value to society and/or to those involved; • those initiatives that are vulnerable, that is, which take place in settings so precarious that they are unlikely to continue the work without support such as from the consultancy. Minimum cost: she charges some high value organisations or groups on slender budgets a minimum amount, probably sufficient to boost them and defray her costs, but no more. This also applies to citizen-led initiatives. Full cost: she treats core services in the public sector, both central and local government, as full cost, and charges them an amount to cover all her fees and expenses plus an overhead which she puts towards other work.

Some consultants may undertake work on a free or minimum-cost basis initially, not on social or value grounds but on the basis that it is likely to lead to full-cost consultancy once the workstream becomes established, along with their expertise in the field. Consultants may also note the cost of preparing and negotiating a bid. In the process, they may finish up losing out in the competitive bidding process, but may feel exploited in that they have revealed as they went along many ideas about how the consultancy could proceed to other bidders and 47

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to the client. This, as they say, ‘goes with the job’. In a series of group meetings organised by management consultants in health and social services in the 1990s and attended by one of us, it was generally agreed that consultants were fortunate if one out of every three bids they submitted succeeded.

Identifying potential areas, problems, tasks and planning In Chapter One we looked at the triangular ‘motivation – supports – capacity’ model (see Figure 1.3) for looking at how individuals, teams and organisations, for example, assess their potential for positive change through consultancy. Working through the pre-contract negotiations This is the preliminary stage. It may or may not at this point lead to a contract and a project. We need to assess the relative strength of the three factors – motivation, supports and capacity – and, in this light, develop a profile of the client’s situation. Example A social inclusion and health promotion project for children and young people centred on the use of basketball as a vehicle.The project was run by a basketball coach/manager and, mainly, basketball players from his team who played at a high level. The players became coaches, which was not difficult, but the broader goal of health promotion and the reality of working with youth workers made the project much more demanding. A small piece of work had been completed for the project on a previous occasion, using a grant the consultant had been able to obtain, and that work had been positive towards the project but on a limited basis, due to minimal data. The coach believed that further consultancy would be very helpful to the project in justifying the substantial existing funding and in seeking further grants and other funding. The motivation for further work was high, but it became apparent that actual support through resources was not available, and that the capacity of the project to change was minimal. Short-term goals were the priority, and thus the consultants declined to be involved after some protracted negotiations, largely as the consultants’ time needed to be paid for, but also because the project manager wanted results that were to his benefit and not necessarily to the benefit of anybody else, an approach that had potential dangers for the reputation of the consultants.

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Three particular questions may be used to guide the consultancy at this point: 1. Does the client have an expectation about what needs to be done and how a consultant can help? 2. Can the client do the work, or is the consultant necessary at this point? 3. Is the consultant happy about the level of citizen participation in the consultancy and, if not, what measures need taking to rectify this?

Challenges to empowering consultancy Things can go wrong at any time during the life of the consultancy, but particularly in its early stages. Consultants and clients are getting to know each other during this early period.While some consultancies are straightforward from beginning to end, there are others that involve complex and detailed negotiations, during which the different parties to the consultancy interact, formally and informally. Vulnerability to challenges The consultancy may be a purely technical input to the work of the organisation, but this is rare. Even the seemingly most banal message, in terms of product, from the consultant to the client may carry implications for changed working practices. Some consultancy work will have implications for policy as well. It may potentially affect the entire orientation of the organisation.The following example illustrates how a local piece of work may have wider implications. Example The university responded to a public advertisement by a government agency, requiring consultants to develop a new policy to be rolled out nationally (throughout England). This required the consultants to negotiate their way into the agency and then to develop with headquarters staff a means of consulting with the different regions, in the process of developing the England-wide policy.

Challenge to status quo that increases vulnerability Some consultancy, by its nature, presents a challenge to the status quo of organisations’ working practices. For instance, in health and social services, government policy in the early 21st century has moved 49

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increasingly towards engaging patients, members of the public, service users and citizens in participating in arrangements for delivering their services. For example, consultancy in adult care services tends to entail consultants and the client organisation involving service users and carers as part of the formal arrangements for employing the consultants. This is only the beginning of the story. Empowering people in the organisation does not, of itself, guarantee transformation as an outcome of the consultancy. Consultants are potentially a threat to the hierarchy of the organisation, which may be exclusive or oppressive. • An exclusive hierarchy is one that does not seek the views of people, but excludes them from the organisation. An example of an exclusive hierarchy in public services is the local authority housing department that seeks the views of residents, but, ignoring advice from consultants, does not engage them as partners in developing the housing policies and practices they want. • An oppressive organisation is one that acts so as to perpetuate oppression of a class or group. An example of an oppressive organisation is an academic department in a university in a country outside Europe, with which the university carried out consultancy. This was male dominated, to the extent that the female academics who visited as consultants from the UK were ignored in the meetings by male staff and talked over.This was discussed and the consultants subsequently proposed ground rules, as a condition of the consultancy proceeding further. Risks to empowering consultancy Among many ways in which empowering practice is vulnerable (Adams, 2008a, pp 43-7), there are risks that the consultants will be co-opted, diverted or that their work will be diluted and, perhaps through insufficiently theorised and strategic planning and practice, too partial and disconnected to be able to achieve systemic change (see Table 2.1). An example of this disconnection is from the public voice and experience of people regarded as users, consumers or customers of the organisation rather than as its members, such as the staff.

Conclusion We have considered in this chapter some of the main aspects of consultancy arising at the pre-contract stage. It is inevitably not possible to compartmentalise this stage of the work and to consider it apart from 50

Negotiating Table 2.1: Risks to empowering consultancy Nature of risk Co-option

Characteristic Rhetoric of empowerment adopted by organisation staff but not implemented Dilution Empowerment implemented in tokenistic form Diversion Distractions used to take focus off empowering activity Insufficiently theorised action Empowerment adopted without reflection and understanding of what is happening Partial outcomes Empowerment adopted and used in an incomplete way Disconnection from public voices The voices of citizens not drawn on, especially those of experience seldom heard Source: Adapted from Adams (2008a)

the rest of the process. What this chapter has demonstrated is that the transition from the pre-contract to the contract phase of consultancy depends crucially on the relationships between the consultants and the people with whom they are working, that negotiation is a complex process and that it is governed not only by formal policy and legislation but also by conventions reflecting the culture of particular sectors of the public services.

Further reading Burtonshaw-Gunn, S.A. (2010) Essential tools for management consultancy: Tools, models and approaches for clients and consultants, Chichester: John Wiley and Sons. [A book full of practical insights into the different phases of the consultancy process.] Czerniawska, F. and May, P. (2006) Management consulting in practice: Award-winning international case studies, London: Kogan Page. [The first two chapters of this book in particular contain useful reminders of the practical expectations of clients and how important it is to attempt to ascertain what they are and to meet them.] Newman, J. and Clarke, J. (2010) Publics, politics and power, London: Sage Publications. [A thoughtful and thought-provoking social policy and sociological analysis of the notions of citizenship and citizen participation in the context of the contemporary nature of public services in the UK.] Salaman, G. and Asch, D. (2003) Strategy and capability: Sustaining organizational change, Oxford: Blackwell Publishing. [A book containing useful insights – especially in the first chapter – on the kinds of changes affecting organisations in general, which it is useful for consultants 51

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to bear in mind when going through the early stages of negotiation with them.]

Website resources Includes a good care guide for service users of care: www. thegoodcaregroup.com

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Contracting This chapter deals with what is entailed in the crucial stage of agreeing the contract. It is tempting to regard this as simply a technical and administrative matter, but nothing could be further from the reality. The fact is that by the time the consultancy is into the negotiating, pre-contract phase, for better or worse, it has already begun. It is vital that as consultants we have made all our preparations well before the contracting stage, whatever outcome is likely. In our experience, something like two out of three possible consultancies do not reach fruition as a viable contract. This is a fact we live with and accept as part of the sector in which we work. So, we include in this chapter the two aspects of developing our resources as critical and self-critical consultants and completing the contract for the consultancy. It is also important for the consultant to include in the planning the ways and means by which the changes or other initiatives will be sustained, monitored, evaluated and reported on, as well as, of course, having an exit strategy for the consultant (see Chapter Six). The better we know people and the more straightforward the consultancy task seems to be, the more tempting it may be, the more disastrous may be the consequences of not having a contract. Consultancies seldom take place over very short periods and there is a likelihood that either somebody will forget or have a different recall of a verbal agreement. Key members of staff, as well as participating citizens, may change during the course of a contract, making some form of written agreement advisable.

Importance of the contract The term contract is used to refer to a verbal or written, formal or informal agreement between the parties to the consultancy about the aims of the consultancy, the work to be undertaken by the consultant, any anticipated contributions by the client and the anticipated outcomes from the consultancy. What is crucial is that there is an agreement. Even though the client may avoid committing to a document called a contract, it is incumbent on the consultant to make sure that the key items agreed are written down and shared between the parties to the agreement.Where consultancies extend over months rather than weeks and where they involve more 53

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than two people – the consultant and the client – working together, a written agreement is necessary. This helps prevent misunderstandings, either at the outset, or as the consultancy proceeds and people’s memories of what was agreed differ.

Developing our resources as critical and self-critical consultants It is vital for the consultants to preserve their independence and criticality and to promote the interests of citizens when negotiating and agreeing the contract. It is important that the meanings of terms such as critical and criticality are understood in this context, and this is explored in more detail below. For the present, being critical means being open-minded, reflective and receptive to new ways of viewing situations, acknowledging that social situations are often both complex and uncertain. Example: Promoting the interests of the citizen The consultants were contracted by the local authority to undertake a review of services provided for older people. The local authority drew up a list of the aspects for consideration. The consultants set about the task by asking for the views not only of managers and professionals but also of citizens – including service users, carers and patients – about the quality of services.The consultants searched the literature to find out what the evidence base reported on the strengths and shortcomings of public services for older people.They used these combined findings as the starting point for their consultancy and directed their consultancy contract accordingly.

Consultants as critical outsiders The traditional consultant comes into the organisation, makes an ‘expert’ contribution, and leaves.The organisation may not be disturbed at all by this. The workflow continues as before. Curtis (2010, pp 945) highlights the helpful distinction between the contributions of the outsider and the insider to organisational development. It is important to capitalise on the value of an outsider’s perspective – referred to sometimes as ‘extrapreneurship’. Curtis (2010, p 94) contrasts with this the also very useful contribution of the intrapreneur, who works in an entrepreneurial way from a position within the organisation. Imagine now the implications of inviting a group of citizens – customers, clients, patients, service users or carers – to join a consultancy on an aspect of the work of an organisation responsible 54

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for supplying them with services. These consultants are what we call critical outsiders.They are outsiders in the sense that they are not part of the staff group and also because they are not recruited from the ranks of professional consultants. They are citizens, members of the general public. However, in one sense, they are experts, in that they are ‘experts through experience’.This expression has been widely used in health and social services in the UK in the early 21st century.They are critical in the sense that they bring their own critical perspectives on the organisation and often make critical contributions that staff find challenging. In this sense, the ‘experts through experience’ consultants in empowering consultancy occupy a contradictory situation, to the extent that the empowering approach engages with some quite traditional, that is, non-critical, work settings. These ‘experts through experience’ – citizen-consultants, whom we can regard as critical citizen-consultants – are likely to have the capacity and motivation to act in innovative, questioning and creative ways. They are able to capitalise on knowledge, understanding and analysis of the situations in which they work. Critical thinkers and critical thinking We now take a closer look at what we mean by being critical. Criticality involves thinking and acting critically. Consultants in empowering practice ideally should combine both critical thinking and critical action, these two, as Adams, Dominelli and Payne (2009, p 5) argue, combining to form critical practice. We are summarising a good deal of theoretical argument in the social sciences, and sociology in particular, when we suggest that critical practice involves thinking and acting reflexively and also questioning ideologies that are embedded in situations involving individuals, groups and organisations with which we work as consultants. Critical theories in the social sciences question and even fundamentally challenge established, perhaps taken for granted, ways of understanding social reality. Criticality, therefore, is a connective idea, an idea with resonance not only in critical theory in the social sciences – sociology, psychology, philosophy and anthropology – but also in literary criticism and other critical activity in the arts – drama, poetry, fiction, fine art and architecture. There are many different theoretical perspectives in the social sciences that could be regarded as critical and we cannot deal with them here, although we continue some of these reflections in Part 3 of this book and in Chapter Eight in particular, where we discuss different theoretical perspectives on organisations that may engage consultants. 55

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Here we summarise the key points about empowering consultancy, as it clarifies in the contract phase the kinds of work entailed in a particular project.Again, we draw on what Adams et al (2009, p 12) have written. They argue that despite the great variety of critical theories, in summary, they tend to agree about three general points: • they emphasise the positive value of social change and the necessity for social action to enable it to happen; • they highlight the intentionality of the actor, that is, the person who acts critically.The notion of intentionality sounds obscure, but really means simply being purposeful; • they emphasise that criticality involves more than rational activity and may transcend a merely technical way of viewing the world, since it is concerned with transformation in aspects of society. Critical theorists – particularly those committed to feminist and socialist ideas – tend to link their analysis of the aspects of inequality, oppression and social exclusion in the world with their perspectives on practice. We return to the notion of transformation in Chapter Nine. Brookfield (1987: 5-7) sets out a perspective on adult learning that relies on the notion of critical thinking. He identifies five particular characteristics of critical thinking: • It is a productive, positive activity. • It is a process rather than an outcome. • Signs of critical thinking vary according to the settings in which it takes place. • It may be stimulated either by positive or negative events. • It is an emotive as well as a rational activity. Brookfield (1987: 7) concludes that critical thinking may lead the individual to be fearful of the consequences of contemplating alternatives to their present way of thinking, but at the same time: we also feel joy, release, relief, and exhilaration as we break through to new ways of looking at our personal, work and political worlds. As we abandon assumptions that had been inhibiting our development, we experience a sense of liberation. As we realize that we have the power to change aspects of our lives, we are charged with excitement. As we realize these changes, we feel a pleasing sense of

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self‑confidence. Critical thinkers and helpers ignore these emotions at their peril. What does being critical entail? Shor (1992, p  122) refers to being critical as ‘extraordinarily reexperiencing the ordinary’, and this captures the creative and energising potential of criticality. The term ‘critical’ has three main meanings in different situations (Adams, 2009). As we saw above, it is an idea that enables us to make connections between ideas and practice in very different fields. It acknowledges a bridge between social work and related professions such as nursing and teaching and the social sciences and humanities. Raymond Williams, the celebrated commentator on culture and society (1958), summarised two important meanings of ‘critical’ in his book Keywords (1984, p 86): fault-finding and making authoritative judgements. Both reflective and critical practice share the feature of continually subjecting practice to new questions and interpretations. So practice is provisional, in a similar sense to the researcher’s analysis of the data being provisional. Brookfield recognises five features of critical thinking: • It is a productive and positive activity, in that critical thinkers (Brookfield, 1987, p 5) ‘see themselves as creating and re-creating aspects of their personal workplace, and political lives.They appreciate creativity, they are innovators ... see the future as open and malleable, not as closed and fixed ... self-confident about their potential for changing aspects of their worlds, both as individuals and through collective action’. • It is a process rather than an outcome, in that critical thinking (Brookfield, 1987, p 6) engages in a process, rather than reaching an end point. • It relates to the context, in that critical thinking is evident in what people do. • It is stimulated by positive as well as negative happenings, in that these can stimulate people (Brookfield, 1987, p 7) ‘to be aware of and to explore new possibilities’. • It relates to emotions as well as to rational thought, in that it is not a purely cognitive activity segregated from emotions, because (Brookfield, 1987, p 7) ‘emotions are central to the critical thinking process’.

Components of critical thinking Brookfield (1987) identifies four components of critical thinking: 57

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• Identifying and challenging assumptions – critical thinkers deconstruct the assumptions inherent in ‘ideas, beliefs, values, and actions that we (and others) take for granted’.They ‘examine their accuracy and validity’ (p 7) and ‘search for new assumptions that fit more closely their experiences of the world’ (p 8). • Challenging the important of context – critical thinkers are ‘aware that practices, structures, and actions are never context-free. What we regard as appropriate ways of organizing the workplace, of behaving toward our intimates, of acting politically, and of viewing television reflect the culture and time in which we live. In realizing this, critical thinkers are contextually aware’ (p 8). • Imagining and exploring alternatives – critical thinkers have ‘the capacity to imagine and explore alternatives to existing ways of thinking and living’ (p 8). • Developing reflective scepticism – critical thinkers ‘do not take things as read’ and are sceptical of ‘claims to universal truth or to ultimate explanations’ (p 9). Creativity and innovation in the workplace: how consultants generate ideas We do not wish to overstate the point, but in order for consultants to enhance creativity and innovation in the workplace they need to harness their own creative and innovative potential. Creativity is defined as the generation of original ideas or the use of the imagination in order to produce something. Creativity and criticality are overlapping notions in that both require the ability to think independently. The difference between them is that whereas criticality responds to what is there, creativity goes somewhere new. When the consultants meet to reflect on how the consultancy is going, we are invariably seeking ideas about where to go next. To a greater or lesser extent, this is a matter of generating creative and innovative ideas. A well-known UK professor of social policy used to say to her research students at the beginning of their programme that they should forget attempting to be brilliant or original, but should develop the habit of working hard, on the basis that success in their research would be the outcome of 90 per cent perspiration and 10 per cent inspiration. Fortunately, the literature on developing creative and innovative ideas in the workplace provides a wealth of short cuts or tricks that can be employed to help with inspiration. Every organisation, every business, engages with the process of change. For some organisations in the public sector, change has been 58

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an increasingly prominent feature since the second half of the 20th century. For some, notably health and social services, reorganisations have occurred with increasing frequency since the late 20th century. Since the early 1990s, there has been a burgeoning literature on generating ideas to stimulate innovation and improvement in the workplace (Grudin, 1990; Robinson and Stern, 1998; Sherwood, 2001; Clegg and Birch, 2007). Writers and educators have endeavoured to supply the world of practice with approaches, techniques and skills to equip them to tackle the challenges of innovation and change in the workplace. Burtonshaw-Gunn (2010, Chapter 5), for instance, provides a chapter offering his ‘top ten consultancy tools’. These comprise: • A model for strategic analysis – a framework developed by Professor Michael Porter, Harvard University, using five forces – new entrants, substitutes, rivalry, suppliers and buyers – to analyse a company or other organisation. • SWOT analysis – a widely used technique for analysing an organisation’s strengths, weaknesses and the opportunities for, and threats to, a given aspect such as a policy or output. • Strategic formulation process – a framework for developing and implementing a business strategy, using a SWOT analysis, accompanied by a PESTLE analysis – political, economic, social, technological, legal and environmental external issues affecting the launch and operation of products and/or services. • Understanding the product/services – a model used to understand a product or service organisation, linked with a SWOT analysis. • The marketing mix – the ‘four Ps’, comprising marketing – product, price, place and promotion – used to help management analysis of, and decisions about, marketing. • Product performance analysis – a matrix approach to studying the relative market share and market growth rate, distinguishing four categories of product – stars, which are products generating high profit (‘invest’); problem children or question marks, which are products with difficulties such as low market share and needing high cash injections (‘exit’); cash cows, which are products generating high cash flow and needing low cash input (‘maintain’); and dogs, which are products with low market share and limited and declining demand (‘harvest’ and/or ‘exit’). • The change pyramid – method of analysis distinguishing lower level changes, such as changing tasks and roles, which are relatively easy to achieve from higher level ones, such as changing structure and culture, which are more difficult to bring about. 59

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• Change strategies – focusing on change strategies entails identifying (Burtonshaw-Gunn, 2010, pp  127-9) the anticipated opposition; the power base of the person initiating change; the demand for information, communication and commitment; and the likely response of the organisational culture. Following this, the consultant, with the client, identifies one of five strategies – directive, expert, negotiating, educative or participative. • Check on business plan feasibility – success depends on three elements – management of the business, approach to marketing, and money the business needs and will generate.The consultant uses these elements to measure against the company’s performance. • Continued performance – a series of key questions providing a framework for judging approaches to improvement, by posing questions – why, what, when, how, where and who? – as posed by the ‘six honest men’ in a poem by Rudyard Kipling. These techniques are immediately recognisable to many managers and practitioners in many organisations in public services and commerce alike. However, to the extent that consultants are engaged in promoting and facilitating management development and organisational change, they often draw on other approaches more widely used in the fields of personal growth, education and organisational development.

Techniques to stimulate creative thinking Running alongside those consultancy approaches aiming to converge on, analyse and prescribe are more general techniques aiming to stimulate creative thought. But to be absolutely frank, it does not really matter what you use as long as it works for you, by stimulating your creativity. Here are some widely known examples that we have used in the past. Lateral thinking De Bono (1990a, 1990b, 1990c) has become widely known as an authority on the skills of thinking. His work on lateral thinking emphasised the virtues of using thinking to generate new ideas and fresh ways of looking at things.The clearest way of demonstrating the contrast between what de Bono (see Table 3.1 below) identifies as the two main ways of thinking – vertical and lateral thinking – is by listing their characteristics.

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Lateral thinking Generative Moves in order to generate a direction Provocative Can make jumps Does not have to be correct at every stage Welcomes chance intrusions Explores the least likely paths Is a process based on chances, being prepared to take them even if they are very small

Source: Summarised from de Bono (1990a, pp 37-47)

Thinking hats De Bono argues in his book on thinking hats (1999) that it may be helpful to clarify which kind of thinking we are using. He identifies six main forms, associating each with a coloured hat the wearer uses to indicate he or she is using it: • • • • • •

white hat: facts and figures red hat: emotions and feelings black hat: problem-focused yellow hat: speculating green hat: creative and lateral thinking blue hat: control and monitoring.

He argues that it helps to use one type of thinking at a time, rather than trying to do too much. Hats provide a convention, and this obvious artificiality helps to provide structure and focus. Imaginising The work of Gareth Morgan (1986, 1989, 1993) has been invaluable, in the fields of organisational and management development. He aims to synthesise and provide understanding of theoretical perspectives on organisations with the task of stimulating change. Imaginising is Morgan’s term used to refer to the use of critical thinking, and metaphors in particular, to grasp ‘the multiple meanings of situations and to confront and manage contradiction and paradox’ (Morgan, 1986, 61

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p 339). He argues that images and metaphors are not merely ways of understanding and interpreting but also ‘provide frameworks for action’ (Morgan, 1986, p 343). Imaginisation is the process ‘through which people enact or “write” the character of organizational life’ (Morgan, 1986, p 344). Creative management Goodman (1995, Chapter 7) argues that the pressures on managers through the increasing chaos of the context in which they work requires a creative approach to management. He makes his argument on the creative management approach, creative response or model (CMR), using four viewpoints on CMR – a three-dimensional figure, as six mind maps and tables, as a summary formula and in the form of an analogy (that is, ‘top gear’) (Goodman, 1995, p 245). CMR is presented in terms of key technical principles and a number of tools, which together comprise what Goodman (1995, p 1) refers to as an ‘introductory creative problem-solving tool kit’. CMR relies on the manager being able to carry out a two-stage procedure: the situational analysis, stating what the situation is, and the tools for creative management, stating how the manager should tackle the situation. The nudge As consultants, we have noticed the tendency of some of our previous clients to scale up the aims of the contract during the consultancy to the point where expectations on the consultants become unrealistic. It may be necessary to find ways to reduce these expectations to what is realistic or achievable. (We return to this idea in Chapter Nine.) Thaler and Sunstein (2008) warn against the danger of raising expectations to an unrealistic level. They have developed the notion of the nudge as a toolkit, approach or prompt for giving a situation a push in a desired direction and achieving modest progress. This may be towards, for instance, cheaper and more effective government. Thaler and Sunstein (2008) claim that by encouraging people to make apparently small changes in social situations, the resulting changes can be disproportionately huge. They regard this strategy as a middle ground approach, appropriate in a polarised society.They emphasise that it puts choices by the individual in the foreground. ‘No less than those in the private sector, public officials can nudge people in directions that will make their lives go better while also insisting that the ultimate choice is for individuals, not for the state’ (Thaler and Sunstein, 2008, p 253). 62

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In the nudge, Thaler and Sunstein have developed a set of methods for enabling what they regard as a rich repertoire of tools available in the contemporary world for tackling complex problems.The principle of nudging is the converse of controlling, directing or manipulating. Thaler and Sunstein regard it as the opposite of nagging, nannying, instructing and exhorting people to change. Instead, the basis of the nudge is to make it easier and more fun for people to figure out the way forward when facing complex situations. The nudge harmonises with the principles of empowering consultancy in two ways: • it is transparent – the subjects or clients are fully informed and aware of its implications; • its purpose is defined by the people being nudged – it is led by the subjects, clients or service users rather than by the professionals. An example of the nudge approach is the Fun Project. This involved placing inside litter bins a mechanism for making a sound like an object being dropped down a well. One observed response is that people looked around for other pieces of litter because the sound made them laugh when they dropped litter into the bin. Clearly, this does not solve the world’s problems of environmental pollution, but it makes a modest contribution to tidying up the local environment. Intervening holistically It is useful to bear in mind an idea which at first sight seems to run counter to the notion of the nudge – namely, holistic consultancy. It is important at the very least, that the objectives the clients expect the consultants to achieve are set by the consultants in the wider context, that is, put in an holistic framework for practice. The book about consultancy by Cockman et al (1999) uses many techniques common to both counselling and social work.This reflects the reality that people skills – the skills associated with working interpersonally and in groups with people – are generic and common to many, if not all, of the people professions. More specifically, in the consultancy field this holistic approach to bringing about change between individuals, groups and organisations shares a good deal with social work. For instance, in our innovation exchange at Teesside University we have developed a forum in which citizens – service users, patients and carers; practitioners – nurses, occupational therapists or social care workers; and academics – engineers, computer scientists, graphic artists and health and social services lecturers and researchers – 63

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from entirely different backgrounds and disciplines are able to examine a problem or issue of practice (such as the care of an older person with dementia in their own home). Best practice is shared around a common area of challenge, such as learning disability or end-of-life care. Often, during a meeting it will emerge that a person from somewhere nearby is doing something that others can learn from. The effect of sharing practice and enriching this with input and critical commentary from practitioners and citizens can be electrifying. Identifying common strands The above techniques share three features: • they all aim to stimulate a view of the situation from a novel or unexpected direction. The phrase we have used repeatedly in our York and Beverley meetings is ‘thinking outside the box’; • such techniques often attempt to encourage people to use not only reason but also intuition in developing creative approaches to situations, including problems; • perspectives on the consultancy may reflect an holistic view of the situation. Both of us happen to be professionally qualified social workers, so it is interesting for us to perceive the similarities between social work and consultancy in general. There is one text about consultancy (Cockman et al, 1999) that writes of providing an holistic approach to problem solving and bringing about change, and goes to some lengths to distinguish itself from counselling. We have explored these and many other techniques over the past decades. However, we have realised the need not just to acquire more and more techniques, but to develop a conceptual framework for consultancy that embodies the values we espouse in public services – of empowering people, putting them at the centre of services, ensuring they are treated equally and inclusively and giving them the right to select, manage and deliver their own services. Again, Cockman et al (1999) devote space to considering how consultants as agents of change can empower themselves and their clients. (For a discussion of the values and principles of consultancy, see Chapter One.)

Completing the contract We have reviewed some important considerations at this stage, hopefully while the contract is on the table, in the process of being drawn up. 64

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We now return to the task of completing the contract.The essence of the contract is that it is a written agreement confirming that it is the consultant who is contracted and who is responsible for carrying out the different aspects of the consultancy. This may seem a banal and obvious point, but it is a basic truth that guides what happens during the consultancy. We say ‘guides’ because no contract is comprehensive and final enough to anticipate every twist, turn and change that may follow. But however inadequate, the contract is the main instrument for protecting not only the consultant but also the citizen. Because the focus of this book is public services, we believe that it is necessary to safeguard the interests of the citizen in any commitment between the consultant and the client, an ethically based commitment that must be spelt out in a written contract. In other words, it is not only important what the contract contains, but how it is arrived at. The process should be transparent (open for all to witness), equitable (fair to all parties) and inclusive (conducted in such a way that people with relatively little power and those who are seldom heard are not excluded). What the contract contains It is important that the contract clarifies what the participants in the consultancy regard as its key aspects. Here is a list of questions that may be useful in determining this: • • • • • •

Who is the contract between? What is the focus of the contract? How, and by whom, will the contract be supervised? What are the expectations of the parties to the contract? What are the anticipated contributions of the parties to the contract? What are the expected outcomes of the contract?

Notes on terminology It is important to choose with care the words used to refer to the focus of the contract. The focus, after all, is a task, issue, problem or goal determined by the client. It could be a problem but is not necessarily so, and focusing on ‘problems’ may militate against moving forward because of the associations conjured up by the ‘search for solutions’. It is probably advantageous for both consultants and clients to focus on seeking opportunities for change. In doing this, they are able to concentrate on identifying the capacity of people and motivation 65

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towards change and the resources constituting resources for change. Among these resources are the data providing the basis for action. The contract anticipates these components of the action phase of the consultancy. It specifies relevant items, including the agreed cost, with these in mind. It is useful to make sure in particular that the contract sets out a summary of necessary background information as well as clearly stating the aim: • Summary and background information: a short paragraph so anyone picking up the contract will get the gist of what it is about. Titles of contracts can be notoriously misleading to anybody who is not involved in the project. • Aim: the aim of the contract should be set out again so readers can pick out on the front page what the contract is aiming to achieve – this may have a few short bullet points to highlight the components or phases. Example Public Care (a pseudonym) is an organisation providing a range of health and social care services, with which the consultants are working. The aim of the contract between the consultants and Public Care is to understand the issues affecting the morale and performance of the workforce, to make recommendations and to assist the senior management team in implementing effective changes, namely to: • conduct baseline research of procedures and structure of the organisation, with comparison to their main competitor; • investigate attitudes to change and the issues faced by the workers and the managers; • develop a comprehensive action plan that will empower the senior management team in implementing change and improvements and efficiencies; • observe the process of implementation and provide objective feedback to improve the process to maximise the sustainability of changes.

Using milestones The use of milestones in contracts is becoming more widespread as it ensures some control for both client and consultant. Many organisations like to set milestones for various purposes. These give some control over the work, ensuring that subgoals are achieved or simply that the project is kept on track. This control can be to the benefit of either party or both – such interim goals provide a convenient way of reducing risks by ensuring payments can be staged. 66

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A brief extract is shown below for illustration (see Table 3.2). The milestones are just that – markers on the journey that must be passed in order to get to the destination. Each can have a date for achievement with some specific requirements in as much detail as necessary, but adding too much detail probably makes the contract less manageable and can make for lengthy discussions. Equally, if the requirements are short and general, the debate can be just as fierce if there is any misunderstanding. Of course any feeling that a milestone has not been achieved will result in non-payment that can have serious implications for the consultant in terms of being able to continue the work. Thus milestones should be clarified and agreed at the outset and should be SMART (Specific, Measurable, Achievable, Realistic and Timely). It is essential that the consultants take great care not to enter into what the military calls ‘mission creep’, where the mission is achieved but the temptation to do just a bit more, based on success and achievement of course, is irresistible.While this can afflict the client, the consultant can do the same and end up delivering more time and effort than will ever be paid for. The consultants could take the view that satisfying the client even more with extra time and outcomes is worthwhile and may result in more business, but the ‘new’ business will be on the same, under-priced basis if care is not taken.

Table 3.2: Extract from milestones in a contract

Milestones/objectives No. to be achieved 1 2.1. To ensure that 25% of the workers respond to the agreed survey and an analysis is carried out. Report to include preliminary recommendations for changes in working practices

Date to be achieved by 1 Sept 10

31 Oct 11 2.2. To ensure 30% of managers are interviewed face to face or by telecom , to determine how the current management team can implement most effectively, the proposals made at 2.1

What evidence will be submitted to confirm achievement An interim report including analysis of findings and recommendations

Net cost of achieving milestone/ objective £4,000 – 1 Sept 10

Total cost inc VAT £9,500

Further interim £5,500 – report at 31 Oct 31 Oct 10 to inform meeting 5 Nov to confirm next actions for the management team

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Anticipating complexities As mentioned earlier, the contract is not a perfect, unchangeable document. It is an attempt: • to clarify at the outset of the formal negotiations between consultants and clients; • to summarise complex reality. However, no contract can ever eliminate the possibility of future uncertainties or ambiguities. It is important to recognise that a contract is a living, working document and not a rigid, inflexible straightjacket. In the Public Care example above, there are uncertainties and ambiguities, not least in the methodology.The consultants have had to negotiate, and neither they nor the clients or citizens are in a position to impose their own views of an ideal world. For instance, we could ask: is a survey the most effective approach? It can be carried out relatively easily by administering a questionnaire that will use relatively little of the consultants’ time, but will the results be worthwhile? The time frames are very challenging and the next phase follows rapidly, so any delay will result in a flawed process or increasing delays. How is the sampling to be carried out and, having done so, can the results lead to meaningful conclusions on which recommendations can be made? The writing of an interim report will take a substantial time in itself, and is that worthwhile for the client? Many consultants in public services will, with overheads, charge a premium sum per day, so either the sums of money are too low, or the time frames or the results sought, or all of these, are too ambitious. Failure to resolve these points to mutual satisfaction will lead only to later frustration and tension between both parties. The key here is to identify emerging problems as soon as possible. It then has to be decided whether to address these with the client as soon as they emerge, or to wait for a scheduled meeting. Neither party wants to spend a lot of time chasing the other or to appear to be fussy, but the general rule is that attending to emerging issues at an early stage is better in the long run. It is also probably best to determine who will carry out this process for both parties. The following example includes ‘ideal’ in quotes because in one sense the ideal can never be achieved. However, it is worth setting out the components of a good contract. 68

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Example: An ‘ideal’ contract We carried out a consultancy based on a contract containing the following list of items, which perhaps could be regarded as near the ideal, in terms of its main headings: • • • • • • • • • • •

Focus Goals Objectives What we each expect What we each will do: values Schedule of proposed activities When we will review Quality assurance Risk assessment Safeguarding citizens Outcomes/products

Example The following example (see Figure 3.1 overleaf) illustrates diagrammatically the components of a good contract, some of the main ways in which they relate to each other and how they are carried forward in implementation. Particular attention should be paid to risk assessment during the contract phase, since the consultant and client need to be aware of the impact of different contingencies on the consultancy and, as far as possible, include this in the contract.

Putting the contract into operation It is important to be aware of the need to keep the contract under review, from the earliest days.There is no stigma attached to revising the contract repeatedly, provided all parties talk it through and agree with this. Revision may help to avoid problems arising from the contract going awry.

We have now completed the contracting stage and are set for implementation discussed in the next chapter. In practice, these stages often blur into each other. Planning also recurs as modifications are made throughout the creative process of consultancy and adjustments are constantly made to the plan.

Conclusion This chapter has dealt with a topic that at first sight appears to be a straightforward, technical activity. However, what has emerged is that a good deal of thought needs to go into the contract. In particular, 69

Figure 3.1

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consultants need to anticipate where the consultancy is likely to go and where it risks going, in order to build these aspects into the contract. Empowering consultants are concerned to incorporate into their consultancy practice the perspectives, experiences and views of citizens as represented by service users, carers and patients. To this end, they need to take measures to assert their independence from their funding bodies and develop their resources as critical practitioners who can use their creativity where necessary.

Further reading Allan, D., Kingdon, M., Murrin, K. and Rudkin, D. (1999) What if! How to start a creative revolution at work, Oxford: Capstone Publishing. [A book full of ideas about how to introduce more creativity at work.] de Bono, E. (1977) Lateral thinking, Harmondsworth: Penguin. [A book, as de Bono states, designed not to be studied but to be used. It deals with the fundamentals of lateral thinking – not how to gather new information but how to rearrange what we already know in order to tackle problems.] de Bono, E. (1986) Six thinking hats, Harmondsworth: Penguin. [In this book, different kinds of thinking, and how to practise them, are explored.] Kay, J. (2010) Obliquity: Why our goals are best achieved indirectly, London: Profile Books. [A stimulating book which offers a form of lateral thinking in the search for ways of tackling contemporary issues.] Morgan, G. (1989) Creative organization theory: A resourcebook, London: Sage Publications. [A classic book which does not date, in that it is rich in stimulating ways of viewing organisational realities afresh and tackling problems in new ways.]

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four

Engaging Engagement is a subject that hardly gets a mention in many consultancy books. Perhaps this is because the preparation of the contract seems to many people to be the most important phase of the work, before the major implementation of the consultancy. We regard the need to engage with the clients and citizens involved in different ways in public services as absolutely crucial to the success of a consultancy. It is important to take time to consider carefully the different individuals and groups with a stake in the particular area of public services being tackled. That is why this chapter is one of the lengthier ones in this book. The phases into which we divide consultancy in this book are a somewhat artificial contrivance that enables us to discuss separately things that in real consultancy practice are often not separable. In this chapter and the next we make a distinction between engaging and empowering, as though they follow each other, which they often do not in a clear-cut fashion. Reassuringly, perhaps, when we encountered the book by Gunn and Durkin (2010, p 167), we found that our division of the phases corresponds closely with their four stages of social entrepreneurship: analysis, instigation, sustaining and reflecting. Although there is some overlap between the focus of social entrepreneurs and that of consultants in public services, there are good reasons why we have located the activity of gathering information rather later in the process – after engagement takes place – than they do. As already noted, most of the phases of consultancy we deal with in Chapters Two to Six overlap and on occasions coincide, or are even repeatedly revisited. However, despite the overlapping nature of engagement and empowerment, they are distinctively different. Engagement in the field of public services is the term used to refer to the early stage in the involvement process where citizens and workers begin to interact significantly. Empowerment goes beyond engagement and is defined in the next chapter. Engagement is part of the process of participation by people – staff and citizens. Participation is often used interchangeably with involvement, but these terms have different, if related, meanings. Involvement is the term used to refer to the full range of ways in which citizens and staff may take part in designing, managing and delivering public services, from minimal consultation with members of the public through to them taking control of the process (Adams, 2008a, p 31). Participation specifically 73

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refers to situations where citizens play a significant part as active contributors to decision making in policy and practice (Adams, 2008a, p 31). To return to engagement, it is the stage of consultancy where implementation of the agreement between clients and consultants begins to take effect. It is where the aims of the consultancy are translated – if not already written into the contract – into objectives and methods.This probably entails working out a more detailed work plan. In the engagement phase, the main preoccupation of the consultancy is how to implement the contract, or any other form of agreement between the consultants and clients. However expressed, the bottom line is that both consultants and clients are probably concentrating on seeking opportunities for change, meaning seeking changes with positive outcomes.They are working to enhance the capacity of people and their motivation towards change and to develop the resources to carry change forward. It is important not to blur the reality that the perspectives of managers, professionals and citizens on tasks requiring engagement may contrast, and on occasions conflict, with each other. The consultants need to use their skills to manage the tensions and dilemmas raised by these differences, conflicts, uncertainties and dilemmas, some of which, by their nature, may not be resolvable. For instance, dilemma is the term used to refer to an unresolved and unresolvable problem or choice, between two outcomes, each of which is equally undesirable and equally unable to ‘solve’ the problem or resolve the choice.The process of engagement, therefore, is likely to be somewhat ‘bumpy’. A further reason for this ‘bumpiness’ is likely to be the engagement of the consultancy in change. The bumpiness can become smoother as over time some conflicts and dilemmas turn out to be more resolvable than at first thought.

Engaging with change We could easily argue that all-empowering consultancy, one way or another, comes down to the task of bringing about change. Much consultancy involves working directly with people – managers, professionals and citizens – involved in change. This may take place at the individual, group, organisational, local, regional, national or international level. It may engage people simultaneously at more than one of these levels.Almost by definition, the process of change involves at the very least a degree of discomfort in organisations, hence the volume of literature dealing with it (Abrahamson, 2004).

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Example: Creating the conditions for change We noted in Chapter One that empowering consultancy does not simply mean bringing in external consultants as the mobilisers of change, but may involve engaging staff and citizens in promoting the agenda of change. The question is how we do this. What staff in the organisation need, perhaps, is permission to change. A striking example of this was provided during the implementation of the Health and Social Services Management Programme (Advanced MESOL) for senior managers in the NHS and social services, developed by The Open University (OU) for the National Health Service Training Directorate (NHSTD) in the early 1990s. When the use of the first module of the programme (Salaman et al, 1994) was evaluated, one group of senior managers in the south of England revealed that they had met regularly to discuss the topics of the programme. However, during the discussions they tended to leave the case with the OU materials in the middle of the floor and hardly opened it to refer to the contents. It was as though this was a symbol that gave them permission to share their ideas and experiences. It gave them permission to think and speak outside the box.

Engaging with citizens, managers and professionals First and foremost, the empowerment approach to consultancy is about empowering people who traditionally would not be considered as consultants. These include all members of staff and – the focus of this section of the chapter – all those patients, service users, carers and other members of the public who come into contact with the organisation providing public services. Potentially, therefore, every citizen is a consultant. How then do the consultants engage with citizens? Second, empowering consultancy means empowering managers and professionals, perhaps even in different ways empowering those who are already in some senses powerful. For instance, managers may be empowered through liberating their minds to different ways of viewing the goals, culture and creative human potential of citizens in their part of public services. Example: Empowering citizens to collaborate with the consultants The consultants were concerned with tackling widespread barriers inhibiting citizens from taking part on an equal basis with managers and professionals. They met with individuals and groups informally to devise local ways of engaging people. They were aware that there were no simple, off-the-peg solutions that

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In recognition that engagement is not straightforward, we consider first the structures and arrangements for running public services, often referred to as governance. Changing governance of public services Barnes et al (2008) provide excellent guidance on understanding and promoting citizen-centred governance and this section draws on this. Understanding governance In the 21st century, there has been an enhanced focus by policy makers on engaging citizens in the process of governance and encouraging local partnerships concentrating on developing shared ways of tackling shared problems (Barnes et al, 2008, p  7). Many such initiatives target specific areas, such as Education Action Zones (EAZs) and Single Regeneration Budget (SRB) partnerships. Collaboration is encouraged between the statutory, voluntary, community and private sectors (p 8). Designing governance It is recognised in the field of governance (Barnes et al, 2008, p 8) that partnership arrangements are so various as to preclude simple definition of a single model or approach. In general, however, paraphrasing and developing at the level of public services, partnership may be defined as a set of relationships involving collaboration between two or more organisations or bodies or groups with shared interests and aims. Barnes et al (2008, p 10) give examples of different governance arrangements in an English city, revealing the complexity of the geography of governance. Some are city wide such as the city council, and involve citizens as a whole, whereas others such as Sure Start partnerships involve children and families living in a neighbourhood. Developing citizen-centred governance The process of developing citizen-centred governance is complex and the involvement of consultants to help its development is likely to be very varied, depending on local circumstances.

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Example: Engaging young people in a neighbourhood The consultants worked with young people and local authority youth service staff who were already involved in a number of initiatives in a locality. Over a period of time, young people expressed frustration at not being sufficiently involved in developing local activities. Through the presence of the consultants, and in particular the recruitment by the consultants of a small, representative group of young people from the locality as co-consultants, a programme of activities was worked out with a view to empowering them to take part. After the consultants left, the local authority youth service disbanded the arrangements for involving the group of young people and returned to the former pattern of provision, not involving them formally, justifying this by stating that staff now knew more about young people’s needs and were more than competent at continuing to use existing informal means of gathering their views. Note: We have used the term ‘empowerment’ in the above example and need to recognise that this is a concept of considerable complexity.

Empowerment: a contested concept Empowerment is by no means a straightforward concept to understand or apply. It is an umbrella word used to refer to a cluster of ideas (Adams, 2008a, pp 3-7) that have evolved over decades in Western countries including the UK, relating both to people’s capacity to take power and to the means by which they achieve this. So, empowerment is the term used to refer to ‘the capacity of individuals, groups and/or communities to take control of their circumstances, exercise power and achieve their own goals, and the process by which, individually and collectively, they are able to help themselves and others to maximize the quality of their lives’ (Adams, 2008a, p 17). We return to this concept again near the beginning of the next chapter. Engaging citizens: patients, service users and carers – a contradictory activity The actual engagement of citizens in consultancy requires development of their knowledge, skills and resources. In one sense, it is a confidence-building task, yet in another, it is important that the citizen is treated inclusively, on an equal basis with staff – managers and professionals – in the public services organisation. This is inherently paradoxical and reflects the contradictory nature of empowerment of people as a goal in the public services. Here are two examples of ways of tackling this. 77

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Example: Sensitising managers and professionals to citizens’ perspectives The customer, client, patient or service user is a key concept in the health and social services. Public services in the UK in the 21st century operate on the principle that the experiences, choices and wishes of the service user are at the heart of personalised services.Yet using the term ‘service user’ in particular does not acknowledge that some people’s experiences are seldom if ever heard because their experience is of exclusion from any interaction between managers, professionals and service users. For instance, a person’s mental health problems may not lead to them having access to professionals or services, either because they are not defined as in need, or are ineligible, or because they are, in their view prematurely, excluded as no longer in need. Workshops and seminars can be held with the aim of raising relevant issues. It helps if service users, carers and patients are present at these. Careful preparation is needed to make the most of such events.

Example: Sensitising managers and professionals to the problematic identity of the service user This may be done by using exercises such as pairing off and spending 10 minutes, each telling the other key autobiographical details, to explore the power imbalance between professionals and members of the general public. Further biographical approaches may be used to gather the experiences of the person, including their experiences of being ignored, marginalised or misunderstood by professionals.

Engaging with senior managers Consultants may regard management as simply offering higher potential for earning and influence. From the vantage point of empowering consultancy, however, we view working with top and senior managers as an even greater challenge than face-to-face work with middle managers, professionals and other people delivering services.There are two main reasons for this: • Ethical issues for the empowering consultant become sharper the higher one moves up the organisation, for the reason that organisational priorities tend to be expressed in terms of financial targets rather than human betterment. • The building of services around the needs, wishes and empowerment of citizens tends to be more remote from the boardroom than from

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the points of citizens’ access to assessment, planning and shaping their services. Example: Developing strategies with senior managers for involving citizens in shaping their services Consultancy aim: To sensitise senior managers to issues concerning citizen participation and personalisation of services. Methods: Consultants set about devising, with a small group of senior management, ways of sensitising themselves and others to what is involved in developing citizen participation and personalised services.A presentation by a drama group, whose working method is participative and interactive, is set up as part of the programme for the annual general meeting of the board and senior management of the organisation. Afterwards, the consultants work with a small, nominated group of senior managers, chaired alternately by the chair of the board and the chief executive, to give it the necessary authority, to devise and subsequently monitor a plan for implementation.

Engaging with public sector agencies Public sector agencies need to be alert to the potential benefits of developing services through internet-based technologies.The early years of the 21st century have witnessed a huge increase in the use of mobile phones, not just as telephones but as interfaces, as well as a revolution in communication through social media such as Facebook and Twitter.The following example uses more conventional telephone as well as some information technology (IT) to achieve service development. Example: Using IT and telephone to develop support services in housing Consultancy aims: To set up partnership for medium-term work with a housing authority, gathering and analysing data from IT and telephone-based services to improve service delivery. Methods: The consultants work with the housing authority and with residents to develop improved, more joined-up and sustainable services.The existing support services for residents include Home Call (with a daily charge for emergency call out), telecare and telehealth linked to supported living and personalised services. The consultants feed insights into the residents’ experience into the analysis of data from IT and telephone-based services, using these to recommend to the housing authority ways of improving the services by making them more costeffective and improving the quality of residents’ experience.

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Engaging with groups and organisations in the private, voluntary and independent sectors Consultancy aims: To improve the motivation and capacity of care staff in the private, voluntary and independent (PVI) sectors. Methods: The consultants worked with agencies in the PVI sectors to improve coordinated attempts to provide staff with training from induction to basic and further training. This was in recognition that the skill sets of staff to carry out professional care work were too scarce. The consultants carried out research to ascertain staff perceptions and used this as the basis for recommending to employers ways of improving support and training on the job and recognition of this by employers across the sector in a particular region. This was with the aim of reducing wasteful and parochial competition for staff between employers and improving the joint pooling of effort by employers and, by coordinating this with local authority workforce development departments and teams in the region, developing more cost-effective and integrated strategies for workforce development.Through this, the aim was to improve the extent to which services met the needs of the public. The consultants drew on data from research highlighting key issues in engaging with cooperatives and mutuals (APSE, 2011). Engagement here was more than an initial introduction – it became an ongoing programme of work.The process of engaging with these issues raised questions as to how workers found out about training and how this, in turn, was funded. A survey soon revealed that workers only found out about training through their manager but that subsequently at least half of the workers undertook training in their own time for no pay. A registration system was devised so that the training and profiles of staff could be validated before going on a website, and that the workers could be informed directly about further training.

Developing innovation as a tool for change A key focus for engagement, in whatever sector of public services and at whatever level, is innovation. Innovation is a key concept and provides a recognisable handle for managers and professionals in public services. We may cynically regard innovation as a label used to cloak other aspects, such as saving money, but the reality is that innovation, at its least, is a tool to be used to achieve change. One noteworthy feature of change is, of course, that it is not necessarily change for the better. Often managers will introduce change with the presumption that benefits will follow. This is perhaps one reason why barriers to change often include longer-serving staff, who may assert that they have seen it all before and that the latest change is a fashion or fad that will fade in time. Change may be associated 80

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with new staff and it may be difficult for existing staff to maintain their profile as still alert to new challenges and willing to embrace change. We short-circuit these debates here. From the vantage point of the consultants, approaches to them on behalf of the agents of change in the organisation are quite likely, by definition, to offer opportunities to innovate for the better of citizens.This is our fundamental starting point. We could argue, in fact, that empowering consultancy is inherently subversive, since the consultants view all such enquiries from potential clients as potential opportunities to turn the consultancy towards benefiting citizens. Some will regard this as a questionable basis for action, but the well-respected critical text in education – Teaching as a subversive activity (Postman and Weingartner, 1971) – attests to the wider credibility, if not acceptability, of this argument. So how do the consultants engage with change in the organisation? They can use the handle of innovation as a means to tackle some of the more intractable issues concerning bringing about the betterment not only of the organisation, its managers and professionals, but also the individual citizen and, at the same time, if all goes well, of the empowering consultants and groups of citizens representing citizens’ interests. Example: Creating a means for thinking outside the box Consultancy aim: To enable people in the organisation and members of the public to come up with and explore creative and innovative ways of tackling change. Methods: The consultants created an innovation exchange. This means bringing together a cross-section of different managers, professionals and members of the public and inviting them to put whatever issues and problems they want on the table and pose the task: how do we tackle this? Alternatively, a person might bring an innovation to the table and use this as the starting point for a further debate or question for tackling.

One illustration of such an initiative in our experience is the innovation exchange created under the umbrella of the Enhancing Practice and Innovation Centre for Care (EPICC), based at Teesside University. In this initiative, the innovation exchange regards services from a citizen, patient/service user/carer perspective. The goal is to achieve what citizens want – joined-up services that maintain or improve their quality of life, rather than having to engage in a constant struggle to identify whether their services should come from health or social care. In this regard, citizens and professionals both share the goal of wanting enhanced services and on occasions, innovation in this field can bring about hastened change. 81

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Further note on EPICC EPICC provides a forum or a fulcrum at Teesside University for joined-up thinking and interactions that lead to change. Staff from different schools in the university come together to examine real problems and attempt to develop innovative solutions, or routes to solutions in the care sector of public services, using cross-disciplinary expertise to do so. In universities, different schools and faculties often exist in their own compartments in just the same way that departments function in public services. In addition, practitioners will be drawn into this process as they are engaged with the process of joint innovation. There are, of course, challenges in this type of engagement. How does one attribute beneficial outcomes? Whose is the intellectual property (IP), which may have considerable value? (See Appendix 3 on IP.) Example: Encouraging innovators There is a need to identify people in the organisation who have, perhaps, already tackled the problem the organisation needs to solve. Consultancy aims: To develop champions for new ideas, to encourage and support existing innovators and to build means by which the organisation can solve problems. Methods: Many different strategies could be employed. We have found the model of positive deviance helpful (see Chapter One), using this approach to seek from communities the families and groups who develop their own successful strategies, seeking to encourage others to replicate their approach.

Pascale et al (2010) argue that rather than leaders and top managers attempting to work at organisational problems from the top down, using resources – people and ideas – brought in from elsewhere, they may be able to identify innovative people in their own organisation, perhaps hidden from view, who have already been creatively working at these problems. The task of consultants, rather than providing the expertise, is how to identify and empower existing people in the organisation who can champion new ideas and solve problems. We have explored some features of engagement and used innovation as a key to engaging in change for the benefit not only of employees but also members of the public. We turn now to some of the technicalities of how the consultants make the contract work for the benefit of people.

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Making the contract work, baselining and translating the contract into a work schedule We now consider how the consultancy engages with the situations, tasks or problems, however these are identified.The term used to refer to the ways the extent of issues or problems are specified is ‘baselining’. It is crucial that the individuals, teams or organisation can own this initial process in order to proceed, but this chapter focuses on how we start to engage. Baselining is the term used to refer to the process of establishing the values of various measures at the beginning of a study for later comparison. It is used in different types of work, such as comparing a computer’s performance to that of its historical performance, surveying land or in medicine.The purpose of the baseline is to provide a means of comparison, since as soon as consultants become involved, change may be taking place. It is important to establish what the situation was at the outset. Example: Baselining A project was set up to investigate the use of health monitoring equipment in care homes to pick up early signs of deterioration in, for example, blood pressure, to prevent the condition worsening, leading to emergency call-outs or hospital admissions. It was important to establish the baseline of historical data (albeit the comparisons cannot be exact) to determine the average number of call-outs and admissions over previous years and the amount of time care staff used to deal with these.

The consultant may work alone or in a team of consultants.The client may be an individual, a small group, an organisation or a connected series or network of organisations.Whatever the combination of these, the next task after agreeing on the contract will be to turn it into a schedule of work. This will need to cover the entire range and detail of each of the aims and objectives and to specify how each is to be carried out. This schedule should also have a time dimension.

Engaging with leadership and management Consultants need to have the expertise to engage senior and middle managers in their consultancy projects. Part of the process of engagement consists of interacting with managers, whether in writing, on the telephone or face-to-face. Sometimes this is straightforward, as in the situation where the top manager has initiated the consultancy.At other times, the consultant needs to work hard to develop a working 83

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agreement with managers in the organisation that will enable the consultancy to proceed. In some circumstances, the consultancy will mean change, which, by definition, implies some discomfort in the organisation. It is even more important, in such circumstances, for the consultant to generate the support of managers. Facilitating leadership styles Consultants are required to work with the organisations in which they find themselves. This may seem an innocent and, perhaps, naive comment, but behind it lies the reality that a range of management and leadership styles is to be found in public service organisations. All too often staff and managers regard management skills and leadership skills as synonymous, which in our view most certainly are not. In short, managers can usually change systems and, if necessary, ‘punish’ in different ways those who do not comply. Leaders may be managers, but they can be anybody in the organisation others respect, as they often lead by example and talk ‘sense’ so that others follow them of their own volition. What are the qualities that the consultants should encourage in leaders? One comment from a consultant was to the effect that managers simply manage the status quo, whereas leaders promote change.The following are suggestions for the qualities and skills required of leaders in such circumstances: • openness; • confidence in what other people can do; • strength in recognising one’s own weaknesses. Example: Is there an easier way to manage contracts? A public service organisation requested evidence from the consultant that certain tasks had been completed by a certain time before a manager, and the contracts department, would be satisfied and make a payment. The danger here was that the milestones became very specific and too detailed, and the evidence needed for these became the aim rather than the scope of the whole project. It was also difficult to plan activities if funding was potentially delayed, the resultant effect often being one of control, so the contracted consultant felt constrained by the milestones.

The three factors in the ingredients of the empowerment approach to consultancy (see Chapter One) – motivation, supports and capacity

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– exist at different levels relative to each other within settings like individuals, teams and organisations: • Motivation – this could come from a motivating leader or from a group of people, perhaps impelled by the view that change is imperative to their survival. • Capacity – there must be the intellectual or skills capacity, either demonstrated now or capable of being developed in the near future. • Support – there must be resources – from the supervision of individuals through to financial resources to retrain people – for meaningful change to occur. At least two of these factors need to be present for change to occur at all; for change to be likely, all three must be present to a significant degree. Each factor can be examined and problems identified as we prepare to set out the tasks that must be overcome in order to affect the changes needed to make progress that all can join. If we look at our three factors at three different levels in turn, we can consider them using a scale of 1–5 to reflect on, as in Table 4.1. This scale is inexact but provides a ‘ready reckoner’ that the consultants, or indeed the individual staff, teams or the organisation itself can use. Table 4.1

Support

Capacity

Motivation

1

2

3

4

5

Demoralised; low pay; no prospects of promotion; no inclination to change

Limited Adequate pay, Actively looking Highly prospects for some prospects for promotion, motivated; ready promotion but of promotion; with growing for promotion; limited rewards ready for expectation incentives if successful so a change if of success; pay around pay limited inclination opportunity satisfactory better than to apply arises expected Little if any Some training Showing High levels of Basically training or available but a competent but distinct signs knowledge educational waiting list to and skills with could do more; of ability to do skills; no time get on it; and more complex time, accredited limited time for personal often cancelled to do training, work but needs training and development at late notice training to resources which is usually or change due to work not accredited realise change available – ready pressures for change No support Sporadic High levels of Regular limited Supervision or supervision; supervision; no support and infrequent happens often no likelihood recording or regular frequent supervision; although can of change plan for future supervision sessions often be cancelled at that encourages cancelled; short notice, change, with full support when but overall requested there is a plan records and plan

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Consultancy – the individual The key to changing an organisation is to effect change through each individual member of staff. However, every individual is different, with different needs, different experiences and expertise. Crucially they will have different motivations for (or resistances to) change, and have different capacities to do so, which appropriate or improving support can alter to the benefit of the organisation. It may well be that affecting change must work initially through change in most or even many individuals. Each box is not prescribed, and those involved in affecting change can create their own version, but Table 4.1 provides a starting point. Where do you see yourself on this scale now, and where would you want to be at various points in your career? Where do you see other individuals you know fitting in? Example: Developing the care home in a competitive market Like many care home owners, an owner of more than one care home was concerned at the turnover of care assistants and the impact of a planning application for a first branch of a large supermarket in the town. Such supermarkets tended to be able to offer the flexibility of hours, rates of pay and conditions of work that competed with what these care homes could offer staff with the least skills and capacity, and the lowest wages and motivation. As there were also other competing care homes, staff could also choose, when opportunities arose, to move to a care home nearer to their own home for less travel time and costs and even slightly better pay. In this case the owner fought the planning application, rather than perhaps providing more support and motivation for existing staff and thus improving motivation.

The above example highlights that, against this type of background, staff turnover in care homes is often high, with many care staff operating at the lowest levels in every category in Table 4.1 above. Riggs and Rantz (2001) proposed a model of staff support in the nursing home that conceptualises it as a supportive social system in which the needs of both staff and residents can be better met, the latter being a vital point we shall return to in detail, but it forms the central component of the new inspection regime that the CQC introduced in 2011. Engaging with teams, units or departments We now turn to a collection of individuals in a unit or team that has at least one manager, and apply the same approach, as in Table 4.2 below. 86

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Support

Capacity

Motivation

1 Demoralised; low esteem; no collective inclination to change; disciplinary ‘threat’ real

2

3

4

5

Occasionally Doing the job Been working Highly an individual ok so why do together a while motivated; team inclined to be more? In the and would like recognition; more positive comfort zone to do a bit ready for new but then others but will listen to more – positive challenges; many stifle and return new ideas feedback is incentives to status quo welcomed

Occasional Team looks Generally little Team away days training half day happen – they forward to training or but it always training and for educational seem helpful skills; no time seems a token at the time but many we learn effort and not and are able to for team we often go everybody development back to where do things better, attends anyway we were quite but some are or change still cynical soon Little support, The odd visit Regular but Clear structure supervision or from a manager infrequent and routine recognition; provides a meetings with support but no likelihood boost in feeling management ideas to change of change supported but but just feels can succeed it’s short-lived like status quo or fail

High levels of knowledge and skills, individually and as a team, with time and resources available and thus ready for change High levels of management support that encourages and supports active change

How does this fit with the team? Again, the consultant can modify the contents of each box and then consider how each team members think about this. Is there any consensus at all which will provide a baseline of where the team is now? The team and the influence of individuals within the team To emphasise the point made at the outset, a team is made up of individuals.They each have different motivations and different capacity for change and in theory should have similar support. The reality is that teams very rarely start as a team. Individuals come and go, and over time, the team will change its personality in some way. The key figure will always be the manager, who has some power to influence behaviour and performance. These powers will be greatly enhanced if the manager is also a leader who is able to bring about change by example, by personality and personal engagement. The situation becomes even more complex where other leaders exist in the team. These may be negative leaders, those who are ‘the old hands’, those who ‘have seen it all before’ and are cynical and at times destructive in their resistance, and these staff are perhaps the ones who should be targeted for change to take place or perhaps ignored as others embrace change without them. 87

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Example: Using an accreditation scheme to advance practice The manager of a residential rehabilitation service with a community day service support resource wanted to improve the service being offered for people who have, or are recovering from, mental health problems. The local university offered an Excellence in Practice Accreditation Scheme (EPAS). This provided a framework for practice development with staff in the work setting, individually and collectively, so that evidence of the quality of service delivery could be gathered over a period of time. The systematic collection, assessment and evaluation of evidence were carried out by a partnership of staff, service users, carers and others (McSherry and Pearce, 2007). This scheme provides a set of six criteria against which the unit, or team, could gauge themselves, and to which they could aspire, with some skilful facilitation and support, to affect improvements in their performance and capacity. The process was slow but stronger as a result of the team being empowered to change themselves, and the individuals with the lowest motivation, and perhaps capacity too, became the strongest supporters of the scheme, gaining the accreditation and the full support of the residents and service users in the process. Two quotes from staff members reflect how the consultancy model could work with teams, as well as individuals, and also demonstrates a lack of faith in the effectiveness of the audit and inspection regimes that predominate (Report, 2010, Ware Street Resource Centre Stockton on Tees): ‘It became routine and unrewarding being involved in the regular service audits, as we seemed only to be looking at operational issues and short to medium term improvements. EPAS presented a challenge that required us to really think about the whys and wherefores of our practice and how we could develop our understanding of national and local strategies, current research and how they apply to our practice.’ ‘… and it was about what I do in my everyday job, and it was about showing that my practice is excellent, just knowing that has really boosted my confidence and self-esteem.’

The organisation, its teams and individuals Finally we explore an organisation that has a number of managers, consists of a number of teams, or units, and will therefore have many more individuals. An organisation will also have certain infrastructure resources like human resources, finance, workforce development and so on that do not exist in small practice-based teams. Again a similar table could be constructed for different organisations using this template.The 88

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process of doing so should be informative about what the problems are and begin to develop the most fruitful or crucial areas to tackle first. Example:Tackling recruitment and retention issues A county council had difficulties in recruiting and retaining social work staff. The challenge was particularly difficult due to competition for the recruitment of qualified social workers in the Home Counties, London in particular. Short-term solutions in social work have tended to be located in three general approaches. First, to use golden hellos to provide a financial incentive for staff to move to the employer, which may be effective initially, but if the appointee discovers after appointment that motivation, supports and capacity are in the lower reaches of Table 4.3 below, then when the next opportunity arises (and there are many), they will move on. Second, the use of agency staff has grown rapidly. Here the worker receives a considerably higher level of pay, can work the hours, within reason, that they choose, and can leave at short notice, but they miss out on pension and training benefits by not being an employee, while equally service users and the organisation miss out on corporate development. Finally, some authorities may try to recruit trained workers from abroad who welcome the opportunity to work in the UK but will, for example, bring limited knowledge of British legislation. The local authority took the longer-term view that they wanted to increase support and capacity, and in turn, motivation. Time and money was invested in training and, even more crucially, in supervision and support. It may be possible over time to develop a general strategy for recruiting and retaining the best staff, enhancing the capacity and support of the staff whenever possible, and also increasing motivation, with a range of incentives and mechanisms for recognition.

In our third example, illustrated below (see Table 4.3), the situation is portrayed at the macro level, across the organisation. In each set of circumstances we can identify a range of problems that need to be tackled to effect change. The pattern of problems and tasks varies between individuals, teams and organisations, as each has strengths and weaknesses to address. The power to effect change may lie in different people’s hands. Individuals can change themselves and possibly their team by being highly motivated, even without great capacity or support, but without becoming more powerful then wider organisational change may not be effected. Equally, a powerful figure who directs a service organisation is unlikely to achieve change simply by being highly motivated. They will need individual, team and organisational capacity to grow and to provide resources in order to move forward. The further challenge is that teams and organisations consist of many individual people who have in their time had one or more of 89

Consultancy in public services Table 4.3

Support

Capacity

Motivation

1

2

3

4

Demoralised; Staff always Staff have a It’s all working low pay; no looking loyalty to the ok so why prospects of for better organisation change? If we promotion; opportunities and some job need to, any staff retention elsewhere satisfaction change needs poor; no but these are but are still to be managed inclination to limited so they very carefully; prepared to change do the job they staff are ok with leave if a better are paid for opportunity this; staff have comes up limited options elsewhere so stay Generally little training, educational skills or staff development; no time for development or change

No support or supervision; little likelihood of change or change without consultation

Identifying Organisation needs for committed to training limited developing the and resources workforce but too, with capacity to priorities not manage this and accurately support staff identified development is limited Limited support for staff initiatives but management can change things with little discussion

Change is needed from time to time and we discuss it but much stays the same as support is limited

5 Highly motivated; held in high public esteem; many opportunities for promotion and personal development; numerous incentives; high staff retention

Workforce High levels of development knowledge staff very and skills with committed planned time but limited and resources resources for a process of to develop ongoing change capacity as and continuous much as is improvement required Change is High levels of needed, support and consulted on resources and supported that promote but tends to be ongoing short term development and longer lasting change

our three factors to a high level, but these have been worn down by others’ cynicism as a result of them working in an uncoordinated way at different times with no significant progress. A minimum level could be considered in each factor, or an overall minimum ‘score’ as necessary for change, thus targeting that which needs addressing in detail. Change may occur in a synchronous and sustainable way, with an upward spiral effect of ongoing and self-reinforcing development at all levels. We now explore a series of practice examples at different levels to provide some context.

Building relationships In highly pressured situations: These situations might, at first sight, be perceived as very unlikely to build relationships, but in our experience the pressures for achievement actually make decision making easier and 90

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progress can be made more quickly, particularly when public money is being spent to improve services.We have noted, however, that there can be competing pressures in organisations that may adversely affect relationships. In one project we encountered a middle manager who had, in effect, a competing project, which she did not declare at the outset, but which motivated her to object to some of our proposals. In the context of goodwill: Sometimes relationships can be strengthened because goodwill has been invested and built up or ‘banked’ over a period of time.There is no doubt that trust can be developed over time as the consultants are seen as reliable in terms of delivering appropriate quality work and on time.This bank of goodwill saves the client a great deal of time but also has the benefit of allowing the consultants to be more challenging if necessary.

Dealing with challenging situations Consultants have to focus on situations that colleagues and others find challenging and facilitate tackling them, grasping the nettle, in other words, which inflicts some discomfort to the consultant but removes something that really should have been removed before, or indeed prevented from growing in the first place. Consultants have less to fear perhaps than many managers, as the consultants will not face longer-term issues within the organisation in the same way. Micro-level problems – and loss of power The individual has generally little power in an organisation unless, of course, they are a director or senior manager. However, individuals have work to do and therefore have some influence as a result, not least on the team but also on the organisational output.This individual power can, however, be eroded if support is not provided so that motivation fades. This loss of power does not necessarily benefit the organisation, even if it makes management feel more powerful, because if individuals do not feel valued then their capacity becomes limited and undeveloped. Against the backdrop of the macro-organisational scale, the individual worker often sees problems on a day-to-day basis that adversely affect their day-to-day work. More bureaucracy, changes in procedures, changes in management, changing legislation and policy all may contribute to overseeing and controlling work in a way that enhances quality.At the same time, the worker may feel more distanced from the work that they believed they signed contracts to do. Their capacity is 91

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thus impaired, and in turn, their motivation lowered, usually with no increase in available resources. As a result there is a feeling of powerlessness in the individual workers to affect meaningful change. More performance measurement requires more data to be entered into computers, leaving less time for the ‘real’ work. Examples include the introduction of the Integrated Children’s System and the recording of stop and search. We now examine these briefly in turn. Example: Implementing the Integrated Children’s System The Integrated Children’s System (ICS) was created in response to Every Child Matters (DfES, 2003). This computer system provides a database for entering and tracking new cases, while also providing reminders as to target dates for the completion of initial assessments. Timely data entry becomes the primary motivation even when the data entered is flawed. One local authority children’s department thus routinely achieved the completion of initial assessments on children entered into the system as new cases. The deadline, the computer reminds the social worker, is seven days. Remarkably this target was achieved, even though many of the children were assessed without being seen, a situation which flies in the face of logic.The computer system has thus become rather more powerful than the social worker, and this example is only one of many that resulted in the Social Work Taskforce challenging its efficacy. The Taskforce was created to address the shortcomings in the systems that were identified so vividly in the case of Baby Peter who died from abuse despite several agencies being involved in his family’s case.Thus ICS has been seen as inappropriate, and as a result it will be heavily modified to again allow social workers some professional judgement. A Channel 4 Dispatches programme in 2011 (www.channel4.com/programmes/ dispatches/episode-guide/series-62/episode-1) showed, through an undercover worker with a hidden camera, a social worker who readily admitted that she preferred to do paperwork rather than see people.This is a very complex issue, since one can argue that, without considerable additional professional support and supervision, the practitioner may back away from a challenging meeting with family members. Professor Harry Ferguson describes in his qualitative research on what he calls ‘intimate’ child safeguarding (Lecture on intimate safeguarding practice with children, Safeguarding Children conference, Cornwall College, 28 February 2012) how when he shadows social workers as a researcher many of them actually find this supportive as well. He asked one social worker why they were walking through a difficult neighbourhood to the client’s house and she said that she had abandoned using her car after a gang of youths tried to hijack the car while she was driving. Also, of course, it is possible for practitioners to ‘blame’ the system because completing work on the computer removes them from the more challenging aspects of the job, namely, meeting people, assessing them and supporting them and their children.

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The point Ferguson makes about child safeguarding is that some families are very cunning in their obstructiveness and it requires the practitioner to develop confidence and assertiveness – as well as being well supported and supervised – in order to confront them. Example: Using ‘stop and search’ Often consultants find that workers become bogged down in delivering paperwork or defending or justifying their work. This example from the police is typical of many other public service organisations in this regard. ‘Stop and search’ is the term used to refer to police powers under the Police and Criminal Evidence Act 1984 codes of practice, of stopping people on the street and searching them. The police have often come under scrutiny for the range of paperwork that they are required to complete, and Reducing bureaucracy in policing was published in November 2009 by Jan Berry, the Reducing Bureaucracy in the Police advocate. However, the recording of stop and search came about to try to mitigate a perception, in the eyes of many of the public, that police officers often disproportionately stopped and searched young men who were black whom they ‘suspected’ of offences. Jan Berry (2009, p 53) stated that ‘The requirement to record full details was removed on 1 January 2009, and consideration is now being given to reducing the amount of information recorded if nothing is found during a search. However, I fear the forms have become a bureaucratic red herring: we are concentrating too much on the paperwork and not enough on the justification for and benefits of stops.’

The paradox of the organisation wanting to consult yet not doing so meaningfully has many different reasons. First, the process is complex and time consuming (and thus costly), and second, there are so many diverse views that even the majority of people who are consulted can rarely agree. The process then tends to make most people sceptical about its potential for change. Typically the government, perhaps the ultimate organisation, makes new proposals in Green Papers, which are filled with cases of groups of workers who have achieved something in terms of a new approach – often a shaded box in the outline proposal document – put forward as examples of ‘best practice’, or as successful pilots or Beacon status. The inference is: if they can do it, why can’t you? There is rarely any explanation as to the reason for their success. It may have been down to substantial additional deployment of resources and managerial support for change, or outstanding leadership, which are invisible to many workers. The participation movement has had many benefits in empowering service users and patients, thus making more workers think more and more about what they do and how effective it is. They can be blamed – and often are – for pieces of ‘bad’ practice or service delivery – but 93

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the ‘blame’ may not be attached to all workers. For example, the Equality and Human Rights Commission (EHRC) report (2011) into shortcomings in home care identified serious breaches of people’s human rights and laid primary responsibility for this at the door of management rather than solely blaming workers who visit people at home. And while it is always easy to say ‘it wasn’t me’, that may be genuinely true for many, and the responsibility for workers not spending sufficient time with a service user may rest mainly with the organisation requiring them to undertake a given workload of visits within a limited amount of time. Mezzo-level problems – and limited power The team can become a source of some strength or of limited power to the individuals within it as they need, sometimes out of sheer necessity, the support of each other because organisational support is limited. Their capacity has been developed by learning from each other, often simply on the job, and thereby their loyalties tend to extend to their colleagues in the team rather than the organisation itself. The consultant may be able to build on existing bonds in what constitutes a team, but frequently the consultant may need to encourage the development of a stronger team identity, or a restructuring to create teams working more effectively for the organisation as well as supporting the individuals within it.The following example illustrates aspects of this. Example: Distinguishing teams and task groups The term team is often used in public services for a group of workers who occupy the same office/s, work in the same geographical area, share significant values and working practices and carry out work with a similar group of service users, patients, customers or citizens. However, this definition does not mean that the group is a team – it simply implies that they work together in a concerted and effective way that benefits their public.We distinguish between this group, which we would call a task group consisting of individuals with different capacities, who may not like working together in any way as they have different values, different professional perspectives, different personal interests and therefore different motivations, and a true team, whose members share common values.

Some teams may be resourced and supported in a similar fashion, but the pressure of work may create inequities in support and supervision that can create tensions. Nevertheless, the fact that they are a ‘team’ often leads to mutual support which can lead to some unity, often in terms of 94

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resistance to the organisation, in respect of limits on resources to provide services, to be trained effectively and so on. A team of youth workers in an isolated housing estate, for instance, may come together not only to tackle the immediate problems they face in the neighbourhood but also to survive the professional and personal pressures they face, often with limited support from the organisation. Increasingly, during the early 21st century, health and local authorities have brought in service users and carers to work collaboratively with service providers. The progress of this may be uneven, not least because the voice of the citizen varies from locality to locality in the views expressed and the strength with which they are expressed. The challenges of this often centre on the ability to be able to meet the needs of service users and their carers as the resources that the team can access are provided through the whole organisation. Consequently, teams may ‘compete’ for resources for their service users and the organisation’s resources may not be responsive enough. Members of the team know what they want to achieve collectively, but may have very limited power in shaping resources to meet local need. Although the power staff may have is limited by what they can offer collectively, they may also know that the alternatives of care or nursing homes are limited by lack of resources. They may, in fact, recognise in the service users that they work with their powerlessness and may not wish to exploit that, although limited resources can give them few options. Macro-level problems for public services with many powers Public service organisations have all the composite challenges of the individuals, teams and units within them, but in all there will be some form of government control, which will limit resources, motivation and capacity. Example Public service organisations are complex and have changing and cumulative – and often interacting – demands placed on them. The funding of specific services is similarly complex, with some services being directly funded from central government, others being indirectly funded through local taxation and others again being funded through a mixture of central and local government sources. Inevitably the organisations tasked with providing the services do so with resources and budgets that they feel are insufficient to deal with the work required of them. In the case of public service organisations, the factors of capacity and resources can become a little blurred. Sometimes capacity can be restricted by the rules

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Consultancy in public services and regulations set by the government. Sometimes capacity can be improved by better training (taking into account the fact that the organisation may need to gain more resources) or by more effective management. Motivation becomes a factor in a large organisation where it is difficult for managers to hold all workers to account, so there is little fear, but equally individuals cannot be identified when recognition is due for successes. The motivational drivers of the organisation can centre on performance indicators which will often be rewarded with more resources or penalised with less, in ways that bear limited relationship to the actual work carried out.

The drive to have more freedom to win and use resources was behind hospital trusts seeking to gain foundation trust status for greater financial and general freedom. This motivation was certainly present in the Mid Staffordshire Trust Hospital, when evidence emerged in the Robert Francis Inquiry (Francis, 2010), but the financial targets and key performance indicators provided an almost completely false picture of what patients and their relatives were experiencing in the hospital. Local politics and elections play their part as politicians are motivated to do what they feel is ‘right for their area’. This creates a tension between meeting local need versus the postcode lottery of what is available, often with differing quality and quality assurance (QA) mechanisms. This problem has led to challenges in allocating children places at successful schools and patients living on either side of a road receiving remarkably different treatments. The massive growth in the older population has made these challenges even greater, and has forced successive governments to consult people and to attempt to tackle these issues in the short, medium and long term. Furthermore, despite many improvements in public services, the resources are seldom provided at the level to deliver services or training to all who need it. In the social care field, for instance, CQC used a system of awarding anything between 0 and 3 star status for care homes, but this has now been abandoned, although many are still using the latest ratings that they were given some three years previously. In end-of-life care the term ‘Gold Standard Framework’ (GSF) is used, although this has only been applied so far to a minority of nursing homes. Aspirations of this kind are commonplace, but the capacity and resources to affect delivery of such are severely limited, and furthermore, it could be argued that holding up such standards that the workforce cannot reach is demotivating in itself. Referring back to the gold standard terminology used in health, there is a question about whether services are resourced properly with all staff having the capacity and resources to achieve that standard. Using the analogy of the medals and metals perhaps it would be preferable to 96

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regard the standards differently. For instance, if the intention is to use a standard that all should meet and which can be resourced properly, one could apply the bronze standard in recognition of a certain quality, but perhaps recognise that with further motivation, capacity, training and resources, some staff could reach silver or gold standards. Achievement should be recognised on the path to even higher standards. In short, these standards must: • • • •

be measurable be achievable give recognition increase motivation to learn more and practise better.

Applying the above ideas, Table 4.4 indicates how the scheme could be developed. If we take a major area of concern in modern practice in health and social care, namely safeguarding, we can apply this model to the workforce. Everybody in the workforce needs to know about safeguarding vulnerable adults and, at the most basic level, protecting them from harm – the bronze standard. But while all need to know what to look out for, some will need to have more than this basic level of competence and knowledge, as they – the silver level – begin to deal with those who may have been abused. Finally, at the gold level, a more specialist worker needs to deal effectively with other agencies and with the full implications, underpinned by their responsibilities to the victims of abuse. Returning to resources in relation to delivering standards, the most expensive resource provided is staffing. More than one quarter of the workforce of about six million people in public services work in health and social services. Providing care properly requires many staff with increasing needs for training. Staff turnover is high, with staff moving Table 4.4 Level Competence Limitations on work that can be carried out Standard for whom

Bronze

Silver

Gold

Introductory basic

Good enough adequate

Excellent advanced Can understand, do and apply elsewhere Can work with different users in different settings

Can do

Understands and can do Working with Can work with more one type of user in than one type of one setting user or setting All of the Workers with Workers with management/ workforce responsibilities supervisory responsibilities

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within the sector and also out of the workforce into other sectors. Internal movement can help develop careers, but more often creates turbulence and delimits the development of consistent standards of care. Usually the expectations are high in terms of the valuable resource of time. Targets in major public services are often set for the current year alone, for instance, for hospitals, the police and for further and higher education. The other resource is funding which can provide more equipment and services, and can increase the number of staff. Although public sector employment in the UK decreased by 22,000 (seasonally adjusted) in the second quarter of 2010, there were still more than six million people employed in the sector in the second quarter of 2011 (see www.ons.gov.uk/ons/rel/pse/public-sector-employment/q2-2011/ stb-public-sector-employment---q2-2011.html/). Budgets, however, are set on an annual basis, so plans are often limited not only by the absolutes of the money available but by the planning blight created when staff do not know what work will be funded until figures are released, sometimes several weeks into the next financial year. The consultancy model works more effectively when the longest possible planning cycle is facilitated. It is also often said that ‘we don’t know what the budget will be for next year’, but the reality is that the bulk of the budget, in most cases, will remain the same as it has been, year on year.Thus a core budget plan can provide the framework to use the consultancy model. We now examine examples from practice, with some details changed to ensure that the organisations and the people concerned are anonymous. Example: Developing the participation of service users and carers A national organisation working through regional bases set out to engage in policy changes involving the participation of service users and carers. In specific terms the work involved speaking to staff and other people involved around the country, while also looking at how other organisations tackled the same issue, it being a requirement for most organisations in accord with government policy. In turn, a policy was to be developed in order that government policy could be implemented. The policy would involve recommending, for example, processes and training and costs. Using the consultancy approach, it appeared initially that: • Motivation was high – policy was a government push; implementation would be popular; other organisations were moving in a similar direction so it was appropriate and in keeping with the prevailing policy to go ahead.

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Engaging • Resources were medium – funding could be drawn down; staff were available to manage and administer the project; the regions were also instructed to support and given resources to do so, but the organisation had many other priorities too. • Capacity was medium – the organisation had many staff, with many at a professional level, some of whom were highly committed to the project, with time set aside to provide support. In comparison, after the consultants had completed the work, it appeared that: • Motivation was limited – there were different camps, one committed to the ideal of the process, the other believing that more empowerment would lead to more problems. • Resources were provided but decreasing – if the organisation itself limited those spent on the project, then it could focus on other areas of work for which there was greater motivation. • Capacity was decreasing – there was a reduction not only in resources but also in motivation among senior management, which led to reductions in the staff centred on the project, lowering the capacity to carry out the work needed.

Example: Introducing quality induction to social care The care sector Skills Council, Skills for Care, developed a Common Induction standard that registered managers should sign off after new staff had been inducted ‘successfully’ into their job after 12 weeks. The signing off is clearly motivated by two contradictory factors. First, there is a genuine commitment to ensuring the standard is achieved to effectively maintain standards of service for service users, but a second factor is that the inspection regime wants to see that staff have been signed off. As there is no independent assessment or accreditation, then in at least some cases the provision of any training, and the imparting of any knowledge, may be at least superficial.The motivation for management here has been to reach targets on dubious standards when the application of real, if only ‘bronze’, standards would have resulted in additional demands for resources. The motivation factors for individuals are diminished if the training they receive is not timely or is of doubtful value. The capacity of the individuals, units and organisations to deliver has thus been diminished. An alternative view was that the standards should contain: • the basic skills and understanding to be a beginning social care worker; • appropriate core values; • the ability to know one’s limitations. In reality, induction may be seen to be ‘done on the job’, learning from others who may be somewhat cynical and not trained effectively themselves, thus repeating a restricted standard of care, and not developing the capacity of the staff or the organisation.

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Consultancy in public services In many instances employers use a workbook that produces two challenges: • persuading individuals to complete the workbook; • enabling people to find the time to do the necessary work within the 12-week induction period. The motivation to complete the workbook in the shortest possible time can result in plagiarism or heavy prompting, neither of which produces a real gain in standards. In addition, as the standard is not real, other employers will often not recognise another employer’s induction, repeating, possibly unnecessarily, much of the ‘training’ and so on. There is also an issue about what happens if people fail – as they are already in the workforce they could be sacked, employment law permitting, if they are not up to standard, or employers may not want to sack them when recruitment is challenging. Here again the capacity of the organisation is restricted in its growth. It may be due to lack of resources, for instance. The outcome overall, however, is an organisation with lowered motivation and morale.

Example: Healthcare monitoring in care homes This initiative came about from an interaction between an academic and a manager of a care home. Neither had the whole idea, but the interaction highlighted that care home staff usually have no training in healthcare but are dealing with residents who often have long-term conditions and acute episodes of illness. By using telehealth technology, health data can be passed to GPs for monitoring and early response, hopefully preventing emergency admissions or treatment. The academic became a consultant to the project by supporting a successful funding bid: by means of some project management and by facilitating an evaluation. This ‘consultancy’ was an informal interaction from which initiatives commenced and these flourished due to the support available, the capacity of individuals to change and the fact that a grant was obtained. The project was built around the development of an understanding of the range of health problems from which residents in care homes can suffer. By definition, residents are in care homes as they are unable to manage for themselves and in almost every case some form of disability, or illness, or age-related difficulties, will mean that they are at a higher risk of having an acute episode, resulting in the call-out of a nurse, the GP or a paramedic, possibly resulting in an admission to hospital (costing at least £2,000, or four to five times the cost of a week’s stay in the care home). The university member of the network observed that principles of telehealth (usually used with individuals in their own homes) could perhaps be applied in a different way. With telehealth, individuals in their own homes monitor their vital signs through a unit that can take a range of appropriate measurements (blood pressure, pulse, oxygenation and so on) and equipment for their condition, which

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Engaging allows measurements to be sent automatically to a community matron (highly trained in health matters) who can observe patterns and react appropriately at a sign of deterioration. In this case the proposal was that the telehealth equipment, usually used on one person in his or her own home, would be used by care staff to monitor up to 20 residents with each equipment unit. The monitoring readings would be transmitted to a computer and logged into a website that the GP or nominee could check against the ‘normal’ parameters for each resident. The approach was beneficial, with GPs able to modify prescriptions, for example, and care staff better able to understand how people felt and how well they were. The monitoring process, while it took time, also gave each resident some additional personal attention. This new perspective empowered the care home manager who, in a sense became her own consultant, and began to realise the benefits for her residents, the potential cost savings, and an extra dimension of service for the business. The growth in the resources available, in cash as well as knowledge from the different professionals and staff, gave a momentum that has only continued to grow. All the staff involved are highly motivated, both in terms of helping residents/ patients and also in terms of the reduction of potential suffering, and cost savings to all as taxpayers, if emergency call-outs and admissions could be prevented. Staff have also developed new knowledge and understanding, which has been an additional benefit as their capacity has expanded. The project has raised yet another issue about our model of consultancy, around the capacity, resources and motivation of all the different parties concerned.The cost of the health monitoring equipment and the staff time to do the monitoring has to be borne (in this case from a grant), but cost savings would be made by the health service through less district nurse and GP time and fewer emergency admissions. The residents should benefit from the reductions in the likelihood of emergency admissions with their families perhaps reassured. The care staff may feel too that their capacity to sustain residents in the home has grown, but ultimately they are working harder than before, with no real benefits or increased resources. There are encouraging signs that others will adopt this approach so that the staff will, in effect, have become consultants for themselves, but also for others who will want to learn from their experience. The consultants in this case maintained their relationship with the care homes beyond the funding available. What emerged was that the ‘tele’ part of the monitoring – in terms of such aspects as website, data transmission and warning system of emails – was perhaps not necessary. Indeed, GPs valued the basic health monitoring data so care staff felt that they had ‘upped their game’ by being able to inform GPs of concerns with additional data. In essence the basic equipment

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Consultancy in public services and the training for one senior care worker per shift to be able to do the basic monitoring was a modest sum. The consultant proposed this approach to a collaborative of primary care trusts (PCTs) and the response was, who would be liable if anything went wrong? Who would buy the equipment and the training and who would pay for updating? These points no doubt need addressing, but the response contained no comment on the potential benefits to residents, care staff and, above all, the NHS, in terms of the reduction in emergency call-outs and admissions.

Engaging with issues or problems identified by the individual A useful approach to tackling issues at the individual level is to develop co-consultancy. We are concerned now with the stages at which the consultant is gathering information, interpreting it and responding to the client. We need to identify how the workers reach this situation of poor performance or poor morale, or both. Can we identify what needs to be done to minimise the impact of these (problems of motivation, capacity and supports)? How do we go about this? Where does the individual want to be? The individual may be anybody involved in the organisation delivering public services, whether a staff member or a patient, service user, carer or other member of the public.What can be done to reduce the feeling of helplessness if work is a chore and the person who is ‘working’ feels demoralised, one symptom of this being to regard work as ‘only a job’? The individual should consider where they would like to be in the future and should look not only to their immediate, short-term future, but also to the medium and long term. A process of self-assessment will help. Better managers do some form of annual, or more frequent, review, and work out a personal development plan for the next year. It may well be that an individual, especially in the example of healthcare monitoring referred to above, decides to look ahead two or three years. If they can start from where they would like to be, they can develop achievable steps to that goal. The stages in this process are as follows, using Table 4.5 below: 1. Identify one’s position on the grid. 2. Specify first where we want to get to in an ideal/changed/ transformed world. 102

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2

I hate going to work

I occasionally enjoy days at work

Nothing ever changes

We think about change but it’s very difficult

I don’t get support from anybody

I get some support from some colleagues and a little from the team leader

I work alone

I work with different people every day I have found a plan but it isn’t worked on. I have ideas but I am ignored

No idea what I am doing or where we are going

3

4

5

Some days are Most days are I look forward to good, others positive but work as I enjoy are not so some are not it, bad days being good no real setback Sometimes we We do change We enjoy change things things sometimes changing things but it often making some if it makes our goes back to progress service users where it was happier I get support Most colleagues I get support from many support each from manager, colleagues, and other, my team team leader some from leader is a steady and all my team leader support and colleagues I see manager I work regularly I work with a All of the team with a couple few people but are working of people not as a team together A plan is talked We have a plan We share a about but most which most vision of where people don’t people are we want to go think it can working towards and we work work but some people steadily to are awkward realise it

3. Identify how we want to get there. 4. Identify the time frame within which we regard it as feasible to get there. In order to achieve this, the person completing the form could take it back in steps towards the present reality. There are four or five steps along the way. The person could go from step 1 to 2 or to 3 as circumstances and personal feelings change over a period of time. Let us assume for the present that the individual is a worker employed by the organisation. Highlighting where the person is now and where the person would like to be may be a useful focus when the person meets the manager for supervision. It may be helpful for the individual to ask where he or she would like to be in an ideal situation. This is a key question, and can provide a route map if the person goes through the steps again. It is useful also to ask ‘Where have I been?’ as this can show the progress made to be where the person is now.

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Example Figure 4.1 represents the situation of an individual joining a typical social care unit in a bigger organisation. It is clearly more complex than this picture, but we can see how things can develop, using the example of a care assistant. The care assistant may journey around the questioning and experience loops seeking more support, trying to build their motivation and trying to do the job better, but at each stage they may be handled differently. Once the worker starts showing disaffection, stress or diminishing competence, they can be responded to differently again. Some support, training or incentive may lead to them going round the cycle again, and even again, but unless the factors change it is a downward spiral that is neither helping the worker nor benefiting the service user. The new care assistant with high motivation – a new job with an income, stimulation and opportunities for promotion – comes into a new job probably with limited capacity, not having worked in this type of job before and has possibly had little, if any, training.They may receive some form of induction, and in practice this induction may vary from, at one extreme, being tokenistic, to, at the other extreme, a fully structured, staged training programme of induction into the workplace, with thorough assessment with the Common Induction standards being signed off by a registered manager and verified by an awarding body. Figure 4.1 demonstrates the variations. Experience builds over time, but with limited supervision and resources of training and time for development as well as assessment, if any, the individual’s morale and motivation dwindles. If they keep asking questions and get answers and therefore develop, it may be that they manage to maintain a level of morale which, aligned to their income, may be enough to retain their services. If, however, they go around the loop of more experience without development of their motivation, then they are likely to leave. They may remain if no other worthwhile employment is available and may develop an embittered cynicism that in time affects newer colleagues, the team or unit, and ultimately the organisation (Hussein and Manthorpe, 2011). Although this research is subject to the limitation that it is based on employers’ perceptions rather than employees’ experiences, it is worth noting the finding of occupational embeddedness and not job embeddedness, in that such employees may move from one employer to another but are quite likely to stay in the same job. Figure 4.1 shows the different pathways that may be taken by the person. In this route into a job as a care assistant, induction is important, as well as gaining valuable experience and asking questions along the way to learn how to do the job more knowledgeably and competently. High quality training that is accredited provides a benchmark to progress and a recognition that in time can lead to promotion, better pay and conditions of service, and the reward of providing a better service.

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Figure 4.1

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Opportunities for change How do we stop the development of a downward, self-reinforcing cycle? The consultancy model provides a starting point for the individual, the team, unit or group and perhaps the organisation or other setting. Who has the power to change this cycle? Our response is that an empowerment approach to consultancy may be able to engender change at any point and by any individual, group, unit or team in the organisation or other setting. Individuals Workers, for instance in care homes, tend to work in teams or units that are often isolated from each other.They have little to compare to, for better or worse. Training often takes place within the care home itself, often led by staff in the home (shadowing, training or NVQs or, from January 2011, Qualifications and Credit Framework (QCF) units, although this is not widely realised), and not with staff from elsewhere who do things differently so there is little opportunity for reflection. But the ability to change can, and sometimes does, manifest itself at the level of the workers themselves. Asking questions, however, in the light of the consultants’ experience of working in an establishment, may provoke challenging responses. Example One of us questioned a rota in a residential childcare setting that involved being on duty almost continuously for 36 hours, being on call while sleeping on the premises. The result was an accusation of leading a mutiny. So, changing practice at the individual level may be challenging and may even be discarded as ‘all too difficult’.

Team (units/groups) Changes can take place more effectively if a group can motivate itself, be led (not managed) or inspired to change by a dynamic or charismatic individual. By definition, change may begin in small isolated ‘pockets’ of individuals or small groups of staff in the larger organisation, each unaware of what others are doing.

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Improving practice in a variety of work settings Organisations and settings vary widely and profoundly affect the nature and extent of change in the workplace. The individual who works in the community may be part of a team but their practice can become characteristically different. In a day centre or a residential home, practice may become more consistent – consistently bad or good, with an individual less likely to be different, good in a bad regime or bad in a good regime. If a setting is one in which different professionals operate, their different backgrounds can stimulate reflection on approaches to use, but that does not always happen, as the first example below illustrates. Example: ‘Blue sky’ thinking and a missed opportunity One local authority adopted a consultancy approach, working with a hospital to take a new, ‘blue sky’ thinking approach to dementia care. ‘Blue sky’ is the term used to refer to approaches not restricted by current thinking and practice.The local authority had the funding and developed a major new centre, in partnership and with a third party, a large national care provider. All three organisations had had their own approaches to such care, but in opening the new building where they would work together for the better support of service users and their families, little attention was paid to joint training to develop an integrated approach. The result was that each organisation continued to carry out its own assessment, when other professionals in another team had carried out their own assessment. This was an opportunity missed, at least in the short term.

The final two examples bring us back to where we began this chapter – the goal of empowering citizens rather than consultants merely reinforcing the power and prestige of professionals.A crucial component of this involves the consultants enabling convergence between the knowledge skills and accumulated experience of professionals and citizens. Example: Engaging with professional and citizen wisdoms This example introduces the notion of different ‘wisdoms’ informing practice – theories and approaches derived from academic perspectives and methods of working with people rooted in practice. Whitaker and Archer (1989, p 37) distinguish between academic and practice wisdoms, and Adams (2008b) argues that wisdoms are more diverse than this, perhaps as many as four different sources of wisdom supporting managers, practitioners, students and service users, in the process reflecting the disparities of power between these main stakeholders in

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Consultancy in public services social work. When we apply this to the topic of this book, the term ‘wisdom’ refers to the knowledge and understanding that pertains to the particular group or interest in public services. Engaging people in practice in public services can be a difficult process for those in higher education. Often neither party has the time to engage in speculative or development work that will not produce short-term gains. The gains are, or should be, mutual, for greater understanding of practice enables lecturers to ensure they reflect the latest developments in the ‘real world’ while equally those in practice benefit from the lecturer’s access to research and the time to think and reflect. Some have used the secondment approach to place a lecturer in practice or a practitioner in a university, but this approach is cumbersome, expensive and limited to very few individuals. In doing this, we acknowledge that service user wisdom is ‘the most universal experience, yet the most nebulous and, from the point of view of conventional academic and practice wisdom it is the least accessible. It consists of the largely invisible world which we ourselves inhabit whenever we go to the doctor as patients, whenever we take our child to the nursery, whenever we visit our aunt in residential care or agree with the care manager a community care package for our relative’ (Adams, 2008a). An empowering approach to consultancy endeavours to acknowledge the authenticity of each wisdom and to build on it.

In the initiative described in the following example, an innovative approach was to seek associates, who were paid a token amount, who wanted to be involved in the dialogue between practice and higher education, and who were committed to such an approach, without compromising their position of employment. Example: Engaging with professionals’ and citizens’ wisdoms through a practitioner forum programme The consultants in a particular region comprising half a dozen local authorities set up a practitioner forum programme with a view to facilitating practitioners in health and social care meeting and exchanging experience. A group of practitioners planned and supervised the programme with the consultants. In each meeting, practitioners met to listen to a few of their number explain how and why they tackled a key topic. These meetings proved invaluable in identifying and exchanging practice wisdom between practitioners, and comparing reflections with the evidence base from research. Local variations in practice were subjected to critical scrutiny. Service users, patients and carers present at meetings were able to contribute their perceptions on professional practice. An example was the forum held on practice in end-of-life care for adults – a particularly lively and well-attended meeting.

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In general, this form of co-consultation between practitioners and citizens empowered the citizens and enabled practitioners to scrutinise their practice self-critically, to consider other ways of practising and, ideally, to work towards a notion of ‘best practice’.

Conclusion We have spent a considerable space exploring different aspects of engagement in this chapter.This is ironic, given the reality that it hardly is mentioned in many texts on consultancy. We regard the engagement phase of consultancy as vital to the success of the entire project, whether this be a minor task or a very major one, whether it involves a single consultant working with individual practitioners, or involves forming and developing professional relationships with people throughout a complex organisation. It is apparent from the examples we have presented that engagement is the early point in the consultancy where the consultants are developing the basis for later work, in terms of working relationships. It is clear also that engagement cannot be separated artificially from the work that follows. It forms part of a continuous process. We stated at the beginning of this chapter that engagement is the point where the involvement of the consultants with the clients – the relationships between them – becomes significant. Typically, in an empowering consultancy, this involvement grows into participation, in the sense that the consultants are sharing power with patients, service users and carers and, on occasions, trying to counteract the tendency of some staff in the public services organisation to invest in them certain powers. This is complex, because in some public service organisations citizens have not made great inroads into the seats of power, so terms such as empowerment, although they may be part of the rhetoric, are not in the mainstream of practice. We go on in the next chapter to examine in more detail some of the implications of developing this empowering practice, out of the early engagement phase of the work.

Further reading Goodman, M. (1995) Creative management, London: Prentice Hall. [Contains a useful discussion of the contribution of creativity to management, which can be applied to the process of consultancy.] Sadler, P. (2001) Management consultancy: A handbook for best practice, London: Kogan Page. [This book contains a wealth of stimulating discussion about the process of consultancy, in particular focusing 109

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in Chapters 5 and 6 respectively on the relationship between the consultant and the client and the phase of engaging with the client.] Scragg,T. (2010) Managing change in health and social care services, Brighton, Pavilion. [A good introduction to how change is managed in the health and social care services.]

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five

Empowering This chapter examines how consultancy can empower people. We begin by discussing how people may be empowered. Following this, we examine how the consultants gather and use information pertaining to the consultancy. Lastly, we dip into a consultant’s notebook to explore how consultants work in different domains of public services organisations.

What empowerment entails We saw in the definition of empowerment in Chapter Four that it refers both to the capacity of people to take control of their lives and to the process by which they do this and, potentially, empower others to do the same.When we consider as consultants the notion of empowerment in action, the image that comes to mind is of waves or rays that are capable of permeating throughout the entire arena of public services, that is, it affects different domains of people’s work and lives, in that they may be involved in self-empowerment, empowering other individuals, groups, organisations, communities and political systems. These different domains of empowerment exemplify five aspects of the concept (Adams, 2008a, p 75), its: • • • •

connectedness, in that they all interact with each other; holism, in that they engage the whole person between them; equality, in that they are not in a hierarchy; authenticity, in that they are not merely technical, but, for the people involved, embodied states of being and doing; • dynamism. Empowerment in practice (Adams, 2008a, p 74) is the term used to refer to ‘the continuous interaction between critical reflection and empowering practice, that is, the continuous in and out cycle of reflecting–acting–evaluation and the interplay between thinking and doing’ – a critical and self-critical process. Staff and citizens are both groups targeted by the empowering approach adopted in this book. The purpose of empowering consultancy is to empower all staff and other people involved in providing and receiving services, rather than to reinforce the power of managers and other senior 111

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staff, while junior staff and members of the public remain relatively disempowered. In order to empower other people, however, staff need to feel empowered themselves. In organisations delivering public services, information is power. People wield power by holding information and sometimes by withholding it from other people. It is vital that consultants ensure that information is used not to control or exclude staff, patients, service users and members of the public, but to empower them. It is therefore necessary that those engaged in the consultancy develop the skills of all relevant aspects of handling information and working with people in the different domains of public services. The heart of consultancy is the empowerment of the consultants and those with whom they work. It is generally acknowledged that in order to empower others, practitioners should empower themselves (Adams, 2008; Cockman et al, 1999). We have grouped the material in this chapter in two main sections: working through the process of empowering consultancy and visiting a consultant’s notebook to illustrate the nature of work in different domains of service delivery. The basis of empowering practice is that the consultants do not do people’s empowering for them. Let us see how this translates into practice.

Aspects of the process of empowering consultancy As the consultancy proceeds, the consultants are likely to become engaged in one way or another with the linked tasks of gathering information, interpreting it and feeding it back to people in ways that would empower them. It is probably advantageous for both consultants and clients to focus on seeking opportunities for change. In doing this, they are able to concentrate on identifying the capacity of people and motivation towards change and the resources constituting resources for change. Among these resources are the data providing the basis for action. Citizens in the different ‘publics’ of each area of public services (see Chapter Seven for more discussion of ‘publics’) need to be active participants throughout this process. It is crucial that the consultants have experience of working meaningfully with citizens in this way and that they have the capacity to gather the necessary information, interpret this and apply this understanding to their work in the consultancy. Empowering consultancy in public services is concerned primarily with processes of enlightenment. By this, we mean that the consultants are customarily a vehicle for the improvement of public services and that this invariably means developing expertise, knowledge, 112

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understanding and critical awareness. The underlying process, we maintain, invariably at some point concerns an element of information gathering, analysis and sharing or reporting back. It would be wrong to suggest that consultants are always involved in this, but there is an undeniable component of consultancy concerned with the passing to and fro of information between consultants and clients, often with analysis by the consultants playing a part in this. It will be apparent that this is very much the model followed in the research process.We focus, therefore, in this first part of the chapter on the stages of gathering, interpreting and using information. Gathering information The first aspect the consultants tackle is the collection of information. Consultants must be equipped in terms of knowledge and expertise to be able to work with staff and citizens through the linked processes of gathering and understanding information.The gathering of information comes first; analysis is the next stage. In the police force and other uniformed services, the collection of data and information and its subsequent interpretation becomes what is known as ‘intelligence’. It is vital that consultants have the knowledge, experience and expertise to gather information and interpret and use this to feed back into the process of the consultancy in action – a continuous process often referred to as action research. Quantitative strategies The process may use some formal methods of data collection, including quantitative methodology, such as carrying out surveys, developing and using questionnaires and structured, semi-structured or unstructured interviews, or taking data from computer-based systems and analysing it.We do not propose to discuss these here – there are many convenient sources dealing with them and some suggestions are made in the further reading at the end of this chapter. The kinds of consultancies in which quantitative data are likely to be gathered include the analysis of statistics concerning the incidence of individual and family needs and the provision and take-up of various services.

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Example A colleague at Teesside University carried out consultancy with local authorities engaged in youth justice, relying on gathering and analysing data on offenders, sentencing and subsequent outcomes. In this way, reports were assembled based on analysis of the profile of youth justice decisions and outcomes.

Qualitative strategies These may include observation, participant observation, ethnography and other related approaches. This is by no means an exhaustive list, however. Each approach mentioned is described briefly below. Observation is the term used to describe research where the researcher may either be located independently from the action and may systematically watch what is going on, or may be a participant observer. As Denscombe (2007: 206), who writes authoritatively about research strategies and methods, notes, observation is a method that ‘does not rely on what people say they do, or what they say they think. It is more direct than that. Instead, it draws on the direct evidence of the eye to witness events first hand’. Participant observation is the term used where the researcher takes part in the form of work or activity they are trying to understand. They may let those so engaged know that they are researching, but equally may take a covert approach, which has the advantage of informality but raises significant ethical issues in terms of securing people’s informed consent before gaining access to data. The purposes of participant observation are twofold, first, to retain the naturalness of the setting and, second, to achieve access to situations and data which otherwise would have remained out of sight (Denscombe, 2007: 217). Ethnography is the term used to describe work with the following features, according to Atkinson and Hammersley (2007: 3): 1. People’s actions and accounts are studied in everyday contexts rather than under conditions created by the researcher…. 2. Data are gathered from a range of sources ... but participant observation, and/or relatively informal; conversations are the main ones

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3. Data for the most part is relatively unstructured…. 4. The focus is usually on a few cases generally fairly small scale … to facilitate an in-depth study 5. The analysis of data involves interpretation of the meaning, functions and consequences of human actions and institutional practices…. The kind of information this qualitative methodology assembles constitutes a kind of moving picture of what is actually happening between the people in (and sometimes around) the organisation. It is a case study in which the consultants are engaged. They are part of the action, so in a real sense they are part of the picture they are studying. The consultants’ perceptions cannot be objective since they are inextricably bound up with what happens. Example A consultant was appointed to develop a young persons’ research team. These young people were to be empowered through support and training, and some resources, to carry out research on young people’s views around crime. The consultant became a form of ‘champion’ for the young people and was so focused on the success (and there was real success) that they did not fully see what processes and interactions were taking place, and potentially how the project could have become more enduring.

Data collection in consultancy is not a discrete stage, since the data is all around the consultants from the beginning to the end of the consultancy. In practice, data collection begins as soon as the client approaches the consultants. Every action by the client is data that contributes to the consultants’ interpretation of what is going on. This process can be very rapid and the consultants can, at times, be swamped with information and data. Recording or somehow capturing this data is a challenge. The process may be in ensuring the retention of documents, questionnaires, the writing and collation of notes, or the audio-taping of interviews or focus groups. The use of software tools such as Compendium (available free from http://compendium.open. ac.uk) can facilitate the mapping of information and ideas. The use of electronic data can be very helpful but is so readily available it may be difficult to work through. The use of web-based questionnaires, like SurveyMonkey, can extract rapid responses from a wide range of people but may not have any greater response rate 115

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than postal questionnaires. Such tools, however, automatically compile response rates and collate the data required. The experienced consultant may pick up significant issues but equally may miss their significance at the time the data is collected. For example, once audio notes are transcribed, there are often key points that were missed at the time of managing the interview or focus group. Other kinds of information, for example, concern the human resources of the organisation and may be vital when the focus of the consultancy is not what the organisation does, but how the organisation functions, and how change is managed and pursued.This focus may rely on what researchers would regard as qualitative methodology, which means gathering information by a variety of non-quantitative means, and focuses on the perceptions and experiences of individual people and interactions between them and others. In some kinds of project, the consultants may continuously gather and analyse information. In such circumstances, their interpretations may change as the consultancy goes through its life.The consultants use these interpretations to guide their further actions.The more sensitive the consultants are to the situation, the more likely their interpretations are to reflect part of the complex reality of the organisation and to be valuable in guiding their further work with the client/s. In summary, whereas the consultants may gather quantitative data and use rationally based methods of collection and analysis, they may collect qualitative data and interpret these relying more on experience, intuition and reflexivity. Reflexivity is the term used to refer to bringing one’s own experience, emotions, assumptions and values to bear on the process of understanding and interpreting what is happening. It is important that the consultants have scope to reach out and engage with different aspects of the life of the organisation and are not restricted by the contract in ways that would prevent them from achieving the goals of the consultancy. Sometimes, while some staff in the organisation are sympathetic to the consultancy and supportive of the consultants, others may be hesitant, ambivalent or actually hostile to it. The reasons for these different perspectives may be part of the politics of why consultants have been engaged. Example Three consultants worked in partnership with a group of service users and carers in order to develop a tender to carry out work in researching and writing a participation strategy for a large social care organisation. Gaining the participation of the service users and carers in the work of such an organisation

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Empowering became regarded as essential in the political climate of the early 21st century. The organisation itself did not deliver services but needed to understand and support those workers who did. In keeping with the project aims, the selection process expected a participatory approach from the consultants tendering, and furthermore the selection of the winning tender, and its subsequent management, was made by a task and finish group chaired by a service user and carer. Senior managers in the organisation knew that it needed to have such a strategy, but it became rapidly apparent that many staff were at best ambivalent about the need for and the potential results of the implementation of such a strategy. At the highest levels of management and the board of the organisation, the motivations for hearing service users’ and carers’ views were mixed, so consequently, as the consultant progressed into the work and talked to more junior staff, their views were even more varied but increasingly imbued with what they perceived their managers thought. One good example involved a telephone interview with a junior manager who did not understand why the process was being carried out. Her response to an open question from one of the consultants about her knowledge of the project was:“I had never heard of a service user until a few weeks ago”. Within an hour of the interview, a senior manager rang the lead consultant to say that all questions should be directed to her as she could “answer questions” for her staff! This particular senior manager, it emerged, was opposed to the whole strategy of participation as it could involve some loss of control and cost significant sums of money. Ultimately the consultants were challenged about costs of participation proposals, and herein lies a challenge for all consultants regarding the price of work in general. Here the consultants took the view that the strategy developed would lead to certain costs, in that the strategy was intended to bring about participation and self-evidently this could not be done without some form of cost. The alternative put to the organisation was that a budget should be dictated, so to speak, and the strategy developed around the funding available. This question was never answered and the project came to a rather unsatisfactory end, as the consultants had feared. The consultants could be ‘blamed’ for being unrealistic, and here the work carried out was eventually rather sidelined so that the funding spent on the work was, we had thought, ultimately wasted. An aside from a more junior manager revealed later that without ‘the strategy’, the organisation would not have received some of its core funding, which would have been very damaging. Consultants can therefore find themselves at the centre of political and power issues and can choose to play along with the more powerful figures they identify in the organisation, or stick to their principles and long-term reputation.

Consultants bring to bear on their work their own learning and experience and the following section illustrates how one of the authors 117

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draws on his experiences in the Territorial Army. Many points of convergence exist between this and other aspects of the public services. ‘Appreciation’: as applied by the armed services Our lively discussions cross all sorts of boundaries and, in one session at the ‘Beverley Hotel’, in discussing a particular proposition, the question asked was, ‘so what?’. This brought back memories of the time one of the authors spent as Infantry Officer in the Territorial Army. In order to prepare for a military operation, for example, the ‘appreciation process’ is carried out by the person in command, or in this book, the consultant. It is a simple process but effective in breaking down a problem and seeking solutions along the way. First of all the mission has to be considered, and an appreciation carried out to work out what time is available to develop a plan and then ensure all other staff understand it so it can be put into action. How often do consultants, and clients, fail to set a realistic time frame, and in particular fail to take into account the time needed to communicate with all the staff who will be affected? In the military, the general rule of thumb is that the officer or leader needs to ensure most of the time is available for the operation itself. In completing the initial appreciation, all factors should be considered and the question ‘so what?’ applied rigorously, so that priorities become clear. If the consultants are involved in developing and then implementing a plan, first, asking ‘so what?’ repeatedly regarding each factor is crucial to interpreting information and other factors. Second, ensuring most time is left for communication and implementation is crucial. Interpreting the information During this phase, the consultants try to ensure that the information is made available for other people with whom they are working to consider it and reach their own considered judgement about its significance and implications for action. Ensuring that people develop their own interpretation of the information Consultants gather and analyse information for many reasons, most of which come under the heading of providing the organisation with data on which to base future policy and practice. Cockman et al (1999, 118

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p 180) point out, however, that the consultants should not unthinkingly do all of this work on behalf of their clients. This is not the way to enable the clients to understand what is going on in the organisation. It is preferable to provide clients with the tools that will enable them to make sense of the information, which will put them in a better position to tackle the issues themselves. Additionally, this process often leads to the clients owning the data in a real sense. Preparing for people’s understanding of the presenting issue or problem to change During the process of people in the organisation reflecting on the information and reaching their own interpretation of what is going on, there is every chance that their previous understanding – perhaps at the point where they envisaged consultancy was necessary – will change. Reaching a wider understanding of what is going on in and around the organisation It is likely that the consultancy process will enable people to broaden their existing understanding of what is happening and will, perhaps, lead to an enriched view of the organisation in its wider context. It is apparent to experienced consultants that their formal agreement with the clients is often the beginning rather than the end of the story of their relationship with them.This is apparent when we consider the formal and latent functions of consultancy in many settings. The use of consultants can take many forms. One unusual but particular group has grown massively in recent years, first in the private sector of FTSE 100 businesses, but then expanding, including into the public sector. These consultants advise senior managers, boards or (remuneration) committees on the ‘appropriate market’ rates of pay to obtain the very best senior staff. Rates of pay for FTSE 100 companies have risen from 47 times those of the average employee to 128 times in the last decade. The Sunday Times reported, on 9 January 2010, that ‘Shareholders need to go much further in ascertaining which consultants are responsible for the pay schemes that backfire. Is it the case that those consultants devising the most flawed and excessively generous schemes, far from being shunned as they should be, end up winning more mandates?’ (www.timesonline.co.uk/tol/comment/ columnists/article6981589.ece). A BBC Panorama programme revealed that ‘more than 9,000 public sector employees are earning a higher wage than the prime minister, who has previously questioned pay 119

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levels in top jobs. New research conducted for BBC Panorama found that there were more than 38,000 public employees earning above £100,000 and 1,000 people on more than £200,000 (www.bbc.co.uk/ news/uk-11319918). These types of consultant are unusual, but being so self-serving is not highly unusual in a competitive world.The consultants want their work to continue, and if it can be with a client with whom they are familiar, all the better, as this momentum is easier to maintain than tendering for new work and building new relationships.The consultant can, in effect, write the brief for the next project and it is much easier, often supposedly cheaper and more productive for the client too if the relationship seems to work. Dong-Gil Ko (2010) states that what he calls benevolent trust being built up pays off more than competence trust, something that initially seems counter-intuitive. Here he finds evidence that the relationship and trust between the consultant and the client really does benefit the client as they work more productively, and that this can outweigh the actual technical competence of the consultant. We have seen a number of cases where an organisation appears to be in some difficulties with financial cuts and the like, but when a consultant is brought in, and then makes recommendations, then substantial, and sometimes increasing, amounts of funding may surprisingly become available.The client can get something done now that somehow could not be achieved before. Here, however, the client effects even greater power and control throughout, and this power and control may be an attractive feature of the process, particularly in an organisation that has rather intractable staff. Against this background, it is hardly surprising that some clients make people bid and, almost ritually, put them through a selection process – for perfectly valid reasons (for further reference to the EU procurement rules see Chapter Two) – and then issue a contract with milestones, targets and deadlines. The client keeps control – if the consultants’ recommendations don’t suit, the clients can push some consultants into changing their recommendations, with much power to do so if the full payments are yet to be made, or they can accept the consultants’ work and largely ignore it, on the basis it is unworthy or unsuitable, and perhaps assert that the consultants’ work has made them reflect on how they, and their organisation, can change, even if they ignore the consultants’ recommendations.Throughout, the consultants know that their reputation is often only as good as their last customer’s views. Consultants themselves have formed a professional body, the Institute of Business Consulting (www.ibconsulting.org.uk/), with the 120

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aim of promoting professional standards and with the strapline ‘clear thinking, straight talking’. Not all clients will exert their power.A smaller or weaker organisation may accept the consultants’ recommendations fully as they are the experts and ‘went through a process’ to get their expertise. It may be only our impression, but we see some evidence that there is an assumption among some funders, including central and local government agencies and organisations, that the more that is paid for the consultants’ work, the better it must be, and the more the consultants must be deferred to. Perhaps, if this is the case, even to a limited extent, it is because funding bodies need to believe in the value of what they are doing, even in the absence of any empirical evidence to support this belief. Consultant trainers The use of consultant trainers is quite common in the public sector. For example, one local authority social care department knew that it had shortcomings in the training of its staff with a forthcoming inspection due. An ‘expert’ consultant trainer was brought in, at a high daily rate, which was magnified as the trainer limited the number of staff who could be trained in a session.The training was confirmed, independently, as being no better than that offered by a local university, which also offered the additional benefit of accreditation. The university could not, however, offer the volume of training needed in the short term to be ‘ready’ for the inspection, but the department could ‘tick the right boxes’. It is a moot point as to whether this short-term approach really achieved its goal or affected any improvement in standards. In general, if the completed work later emerges in some way as being flawed, the consultants can be blamed. In the example quoted, the impact of the trainer’s short-term work could be seen for what it was, at no fault of the trainer. Practice in organisations may become very ‘traditional’, evolving against the background history of the organisation and the procedures within it. It may be bureaucratic, with procedures becoming more complex, for some good reasons, but often, as more and more people become involved, adding systems of cross-checking, signing off and so on.These organisations tend to be long-winded in their responsiveness and lacking in any joined-up thinking, with different departments in their silos, defending their own territory, resources and assets, and their influence in the organisation. They may go through the motions of bringing in consultants to effect change, but their behaviour may not bear this out. 121

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Example: Consultancy as part of the rhetoric rather than reality of bringing about change One of our consultancy initiatives involved a proposal for using an online system, initially for allowing care homes to record staff supervision, action plans and to identify training needs for their staff.The system would then allow others in the local authorities to collect training needs and plan new training and delivery. The approach sparked in the consultants the added value to be gained from a joined-up approach involving examining quality issues in the care homes and allowing contracting staff to monitor the homes’ action plans and performance, online, to supplement the limited inspection process. At the point of preparing this book for final publication, the project has still not reached implementation. This example underlines the reality that consultants can carry out preparation and planning work for initiatives that to them seem perfectly feasible, logical and desirable, yet this is no necessary guarantee that they will be implemented.

Using information The third and final aspect dealt with in this part of the chapter is how consultants use information. In the first place, the analysis of information is followed by feeding it back to other people. Giving people different kinds of feedback Feedback may be given in many different ways, including the following three common ways: • giving individuals feedback • giving informal feedback • giving formal feedback to groups. Feedback can take many forms. In the examples above, we talked about the formal report at the end (or at an agreed interim stage) of the project, or about certain agreed tasks (data collected, interviews held and so on) being completed to give clients information in accordance with milestones.The key here is to understand what the client wants and what they might need, which can be slightly different, and increasingly so as the project progresses. It will be a very unwise consultant who does not respond directly to the client brief, but a key role of the consultant is to use their expertise and a new outlook to advise the client on how to effect change or otherwise advance a project. Some of the examples early in this chapter referred to the need for success to maintain a project, the continued employment of its staff 122

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and, of course, the ongoing delivery of a needed service. In some cases, also hinted at earlier, individual managers may want reports that are positive for their own personal ambitions.Thankfully, however, in our experience anyway, these somewhat cynical requirements are usually not found.The client wants the consultant to help bring about positive change and therefore wants feedback at the earliest opportunity, so positive developments can be built on and any lack of progress can be understood and addressed. This centres on an action research type of approach where there is a continual feedback loop, although care has to be taken that the time taken to give such feedback through meetings, telephone conversations or emails is not excessive. Of course, it has to be agreed how, and more importantly, to whom, the feedback is given. Is it to the manager, the project task and finish group or board, or to individuals or teams? This process needs to be carefully agreed, but it may change as the consultant and client develop their relationship, trust grows and the ability to freely make critical, but constructive, comments grows. As with the example of the large social care organisation, however, care must be taken as to whom the feedback goes to. A misplaced criticism may result in the manager, and usually therefore the client, becoming annoyed. Informal feedback therefore needs to be carefully given, while formal feedback, in meetings and reports, can take more time to achieve. It is important for the consultants not to perpetuate the disempowerment of the staff by coming in as experts from outside, gathering data, taking it away and analysing it, then reappearing to feed back the analysis and implications to staff. Example A consultancy team on the provision of social housing by organisations in the public, private and third (not-for-profit) sectors contracted with several local authorities in turn to carry out statistical analysis and then meet with managers and professionals to feed back the implications of this for practice.

An alternative consultative strategy would be for the consultancy team to spend time equipping the local authorities to carry out the analysis themselves, thereby making it unnecessary to hire the consultants next time round. In other words, the consultants empower the client local authorities by facilitating the process by which they are able to accrue, manage and interpret the data themselves.When we refer to the team of consultants, we are aware that the term ‘team’ is somewhat maligned and misused, in the sense that many working groups have the word 123

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‘team’ applied to them when in fact all that is taking place is that a task group is working at a task. Example A consultant, ever aware of potential developments that could assist current or future clients, became aware of an online CPD (continuing professional development) product.This product is extensively used in the education/schools field, and allows teachers to consider the training they need. It allows supervisors to rate their staff and give feedback, giving endorsement of progress or suggestions for future training needs. Staff may undervalue their own achievements and this attitude is common in consultancy projects where, with no comparison, the client thinks that their progress is limited. It also allows the headteacher to create a meaningful action plan that addresses the school’s needs by meeting the needs of the staff, and the pupils, of course.The consultant can give a wider perspective and feedback against other similar projects that it is unlikely the client will be aware of. The system also performs the important function of assimilating data that the manager and workforce development staff can interpret for themselves without recourse to the consultant. The data assimilated forms a process by which managers can manage and develop their service, thus being empowered to achieve ever higher goals. Staff give feedback on the action plan, although it may, of course, be rejected by staff. The positive outcome is that the action plan is likely to be endorsed.

Writing reports for the clients Consultants would be wise to articulate their policy on ownership of any reports they write, and their procedures for dealing with differences of view about their contents, before the consultancy begins. In the following example, the consultant writes a report for the client, which the client subsequently alters, illustrating a reality that many consultants encounter which is the triangular relationship between the consultant, the client and the report. Example A consultant involved in a project around social inclusion for young people had to deal with three teams working in different parts of an inner city. Each team was different and had a degree of autonomy, being separated from the overall project manager who commissioned the report. In this case the manager changed too (not an unusual situation in medium- to longer-term projects), so inevitably there was a slightly different interpretation of the original contract. The new manager had been brought in as there was apparently a perception that the original manager had not been performing well enough. The new manager might have seen some

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Empowering of the shortcomings as indicative of their performance, however, and as a result wanted the report to be as positive as possible. Interestingly the interim report provided some promising findings that were used to support a high profile event when a royal patron visited, but when the final report was written, the manager demanded changes.These changes were much more than presentational, and the consultant was not keen on altering anything more than presentational issues. The manager then took over the report and edited it to suit the organisation as they saw it. The consultant had no opportunity to challenge this editing.

Example In another project, a small intensive educational project, concerning small numbers of young people not in normal education, the manager was demanding a report that met their perception of a ‘good’ report, centring on presentation almost to the point of exclusion of content.

In these two examples, despite some initial discussion, the editorial power lies with the client unless some agreement can be made at the outset. The consultant clearly wants to be paid for their work and the report is the evidence of completion in many respects, but equally the consultant may (usually) want to maintain their independence and integrity as their long-term reputation is more important than short-term gains. In such a case, the consultant can only insist that their name is removed from the report. However, our experience would indicate that generally consultants work with many different clients, and that these clients rarely talk to each other, and some would say, as a result, that worrying about editing rights is simply not worth the effort. In the case of national work, however, as the following example shows, reputation can be affected badly. Example A large-scale piece of work by a team of national consultants (with a very high reputation for the rigour and excellence of their work) involved several subcontracted consultants working in the regions. The work involved young people and the collection of a great deal of quantitative data and, to a much lesser extent, some qualitative data about small local projects. The government department that commissioned the work had set out very ambitious quantitative targets for the project, but it became evident that, in almost every way, these targets would not be met.There was pressure to acquire more positive data and to write the project up accordingly. The consultants strongly resisted changing their report, at great risk to future contracts with that department, as political

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Examples of best practice are found and used as ‘case studies’ to ‘demonstrate’ that the overall project aims can be achieved only if all such projects could work in the same way. Helping staff to identify issues As the consultancy proceeds, there is likely to be a stage where the consultants share with the clients their own understanding of what is happening.This process can be akin to the strengths-based approach in social work advocated by Saleeby (2002), where the positive stronger aspects of the organisation are supported or simply recognised and perhaps praised in order that a foundation for progress is established or reinforced. Such an approach empowers the staff and encourages a longer-lasting solution that can endure beyond the ‘life’ of the consultancy. As far as the contract between consultants and clients is concerned, this process may be integral to the eventual handover that takes place when, at the end of the contract, the consultants disengage from the work. Dealing with resistance by staff At the same time as sharing with staff, the consultants are likely to be concerned with tackling resistance by staff. This may be easier to deal with when it is restricted to more junior staff and more complex when the resistance is in management. In some cases, management may have engaged the consultants but may themselves be resistant to some messages from the consultants – in effect, the consultants’ advice is for the staff and not the managers! In such organisations there are likely to be many challenges because in these organisations managers may have ‘imposed’ changes or other consultants’ views, often without talking to the staff first. The result may be that staff have an attitude that ‘we have seen these initiatives before. Management try to come up with something new, but we have seen it all before.’ Such projects are very likely to have nothing better than short-terms gains, if that. Staff may consider the consultant as a confidante to whom they can pass views that would not be shared elsewhere for fear of repercussions, or they may try to influence or manipulate the consultant. The consultant may act as an intermediary or mediator in the process of bringing about change and progress. 126

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Sturdy examined existing literature (1997: 397), and argued that there was a tendency to ‘portray management as passive victims of confident consultants’. He felt a change was apparent and proffered an alternative model based on an interactive model ‘based [on] reciprocal and self-defeating concerns of clients and consultants’ to grasp identity and control (see Figure 5.1). He takes the view that managers can have an active role in resisting consultancy, and acknowledges the challenges and pressures that consultants can experience. Sturdy sees the consultancy process as an iterative one. He takes the view that consultancy is fuelled by consultants providing management with some reassurance, but simultaneously it reinforces, or even creates, insecurities. In turn the client may challenge the consultant, not least as they feel challenged themselves as to their own competence, but experienced consultants will be prepared for such challenges, and that renews the client’s anxiety. The interest in new ideas must therefore be strong to drive the motor for change, a motor that no doubt the consultant will lubricate in every way possible. Figure 5.1

Helping policy into practice Appreciation may help to reach a sound or a good decision. In complex situations decision making is not likely to be straightforward and may not lead to a ‘solution’ or single outcome. It is important to develop practices in decision making that involve seeking sufficient information 127

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on which to base decisions. Decisions should not simply result from pressure from the most powerful individuals or groups in and around the organisation. Beyond and behind day-to-day decisions lie the complexities of achieving policy into practice.The following example is of the use of external consultants to tackle systemic change, and to support the implementation of policy and practice. Example In a particularly lengthy three-year period of consultation, a team advised the manager of a residential setting dealing with young people with behaviour problems in setting up and implementing a system for managing the setting and treating the young people as individuals, in a humane and caring way. Integral to the consultancy was the need to engage all staff and, at times, all the young people, in the process. Many meetings were held with individuals, between small groups and with the entire staff group, to attempt to secure the commitment of all to the process. Documentation was drafted and introduced to support the process, and this provided symbolic material over which to consult with staff and young people.

Problem solving In one way or another consultants may engage in problem solving.The client must be seeking from a consultant an improvement or change, and, by definition, as above, that means new ideas – if they had come up with ideas that could resolve their problems, then there would be no need for the consultant. At the outset the perceived problem, or problems, are unlikely to be the only problems that the consultant will be faced with or expected to resolve. Resistance to the consultants’ involvement can take many forms, from inertia to outright resistance, with obstacles and challenges being mounted all the way. We have encountered too, many times in public services, ‘Why are we spending money on consultants or an evaluation?’, or ‘We should be spending the money on services’. In the voluntary sector, the challenges can be even greater, especially in projects that are short-term funded, for here money spent on consultants can shorten the life of a project or a period of employment for workers. However, consultants may remind staff that when public money in particular is provided to a voluntary body, it is often done on the condition that an evaluation takes place. Overcoming these types of issues may well be the first wave of problems that the consultants face. Problems can then develop relating to how information is made available to the consultants, or staff are made available to be interviewed. 128

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These challenges can be real or created, but suggesting ways in which data and staff can be made available when required could be the next obstacle. Having worked through these issues, the consultants will hopefully be approaching the heart of the problem solving for which they were brought in. Inevitably, as projects progress, further issues arise, not necessarily due to the consultants, but they are there to help, so can be pulled in to assist. This can lead to additional work for the consultant but the trade-off may be that it helps the project along and builds a greater rapport that will be helpful in the long run (see Ko, 2010, regarding benevolent competence). Problematic role of consultants In some senses staff may identify the role of the consultant as part of the problem – the role of change consultant is inherently problematic in circumstances where the consultant enters the organisation with the brief of facilitating a change some staff do not want. Ironically, to the extent that the consultants present staff with new perceptions and perspectives, these are likely to be unrecognised, while in contrast, as Koch describes (2000, pp 11-13), coming up with an original approach is much less important than synthesising what is already available in the organisation, that is, clarifying where it may most usefully be applied and putting it into reality. This goes beyond the boundaries of the organisation’s work and involves activities not traditionally part of the organisation which potentially challenge its structure of the main work, and decisions being carried out by the paid employees, and means shifting the subject matter of the consultation from being project management to becoming embedded in the organisation as part of its routine activities (Lockyer and Gordon, 1996, pp 3-5). The involvement of citizen-consultants throughout the life course of the consultancy makes its implementation more complex.The greater the degree of their participation, the more intensive and, to some extent problematic, the process. This is because of the inherent strains in many service-providing organisations in public services that may reveal barriers when entering into fully participative collaboration on an equal basis with citizens (Carr, 2004). Consolidating good practice An integral part of some consultancy is concerned with embedding good practice in the organisation. The following example concerns 129

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the development and management of an end-of-life strategy, through the NHS. Example A strategic health authority (SHA) wanted to increase awareness and understanding of people approaching the end of their lives in care homes in order to try to maintain the best care for such residents, and to reduce the need for admissions to hospital for the last days of residents’ lives. The SHA asked collaborative groups of workforce development staff to undertake the training in the most effective way using substantial resources. One of these collaboratives asked an alliance of social care employers to undertake this work, and they went about this in a very different way, described later by senior managers as an excellent example of lean thinking. Lean thinking is an improvement approach to improve flow and eliminate waste, developed by Toyota, which is concerned with getting the right things to the right place, at the right time, in the right quantities, while minimising waste and being flexible and open to change (www.institute. nhs.uk/building_capability/general/lean_thinking.html). The requirement was for an efficient delivery of expert training in the most cost-effective way for the maximum number of social care staff in the shortest possible time. The alliance consulted, thus engaging the maximum number of people who owned the process, in designing the content of the training. An expert in end-of-life care with training expertise became the lead trainer but could not do all the training herself. Accordingly, all of the further education colleges in the subregion were asked to participate so that each could provide a co-trainer and a venue in their own local area, which would suit social care staff best, as well as being supported by their managers. The lead trainer, and the designed package, including hand-outs and exercises, was thus advertised as a standard for the area, with the final point being that all attendees would only get a certificate if they demonstrated through an agreed test that they had understood and assimilated the day’s training. This all-round approach also ensured that if social care staff moved jobs, as they often do, then all employers would recognise the training and not seek to repeat it. On this basis, within six months about 1,600 care staff received that crucial insight into what end-of-life care was all about, in turn affecting the way that many residents are treated now as well as in the future.

Enabling innovation Whether or not consultants are initially engaged as innovators per se, their work as problem solvers, team developers or on particular initiatives may lead to them stimulating innovative practice. We need to bear in mind, as Curtis (2010, p 83) acknowledges, that innovators by definition may be somewhat maverick figures. They are often at 130

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best deviant and at worst may be uncontrollable. Consultants need to tap into this characteristic and, on occasions perhaps, to cultivate this in themselves. Just as in the example of our meetings in York and Beverley (see Chapter One), this process often involves offloading by staff, in groups or individually, and sometimes at length. Some critical analysis can follow, preferably by the staff themselves, and between themselves too, with the consultant facilitating understanding before the final phase of creative thinking. Sometimes, of course, this process may take place in a different order depending on the characteristics of the staff, but the process overall, represented in Figure 5.2, is likely to involve all three components interacting for innovation. Figure 5.2

Working in different domains: a consultant’s notebook We turn now to the second part of this chapter: viewing the empowering consultancy from different vantage points, according to the focus, whether this is in the strategic domain (organisational change is the aspect selected below) or whether it is closer to the domain of practice, at the interface with citizens. We present this in the form of notes made by a consultant – some in the form of examples and others as commentary. 131

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Tackling service development Consultancies may be associated with change in different domains in the client organisation and change may be a direct or indirect consequence of the consultancy. The broadest and more strategic of these changes are likely to be part of the responsibilities of more senior managers. Issues of power and control are likely to be inextricably associated with change as a focus of consultancy. On the whole, consultants are better placed than staff in individual local authorities to tackle issues that, although critical to the health and well-being of citizens, are, in a day-to-day sense, beyond the scope of individual authorities. As this second part of this chapter proceeds, we note the increasing complexities, to which we cannot do justice in these brief snapshots of consultancies in practice. Organisational development We select a small number of topics from within the huge range of issues concerning organisational development as part of the development of services. Example: Supporting whistleblowing The organisation providing services was required to demonstrate to central and local government funders that whistleblowers are not punished for raising issues about quality. A consultant was approached to develop a brief around the principle of nurturing whistleblowers rather than excluding them from the organisation. This was a delicate issue, since within the organisation there were tensions between different managers and professionals concerning the appropriateness or otherwise of supporting whistleblowing. The consultant arrived at the view that one criterion for assessing the extent to which significant change in this area had been achieved was whether space had been created in the organisation for the soft sigh of the whistleblower to be heard above, and unaffected by, the strident noises made by the defensive members of staff. The consultant devised a programme engaging citizens in the work of the organisation and providing them with support from sympathetic managers and other staff in the organisation, with a focus on promoting the patient/service user/carer perspective. Simultaneously, the consultant initiated a programme of staff development in the organisation, focusing on issues concerning citizen participation and empowerment and the promotion of whistleblowing by any person, whether or not they were a member of staff.

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Example: Changing the culture of the organisation Consultancy aims: Identifying the barriers to change; empowering change agents to promote culture change. The consultants discussed with the senior managers in the service the need to promote some changes in the culture of the organisation, in order to achieve improvements in service provision. This proved a very challenging initiative. Consultants were called in to work with staff in a situation of major change to the way services were organised and delivered. The changes were creating stress for some staff – some staff were resistant to change and some stated that the changes might be appropriate elsewhere but they would not work in this setting. The consultants provided information for staff and the citizens who formed their public – whether patients, service users or carers – that enabled them to compare their circumstances with those of others in a range of settings. The consultancy enabled them to identify reasons why some changes enabled people to benefit.

Example: Promoting change in the organisation Consultancy aims: To work with groups of staff to promote change; to harness the motivation of staff towards change. The starting point for the consultancy was a request by service managers to develop the infrastructure of the organisation to support change and a changeoriented culture. What was required was not the novelty of innovation and change, but to develop the passion of staff for building on existing strengths and overcoming difficulties. The consultancy was based on the assumption that some people had worked out ways of coping. The focus of the consultancy was on identifying supports for change, building resources for change and, in the process, capitalising on the likelihood that staff and citizens felt more motivated and valued because they were the subjects of this special initiative. When the project was under way, the consultants facilitated managers, practitioners and citizens evaluating the extent to which this initiative had harnessed and capitalised on the energies of newly recruited and trained staff in particular.

It is a short move from this to developing a follow-up initiative, incentivising a few selected or volunteer staff as change agents or ‘reticulists’, focusing on empowering change agents to work with the grain of the organisational culture to promote change. A reticulist is a person ‘committed to achieving change through their skills in crossing 133

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organizational and professional boundaries, strengthening existing networks and forming new networks with individuals and groups’ (Adams, 2008a, p 145). Example: Surmounting barriers to continuing professional development Consultancy aims: To identify barriers to CPD and to empower employers and staff to tackle and surmount these barriers. In the current funding climate, higher education providers tend to charge the full cost of provision of professional development programmes. Longer programmes have the advantage of being certificated, but the disadvantage of being delivered in relatively large modules of 10, 15 or even 20 credits – 20 credits being the equivalent of a sixth of a full academic year of study and technically viewed as 200 hours of learning. The consultants encouraged staff to identify possible barriers to change, at different levels and in different domains, such as academic, financial and administrative, and to implement the changes.

Example: Improving the effectiveness of drug awareness and intervention services In this consultancy, the police wanted to know more about the effectiveness of drug awareness and intervention programmes in their area. There were many different projects, with their own individual funding and with different, although often complementary but sometimes competing, goals and interests. The consultants developed an overall view of the differing motivations and timescales of those involved in the different initiatives. They became aware of the lack of an overall strategic approach, not only regarding procedures and protocols but also with respect to the training and support of staff. The consultants engineered bringing together all those involved in workshops to discuss the consultants’ findings. This on its own failed to bring about the changes the consultants desired.

Example: Implementing personalised health and social care services Consultants were employed by a number of health and social care authorities to further the development of personalisation.The consultants highlighted different issues regarding implementation, and created opportunities for staff involved to work through with citizens who were potential and actual users of these services. Examples of particular issues encountered included the following questions:

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Viewing personalisation from a critical perspective, we can pose a similar challenge to that put by the notion of mass customisation that sets out to respond to the requirement that, on the whole, citizens are not as interested in being offered a choice as they are in receiving precisely what they want. Example:Tackling the quality of the working and living environment Consultancy aim: To improve the environment within which public services are delivered. The consultancy set out to work across the entirety of departments within local authorities and health authorities, locally, regionally and nationally, using the argument that it was more practicable to tackle issues of environmental quality in this way. Much of this work was focused on education and awareness raising. Citizens were involved centrally in this work, notably through seeking the views of users as services and engaging a group of them as collaborating citizen-consultants throughout the process of the consultancy.

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Example: Improving the design of care facilities Consultancy aim: To improve the design of care accommodation for older people. The consultants advised that the design should be holistic, that is, embracing both the design and management of services. They advised that any scrutiny of care services should be informed by the views of service users, carers and patients. The consultants illustrated their point by contrasting the concept of ‘secured by design’, which emphasises designing for community safety, and ‘design and management’, which holistically covers both the physical design and the design, setting up and maintenance of a good place for people to live, whether this was a hospital or care home.The consultants drew on the work of Cantley and Wilson (2002), who set out a model based on seven case studies of dementia units.

Exercise: Bringing about change in the care of older people in hospitals and residential care Consultancy aim: To improve the quality of care of older people in hospitals and residential care. The consultancy used two main approaches, one based on targeting shortcomings and the second working with the entirety of the workforce and with citizens – primarily service users, carers and patients – to optimise quality of care. The consultants drew on the evidence of persistent problems, for instance, the report by the CQC (2011) on the quality of hospital care of older people, which identified three main factors as contributing to the appalling standards in some hospitals where there were poor quality wards: • poor leadership; • inadequate staff attitudes to working with patients; • resource shortages. These were used as the focus for remedial work with clients. Throughout, the perceptions and experiences of citizens, as patients, service users and carers involved in hospital and residential care, were drawn on. In the first place, consultancy focused on measures to improve leadership so as to bring about change in the workplace. An emphasis on leadership rather than on bureaucratic and procedurally based management was developed. Staff commitment and motivation were tackled, through heightening the capacity of the workforce to deal with stress, developing supportive teamwork and using an employer assistance programme to build the capacity of employers. Resource issues, where raised, were tackled by the consultants, with a view to ensuring that rationing resources did not undermine the quality of care, as perceived not just by managers and professionals, but by people who use services.

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Leadership and management The notions of leadership and management overlap with each other, but are conceptually distinct.They have changed significantly through the past century or so, and we note later in Chapter Eight some of the changing perspectives on organisations and their running that accompany these shifts. One of the main distinctions between theories and perspectives on organisational management and leadership is between those who view from the vantage point of managers what the organisation requires in order to be effective and those who keep the views, experiences and needs of all staff and customers in the forefront of consideration. The issue of resources often involves the management of tensions in services, as in the following example. Example: Closure and reallocation of resources Consultants might be called in when managers have to make the most difficult of decisions – about how to achieve rationalisation of resources and in the process reduce the units of resource where services are delivered. For instance, this could be a police authority wanting to shift to employing more community support officers and keeping up the presence in the community, or an NHS trust wanting to close down a large hospital wing because they are ‘rationalising’ services across a region – to make the changes in a way that enhances the service to citizens. Although settings will vary, the common element is the strategies the consultants develop for enabling the top managers to look objectively at the service, how it needs to change and how to transfer the resources to ensure that it remains fit for purpose.

Health promotion provides an example of empowering consultancy in action. Example: Empowering groups and communities to improve health promotion and development Consultancy aim: To enable citizens to have access to information about promoting healthy living. The consultants set up and made available learning resources, both online and short courses, ensuring that it was not necessary to be a health professional in order to acquire understanding and knowledge about promoting healthy living. Problems may exist in the organisation and change may be needed. Some staff may not be inclined towards change and management may have failed to dislodge them.

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Defensive contracting The essence of defensive contracting is that it is a tactic used by a contracting client who is under pressure to show commitment to an area, but in reality is undertaking the consultancy largely or entirely for other purposes than the completion of the contract. Thus, the consultant is likely to experience either unreasonably and impossibly tight deadlines, or a total lack of freedom to progress the consultancy to a successful conclusion. The client, meanwhile, has ticked the box to indicate to a third party that the territory of the consultancy has been covered. Example: ‘Don’t listen to what I say, but to what I do’ We undertook a consultancy in two phases. The first contract left us under pressure to complete the first stage of the fact-finding and reporting, because the contracting process was delayed by the organisation. A similar delay occurred in the second contract.There were organisational pressures for these delays not to affect the dates fixed for us to deliver results.These pressures and the associated delays beyond our control added to other factors preventing us from delving into what was going on in the organisation in as much detail as we would have liked. There were factors that from the outset militated against completion under pressure, for example, lack of clarity about to whom we were accountable (whether to senior management, a committee representing management and practitioners and service users and carers, or an officer in charge of the project) and shifts in our contract terms, aims and objectives after we had ‘signed up’. The uncertainty over our accountability ran through the life of the project. As we proceeded, organisational dynamics became clearer, and as we mapped these, it was apparent that our presumed simple accountability at the outset to one project manager was fractured by the complex patterns of change, conflict and uncertainty within the organisation. The shifts in our contracts reflected actual staff and organisational changes. Quite simply, at the end of three years we were more of a medium-term presence in our aspect of the organisation’s life than some staff who had arrived since we were appointed. The politics of the consultancy became apparent.We were part of the strategy of senior managers to demonstrate to central government that sufficient resources were being devoted to this policy change for their performance to be evaluated as positive and sufficient in this direction. Money and staff time and other resources were being devoted to the changes and we were a major part of the evidence

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Empowering of that. Out of sight of this, in the complexities of work within the organisation, our efforts to form an alliance with staff committed to the change were not successful in clear-cut terms.The harder we pushed and the more assertively we made recommendations, the stiffer became the resistance. Gradually, we, rather than the issues associated with change, became the enemy. We as consultants appeared to be part of the pain the organisation was faced with undergoing. As the consultancy drew to a close – and this happened in both phases – we started to draw the fire of staff who were opposed to the changes. We felt the relevance of the process of psychotherapy, where the therapist may attract the negative feelings of the client. We concluded both phases of both contracts in similar vein, aware that we were taking away with us much of the immediate discomfort and pain experienced by staff relating to the organisational changes being considered. There was a sense that we had been employed to take this pain with us, and we were not thanked for reminding staff of the outstanding tasks in the change agendas still remaining on their desks.

Working with teams/improving team working An important aspect of the work of consultants is work with teams, which often amounts to activities associated with improving team working.The consultant is usually greeted as neutral and there to help, after perhaps some opening challenges, as stated earlier. The fact that the consultant will work with members of the team as individuals as well as the manager(s) leads to the consultant’s independence of the team, which assists the change process. Based on trust, and maintaining anonymity, the consultant can hear and see problems, and suggest solutions that the team have been unable to find. In this way the dynamics of the team can be altered considerably as greater understanding is fostered and the team becomes more effective in the way it works. A new manager can initially work effectively as an independent consultant in the role just described. This is a new face and as such they may well be perceived as having no particular stance, although the management role will engender some challenges. One new manager in a community health team, with staff from a number of different disciplines, took a fresh look at procedures and processes, insisting on substantial integrated working.As a result a typical response from the team members, now providing a more joined-up and effective service to the public, was along the lines of “I am working

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just as hard as before, but I am enjoying it, as I can see we are providing a much better service”. Example: Promoting social care employers working together Consultancy aims: To enable social care employers to share certain functions, including support and training services, and to work more closely with another agencies. A number of consultancy methods may be used to illustrate shared working arrangements for employers in the PVI sectors. One model drawn on is the four social care alliances created in North East England more than a decade ago, serving about 2,000 employers with approximately 80,000 staff between them. Such arrangements are encouraged by Skills for Care, the sector skills body. Alliances are urged to work closely with local authorities and health and other bodies with common interests, and to work to the National Occupational Standards and the Qualifications Framework and CQC standards, as well as those of local authority commissioners and the Department of Health; alliances should also try to ensure the robustness of QA processes and procedures.With the current budgetary cuts faced by social care employers, local authorities and the NHS at local levels, there is scope for consultants to help the delivery of improved services in the community and, given the increased proportion of older people in the population, to ensure that the quality of citizens’ lives is maintained while not disproportionately increasing the burden on the NHS.

Using an information gathering approach to monitoring and modifying practice Example: Improving the rate of organ donation Consultancy aim: To achieve optimal outcomes as defined by the person who receives services. The consultants advised the authorities on how to move from an opting-in system for organ donation to an opting-out system, perhaps linked to other procedures such as when people renewed their driving licence. The consultants worked with service users who had experienced both systems, engaging as coconsultants in meetings with clients. They referred to evidence that a system where the default mode meant already being opted-in led to a significantly higher rate of organ donation.

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Example: Enhancing the quality of hospital food Consultancy aim: Developing empowering strategies for professionals and citizens to tackle obesity in the community. The consultants advised that it was not sufficient to say that people must take personal responsibility for their weight. The evidence suggested that whether or not they were exhorted to do this, it did not happen; and also, that media campaigns, and education and information had not worked.

Example: Developing sources of affordable food Consultancy aim: To develop local sources of affordable fresh food for empowered citizens. The consultants advised the clients of an example of a food cooperative. The Fresh Food Cooperative (pseudonym) was set up on the Bigthorpe Estate by a Development Trust in Yorkshire. The initial funding paid for a shop manager for two years and the remaining workers were volunteers. The saving in staff wages would be ploughed into reducing the level of food prices, enabling the cooperative to compete with supermarket and large store prices. The consultants advised a more regulatory approach, monitored by the professionals in various agencies and capacities.

Example: Managing/shortening waiting times for citizens Consultants were called in to help the service reduce waiting times for members of the public. They analysed the use of the service and the reasons for people making a personal call to request it.The purpose of the analysis was to determine which requests could be screened out as unnecessary because immediate help could be given through another means. An assessment and selection process was set up for the remainder of the calls. Further screening was introduced. The relatively small number of people requiring specific and more specialist services were able to choose where they would prefer to be dealt with from the options available. The introduction of choice for citizens meant them receiving much fuller information than hitherto, and their satisfaction with the service tended to increase. www.patient.co.uk/doctor/Telephone-Consultations.htm

Research into influencing people’s behaviour through policy into practice can lead to cost savings, in both medical and dental services.

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Exercise: Reducing costs to NHS of no-shows for medical appointments Consultancy aims: To reduce the numbers of no-shows for GP and dentist appointments. These involve using techniques to improve rates of attendance at GP surgeries and dentists by patients who have booked appointments.Three techniques used improved attendance and decreased no-shows by up to 30 per cent.Attendance rates were improved by: • asking patients publicly to confirm appointments and to call if unable to attend; • at the time of booking, rephrasing by the clerk booking the appointment, to ask ‘Please confirm the day and time of the appointment’; • requiring the patient to write down the day and time of appointment rather than supplying a slip. www.textmessageserver.co.uk/sms-in-the-health-sector.php?gclid= CMfir5CI6qoCFUFP4QodFDzYPw

Example: Improving monitoring of the use of pharmaceutical prescriptions Consultants could improve monitoring of the use of pharmaceutical prescriptions, for example by planning with staff and patients the introduction of a system of computer-monitored pharmaceutical administration, as opposed to dispensing. The system means an auto warning being given when a prescribed drug is missed, that is, not administered to the patient.

Example: Promoting innovation and development Consultancy aim: To encourage innovation and development. The consultants tried two main approaches, in different consultancies, with this general aim. The first involved offering the clients space at the university, time and university staff and other resources to explore different innovative ideas concerning service development. The second meant working with small businesses, locally and London-based, at centres such as Silicon Roundabout (the name given to the locality around Old Street roundabout in London where many incipient and small ventures are located). The notion of innovation was relevant, in the sense that it reflected a belief that doing things better meant doing things differently but not necessarily more expensively. Silicon Roundabout has a reputation for coming up with innovation cheaply.

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Example: Innovative use of online support groups to enhance implementation The consultants were engaged in helping a regional group of service users, carers and patients contribute to developing a scheme for empowering the patients of the future, through the government’s policy initiative, Healthwatch. The consultants decided that they should focus on the crucial role of communication to gather citizens’ views, not through traditional methods such as letters, questionnaires, leaflets, posters or advertisements on television or radio, but through email and social networking such as Twitter and Facebook. Time was spent using android phones and iPhones to design a system enabling short, sharp views from people to be gathered. For instance, a contractual arrangement between patients and GP practices in a locality was developed as a pilot project. A limited series of questions was posed regularly and patients were encouraged to respond.The assumption was that once patients saw results from their views being expressed, they would be motivated to do more because they felt they could influence the direction and pace of change. After reviewing this pilot, it was decided to expand the questions, so that patients were encouraged to contribute issues they believed needed tackling. Questions based on these were devised and distributed to all citizens involved in the project.

Workforce development Consultants can have a major part to play in public services workforce development.There is a balance of interests, naturally, between those of the employer, the worker and the person who receives services. More significant, from the viewpoint of empowering consultancy, is the balance of power between meeting the needs of the organisation, the employee and the citizen.There are tensions, too, between the interests of different groups of staff and, at a time of limited resources, managers have to make decisions about which groups of staff to prioritise when training needs and programmes are being considered. Should training be for all or for selected groups of staff? Should cuts in public service budgets be translated pro rata into cuts in training provision, or should training be exempt from cuts? The balance between basic qualifying education and training provision for staff and the provision of CPD programmes must be considered. Employers could work in partnership with universities and colleges to provide such programmes. Some components of education and training programmes could be designed (with the help of consultants) so that staff could undertake them in segments and in different combinations. Assessment could be attached to learning materials so that the learning could be assessed at 143

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different levels, and credit could be granted by colleges and universities for small, creditworthy fractions of modules – these are often more practicable from the viewpoints of learners and employers.The smaller the module the cheaper it is, and the more practicable it is to target it and, from the point of view of the employer and member of staff, to value it. Smaller modules also can be focused and potentially offer very specific skills and knowledge, that, provided a range of modules exists, can meet the practitioner’s needs with greater precision. It is unlikely that every worker in every setting will need exactly the same skill set, especially after gaining a set of professional standards in a qualification. Typical topics for modules broken into smaller parts could include safeguarding people and health promotion. We found that a learning organisation committed to changing staff development encouraged staff retention and made recruitment easier.The term ‘learning organisation’ has a particular meaning in this context, as it refers not to the orientation of workers but to features of the organisational culture that empower staff and promote positive changes. (See Chapter Eight for further discussion on this.) Example: Developing e-learning as a resource for workforce development Consultancy aims: To specify goals for workforce development and to identify the specific contributions e-learning can make to workforce development. The first concern of the consultants was to find out what different workers needed to better do their jobs and deliver better services, set against the resources available. The plan developed had to be realistic. It was vital that the needs and aspirations of people taking part were fed into the process. The consultants devised an e-based means by which workers’ profiles of experiences, learning, needs, reflections and aspirations could be collated and managed by them.This, however, was not met with universal enthusiasm by all workers, some of whom regarded it as useful, others viewing it with suspicion as a means by which management might intrude into their work and extend control over them. In retrospect, the consultants reflected on the above issues and also on ways of engaging staff more meaningfully throughout the process of implementation of an e-learning workforce development programme. Another aspect on which the consultants reflected was the points of comparison and contrast between traditional learning and e-learning. Undoubtedly, they concluded, there were areas of strength in e-learning, in that it could empower the learner. However, there were some problematic areas, notably the support of the learner throughout the learning process and also the difficulties of devising

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Empowering meaningful assessment tools. One particularly problematic aspect encountered by the consultants was the development by organisations of e-learning materials that were nothing more than books and similar documents converted into internet-based documents.These, the consultants felt, might represent a wasted opportunity. A further issue was programmes with an element of self-assessment built in through multiple-choice questions at the end of each section. Some students pointed out in group sessions where experiences of e-learning were shared that learners could work out how to ‘work’ a particular assessment system that was not based on a test supervised and assessed by an independent third party. The consultants recognised the tension between the extremes of failure of an e-learning scheme – at one extreme a tick box system that was unmonitored by assessors and became meaningless; at the other extreme a demanding and complex system of assessment that was so resource-heavy staff did not want to use it, and so intimidating that learners were deterred too.

Example: Developing internet-based education for public service professionals and citizens Consultancy aim: To use internet resources, for instance, web resource packs and webinars, to enable people to share experiences and reflections. The consultancy looked at developing ways in which employers could put online the curricula vitae (CVs) of staff and also details of their identity, qualifications, CRB status and courses they had attended, with scope for staff to add their own material and identify their own training needs.This would therefore be not only a tool for managers, but could also be used by staff, thereby empowering them to move up the promotion ladder and motivating employers to take measures to retain staff.

Example: Developing e-learning and virtual learning environments The consultants were engaged to help a university working with partner employers to develop in-service programmes of basic and post-qualifying training for staff to design an e-learning environment. Over several years, the consultants equipped the university and partners to run the scheme themselves. One particular factor noted was the relatively large up-front investment of time and resources needed to set up the scheme. When the scheme was running, the early evaluations by students and staff suggested that the vast majority of ‘e’ students treated the programme as a traditional correspondence course and did not engage as much as staff had anticipated in the process of interaction, whether with other students or with staff. The consultants reviewed the entire consultancy with staff and concluded among other things that there were parallels in the public service and in the e-learning environment in the relationship between the ‘client’ and the organisation.

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In public services, there are areas where citizens are expected to monitor their own circumstances, for instance, in a cardiac unit where patients can use equipment loaned from the unit to monitor their own situation at home.

Conclusion In this chapter, we have highlighted the kinds of considerations that consultants concerned about empowering citizens need to consider when carrying out the consultancy. We have noted two main areas: the considerations associated with the gathering, interpretation and sharing with the clients of information and the practice of consultancy in different domains of the public services.Throughout the consultancy, the interests of the citizen are simultaneously more vulnerable than those of staff in the service and more important to safeguard.

Further reading Adams, R. (2008) Empowerment, participation and social work (4th edn), Basingstoke: Palgrave. [Chapter Nine examines relevant aspects of approaches to research that have the potential to empower citizens using public services.] Bell, J. (2010) Doing your research project, Maidenhead: McGraw Hill and Open University Press. [A practical guide to different aspects of data collection and analysis.] Curtis, T. (2010) ‘The challenges and risks of innovation in social entrepreneurship’, in R. Gunn and C. Durkin (eds) Social entrepreneurship: A skills approach, Bristol: The Policy Press. [A discussion of factors promoting, and barriers to, innovation in social enterprise.] Denscombe, M. (2007) The good research guide: For small-scale social research projects, Maidenhead: McGraw Hill and Open University Press. [A very comprehensive examination of many aspects of research strategy and methods to help the consultant who is less familiar with these and wants to gather data in reliable, valid and professional ways.] Sadler, P. (2001) Management consultancy: A handbook for best practice, London: Kogan Page. [A useful discussion in Chapters 7 and 8 respectively on data collection and interpretation and presenting advice.] Silberman, M. (ed) (2001) The consultant’s tool kit, New York: McGraw Hill. [A wealth of information and advice on many different aspects 146

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in which consultants give help to clients, mostly using the ‘How to ...’ formula.] van Zwanenberg, Z. (ed) (2010) Leadership in social care, London: Jessica Kingsley Publishers. [A variety of aspects of leadership in the public services highlighted in this useful collection.] Womack, J.P. and Jones, D. (2003) Lean thinking: Banish waste and create wealth in your organization, New York: Free Press. [A useful source of ideas for developing lean thinking.]

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Disengaging This chapter examines the phases of the consultancy associated with endings or follow-on work.The disengagement phase should also make space for reviewing and evaluating what has been achieved and what has been left undone, and should enable the consultants to review their own performance self-critically, quite separately from their review of the consultancy.This is in recognition that the consultancy has engaged people who receive public services as citizen-consultants. They have been drawn into the consultancy intellectually and emotionally and have acted as critics as it has proceeded. Now, as the consultants disengage from the consultancy, the citizen-consultants maintain their critical gaze on the process. What disengagement means Disengagement is the term used to refer to the process of withdrawal by the consultant. Ideally, this should be a gradual and smooth process, which seems to all parties inevitable since the consultant has worked her- or himself out of a job.The bottom line is that when individuals, groups and organisations reach the point that they can continue to carry out, or work on, what the consultant has been doing, this is when the consultancy, de facto, ends, whether or not any of the parties recognise this at the time! This is the point where any contingency fees are paid, which are separate from the regular fees normally paid in stages throughout a consultancy extending beyond a few weeks. Contingency fees are fees paid only when specified conditions have been met by contractors, including the consultant. In some consultancies, the consultant may be paid a retainer by the client at the conclusion of the contract. Retainer is the term used to refer to a regular or one-off fee paid by a client to retain the consultant’s services.

Various ways of disengaging Disengagement, or withdrawal, can take many forms. The parallels with military disengagement are not precise, but there are perhaps some thought-provoking analogies. Four main forms of disengagement occur to us: 149

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• Surprise withdrawal – all comes to an end, all contact is severed and the consultant literally slips away.The consultant may often feel like doing this, but such an approach is unlikely to endear the client who paid, or worse, who has still to pay for their services, and in turn may harm the consultant’s reputation. • Fighting withdrawal – here the consultant and the client battle it out until one is exhausted and gives in the fight. Again, this is unlikely to enhance the consultant’s reputation and is worth nothing if all the work completed has not been paid for or if the client has sought to change, or worse, has changed, the consultant’s report or recommendations. • The withdrawal could be a planned or tactical retreat when ‘engagement’ has largely ended, as the client and consultant each count their gains and cut their losses. • Finally, the process could be more of a final handover of power, so to speak, where much preliminary and substantive work has been done, and, at the last stage, the consultant hands over control of subsequent actions to the client. This process takes a little time but is far more likely to enhance the reputation of the consultants through achieving an empowered approach with a very satisfied client. Disengagement may simply mean bringing the present consultancy to an end, one way or another, and much as planned. However, more often than not, the practice of disengaging may be tricky, complex and uncertain.The consultancy may not be a one-off, in the sense that the consultants may view this consultancy as possibly the prelude to a further contract or an extension of the present one. One distinction between consultancy and the everyday work of the public services organisation is that consultants contribute to the service but, in normal circumstances, they are not the continuous service providers.We are quite certain that if we dared to state in writing here that there are no circumstances in which this would arise, someone would contact us with proof of an exception, but we believe that this would be an exceptional situation. In summary, disengagement is affected by the position of the consultant, that is, the extent to which the consultant is an insider or outsider to the service, once the consultancy has ended. There are benefits to be gained by the consultant simply carrying away the unpleasantness and bad feelings as though they are waste, rather like the person employed to clear the drains (see the environmental protection image in Table 8.3, Chapter Eight). More positively, however, the consultant and client may agree that there is

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benefit to be gained from the consultant supporting the empowering purposes of the consultancy through continued involvement. Cockman et al (1999, p 220) note that the best way to ensure that there is continuity in the process of concluding the consultancy – in particular, avoiding an uncomfortable and unhelpful gap when the consultant leaves – is to build in how the period of disengagement is to be handled when planning the project in the first place.They identify four particular ways in which this may be achieved: • by building up roles for specified people in the client organisation to take on similar roles to those performed by the consultants; • by agreeing a sliding scale of involvement and charges by the consultant for the period leading to the conclusion of the consultancy; • by setting in place a continuing maintenance involvement of the consultants after the conclusion of the consultancy; • by agreeing with the client a celebration or collaborative event, such as a publication, to mark the conclusion of the consultancy. These tactics will have varying relevance to the circumstances of the client organisation and some will be regarded as less relevant and helpful than others. Whatever approach is adopted, it is vital that the consultants are sensitive to the issue of timing when planning their disengagement and that this is done with the participation of the clients. However, it has to be acknowledged that the consultants and clients may view this issue differently, and there may need to be negotiation, compromise, or, in some circumstances, an agreement to differ over how disengagement is managed. Dealing with data: negotiating over different interpretations of the data Data can be presented in many different ways to suit different people’s needs. Example A senior police officer spoke of his regular meetings with his superior. He asked his superior officer what he wanted the figures to demonstrate, a reduction in burglaries, car crime or theft? The officer would return a week later with necessary outcomes based purely on manipulation of the statistics.

When the client wants data to prove a point or to provide evidence for a change, or more often further funding, then the pressure on the consultant is intense to present data in the most favourable light, 151

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something that can be very challenging when trying to disengage satisfactorily. Example A consultant working with a national agency came to the funders of the consultancy with the report of the data gathering and analysis and found that they wanted the results presented so as to put a more positive gloss on the findings. This presented the consultant with an ethical question about whether to remain strictly governed by the data and refuse to alter one word of the report. In the event, the consultant asked the agency to go through the report and indicate anything that was factually inaccurate and, separately, anything with which they were unhappy for other reasons. A process of negotiation then followed, during which the consultant listened to the agency’s points about each item and then made a decision about whether, and if so how, to change the report at that point.

Example A national firm of consultants employed regional consultants/evaluators to study the impact of small local schemes targeting young people. Another international firm of consultants had originally been employed to set a small range of very ambitious targets on which the national project was based, and due to the potential benefits if these targets were achieved, substantial funding was to be made available. The work was carried out at all levels, as set out in the project plan. Unfortunately the data collection procedure had some initial challenges, but it soon became apparent that targets were not going to be achieved at anything like the levels set out. Great pressure was applied as ultimately ministers wanted the project to succeed.The project ran its course and, as it approached its conclusion, there was such a shortfall in targets that additional ‘evidence’ was sought through case studies that ‘demonstrated’ that the project had worked. Disengagement had begun, but additional demands were being made. Of course the final report did not contain the results that had been the initial aspiration, so the ‘results’ were challenged. This process went on for so long that the ‘report’ became of very limited value, the disengagement process having obfuscated the real outcomes.

Example An international firm of consultants was asked to review the human resources, finance and training functions of a local authority with a view to contracting these services out to a private company. They carried out a study and produced a large report recommending that privatisation or contracting out should take place. Their report on the town unfortunately contained references and recommendations relating also to a nearby town. Two pieces of work, at least, of a similar nature had been taken on, and sufficient care was not taken to fully realise the differences.

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It is common for consultants to be engaged in more than one project with the same client. For clarity, it is helpful to go through the process of ending the project, even though the consultancy may enter a new phase. Whether or not this constitutes full disengagement is a somewhat academic point, since the consultant may enter into negotiations for a follow-on project while still engaged in the previous project. This may take different forms, according to the nature of the consultancy. The assessment of problems earlier in the first consultancy period may lead to the identification of further areas and tasks needing attention, and the consultant could be invited to submit proposals for these to be tackled, or a fresh tendering process could be set up. Or a regular review may be set up and the consultants could be invited to take part in this. The consultants might identify the value of a support group or further training and may be invited to take part in these. A similar process of handing over may take place during these, with the consultants taking a lead early on in planning and leading events, later playing the role of facilitators, and finally dropping out. Example The consultant was engaged by a national charity for older people. The work was challenging but achievable. However, the consultant allowed the client’s expectations to rise – something that can readily occur in trying to help. Accordingly, disengagement became very difficult and the consultant spent more time (and therefore money) than the client had provided. Even though it was recognised that additional work had been done, no further funding was made available, leaving all parties disappointed even though the work had been fruitful.

Sometimes the consultancy is not for the purpose officially stated, as the following example illustrates. Example The consultants were carrying out consultancy for a public service body, with the aim of setting up systems to enable citizens to participate systematically and meaningfully in the work of the public service. As the consultancy gathered momentum from the consultants’ point of view, they became aware that the clients did not share their motivation.Towards the end of the consultancy, it was apparent that the clients were not expected to be successful in achieving the outcomes of the consultancy – engaging citizens in the public service. At best, there were mixed views among staff of the actual value of the goal of the consultancy. Thus, the formal goal was stated in the aims, but the latent function was to save the face of the organisation and fulfil political purposes, and:

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Consultancy in public services • to carry away the negative feelings about the purpose of the consultancy; • to manage problematic aspects of the goal of achieving participation and empowerment of service users; • to make uncertainties manageable; • to contain politically contested issues.

The more the consultants have acted literally as consultants, in the sense of advisers, throughout, the more smoothly the process of disengagement is likely to go. Problems of dependency by the clients are more likely to arise where the consultants are regarded from the outset and throughout as irreplaceable ‘experts’. It is important for consultants and clients to be able to learn from the process of disengagement, whether the experience went well and, if appropriate, in what respects it could have gone better. This brings us to the linked but separate matter of evaluation of the consultancy.

Evaluation It is vital for consultants and clients to evaluate and learn from the experience of carrying out the consultancy, although often and for many reasons this may not occur. Not least, this is because it appears to be an unnecessary extra, a good thing in theory, but because of lack of time, not practicable in practice. Evaluation is the term used to refer to the process and the products of reflecting on, and making judgements about what has gone well, what has gone less well and what can be learned from these.This requires time and space to reflect and it is important to take this as seriously as the rest of the often hectic process of the main body of the consultancy. The consultants should be well placed to consider the balance sheet of what has been achieved – both in terms of gains and losses. There is the question of managing the tension between positive and negative perspectives on the consultancy, by the clients, others such as non-involved staff, and/or patients, service users and members of the public.There should be space made for airing of views and feelings by those who have taken part – managers, professionals and citizens as well as the consultants. It is vital that during this process the consultants systematically seek the views and experiences not only of staff but also of citizens who have interacted with the public service during the consultancy. Finally, of course, the evaluation itself should be evaluated by the consultants – a stage often left to one side in the pressure to deal with the next piece of business. It is invaluable, however, for the consultants to reflect on the different roles and functions they have performed and on the opportunities and limitations of their 154

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involvement in judging the entirety of their performance critically, through to the final stage of evaluation. Consultants neglect evaluation at their peril. Cockman et al (1999, p 229) note that the most appropriate time for consultants to consider evaluation is at the start of the consultancy and not just before the end. The problem with leaving the evaluation to the end is that there is then a lack of data against which to evaluate progress. It is important to set out in the agreement with clients near the start of the consultancy what the aims and objectives are, that is, what the clients hope the consultancy will achieve. There will be some negotiation about these, especially where there is tension between the expectations of the clients and the desire of the consultants to be realistic about what can be achieved with finite resources within a limited period. Ideally, these agreed objectives would be stated with sufficient clarity to enable them to form benchmarks by which the consultancy will be evaluated. Example: Moving the goalposts A large public services organisation had put out a tender for consultants to contribute to organisational changes. The start of the work was initially delayed due to requests by the organisation to do additional work, which was not a promising sign. However, having completed a lengthy tender and selection process, like most consultants, we went ahead with the work as otherwise the whole tender process would have been a waste of time and resources.We persisted, not least because we believed in the work, and perhaps that in itself should have been a warning sign to us. Can a consultancy be a completely dispassionate process? We negotiated a series of milestones, trying to make these as clear as possible, but as the project came towards its end there were more and more areas for clarification that the client wished to pursue, making disengagement more difficult. As one problem appeared to be resolved, another appeared – the goalposts were shifting – and of course the consultants want to satisfy the clients for the sake of payments and, indeed, reputation. The final piece of written work extended over several weeks and was, in fact, always stated as an ‘extra’ in the tender, but disengagement was never really completed, although payment was made, simply because a member of staff was worried that the written work might cause some problems, even though it was entirely owned by them as the client.

Example: Milestones reinterpreted A consultancy, which involved an evaluation, was completed for a large charity working in crime reduction. The work proceeded largely well with the workers,

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Consultancy in public services but the manager left after some difficulties, and was replaced by another. Here, thankfully, milestones were written down at the outset, but the new manager had a different interpretation, chiefly around the wording of the final report. Such reports can cause great discomfort if the client perceives them as negative, and here, the new manager wanted to edit the report to her satisfaction. The consultant was largely pragmatic concerning style and general points, but not so when it came to recommendations. This ending was far from clean.

These experiences should, however, be tempered by the fact that such cases are exceptional. In most cases, after reasonable preparation at the outset, disengagement is quite straightforward when agreed milestones are achieved. We should also add that sometimes one piece of work can develop into another, and consultants should always be aware of this possibility. In our experience, total commitment to the contracted piece of work is vital, and other work may ‘naturally’ follow; and this is far better than attempting almost to curtail the current work so as to create further work later. These examples show how consultants may need to be rigorous in ensuring that the clients’ expectations are not raised unrealistically and that their horizons do not shift during the consultancy. It is not in the interests of clients or consultants for additional objectives to be generated during the consultancy, however laudable these may be, without negotiating these with a full assessment of the additional resources and time required to carry them out. Evaluation is best managed and carried out jointly by those involved directly in the consultancy. In public services, this should include not only the providers but also the service users. In health and social services, this includes not only managers, professionals and other practitioners, clients, patients and service users but also carers and sometimes other members of the public as well. It follows from this that evaluation is not a simple matter. It brings together the viewpoints of different parties to the work of the organisation who may hold very diverse views about what public services do and should be doing, as well as disagreeing about this consultancy. It is important that consultants and client organisations are not shielded from these intrinsically problematic aspects. Evaluation means managing the complexity of the context in which the consultancy takes place and working through a process of critical reflection, posing the following questions: • • • • 156

Was this consultancy appropriately located? Were its aims and objectives appropriate? Were its methods appropriate? Was the contract clear and sufficient?

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• Was it carried out appropriately? • To what extent did the consultancy achieve its aims and objectives? • If there were areas in which it was less effective, how could these have been tackled? • Did the consultancy highlight other areas needing attention, and if so, what were these? • Are there any other matters relevant to the evaluation of the consultancy? The consultants should be interested not only in the results of the evaluation but how it is carried out. This important process is often neglected because the consultants are concerned to move on to the next project. However, it is necessary for the consultants to take an independent and critical view of how they have conducted the evaluation of the consultancy and to put in place any necessary measures for improving this in future. During this process, however, the changing balance of power between the consultant and the client needs to be acknowledged. Figure 6.1 portrays this, and also represents the complexity and variety of roles the consultant may perform. Pellegrinelli (2002), from which Figure 6.1 is adapted, proposes a ‘descriptive model in which the roles played by consultants can be understood in terms of a continuum’. At one end the client holds sway with the consultant playing a very passive non-directive role, moving through a continuum to a point where the consultant is in the more powerful directive role.

Figure 6.1

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Evaluating the evaluation Beyond the evaluation, there is a need to look at the entire process critically, including making a judgement about the appropriateness and effectiveness of the evaluation itself. Sustaining the quality of future consultancy It is important to find ways of sustaining the quality of future work with the public services organisation, both within and outside further consultancies. Clearly, the consultant has a relatively insecure grasp of this, being dependent on future invitations from the organisation to take part in ongoing work beyond the present contract. The reality for consultants is that they move from job to job and, in smaller consultancies, this can lead to a form of short-termism in which there is no investment in future quality once the present contract has ended and there is no incentive or motivation for the consultant to pause and to reflect critically and self-critically on the consultancy just concluded.

Conclusion While the ending may be a form of release that, in this sense, is cathartic, it could be the actual conclusion of all contact with the client, and it may be uncertain as to whether there will be further work.This ending that is not a final end may be an aspect of the consultancy’s uncertain nature and situation. As part of the consultants’ responsibility for sustaining their critical gaze, they are engaged in continuing critical reflection. We turn next in Part 3 to the kinds of material on which the consultants draw when engaged in this process.

Further reading Cockman, P., Evans, B. and Reynolds, P. (1999) Consulting for real people: A client-centred approach for change agents and leaders, London: McGraw Hill. [Chapter 13 provides a discussion of disengagement that is rare to encounter in books about consultancy.] Sadler, P. (2001) Management consultancy: A handbook for best practice (2nd edn), London: Kogan Page. [Chapter 8 gives some hints on the role of the consultant at the stage when the work of analysis is done, the report is written and the presentations are made.]

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Part 3 Reflections This part of the book returns to the consultant’s notebook that we dipped into in the latter part of Chapter Five. The notes in these last three chapters of the book reflect more widely on the contexts of policies and ideas that have a bearing on doing or using consultancy. We call them notes because they are not finished, in the sense that they are continuing reflections, thoughts that have arisen as we have carried out our consultancy projects over the past two decades.We have found that we continually revisit previous consultancies to highlight new facets and introduce new interpretations, in the light of further experience. In Chapter Seven we explore the reasons why consultancy makes a significant contribution to public sector organisations, which may grow in future, as the balance between state and independent (private and voluntary, or what is often called ‘third sector’) provision of public services changes in favour of the latter. We discuss the different ingredients in consultancy in public services. We also examine factors that lead to universities and university staff taking an increased stake in consultancy. Chapter Eight deals with the ideas associated with consultancy and its different meanings, moving on to explore in more detail a variety of ideas about, and approaches to, empowering consultancy. It will be apparent that no single perspective on consultancy can do justice to the complexity and variety of the field of public services.What we can do, however, is to develop ideas about the values and principles that are common to a great many different approaches. We can, somewhat speculatively, develop some coherent ideas about the basis for practice, which amplify our reflections the examples explored in Part 2.

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seven

Reflecting on contexts for consultancy The approach we have adopted over the past two decades is somewhat opportunistic, in that we have relied on the consultancy business that has come our way at the university and that which we have generated. However, during this period we have gradually been able to accumulate experience and arrive at the categories of the consultancy process that we set out and followed in Chapters Two to Six.We have reached the point where we feel convinced that an empowerment approach or model to consultancy is not only possible, but is practicable and desirable from the citizen’s point of view, given the present trajectory of government policy and the nature of current practice in organisations delivering public services. The journey through our practice has enabled us to accumulate observations and reflections on our work in progress. We expand on these in this third part of the book, making connections between the very different settings of consultancy practice in the public services.To continue the cartographical analogy a little further, if this is a map, it is not only unfinished but is also changing as we journey, in the sense that public policy is in a state of flux.This is not a temporary situation, but is part and parcel of the context of public services. The division of material between this chapter and the next is that we attempt to set consultancy in the public services in its broader context in this chapter, and explore some perspectives on it in the following chapter. We begin by reflecting on the somewhat problematic and changing nature of consultancy.

Problematic and diverse: changing nature of consultancy In terms of the prominence of consultancy in contemporary discourse about public services, we are in the era of the consultants. There is little doubt that consultancy has been the boom industry, from the second half of the 20th into the 21st century. There are many types of consultancy and this is unsurprising, given the range of settings where consultants practise and the variety of people calling themselves 161

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consultants. The nature and range of consultancy activity mirrors the shape of the sectors they serve. To a large extent, changes in public services are reflected in the consultancy that they generate, in the sense that consultancy is affected by larger changes – in policy, legislation, organisation and management – rather than the reverse. Diversity of consultancy The diversity of consultancy may be characterised as its strength. This implies that consultants come from a great range of backgrounds and bring with them a rich array of different perspectives on consultancy and on their client organisations. However, this diversity is not an unambiguous ‘good’. Salaman (2002, p 247) puts it thus: Research into and discussion of management consultancy draws writers and scholars from various provenances, using various theoretical frameworks and, in some cases, none.This hybridity could be a strength resulting in a rich variety of perspectives and insights. And this may indeed be a feature of the literature. But it can also be a weakness if it leads to a pre-occupation with a limited range of problematics arising from an insufficiently theorized or even commonsense approach to consultancy. It is important to manage the tension between the expectations of the client that the job should be done and our desire as consultants to understand and reflect critically on the work as we proceed. We need to recognise that the simple definition of consulting with which we began this book needs further exploration and discussion. Reflecting further on consultancy as a problematic concept We return here to the ‘simple’ definition of consultancy that we gave near the start of Chapter One. There are probably nearly as many definitions of consultancy as there are people doing and receiving consultancy. We could duck the complexity implied by this variety and assert that it is simply about helping to effect change. However, in the light of reflection and the experience illustrated in previous chapters, consultancy emerges as a somewhat problematic concept, shaped by the different notions and usages of consultancy by ‘client’ organisations and interests.Traditionally, consultancy was something experts came in from outside the organisation to carry out on, or on behalf of, those 162

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already in the organisation. The consultants retain their power and mystique. This view of consultancy, however, cannot be sustained in the contemporary world of public services. It is common nowadays to find consultants who are rooted in the client organisation, to the extent that over a period of time they operate almost as additional members of staff. Far from retaining their label as experts from outside, they become colleagues to members of staff and act so as to empower them.There has also been an increasing tendency for former colleagues in the workforce to return as consultants. A great variety of different approaches to consultancy exist, and even during the lifetime of a single consultancy, different approaches may be encountered. Consultancy approaches range from those that involve an expert focusing on a particular technical aspect of the organisation and those that are more generic, systemic or holistic.Table 7.1 is our attempt to represent diagrammatically the variety of approaches, although there is an abundance of handbooks that offer clients and consultants techniques. For instance, Silberman (2001) provides a tool kit for consultants, and Sadler (2001) has written a handbook for best practice in management consultancy. His book identifies four main phases of the consulting process: entry, data collection and diagnosis, presenting advice and solutions, and implementation, which corresponds to the generic approach adopted in our book. Table 7.1: Traditional and contemporary consultancy Location Role Focus Orientation

Traditional External Expert Specialist Product

Contemporary Internal Colleague System Process

Broader context of empowerment approaches in public services The empowerment approach to consultancy developed in this book is holistic and empowering and is rooted in the notion of the consultant as colleague rather than expert. The pace of change imposed by government policies and inclinations means that agencies and organisations in this field rarely have the capability and the capacity to respond to ever more pressing deadlines and targets.These pressures have altered the way such work is completed. According to Block (2011, p xv), the advent of internet-based communications means that we are living more virtual lives than formerly so many 163

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relationships – including those at work – are long-distance. It is even more important, therefore, to make the most of face-to-face encounters between the consultant and the clients and ‘to take advantage of real meetings to become personally connected in ways powerful enough to overcome the distancing and isolating effects inherent in an electronic connection’. One point which is entirely consistent with our approach to empowering consultancy is Block’s shift ‘from a primary focus on needs and deficiencies to a focus on possibilities, gifts, and strengths’ (Block, 2011, p xvi). Consultancy reflects social changes – in particular, those changes that affect work in organisations. Czerniawska (2002, Chapter 9) develops the notion that we are all consultants now, and provides some useful case studies (Czerniawska and May, 2004). The empowerment approach, as spelt out in this book as being in the public services, is located more broadly than this, because, since the 1990s, notions of participation by citizens and citizen empowerment have become explicitly part and parcel of the discourse of social policy and practice. Socially, politically and conceptually, the empowerment approach in public services relates to historical traditions of mutual aid and self-help in the UK and in other countries that pre-date industrial society. These developed a renewed vigour from the 1960s, with the emergence of consumer movements, pressure groups, advocacy among people with disabilities and community action and social protest (Adams, 2008a, pp 3-30). The fact that empowerment derives from such a wide social, political and conceptual cluster of ideas and practices illustrates its inherently contradictory character (Adams, 2008b, 2009), and reinforces the complexity of developing empowerment approaches in public services. Legal and policy contexts We saw earlier (Chapter Two) that there are strict protocols in the EU governing tendering processes for consultancy. In the UK, this is within the changing nature of public services since the late 1980s, with the growth of a contract culture in public services. The Local Government Act 1988 introduced compulsory competitive tendering (CCT) in local authority public services. The growth from the 1980s of what has been called the ‘competition state’ (Evans and Cerny, 2003, p 23) developed what were termed internal markets, enabling central and local authorities to shift from being main providers of services to becoming commissioners and procurers of services, thereby ensuring that the market philosophy was brought into public services. A major consequence of these trends was the development of a much more 164

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fragmented and diversely located workforce delivering public services, often through the provision of such services as meals and care services being outsourced. Outsourcing is the term used to refer to putting out work to contractors, including consultants, that was formerly carried out by the organisation. These shifts ensured that the circumstances were such that public authorities were increasingly benignly disposed towards hiring consultants to contribute in various ways to the commissioning, contracting and QA of public services. Increasing resources were devoted to paying consultants for aspects of public services, alongside staff employed by central and local government, centrally, in local government and outside, in the ‘third sector’. Scope of consultancy in the new public services Consultants are a universal feature of our society and within this, the public sector, which is the focus of this book. The main public sector territory in which consultants operate in the UK appears to be that occupied by the state, statutory or local authority services, rather than by the private agencies and organisations – the so-called ‘third sector’ of not-for-profit agencies and organisations which contribute to public services. Whether or not this is the case, there is no doubt that the relationship between the statutory and private, voluntary and independent (PVI) sectors is so close that they probably feel the influence of consultancy to an equal extent. Certainly, it is the case that the term ‘new public services’ (Farnham and Horton, 1993) refers to the great impact on the entire array of public, private and voluntary agencies of ‘a series of radical political, legislative and organisational changes, prompted by governmental initiatives, since the 1970s’ (Farnham and Horton, 1992, p xiv). Farnham and Horton (1999a) identify two main forms of change that have taken place in this period: • attempts to improve management in central and local government, to which the term ‘managerialism’ is often attached (Farnham and Horton, 1999a, p 42); • borrowing techniques from the private sector and applying them in the public sector. It is the second of these (Farnham and Horton, 1999a, p 44) that is particularly significant, although both contribute to the incorporation into the public services of generic management approaches that reflect

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more mobility than hitherto between private and public sectors (Farnham and Horton, 1999a, p 43). Scope of public services The scope of public services is shown in Figure 7.1. Public services organisations have changed dramatically in a single generation, say over the past 30 years.The public services workforce in the early 1980s still consisted overwhelmingly of staff who expected to be employed by the NHS or the local authority for their entire working lives. Since the 1980s, the policy context of consultancy in the field of health, children’s and adult social work and social care services in the UK has moved towards a contract culture. This is one consequence of the fragmented market created by funders, employers, service commissioners and providers.There is an increasing diversity of service providers, reflected in the growth of the ‘third sector’, consisting of not-for-profit, voluntary and informal groups and organisations. Within the NHS and local authorities an increasing proportion of professionals are agency staff, that is, supplied on short-term contracts by independent agencies. Some of these – particularly those in management and specialist professional roles – may even be engaged in roles designated as consultant. From the vantage point of the public authority, these arrangements enhance flexibility in the workforce. From the viewpoint of agency-supplied staff, this flexibility is circumscribed by the need to ensure that their rewards are enhanced sufficiently for them to make their own provision for personal and professional development, adding pensions and other on-costs. Setting aside the larger political and organisational issues about the creation of markets to commission and Figure 7.1: Scope of public services Health Housing Criminal justice Adult social care

Consultancy

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Uniformed services

Social services

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deliver services, there is an exponential growth in consultancy which runs alongside these processes and is driven by central government agencies, local authorities and other organisations, with tasks focusing on a multitude of aspects connected with the entire process of policy formation, strategic formulation, workforce development, organisation and management development and service delivery. The argument of Block (2011), referred to above, is that clients should be empowered to identify, examine and respond to their own questions.This position is somewhat contradictory, just as the fragmented workforce of the public authority is contradictory – strengthened by its flexibility but weakened by lack of investment in staff development and continuity in organisational culture. However, on the whole, Block’s argument reinforces our own position. Since the last quarter of the 20th century, different aspects of public services have been subject to repeated reorganisations. In the health and social care sector, which constitutes the largest single unit in terms of size of the workforce and annual expenditure, there have been major reorganisations since the early 1970s. The 2020 Public Services Trust (PST) was a think tank created in 2008 with the aim of stimulating debate about the challenges facing UK public services in the medium term. Its functions were transferred in 2011 to the Royal Society of Arts (RSA). Sir Andrew Foster, chair of the 2020 Commission on Public Services, advocated careful consideration of the options facing public services in the light of the publication of the government White Paper (HM Government, 2011) on their future organisation.The White Paper put forward five principles for modernising public services: • Choice: increasing choice wherever possible. • Decentralisation: decentralising control over public services to the lowest possible level, that is, wherever possible to individuals using the service. • Diversity: increasing the diversity of provision through expansion to a variety of competing providers in the public, voluntary and community and private sectors. • Fairness: ensuring fair access to public services. • Accountability: making public services accountable and responsive to users and taxpayers. In this climate and these circumstances the use of consultants becomes ever more attractive despite the challenges to it. At every stage, consultants are employed who bid against each other for successive contracts rather than engaging in long-term work in a particular field. 167

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Who are the consultants? The growth of consultancy has been largely in the independent and university sectors. Independent consultancies are often difficult to disentangle from academic institutions, since academics look to consultancy as an additional income or as a second career when they leave full-time academic employment. Another important source of consultants is the public, private and voluntary sector of employment in public services. Consultants from the public sector Consultants who come from the public sector differ significantly from ‘academic’ consultants in two main ways: • There is a manifest difference between their experiences of public services, the academics relating to these services from an external vantage point and public service employees being rooted directly in them. • There is scope for academics to undertake consultancy throughout their academic careers, whereas traditionally, full-time public service employees have waited until retirement before taking on consultancy work. Since the late 20th century, however, the trend towards public services being contracted by central and local government through independent – private and voluntary – providers has created a new workforce of independent professionals who make up their work from a portfolio of activities, including consultancy. There has been substantial growth in the number of public service workers, particularly long-serving managers, able to retire early. They do so with advantageous terms (perhaps due to a reorganisation), and their pension and lump sum, to become limited companies, with various tax benefits.They are then able to work as consultants, often returning to work for the very organisation they have left.This pattern is similar to the spectacular growth in recruitment agencies that provide ‘agency workers’ for the public sector. Universities It is increasingly likely that universities will expect academics to engage in consultancy. It is possible to dismiss this as a sacrilegious use of academic resources that should be devoted to activities deemed higher 168

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level, such as research. However unholy this may be to advocates of the traditional research role of universities, there is a convergence between the enterprise agenda of universities and consultancy activities, often referred to as ‘business engagement’. Students are increasingly taught ‘enterprise’ or ‘entrepreneurial skills’, even outside business departments and courses. For example, we have experience of students in the School of Health and Social Care at Teesside University being made aware of enterprise.This is increasingly relevant, since, in contrast with students of a generation ago, invariably working in NHS hospitals, nowadays many health professionals, such as nurses, physiotherapists and occupational therapists, work outside hospitals in community settings, or even in commerce and industry. Practitioners in health – like those in complementary medicine – are now more likely to become involved in a third sector or private business venture, perhaps as micro-employers of a group of complementary therapists, or as contractors providing an agency-based aspect of particular public services. In these ways, the provision of public services has become much more complex than it was a generation ago. Consultancy and enterprise in the universities The Sainsbury Review of the UK government’s science and innovation policies (Lord Sainsbury, 2007) proposed building on existing successes and strengthening the transfer of knowledge between the research base of universities and business, through an enhanced Higher Education Innovation Fund and doubling the number of knowledge transfer partnerships (KTPs) so as to boost links between research and business. Headline terms such as ‘knowledge transfer’ and ‘science and innovation’ have general currency in UK universities that since the 1980s have experienced a widespread expansion of their student numbers. At the same time, in line with trends in other countries, notably Australia (Bessant and Watts, 2007, p 372), there has been a commensurate decline of public funding, as the principle of ‘user pays’ – whether the user is the student or the ‘business’ client – has percolated through the system. Some courses are provided – for overseas students and for some postgraduate courses – on the basis that the client pays the full economic cost of provision. During the 1960s, higher education in the UK expanded rapidly. A university education shifted from being a minority experience to becoming an accepted route into employment for between a third and a half of the population. In the wake of this expansion, enterprise has developed rapidly since the 1980s as a distinctive area of activity in 169

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universities as a consequence of the motivation to innovate, undertake outreach work locally, regionally and nationally, and to expand sources of revenue, to the extent that the term the ‘enterprise university’ (Marginson and Considine, 2000) has become part of the mainstream discourse of UK universities. In the 21st century enterprise has become accepted alongside teaching and research as the third major role of universities. Universities have responded to the contract culture developed since the 1980s by developing their capacity to compete with each other in recruiting students and attracting research funding, and nowadays, in business engagement and social enterprise. However, the playing field for this competition, especially in research, is not level.To continue the sporting analogy, the premier league of universities – Oxford, Cambridge and a small number of closely allied provincial universities – tend to score most highly with the quality of their research and to continue to attract investment and further research funding in a self-fulfilling prophecy. The Russell Group of about 20 UK universities claimed to have received over £1.8 billion, 65 per cent of research money for 2004/05.The unique ‘pulling power’ of Oxbridge is illustrated by the fact that Microsoft Research Cambridge, set up in 1997, now employs 100 researchers, the Bill and Melinda Gates Foundation is investing in student sponsorships at Cambridge, and Microsoft is investing tens of millions of pounds in technology industries in the Cambridge area. To some extent, the gap between subject areas in universities of international research excellence that universities can use to enhance funding and staffing, and other teaching and outreach work is widening. Some newer universities in the UK, which were formerly colleges of higher education and polytechnics, attract no significant research funding and rely mainly for their income on students and outreach work. In the effort to expand recruitment, many universities have expanded their teaching bases, using a multi-campus approach. The development of multi-media communication technologies has made it possible to speak of ‘virtual enterprise’ as a contributor to developing the global campus, as increasingly universities, like other corporate organisations, measure themselves against international performance indicators.The virtual campus can be regarded as a way of making profit by expanding student numbers beyond the overcrowded classrooms of the existing university, or, with the quality of student learning in mind, creating a ‘new learning environment’ (Lewis and Whitlock, 2003, p 163) where e-learning is regarded as a new, well-resourced paradigm, and not simply as a peripheral alternative to the mainstream.

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The realities of being left outside prestigious sources of research funding have led many of the newer universities that are not in the premier league or the Russell Group to develop greater ambitions for their earnings from outreach work through enterprise. The term ‘entrepreneurial university’ has been used since the late 1990s (Clark, 1998), and Slaughter and Leslie (1999) have used the expression ‘academic capitalism’.What this amounts to, of course, is the wholesale importation into higher education of the discourse of business entrepreneurialism (Bok, 2004). Universities are powerful institutions, in that they represent a huge source of capital investment and student revenue, not just for themselves, but in the communities and regions in which they are located and are working (bearing in mind that some of their operations will be distant from the home campus). They are also political institutions that are aligned increasingly with industry, employers and stakeholders in these communities and regions. In the process of this shift, tensions arise between the notion of the competitive business and the academically independent institution; the business building organisation and the state building organisation; engagement in the application of knowledge and intellectual distance and autonomy; shaping of policies and being shaped by policies; and the developmental empowering of employer partners and authoritative distance from them. These are real tensions, but they can be managed. Two particular factors ease this process. First, there are groups of staff in the new universities whose backgrounds lie in non-academic jobs and non-traditional routes to higher education. They express significantly different values and commitments to those who have pursued the traditional routes to lecturing and research. Second, these and other staff in the new university sector have struggled to develop enterprise since the 1980s and have a good deal of experience of negotiating and ‘project managing’ the consultancy contracts that result from this. The foundations have been laid in ways described above for the new universities to make a significant contribution to outreach work with national, regional and local partners, through consultancy rather than research, through engagement in the process of empowerment rather than simply contracted research, and through democratic approaches rather than elitist ‘distanced’ contributions to knowledge.

Conclusion The pace and extent of change in public services is paralleled by changes in colleges and universities providing courses for students intending to 171

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work, or already working, in public services.There is a trend away from staff being trained and working in one post for life in public services, towards repeated retraining and career changes, as people continually ‘reinvent themselves’ to equip for new types of organisation and new job opportunities. The approach to consultancy that we advocate is rooted in the empowerment of the person – whether manager or practitioner in public services or a citizen receiving such services.This parallels the policy trend towards the personalisation of services, since it relies on measures being put in place that empower the person so that he or she is able to design, manage and deliver services to meet his or her own needs.The term that comes to mind in this individualised process is ‘micro-management’, a notion that is equivalent, perhaps, to the micro-market involving micro-employers and micro-employees.

Further reading Craig, D. (2005) Rip-off! The scandalous inside story of the management consulting money machine, London:The Original Book Company. [This book is a useful critical examination of the weaknesses of consultants, and in the last few pages, the author reveals a respect for good consultancy and discusses some ways forward.] Haynes, P. (2003) Managing complexity in the public services, Maidenhead: Open University Press. [A useful text, introducing the notions of management and complexity and examining how these relate to the performance of public services.] Seddon, J. (2008) Systems thinking in the public sector: The failure of the reform regime ... and a manifesto for a better way, Axminster:Triarchy Press. [An interesting analysis of public services, from the viewpoint that a systems approach is required in order to counteract the weaknesses of the market approach to public policy and practice.]

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Reflecting on perspectives on consultancy This chapter deals with the ideas and concepts associated with consultancy, exploring in more detail a variety of ideas that occurred to us while carrying out different consultancies about perspectives on, and approaches to, consultancy. Consultancy is, or should be, a continually reinvented concept, for each client. It is important that what the consultant does is tailored to meet the needs of each unique consultancy setting. In this sense, consultancy is a multifaceted concept that to an extent, chameleon-like, takes on the appearance of its surroundings. At the same time, consultants bring their distinctive contributions to the setting, which, after all, is the justification for paying for them in the first place. These statements encapsulate the tension between two different perspectives on consultancy – on the one hand, as ‘simply’ an additional contribution to the present functioning of the organisation and, on the other hand, as a critic, gadfly or catalyst for significant organisational change. There are probably as many perspectives on consultancy as there are consultants. While it is apparent that no single perspective on consultancy can do justice to the complexity and variety of the field of public services, what we can do is develop ideas about the values and principles that are common to a great many different approaches. We begin, tentatively perhaps, to develop some coherent ideas about the basis for practice, amplifying our reflections on the aspects of practice explored in Part 2. In the first section of this chapter we view public services consultancy from different theoretical perspectives, from which we may also view the host or client organisation – the appearance of consultancy changes according to one’s view, including one’s conceptual vantage point. In the second section we consider different ways of viewing consultancy. In the third section we explore different imagery arising from our reflections on consultancy, and in the fourth and final section we examine two different research strategies that we found invaluable in doing, and reflecting on, consultancy.

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Different perspectives on consultancy and the organisation Morgan (1986) develops the view that theories and perspectives regarding organisations are rooted in images or metaphors about them, and whether or not this is true we do set out in this chapter, first, a map of different theoretical viewpoints on organisations and, second, a range of images of them. In this section we deal with what are often called organisation theories, which, for the purposes of this book, we apply to the bodies, organisations and agencies concerned in developing, managing and delivering public services. We can view consultancy through the prism of the variety of theoretical perspectives on the organisation (Figure 8.1), and arrive at very different views of what consultancy entails.When we are working as consultants we often make assumptions about our particular perspective, and find when we are deep in discussion that somehow our differences over a particular matter refer back to ideas and assumptions each of us is taking. It is necessary at this point to divert from the immediate discussion and visit our implicit and taken-for-granted notions of – or theories and perspectives concerning – organisations in public services. There is no right and wrong about these matters, but these notes simply revisit our reference points when we have those debates. Figure 8.1: Different theoretical viewpoints on the organisation

Critical Postmodern

Conflict

Open systems

Human relations Closed systems

Scientific management: consultancy in the economically efficient organisation Frederick Winslow Taylor (1856–1915) is generally considered to be the founder of scientific management, which advocates the analysis 174

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of workflow and people’s roles as a prelude to placing people in the positions most advantageous to the requirements of the organisation. For decades in the first half and middle years of the 20th century, theorising and practice in business was dominated by the goal of arriving at the most practical, ‘scientific’ and economically efficient way of managing the business. Lean thinking and lean management may – or may not, depending on one’s own critical perspective – be viewed as reminiscent of scientific management, to refer to ways of managing and developing organisations, products and services that maximise efficiency and effectiveness and minimise costs, waste and environmental impact. The contribution of consultants, according to this view of public services, would be towards the promotion of the most productive way of managing the service, contributing in an extreme circumstance to the disempowerment and deskilling of the workforce. In this regard, the wishes and interests of workers are secondary to those of the service. Open systems: consultancy in the organisation as an organism The view of the organisation as an organism is an open systems perspective, set out in general terms by Bertalanffy (1956) and applied widely in the social sciences, including organisation theory. It can be applied readily to public services, since it provides a framework for mapping individual locations for service delivery in the wider context of local, regional, national and international groups, organisations and agencies. In other words, an open systems approach maps the organisation internally in terms of its subsystems of related functions, roles and relationships, and externally in terms of the other systems to which it relates and the broader systems of which it forms a subsystem. The function of the consultant is perceived as helping the organisation to relate and respond more effectively to its environment. Human relations: consultancy in the relational organisation The human relations movement, proselytised and applied in organisational management by Elton Mayo (1880–1949), and predominant in that field until the 1950s, spawned a huge mass of ‘human relations movement’ research and literature on individual, group-based and organisation-wide applications of the disciplines of social psychology and organisational sociology in particular, concerning improvements that could be made to the everyday life of the organisation. The deployment of consultants was prioritised in 175

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aspects to do with improving relations between different roles in the workforce. Conflict: consultancy in the fractured organisation Conflict-based sociological perspectives on society recognised the existence of a diversity of often competing and conflicting interests. Conflict theorists such as Coser and Dahrendorf, and Marxist theorists have, since the 1960s, been active in different aspects of the social sciences, both analysing and prescribing in relation to conflicting groups and interests in social institutions and organisations. Consultants may be recruited not just with a view to working in recognition of a plurality of interests, but also to taking on board conflicts between different groups. Whereas some commentators view conflict as fundamental and unavoidable in the sense that any collaboration between different groups merely represents a temporary truce, others view conflict as no less important but as superficial and temporary and, therefore remediable, leading to an extensive literature on conflict management (Borisoff and Victor, 1997). Postmodern: consultancy in the fragmented organisation Since the last quarter of the 20th century, postmodernist, poststructuralist and, linked with these, feminist perspectives have enriched our understanding of organisational realities (Hancock and Tyler, 2001). The notion of discourses as multifaceted routes to the construction of social realities has supplanted the positivist essentialism of scientific perspectives on the organisation in society. Consultancy occupies a somewhat fluid place in the postmodern organisation. There are less definite positions on which to base actions, since there is a widespread perception that there is no stable state; in fact, the stable state is viewed as somewhat mythical, or in any case, outdated. In such circumstances there are no fixed structures that determine the relations between consultants and assumed goals, or relations with clients.These are subject to the constant flux of changing constructions of organisational reality. Critical: empowering consultancy in the transforming organisation Within and around postmodern, poststructural, feminist and associated perspectives there are viewpoints rooted in critical social sciences. Non-rational factors are acknowledged as contributing to organisational cultures, shaped by a variety of differences and understood through 176

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various critical prisms, including feminism (Aaltio and Mills, 2002). Consultants engaging with organisations relate to the discourse that is dominant at a given time.They are part of the history of organisational change in society as a whole.They may be engaged by a particular group within, around or outside the organisation, as part of the struggle of a subordinate interest – trade unionists, women, people with disabilities, service users, patients. We could argue that consultants are like sailing craft which, if not steered by a sailor competent in the complexities of tacking, would simply blow with the prevailing wind. On the whole, it is difficult to resist doing this because of the nature of consultants’ contracts. Because they are hired by a client for the client’s purpose, they tend to reflect, rather than to lead. Yet often consultants are brought in because the organisation has a problem which – to continue the analogy – cannot be tackled by the existing crew. It is open for the consultants to suggest that a new direction needs to be taken; it is their task to convince management of this. In other words, the consultants may adopt the role of critics of the status quo and act as agents of change. This helps to explain the inherent complexities and problematic nature of the role of consultants. It also helps us to understand why their position may be somewhat ambiguous, their work somewhat stressful and their position somewhat insecure. The character of these different viewpoints on the organisation is differently shaped by each participant – staff, consultant and citizen-consultant. Consultants will recognise these different viewpoints from experience, even though the words they use to describe them may differ. Consultancy and the richness of different perspectives on organisations and services It is an illustration of the richness of reflection on different ways of conceptualising organisations that we can point to a shelf full of different books on this topic. As consultants, we draw constantly on different frameworks to help us to conceptualise the work we do with different agencies, organisations and groups creating, managing and delivering public services. Mintzberg (1989), for instance, distinguishes the five main organisational structures that he views as relatively successful as follows:

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• Entrepreneurial organisation – typically a small, perhaps recently formed, and probably rather non-hierarchical organisation, focused on the purposes set out by its founder who may still lead it. • Machine organisation – a rather formally managed bureaucratic organisation structured around its hierarchy and specialisation, reflecting its major functions. • Professional organisation – a similarly bureaucratic organisation to the machine organisation, differing, however, in the dominance in it of the professionals who contribute, and maintain control over, their own specialist work. • Divisional organisation – an organisation with a diversified structure based on the variety of different products and services it provides. • Innovative organisation – a creative organisational ‘adhocracy’ (that is, opposite to a bureaucracy) that is probably quite newly formed and has a ‘youthful’ culture, typically like those internet-based organisations which have sprung from the World Wide Web. Consultancy: need for a critical perspective Fincham (1999) discusses the role of consultants, their relationships with clients and their contribution to organisational change. He notes that from a critical perspective it is somewhat paradoxical that the relatively non-codified body of knowledge called consultancy is about to make such a significant contribution to organisational change. One explanation is that what consultants do is to persuade, and that, to this end, consultancy plays a symbolic part in the organisation, which gives it additional power. From a structural perspective, of course, the potential contribution of consultants as change agents is constrained by structural forces. We can, of course, look at this another way, and consider how citizen-consultants share with other minority or relatively powerless groups in public services the capacity to resist dominant perspectives, to challenge oppressive practices and to campaign for more inclusive services. Mechanistic and organic organisations: the learning organisation Burns and Stalker (1961) distinguish mechanistic from organic organisations. Mechanistic organisations are more suitable for stable conditions, with their more hierarchical management and greater control of staff. Organic organisations are less hierarchical, information and control are able to be decentralised and networking and communication in any direction are as important as communication 178

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through the hierarchy. A learning organisation displays many of the characteristics of the organic organisation. According to Gould and Baldwin (2004), the learning organisation is equipped for change. Learning organisation is the term used to refer to the kind of organisation where change is the norm and, ideally, staff throughout the organisation are constantly re-equipping themselves to cope with change. The notion of the learning organisation, conceived by Pedler and colleagues as enabling learning by all of its members and continuously transforming itself (Pedler et al, 1996, p  1), remains an ideal. Donald Schön (1973) maintains that instability rather than stability is the norm in the modern organisation, in which people should expect continuous change. In fact, this ability of staff to reinvent themselves, to reshape what they do and through this transform the organisation is a feature of organisations that survive and prosper. Silberman maintains that one particular advantage of learning organisations is their capacity to ‘increase the quality and speed of knowledge management’ (2001, p  20). Schön arrives at a similar conceptualisation to that of the learning organisation when he writes that organisations may become learning systems in order to transform themselves (Schön, 1973, pp 28-9). Adams (2008a, p 148) identifies six main features of the learning organisation: • change – staff are enabled to change their patterns and practice of working; • learning – staff are able to learn as well as work in the work environment; • exchange – staff are equipped with the appropriate knowledge and skills to enable change to take place individually, in groups and in the organisation as a whole; • innovation – staff are encouraged to innovate; • experiment – staff are supported in their experimental new ways of working; • risk taking – work promotes rather than discourages risk taking in the context of a ‘no blame’ culture in the workplace. A particularly distinctive feature of the learning organisation is an empowered staff. The culture of the learning organisation tends to be one where all those involved share common values and goals. In public services, various initiatives have been attempted since the late 1990s to promote a more participative culture, as far as managers, professionals and citizens are concerned. Kirby et al (2003a, 2003b) distinguish three types of participatory organisational cultures: consultation-, participation- and people-focused, to which Adams (2008a, pp 150179

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1) adds change-focused. In consultation-focused organisations, consulting citizens is routine and continuous. In participation-focused organisations, arrangements go beyond consulting people to involving them in making certain decisions, within certain specific boundaries. In people-focused organisations, the views of people are taken into account when decisions are made. In change-focused organisations, people’s views contribute significantly to decisions and to changes. While staff are a concentrated interest, as noted in Chapter One, service users and carers are a dispersed interest. This is in the sense that because staff work together on a day-to-day basis, they are able to develop a shared culture. In contrast, without special arrangements being made, service users have no opportunity to do this on a continuous basis. Wilkinson notes that in order for citizens to take part in public services, they need to feel confident enough to assert their views with local authority employees – managers and practitioners – and elected councillors (Wilkinson, 2004, p 24). In order to change the culture of public services, according to Adams (2008a, p 149), the following five components must be tackled: • values: the beliefs of people in the organisation about what they should and should not do; • norms: the generally accepted codes of practice in the organisation’s everyday work, governing such areas as procedures for paying expenses; • organisational systems for supporting people: human relations or personnel functions, from recruiting and inducting new staff through to communications strategies and arrangements for rewarding and paying people; • peer support: the formal and informal means by which staff relate to and support each other; • climate: the general atmosphere of the workplace, how friendly, relaxed or not it is.

Empowerment approach to consultancy in practice We are now in a position to explore the practice of an empowerment approach in more detail. If we examine the more procedural stages outlined in Chapters Two to Six, we perceive an embedded process which means moving from understanding public services, through identifying what needs doing, to transformative action. This is not necessarily a linear process, since it may involve looping back repeatedly and even jumping between these activities. Critical reflection may be 180

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followed by action, followed by further reflection, and so on. Bearing in mind this caution, we briefly consider what each of the three main activities involves: • Understanding public services: this means moving through the stages of gaining knowledge, raising awareness of key aspects and developing a critical awareness of the situation. It consists of shifting from critical thinking to critical consciousness, seeking an understanding of what is going on in and around the organisation, appreciating and interpreting below the surface (what sociologists refer to as going beyond the manifest to the latent functions). Another way of characterising this is probing beyond the symptoms of the problems, seeking the sources rather than the surface of the presenting problems. • Identifying what needs doing: in this second set of activities, we move from critical consciousness to critical analysis, in preparation for action. Identifying what needs doing requires some persistence, since we do not simply accept ‘facts’ and situations as these are presented to us, but delve beyond them. We seek evidence from different sources and either corroboration or conflicting evidence that perhaps suggests multiple views, perceptions and experiences of staff and citizens. It opens up the possibility of alternative interpretations of what is happening. We draw on critical theories to help us understand where power is situated in and around the organisation, whose definitions are dominant and what other, subordinate definitions exist, concerning what is happening. • Transformative action: in this third set of activities we move to critical practice. We have shifted from thinking critically to embodying our critical thoughts in action. This constitutes critical practice. Practice, therefore, is the embodiment of theory in action. Just as critical action embodies theory in practice, so embodiment means the integration of theory and practice. As consultants, from such a position we are able to empower staff and/or citizens to launch transformative initiatives, collaborations with those in the organisation and connected with it such as service users, patients, consumers, customers and members of the public. Our roles as consultants are potentially connective, between individuals and the organisation, between individuals and groups, between inside the organisation and outside it. Our position enables us to potentially 181

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connect public services in the locality with regional, national and global issues, such as environmental sustainability. We are able to use our own emotions and responses to our own biographies and experiences reflexively to develop our critical praxis. Participatory and empowering practice At the heart of empowering consultancy are the twin principles of participatory and empowering practice. These are distinct from each other, but they do overlap, since, as Ledwith and Springett (2010, p 37) observe, participatory activity entails a grasp of power. It is essential to participatory practice to understand, analyse and grapple with the structure of power in the organisation. The participatory nature of critical practice is reflexive and social – that is, it adopts a social perspective. By social, we mean providing frameworks of understanding that transcend individual and group ways of explaining reality, rooted in societal and other collective perspectives. The reflexivity of critical practice is sustained through the consultant maintaining openness and self-awareness in using reflections on personal emotions and experience to inform practice. Its sociality is sustained through the consultant engaging with the interaction between the personal and the social aspects of the situation. Example: Shortcomings in hospital services A management consultant was engaged by Westbrough Hospital (pseudonym), which was attempting to remedy shortcomings in services after a scandal in which patients died, and an independent inquiry report upheld criticisms of the culture of malpractice, as well as individual failures. After the inquiry report, the NHS trust was taking measures to deal with the outcomes as far as possible by avoiding confronting the problems, but adopting remedial measures rather than more radical measures to tackle the roots of the surface shortcomings. The consultant was faced with a choice, either to collude with the desire of some staff to avoid radical reform or to challenge this and confront the roots of bad practice. The consultant adopted the latter course and was engaging with the politics of change in the hospital. This transformative work meant: • working with patients’ groups to identify their proposals for action; • working with staff to develop plans to transform services. Throughout this process, change was slow. It emerged that the above agenda was not the end of a process so much as ‘the end of the beginning’. Any progress was somewhat uneven, requiring commitment by the consultant over a period

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Reflecting on perspectives on consultancy of years rather than months, provided, that is, that they were permitted to stay with the process.

What can we say in summary about this dynamic experience of empowerment in and through consultancy? It potentially means the empowerment of all people involved – whether staff or other citizens. It potentially involves enabling all participants in the process to become consultants and co-consultants, identifying people’s motivation, supports and capacity. These are key activities, reminiscent of work we have done which relies on the strengths-based approach advocated by Saleeby (2002). It means focusing on ‘how’ rather than ‘what’ tasks, in working through the consultancy. We have become aware that change can be engaged in by any citizens connected with the setting, starting anywhere in the network, regardless of formal power or position. For instance, change could be stimulated by service users, or a small group of junior carers in a residential care home, or an individual anywhere in an organisation with which we have been engaged in a particular consultancy project. Change may occur which is driven from the bottom up, initiated perhaps from outside the organisation rather than controlled by managers.This is the implication of engaging in consultancy that is capable of transforming the powerlessness that individuals commonly feel into empowered action together with colleagues and service users/clients. It may be an evolutionary process, which is gradual, with many barriers and hurdles to overcome. However, the staff and citizens involved may develop resources and progressively own more of the process as they proceed. They may develop ways of working that enable them to build frameworks to support change and to engineer further change. In other words, they may move from day-to-day, tactical practice to leadership roles and engagement in strategic work in and around the organisation.

Ways of viewing consultancy Analytic and action-based The distinction between analytic and action-based consultancy is well established in the literature. Analytic consultancy, in its extreme form, involves the consultant lifting the presenting problem off the client, taking it away and some time later presenting the client with the solution. Action-based consultancy, in its extreme form, consists of the consultant, in effect, joining the client’s organisation and working with members to explore, identify and tackle the issues.

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Consultancy in public services Table 8.1: Fact-driven and process-driven consultancy Fact-driven Consultant hired to solve a problem Foci are discrete, strategic, finite Outcomes matter ‘What’ questions are important

Process-driven Consultant hired to contribute to culture change Foci are complex, interactional, open-ended Process matters ‘How’ questions are important

Source: Developed from ideas in Czerniawska (2002, pp 96-7)

Outcome and process There are different ways of labelling this contrast between outcome and process orientations to consultancy. Czerniawska (2002, p 96) makes the distinction between fact- and process-driven consultancy (see Table 8.1). In more traditional fact-based consultancy, the consultant is hired to give the client the benefit of expertise, usually in the form of advice.The process-driven approach involves the consultant and client engaging in a process together – the contribution of the consultant is more on the basis of establishing how this takes place rather than specific outcomes the consultant gives to the client. In practice, it is probably more accurate to regard fact- and process-driven consultancy as extreme points on a continuum, where most consultancy takes the form of a mixture of the two approaches. The focus on problems that are discrete means using data to understand their implications, ‘something which might not be possible if the problem was particularly complex and open to a variety of ill-defined variables’ (Czerniawska, 2002, p 97). The focus on strategic or logistical problems arises ‘because the analytic model relies on data rather than softer issues such as the behaviour of people or the effectiveness of organizations’ (Czerniawska, 2002, pp  96-7). The focus on finite problems arises because the analytic approach ‘provides a snapshot of a particular situation, but it is less effective at addressing ongoing issues where the circumstances change almost daily’ (Czerniawska, 2002, pp 96-7). Further consideration of the consultancy process It is apparent from the above discussion that each of these orientations to consultancy – analytic and process – has its strengths and weaknesses. It is useful at this point to consider further the process orientation. As reflective consultants, we may use imagery as a way of conceptualising what often goes on and use illustrations to examine the different 184

Reflecting on perspectives on consultancy Table 8.2: Phases of consultancy and classical tragedy Five phases of consultancy Entry Diagnosis Implementation

Five phases of classical tragedy Exposition Development Crisis and peripeteia

Consolidation

Denouement

Ending – with evaluation

Catastrophe and exodus

What is entailed Introduction of main characters Unfolding drama – the problem Crisis originally a judgement and in Greek tragedy the point of maximum tension in the unfolding drama peripeteia or upset – reversal of fortune or fundamental shift in point of view Resolution – things get sorted or they come to a tragic close Catastrophe or downturn, unwinding and the exodus or moving on of all the characters

Source: Tabular representation of material presented in de Haan (2004, pp 1-48)

tensions and issues that arise in consultancy work. De Haan (2004) identifies five phases of consultancy and compares these to the classical phases of drama (see Table 8.2).

Using imagery to interpret consultancy in action Consultancy is a creative activity and it is vital that consultants use their creative capacity when reflecting on their practice and attempting to understand what is going on. We have spent time over the years generating a variety of images to refer to the different consultancy experiences we have had. As a way of introducing these, here is an example summarised from part of our discussion of the way a particular consultancy was going. Example We were in the middle of a consultancy. We left the meeting and sat in a cafe to consider what had gone on, before travelling for a couple of hours to our respective homes. We both felt as though we were being used, or rather exploited, by the clients. This was because beyond the formal justification they used for asking us to carry out the consultancy lay what we were becoming aware was the latent reason for our involvement. We began to exchange comments about our function as the equivalent of rubbish disposal or waste management in the organisation. We interpreted our consultancy at different levels: there was the formal task, but because we were temporary, and because the initiative we led generated such strong feelings among staff and provided a hook on which a number of other related longstanding issues could be hung, we would, in effect,

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Consultancy in public services be providing an outlet for these and a focus for people’s negative feelings which, when we left, would go with us.

The task, then, in interpreting consultancies in which we have engaged, is to review what we have actually done, rather than simply what is written in the contract, and ascertain what our key role actually is. Table 8.3: Images of consultancy Image Reform Drama Innovation Problem solving

Key role of consultant Change agent Actor Inventor Fixer

Therapy Cosmetic change Environmental protection Organisational functioning Production Management development Research Adult learning Empowerment

Symptom-reducer Window dresser Waste manager Technical expert Project manager Team facilitator Interpreter Mentor Consciousness raiser

Sometimes we worked as part of a team of several people and fulfilled many roles, but the question is, which one of these was the key role? We select here, from a list we are sure could be much longer, those that we encountered most frequently, we represent them diagrammatically (see Table 8.3), and afterwards briefly discuss each in turn. Reform: The imagery of reform rests in the notion of the consultant as the agent of change, bringing about opportunities in the organisation for individuals and groups to act differently and change direction, thereby having an impact on the way the organisation delivers products and services. We should bear in mind imagery commonly used in organisations with overtones of religious or moral campaigns, notably concerning the mission statement behind which all employees and others associated with the organisations are expected to line up. Myths associated with great figures, such as St Joan and St George who slew the dragon, remind us of the virtuoso roles played by some consultants as, figuratively speaking, dragon slayers. Some of these stories date back centuries, even to Medieval Britain, at the time of the Crusades a thousand years ago. 186

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Drama: The process of exposition, development, crisis and denouement may be acted out independently of any relevant issues concerning organisational or management development. It may be repeated indefinitely without any significant consequences for the organisation in terms of change.The consultant as actor is merely the lead representative here of the entire field of the creative arts, in which consultants may play roles as diverse as the arts themselves. They may simply enable people to express their feelings during a time of change, bringing sensitivity to the fore in settings where there is pressure towards action rather than reflection. Issues drawn out may cause other people to act out, but these may be only gestures, albeit dramatic, illusory and only created for the moment, showing no real commitment to change. Innovation: The inventor is the archetypal innovator, but there are many varieties of innovation and many levels at which it takes place. The central place the consultant occupies can bring together people and issues in a way an organisation has not been able to do, and allied to a fresh perspective, can bring about innovations previously regarded as inconceivable. Problem solving: The therapist is the most visible representative of problem solvers, but problem solving takes a great many forms and does not have to be associated with pathology in the organisation. Therapy: Not all problem solving is associated with positive imagery. In the therapy model, there are some similarities between what consultants and therapists do: • both are in the business of promoting change; • both have a focus on enabling the client (whether an individual, group or organisation) to become empowered and to make changes; • both are, to an extent, concerned with enabling the client to manage the pain of change, recognising in effect that significant change cannot take place without some discomfort at the very least; • both are outsiders inside a situation, engaged, yet exercising critical independence. Doctoring and pharmacy are linked activities that symbolise the treatment model, common in therapy, a process where the reliance is on a prescription, such as a pill, providing a quick-fix – symptom reduction rather than complete cure. The process commonly involves self-diagnosis and employing consultants, perhaps as therapists or 187

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perhaps simply as pharmacists, to produce a prescription and remedy for symptoms, but not a cure.The management have identified a problem and they approach the potential consultants with a prepared brief.This sets out the problem but is also specified in narrow, unambiguous terms. It allows no scope for any widening of the brief, once the contract is under way, should the consultants become aware of the necessity for this. The consultants are, whether they like it or not, manoeuvred into simply offering the prescription to suppress the symptoms in the here and now. Cosmetic change: Window dressers are the most obvious illustrations of people employed to bring about surface change, which does not significantly affect what happens in the organisation behind the window. Tokenism is a key concept associated with this. Management perceive the organisation as under threat and approach the consultants, who accept the seemingly straightforward brief.As the consultancy proceeds, the consultants begin to formulate their work plans. Difficulties emerge each time they propose some action which disturbs present working arrangements. Ultimately, the consultants conclude that the formal purpose of the consultancy may be significant results that change implications for the organisation, but the latent purpose from the vantage point of management is to reassure other people that something is being done, while ensuring, in effect, that nothing significant is being done and nothing changes. Environmental protection: Environmental issues are the contemporary manifestation of problems of sewage management that have preoccupied communities increasingly since the Industrial Revolution, when in Western countries people began living together in crowded urban settings. Sewage disposal is the symbolic activity associated with removing bad feelings in the organisation. It is the less acceptable face of pollution prevention and treatment, which nevertheless forms one important dimension of the present-day movement to improve the environment. In a key associated image, there is a blockage in the drains. This builds up, to the point where the consultants are called in to clear it. In a positive interpretation of this form of consultancy, clearing the blockage leads to a feeling of catharsis or relief when the blockage is cleared. However, in the example given near the start of this section, we began the consultancy by accepting the formal assumption proposed by the organisation’s project leader that we were there to facilitate major organisational change. Once the project leader had handed over to other staff, we became clear that our latent function lay closer to 188

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that of waste management. The organisation was large, national and complex. The problems associated with major change were legion. There were stakeholders in the organisation committed to change, to maintaining the status quo and to many positions in between. We witnessed cross-currents between these different stakeholder positions. We became aware of the tensions between change and maintenance in the organisation, but we also realised that government was pressurising them to change in the direction of the formal goals of our consultancy. Even in the most positive circumstances, blockages can continue to occur. The consultants may be called back repeatedly to clear them, without ever approaching the causes of the problems. Organisational functioning: Many aspects of the day-to-day functioning of the organisation require input from technical experts of one kind or another. Consultants often fulfil this role, in much the same way that we may go to a garage to have our car tuned or serviced.They are employed by the bureaucracy to carry out tasks, rather than to reflect critically on the context in which these arise. Production: Some issues connected with the processes of production benefit from a project management approach. A colleague volunteers time and experience, for example, as project manager for a charity researching the causes of, and treatments for, a life-threatening, degenerative disease. Project management is seen as a key part of the consultancy. An extreme of the project management approach is where the consultants are required at the outset to supply very detailed expositions of the process and anticipated products of the consultancy, on a month-by-month basis, on Gantt charts or Microsoft Project or similar software, only to find that the clients do not refer to these again. Management development: A consultant is well placed to act as the facilitator for an organisation whose staff require aspects of its management to be developed. Management development can take many forms, but lean thinking, Sigma Six approaches (these are particular techniques aiming to improve performance – see, for instance, www.sigmapro.co.uk) are widely popular for developing management and organisations. The Teesside Manufacturing Centre uses a refinement of such approaches using the CHI (Consensus, Homing- in and Implementation) principle to facilitate management awareness of change processes – gaining a consensus from management about what the organisation should achieve, homing in on the issues and blockages and then implementing changes throughout the initiative. 189

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Research: Consultancy is often used as the vehicle to provide some systematic feedback for the way the organisation delivers services and/or products.The general form taken by research is to go through the linked, often overlapping and yet distinct processes of identifying problems/ questions/tasks, data gathering, data analysis, feedback and evaluation. Research provides an air of mystique and academic rigour that can facilitate change, but equally can slow it down. Research often takes longer than many other forms of intervention or consultancy-driven activities, and is therefore more expensive, but may effect more lasting change or may become irrelevant if it takes too long as organisations, in the public services too, can change often. Adult learning: One model for consultancy in the organisation involves the consultant acting as tutor, focusing on staff training and development. The aim may be to provide individual staff and groups of staff with opportunities for personal and professional development, linked with organisational goals. This may be done in conjunction with the organisation’s own staff training programme and handed on to them once a new initiative is established.The typical process for this involves assessment, planning, implementation and evaluation. This process provides a longer-term solution, if properly developed and managed, as new staff come and go, and nowhere is that more apparent than in public services. However, just like research, this process is lengthy and more expensive than some roles, and may not be an option, especially when public services often work to annual targets and budgets. Empowerment: Consultancy may be envisaged as part of a process of empowering staff, patients and service users in a public services organisation. This is likely to involve the consultant in some form of awareness or consciousness raising. Awareness raising and some forms of collective social action in the organisation may be the aspiration, at any level, including the organisation as a whole. It may engage staff and citizens in an holistic process, working across boundaries between the different systems with which the organisation is engaged, taking into account the interaction between the organisation and the environment. The typical process of empowerment in consultancy identified earlier in this book (as headings of the chapters in Part 2) are negotiation, contracting, engaging, empowering and disengaging. To some people, this approach can really have a positive impact on the organisation’s long-term future but to many, as we have discovered, it equates to losing control and thus becomes threatening. 190

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General reflections on the relations between consultant and client What can we say in general about consultants and clients? Clearly it is difficult to envisage drawing general conclusions from the above concerning the likely patterns of interaction between them. However, we can speculate to a limited extent. The more successful the consultants are at facilitating change and enabling people to face up to associated painful issues, the less likely they are to receive the client’s thanks immediately. Successful consultants in managing organisational change are likely to be associated with the surfacing of painful issues, so subsequently this makes it less likely that the organisation will keep returning to the same consultant, contract after contract. The more involved the consultants become in the dynamics of life in the organisation, the more some staff regard them as a threat and act defensively. Equally, we could say that the more enlightened the management of an organisation is, the more they will research the consultant and their work in bringing change, and thus may opt for consultants who are effective, if painful, rather than ineffective and unchallenging.

Doing consultancy: action research and empowerment In Chapter Five, we referred to the research component of the process of consultancy. We set out here some of the reflections generated along the journey, not as a set of finished observations, but as a statement of work in progress. We use the imagery of the journey and relate to it by stating that when engaged in consultancy we occasionally need to take a close look at the features around us.This helps us to understand in detail what is happening. At other times, we need to move back and examine what people call ‘the bigger picture’.We take a broader, macro view of the distance (the strategic features), the middle ground (the intermediate or mezzo features) and sometimes the foreground (the close-up or micro features). Also, we are sometimes engaged fully in the journey and cannot spare time to stop to view the detail. However, the more we understand both – the particular features and the journey – the more likely our work is to be rewarding and enjoyable. There is a tension, therefore, in our consultancy between doing and reflecting. We are practice-based but we reflect critically on this practice as well. In what kinds of systematic reflection do we engage? Well, as researchers we recognise links between our consultancy 191

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practice and some of the research strategies and ideas which perhaps are more traditionally associated with universities. Two of the sets of research-based strategies and ideas are action research and grounded theory. They are both strategies and ideas, in the sense that they are concerned with particular ways of doing research and also with the ideas embedded in it, that is, the theories and perspectives. In relation to this book’s focus, a theory is a system or framework of ideas that provides the basis for understanding an aspect of mental, physical or social imagination or reality. This is not to suggest that our consultancy is really research, but we find the ideas and associated strategies help us in our attempts to understand and interpret our work as consultants. Action research Action and research are words that have been linked since the work of Lewin in the mid-20th century. Action research has been conceived variously, but in the context of empowerment consultancy we favour approaches that give more power to the participant subjects of the research rather than to external experts researching them. Action research is the term used to refer to an approach that combines research and action, by using the results from reflection on earlier actions to guide later ones, and in which the researchers engage in a spiral of planning, action, reflection, analysis and further actions which are changed in the light of the analysis. Thus, action research is a type of reflective practice. In many empowering consultancies, action research approaches are likely to be the preferred way of driving the consultancy forward. Grounded theory As consultants, we are concerned to discover what regularities of meaning are embedded in our practice, and we have been influenced by grounded theory in this respect.We would not go so far as to claim that we have generated a theory of an empowerment approach to consultancy, but we have encountered the ideas of Glaser and Strauss and have found them exciting at the time of discussing them in relation to our practice, so, even though we have not worked in any sense systematically and rigorously through the links between their work and our practice, we refer to them now. Glaser and Strauss (1967) argue that data arising from case studies or other qualitative illustrations of human activity may be used to generate and interpret grounded theory. They use the term grounded theory to refer to the outcomes, in terms of theories and theoretical perspectives, that can 192

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result from systematically gathering an amount of data, analysing and reflecting critically on this and using this process to generate theory. The approach we have adopted over the past two decades is somewhat opportunistic, in that we have relied on the consultancy business that has come our way at the university and that which we have generated. However, during this period we have gradually been able to accumulate it and arrive at the categories of the consultancy process that we have set out and followed in Chapters Two to Six. We have reached the point where we feel convinced that an empowerment approach or model to consultancy is not only possible, but practicable, given the present trajectory of government policy and the nature of current practice in organisations delivering public services.As for the connections between our reflections and a consideration of grounded theory in relation to an empowerment approach to consultancy, we can only say that this remains for us work in progress. Our thoughts are tentative, too preliminary for us to generate ways of articulating a theory of citizen consultancy. We do, however, spend a good deal of time reflecting and discussing it.

Conclusion We continue as consultants in the present with the journey we have been on for the past 25 years.This chapter has brought together some of the ideas which have surfaced for us as particularly relevant and helpful in understanding our practice. We believe that it is important for consultants to develop tools – strategies and ideas – which help them, and they will be different for each person. We have simply highlighted those that are stimulating and fruitful for us, keeping our practice alive and our minds and emotions engaged in the work we are doing. In this way it exercises our critical faculties and ensures we do not become stale.

Further reading Carson, K.A. (2008) Organization theory: A libertarian perspective, Charleston, SC: BookSurge (www.booksurge.com). [An encyclopaedic examination of different perspectives on organisations.] Gould, N. and Baldwin, M. (eds) (2004) Social work, critical reflection and the learning organization, Aldershot: Ashgate Books. [An up-to-date discussion of the literature on developing a learning organisation.]

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Kline, P. and Saunders, B. (1993) Ten steps to a learning organization (2nd edn), Salt Lake City, UT: Great River Books. [A practical guide to developing a learning organisation, with a major focus on developing a learning culture in the organisation.] Senge, P.M. et al (1994) The fifth discipline fieldbook: Strategies and tools for building a learning organization, London: Nicholas Brealey Publishing. [An imaginatively written handbook which, despite its great size, is well illustrated and easy to read and contains sections on important aspects such as developing team learning.]

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Doing consultancy and transforming public services This book has explored prospects for new approaches to empowering people in organising and delivering public services.The empowerment approach to consultancy is based on a critical view of contemporary organisations and management, and relies on a new prospect for the shape of public services and the way they are led and delivered in the 21st century. This chapter explores prospects for the further development of this approach. The focus of previous chapters has been on achieving significant change, and we use the term ‘transformation’ to refer to this.

The transformative agenda in public services The positive goal for the future of public services is to create modes of delivering them that empower the staff working in them as well as the citizens receiving them. Using the terminology of the economist, it is concerned with working on the challenging and complex goal of achieving the opposite of the four features of the ‘uneconomy’, which is unfair, unequal, unsustainable and making people unhappy. The case for innovative consultancy concerned with bringing about change is rooted in the notion of transformative activity, which is not only desirable, but necessarily rests on three linked ideas. 1. Change is endemic in society as a whole and in public services as an aspect of society. It is a permanent feature of society in which many major functions of government and the economy are becoming globalised. However, globalisation is not a universal and inevitable feature of all aspects of life. The typical young person with higher qualifications cannot expect to enter a profession in their early twenties and remain in a secure job until retirement. It is more likely that after a decade the half life of their degree will have expired and a fresh round of learning will be necessary (Lynch, 2001, p  60). Lynch describes this notion of ‘accelerated lifestyles and experiences’ as increasingly typical of the professions, since ‘the body of professional knowledge will be modified and changed as 195

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society changes, and as fresh and innovative demands are made of the profession’ (Lynch, 2001, p 61). Public bodies concerned with further and higher education must respond to these challenges, reflected in the changing nature of the educational requirements that students are expected to meet. Schools, colleges and universities, for instance, must engage with the community and change, through delivering existing courses, developing new ones and providing updated education and training for the workforce. Prominent among this provision should be education that relates to the changing needs of society, including, for instance, the development of social entrepreneurship in the changing public services. Change in public services is often talked about as though it is a relatively recent phenomenon. The reality is that for more than a generation, there have been significant changes – usually represented by reorganisations – in various aspects of public services. In the health service, for instance, there has been a succession of major reorganisations since the early 1970s – a period of almost half a century. A widespread myth has existed for many years in public services that the present wave of reorganisations is a departure from the norm. Donald Schön (1971) wrote in his book Beyond the stable state that we are mistaken to assume that as soon as the current wave of changes is over we can settle back into a stable state. In the public sector, as in the private sector, change is endemic. His argument is that stability is a myth, and it is false to assume that the organisation can be ‘controlled’ and governed in all details from the centre. Schön’s point chimes with the empowerment approach when he states that the key is to devolve power from the centre to the periphery, where the interface is between staff and citizens, ensuring thereby that services can be delivered more efficiently. This is also very much in keeping with the contemporary emphasis on personalising services. 2. The context in which public services are delivered is one of limited resources. 3. The Public Services (Social Value) Bill proposed by the Coalition government (in power from 2010 onwards) has set out an agenda for change that can be regarded critically in two ways: as too little or as too much.

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Areas of expertise required of transformative practitioners and consultants Similar qualities and skills are required of managers, professionals, patients, service users and associated citizens and consultants working on the transformative agenda for public services.These people should be equipped to carry forward four main areas of expertise: • with appropriate support and professional supervision, they can work in very stressful situations; • they can manage tensions between different approaches and outcomes, for which there is often no simple or complete resolution; • they can bring to bear on people’s problems a level of knowledge and understanding based on different disciplines, and ways of tackling them based on more than one social work approach; • they continually reflect self-critically on what they do and what they could do differently and better next time. Engaging citizens – the least powerful group – as change agents The challenging nature of the task of engaging citizens – such as service users, patients and carers – in bringing about changes in public services was acknowledged briefly in Chapter One. This is because of their position as relatively powerless customers of public services, when considering the powerful positions of policy makers, managers and professionals. However, some of the most dramatic and inspiring examples of relatively powerless people who have taken on the challenges of innovation in public services come from the growing literature on social entrepreneurship (Gunn and Durkin, 2010). Potential contribution of the university There is potential synergy between the university and groups, bodies and organisations in its local and regional communities in particular. The university, in these communities, provides enduring, self-sustaining initiatives. The community is able to capitalise on the university’s continuity and on the fact that there is continual synergy, or interchange, between the university and public service workforce in diverse settings, as well as businesses. The experience of local staff in these services then feeds into the teaching in the university and vice versa. There is also investment both ways. The following example illustrates how in

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some circumstances the community of the university may even extend beyond the UK. Example: Developing social work training and practice in Uzbekistan A team of university consultants had worked with UNICEF and government bodies and organisations in Uzbekistan over a period of several years, until 2011, when the university ceased to be involved. The goal of UNICEF and the government of Uzbekistan was to transform childcare institutions, by progressively developing alternatives in the community, whereby children in need could be placed with foster parents or relatives. Students acted out scenarios using learning materials developed during the project. This came about in response to the requirement that the practitioners who ran the institutions, as well as those who placed the children there, needed to be transformed in their approach.They had real situations to face, and various experiences of dealing with them. The idea of asking them to produce a video of the challenges they faced empowered them all to seek changes of their own making, in accord with their culture.This proved to be effective in enabling them to bring about changes themselves rather than the consultant directing them. This approach brought people together and enabled them to collectively develop strategies to deal with their problems and challenges. It involved working with the cultural grain of the country, building on the strengths of the Mahallahs (community organisations that usually dealt with the more practical, everyday problems of people’s lives).

The conceptual and theoretical themes introduced in Chapter Eight are now continued by looking at the wider context of ideas about change in society and in organisations.

Transforming organisations: innovation rather than adaptation The work of Gareth Morgan (1986, 1989, 1993) aimed to synthesise an understanding of theoretical perspectives on organisations with the task of stimulating change. Morgan (1986, 1989) wrote about the need to view the organisation through different lenses, in order to reframe problems and create the conditions for creative ways of tackling them. Morgan’s (1989) workbook on the theme of creative organisation theory illustrates the argument that innovative practice is necessary, based on reframing – generating different understandings of the situation. Goodman (1995) provides a different sort of change-based 198

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agenda, setting out the case for innovation rather than adaptation in his book on the creative management approach. He argues that while management has adapted to meet the challenges of new circumstances, what is needed is innovation based on a creative management response. While Goodman was writing predominantly about commercial organisations, because many services are commissioned and contracted through quasi-commercial processes, much of his message is still relevant to settings where public services are being delivered. Beyond rationality: complexity, change and the example of obliquity John Kay (2010) makes a similar case to Goodman for the complexity and chaos of change in the contemporary world requiring innovative and creative approaches to management. However, Kay argues for a response beyond the rationalism of the scientific approach and even beyond a simplistic reliance on intuition rather than rationality. According to Kay, problems may be tackled using obliquity in a similar fashion to the creative researcher, manager or practitioner: ‘Oblique problem solving relies on constant experiment’ (Kay, 2010, p 83). The approach of obliquity is beyond intuition, however. Kay, the exponent of obliquity, which he insists is not a contemporary invention but is based on ancient wisdom, maintains that obliquity is suited to the modern world,‘whenever complex systems evolve in an uncertain environment and whenever the effect of our actions depends on the ways in which others respond to them’ (2010, p 179).This attribution of complexity and uncertainty is one we would readily recognise across today’s public services in the UK. Kay (2010, p 179) maintains that the opposite of obliquity – directness – is only appropriate ‘when the environment is stable, and objectives are one-dimensional and transparent’, a situation which hardly ever corresponds to reality in public services such as criminal justice, education, health, housing, leisure, the police and social services. We can readily recognise in the public services Kay’s broader argument that in today’s world it hardly makes sense to try to use mechanistic or scientific management approaches to management – the machine analogy does not hold up. Modernist architecture has its limitations: ‘A house is not simply a machine for living in’ (Kay, 2010, p 5). Obliquity means identifying a core set of values that transcend profiting financially from customers; indeed, pursuing the visionary goal of the organisation may ironically lead to more profit being made than if profit was the sole goal. Kay provides examples to illustrate that some organisations that concentrate on the quality of their product rather 199

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than on the pursuit of profit may eventually make a profit, attaining an unrivalled market position. He cites Goodhart’s Law, ‘after the British economist who observed that as soon as governments adopted monetary targets the aggregates they targeted changed their meaning and significance’ (Kay, 2010, p 86). Kay argues that the complexity of many situations makes it difficult to understand them adequately, and therefore direct problem solving is impracticable. High-level objectives mean a multiplicity of goals, which in order to tackle their resources, must be decentralised (Kay, 2010, p 86). ‘The achievement of high-level objectives, intermediate goals and basic actions needs an oblique approach, based on interactions that value and make use of the parallel objectives, goals and actions of the individuals who are asked to contribute to their realisation’ (Kay, 2010, p 87). His point is that it is tempting, but mistaken, to draw conclusions about what is going on in complex settings. It may be more realistic and less risky, in some circumstances, to delegate so that the people who are best placed to use their expertise and creative energies are those closest to the problems, who have the deepest understanding and, therefore, have the best chance of making progress with them. Another way of viewing the situation is to contrast the direct decision maker – who ‘perceives a direct connection between intentions and outcomes’ (Kay, 2010, p 122) – with the oblique decision maker – who ‘believes that the intention is neither necessary nor sufficient to secure the outcome’ (Kay, 2010, p 122). According to Kay, problems may be tackled using obliquity in a similar fashion to the creative researcher, manager or practitioner: ‘Oblique problem solving relies on constant experiment’ (Kay, 2010, p 83). Whereas the direct decision maker assembles all the necessary information, ‘the oblique decision maker recognises the limits of his or her knowledge’ and ‘is continuously adaptive’ (Kay, 2010, p 122). Kay spells out the implications of this contrast: The direct problem solver can always find an explanation for his or her choices; the oblique problem solver sometimes just finds the right answer. The direct decision maker believes that order is the production of a directing mind; the oblique decision maker recognises that order often emerges spontaneously – no one fully grasps it. The direct problem solver insists on consistency, on always treating the same problem in the same way; the oblique problem solver never encounters exactly the same problem twice.The direct decision maker emphasises the importance of rationality of 200

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process; the oblique decision maker believes that decision making is inherently subjective and prefers to emphasise good judgement. (Kay, 2010, pp 122-3)

From technical and knowledge-based to imaginative culture Morosini (2010) proposes tackling local and global crises in organisations and businesses by raising the profile of imagination. He sets out case studies of the contributions made by people and organisations that have transformed their circumstances and the circumstances of others, and argues that ‘in order to create new and positive futures, they all engaged in a plurality of complex and large-scale initiatives that have in common the attainment of astonishing levels of innovation-fuelled growth’ (Morosini, 2010, p 223). Morosini’s writing is the inspiration for Table 9.1, which sets out three major organisational forms that have dominated Western countries from the early 20th to the 21st century. Table 9.1 represents the shift from the organisational form of scientific management as espoused by Frederick Taylor (1911) and illustrated in the mass production factories, for instance, of Henry Ford. During the latter years of the 20th century, there was a shift to the knowledge economy. In harmony with this, there was an increasing emphasis on the value to society of technological change. As new (‘e’) technologies became more embedded in society and in organisations, managerial and professional functions associated with these assumed core positions and were rewarded accordingly. In the 21st century, fears for the impact of industrial and other equivalent aspects of society led to a renewed preoccupation with more holistic and environmentally aware approaches to social policy and social institutions and organisations. Table 9.1: Major organisational forms from the early 20th to the 21st century Using people The mechanical economy Organisation as machine Taylorism Fordism

Scientific management

Teaching people The knowledge economy Organic organisation Valuing expertise

Empowering people The holistic, environmental economy Imaginative organisation Valuing imagination and new kinds of knowledge Education MBA (Master of Business  Administration) MFA (Master of Fine Arts) Technological management Creative management

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The knowledge economy was not necessarily replaced, but there was increased awareness of the value of imagination. The shift to the empowering, imaginative organisation was one reflection of this – valuing intuition in leadership rather than rationality alone. It was argued that an imaginative leader would have the capacity to empathise, that is, to get into other people’s minds and into their heads and to see the world as they see it. The imaginative leader would be able to empower people through listening to them and liberating their own imaginations. Often, the process may begin with a crisis, representing an opportunity to change, and by putting oneself in the minds and experiences of customers, service users and patients, the imaginative leader would be able to focus energy and stimulate change. This is, some might say, a challenging process that, because of its transformative potential, may represent dangers for the status quo. The following example views this contrast between the technical and the imaginative aspects of organisation, using a musical analogy. Example: Readers and ‘jazzers’ One way of managing the tension between mechanistic, organic and imaginative organisations is by bringing together the creative arts with the ‘science’ of running organisations. For instance, in balancing rule following and creative improvisation in bringing about change, as consultants we have worked with colleagues who are musicians – one group of colleagues in the academic area of management at Teesside University are also jazz musicians. They have developed convergent ideas about playing jazz and working in the organisation (Dennis and Macaulay, 2003, 2007).They distinguish between readers and ‘jazzers’. Readers, according to this argument, are jazz musicians who are competent with their own instrument but can only play the tune that is on the music set in front of them.They are not confident enough to stray from the musical score, as they fear that may spoil the whole sound of the band. They are conservative in many senses although they can be effective and play a tune that an audience appreciates. ‘Jazzers’, on the other hand, are just as capable with playing their own instrument (they may be inclined to play other instruments too), and can read music and play as readers. But they are more confident and adventurous and readily depart from the score without causing disharmony, adding to the depth and complexity of the overall sound, but still not losing the tune.They add richness through their innovation and add dimensions that the audience will appreciate as potentially unique in that one performance.

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The imaginative organisation ‘The imaginative organisation’ is a phrase used by Morosini.According to Morosini (2010), who draws partly on traditions of his native Peruvian society, there are seven keys to achieving an imaginative organisation: 1. Trade-on mindset.This is the opposite of trade-off. Economies of the fixed cake, that is, for gains there are losses; doing more with less; win-win situations. 2. Customer obsession. Empathising with the customer, saying the customer is the best asset is not necessarily acting this out in practice. Constrained by size of ego, so do it ego-less. 3. Purposeful mission. A masterful management of emotions. Embrace an image passionately and become a missionary for it. Use emotions to become creative. A new world opens up beyond the rationalist-dominated world. Morosini (2010, p 225) writes of the harmony – what he calls the emotional fit between the leaders’ goals and the mission of the organisation – as a necessary ingredient in the development of the organisation. 4. Wiraqocha leaders. Demonstrate five qualities: wholeness, tolerance, walking-the-talk, generosity and patience. 5. Tinunacuy relationships. An open and honest encounter, after rational and emotional preparation, in the acceptance that it may or may not work out. 6. Gentleman’s promises. These are commitments that must be fulfilled. The person promises to honour these with no reservations. 7. Common glue.The notion of alchemy, rooted in the belief in a secret tradition of primal wisdom handed down over centuries in many countries, expressed, for instance, in the psychiatrist Carl Jung’s dream about The Emerald Tablet in 1912. Morosini (2010, p 222) explains that The Emerald Tablet’s alchemical principles provide a suitable metaphor to describe how imaginative individuals and organisations go about creating radically new and positive futures for all of us.They are able to do this successfully by performing a sort of social alchemy both inside their teams and organisations and outside them. I call this kind of social alchemical process ‘the common glue’. Common glue (2010, pp 228-9) possesses holistic qualities, builds on a common language, exemplifies cross-boundary networks and uses significant patterns of communication, that is, communication rituals which are called rituals because ‘they symbolize important meanings that have the potential to emotionally engage participants and stimulate 203

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positive responses from them in support of their common mission’ (2010, p  234). Additionally, common glue possesses the quality of a hologram, that is, in any part of the organisation the overall character of the organisation’s values and purpose shines through, is illuminated and discerned.

A value-driven future It is no coincidence, perhaps, that Morosini, a social worker in Peru, puts values at the centre of his ideas for change (2010, p  239). He suggests alternative futures, one driven by people’s individual, selfish goals and the other by the wish to benefit other people.This amounts to highlighting the tension between the profit and social benefit motives for the innovative efforts people make. The essential point is that the empowerment approach to consultancy should be value-based, that is, based on values expressed in principles of social betterment. These principles include: • benefiting people equally, regardless of their resources and power; • setting out to include socially excluded and seldom heard individuals and groups; • basing actions on the experiences of customers, clients, patients, service users and carers in the public services. Example:Three cups of tea One of the most startling and impressive illustrations of a value-driven approach to transformative change is to be found in the work of Greg Mortenson, which continues as this book is being written and published. Mortensen writes movingly and dramatically (Mortenson and Relin, 2006) of his physical and conceptual journey through life-threatening situations in Pakistan and Afghanistan, to found schools for girls. He does this by using his intuition and relying not on professionals but on his own openness and transparency to make links with indigenous people, regardless of their reputations and, in some cases, social exclusion. The decision to negotiate in those male-dominated societies where schooling for girls, on the whole, is not socially approved, for the building of girls’ schools has proved to be challenging yet ultimately symbolic of other changes which become possible once girls and women are empowered through schooling. Mortenson’s achievements have to be read – on the internet and in his books – for their dramatic transformative potential to be appreciated. They have implications for the entire territory of consultancy in public services about which we have written in this book.

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A further example of a value-driven initiative is provided by Bazalgette (personal communication), who has worked with schools and other organisations in the UK and abroad. He and colleagues (Bazalgette et al, 2006) write of acting in a consultant capacity, and have worked with three schools to enable the headteachers to empower pupils and teachers and to transform the schools.

Transforming organisations There are many different approaches to achieving organisational change and, in the process, to conceiving the organisation. Citizen involvement, participation, engagement and empowerment Whereas in the business organisation the workforce is the primary focus, the public service sector embraces the customer, client, patient, service user and carer. This creates a much larger, more complex and, potentially, richer setting for development. But there will continue to be tensions, and possibly dilemmas, in the process of implementing schemes of citizen involvement. For instance, in 2011, the British Medical Association (BMA) called for the NHS Choices feedback services on the internet (where people can post praise or criticism about their experience of health services) to be scrapped because they were unrepresentative. Out of nearly 30,000 comments posted since the service began in 2009, moderators deleted 2,000 as being defamatory, abusive or racist. The contribution of strong and effective social connections The public service organisation is not a closed system, but exists in relation to other organisations in the public, private, voluntary and informal sectors.We now look at how these ideas fit with present-day policies on developing and delivering public services in the UK. Government initiatives in delivering public services We argue in this section that the empowerment approach to consultancy proposed in this book is more consistent with a citizen-centred approach than with a citizen-led approach to the delivery of public services. In order to explain this, we situate the empowerment approach in its policy context.

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Since the 1990s, the devolved governments of the four countries in the UK – Wales, Scotland, Northern Ireland and England – have become increasingly committed to stimulating contributions to public services by independent – that is, voluntary, private and service user-led – groups and organisations. In the sense that public services serve society as a whole, the community of service users, patients and carers potentially extends to all citizens. While the present-day trajectory of public services is towards more personalised services, there are different ways of pursuing this goal.We now look at two particular models in greater detail, to highlight some of the implications of different models of implementation. Different models of public service delivery Major changes are occurring in the early 21st century in many aspects of public services. Here is one fruitful area for discussion on consultancy – the NHS. In 2010, the Coalition government published a White Paper (DH, 2010) containing recommendations for reducing bureaucracy by up to 40 per cent through abolishing PCTs and SHAs and devolving key decisions on patients’ treatment to GPs, thereby bringing services close to patients through enhanced control and choice, and through patients and doctors working more closely together. Clearly, however, at this early stage no final judgements are possible about the likely impact of these changes on the quality of health services and the health and well-being of people.There are risks, on the one hand, that markets for the delivery of health services will suffer the weaknesses of competition and fragmentation. On the other hand, according to the Coalition government, there are opportunities for genuine savings of up to £20 billion through efficiency savings over the four years from 2010 to 2014, and better delivery than hitherto from more joined-up services in the Health and Social Care Act 2012. The direction of travel of government policy on the delivery of public services in England and Wales provides a clear illustration of the contrasts between customer-focused and citizen-centred approaches. England: customer-focused choice The English model of public services – referred to here as the ‘customer’ model – refers to ‘user-focused’ public services (House of Commons, 2005, p 3), and emphasises the ability of the customer to exercise choice. The use of the terms ‘customer’ and ‘choice’ is significant. Critics of 206

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the English model (Beecham, 2006, p 5) argue that it relies on ‘exit’, that is, the consumer demonstrating choice by refusing one service and taking another.This model can only work if three conditions hold: • if people who use services have access to a realistic and appropriate range of alternative services; • if people have sufficient information on which to base a choice; • if people are confident and assertive enough – in other words, empowered – to insist on their preferences being honoured by service providers. Wales: citizen-led leadership The Citizen-led Leadership Programme in Wales (The Improvement Consultancy, 2006) is the main outcome of the review of local service delivery in Wales chaired by Sir Jeremy Beecham. His report on citizen-centred local services for Wales (Beecham, 2006) has provided the main stimulus for the subsequent Making the Connections programme to implement citizen-centred local services, referred to here as the ‘citizen-centred’ model. It rests on four principles: • • • •

putting citizens in the centre; promoting equality and social justice; working together between providers of public services; achieving value for money, that is, making the most of resources.

The Improvement Consultancy proposes the Citizen-centred Leadership Programme, a management development programme for public services that aims to enable managers to develop their capacity and to improve services. The ‘outside-in’ approach builds on the idea that managers should manage the organisation and think about it from the outside in, and it draws on experience developed in the Institute of Citizen-centred Service, Canada. Service improvement is based on lean thinking – processes that improve services designed and managed around what citizens require and need (for more on lean thinking, see Chapter Eight). Policy initiatives are not driven solely by impersonal forces, but by people. The strength of Morosini (2010, p 56) lies in his capacity to envision the qualities of both individuals and organisations in their relative contributions to the development of successful businesses.The limitation of this vision, perhaps, is its focus on growth as a partner to innovation. The experience of periods of economic retrenchment exemplified in the global recession of 2007 onwards is a salutary 207

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reminder that even in times of budget cuts, public services need to maintain their concern with delivering quality to consumers, clients, patients and service users.

Changing the culture of public services organisations Beecham (2006, p 5) identifies four particular challenges for public services organisations of the move to a citizen-centred model for delivering services: • ensuring that the citizen’s interests are put before those of the service provider; • weakening the boundaries between different departments, so that citizens are placed in the centre of seamlessly supplied services; • learning from the strength of the customer model, which is that it pushes service providers to respond to what consumers demand; • gaining from the strength of the citizen-centred model, which is not restricted to a view of consumers choosing between service providers but raises the option of different forms of choice, personalised services and service users influencing the nature of provision. Beecham (2006, p 6) argues that the citizen-centred model is superior to the customer model in that it acknowledges the rights and responsibilities both of service providers and citizens, and engages citizens in debates about the tensions between public investment and constrained budgets in particular services.We can see that this approach advocated by Beecham opens up the possibility of the citizen who is seldom heard being listened to regardless of the individual’s ability to articulate needs. It also increases the potential for citizens to appreciate the tension between their individual needs and the collective needs of people in society to be met. We can see that citizen-centred services provide the potential for empowered people to develop a more sophisticated and long-term relationship with service providers, thereby increasing the likelihood of complex needs of particular people being met in an holistic fashion. Casualised organisation The workforce of the organisation delivering public services – archetypally the local authority – has traditionally been recruited for a ‘job for life’, with a lower wage or salary than equivalent positions in the private sector, the compensation being in having secure employment 208

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and an advantageous final salary, index-linked pension.There is a shift in the public services workforce, from being a permanent, fully employed workforce to a significant proportion being employed as temporary, perhaps agency-supplied, staff. This applies not only to professionals, including staff working with clients – customers, patients, service users, carers and other members of the public – but also to managers and administrative staff. Some of these staff, particularly those in senior managerial and also in professional positions, work in consultancy roles. One way to view practitioner nurses and social workers, for instance, supplied by agencies to NHS trusts and local authorities, is as quasi-consultants or ‘mini-consultants’. Agency staff offer the employing organisation some benefits in the short term, in that they carry none of the on-costs of permanent employees. A permanent employee would be recruited through a relatively expensive process of advertising and selection, whereas the agency worker would be supplied on a short-term, or perhaps emergency, basis, as part of a contract between the employing organisation and the agency. The permanent employee would undergo induction training and staff development that would accumulate costs throughout the person’s career. Sick pay, parenting and holiday entitlements would be taken. Pension contributions would be paid by the employer and employee. From the viewpoint of the agency worker, the hourly or monthly rate of pay may be higher than that of permanent staff, but on the other hand, pension, sick and holiday entitlements are met by the worker and not through employer contributions. Critics of the casualisation of the workforce maintain that it leads to an impoverished organisation, with an erosion of the collective knowledge and experience of staff. Corporate memory and corporate expertise tend to decline, and potentially a less highly trained and experienced workforce delivers less reliable and joined-up services. Reorganisation: physical changes rather than cultural organisational change The quickening pace of change in society over the past half century has been matched by the increasing frequency of reorganisations within many public service organisations, notably local authorities and the NHS. Senior managers may stamp their personality on the organisation by conducting a reorganisation. The following example illustrates this landscape of perpetual and accelerating reorganisation from the vantage point of a consultant in public services. 209

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Example: The experience of a public services consultant Here is an account written by a consultant: Sadly in long experience of work with local authorities one tends to see two patterns. Firstly an inclination to follow emerging patterns of practice elsewhere – if so-and-so is doing it, it must be good – with seemingly little evidence of the benefits of these approaches. Indeed many of these ‘fashionable’ changes cannot have created any significant evidence as the changes are so short term. The second trend that is highly used is that of the reorganisation. Accordingly, having seen enough new Directors over the years, I was confident to ask if a new Director was going to follow this trend. The reply was a negative one, but sure enough, some months later, a ‘new’ strategy was devised, largely by the Director, and staff became embroiled in all the fears associated with applying for their jobs again, possibly under new titles in different offices or teams. This process can often take months, and yet at the end of it all, most staff have emerged doing the same type of work with the same resources, but having been somewhat set back by the weeks of uncertainty. This consultant concludes: In this context there is a highly relevant alleged quote from Gaius Petronius Arbiter 210 bc: ‘We trained hard, but it seemed that every time we were beginning to form up into teams, we would be reorganized. I was to learn later in life that we tend to meet any new situation by reorganizing; and a wonderful method it can be for creating the illusion of progress while producing confusion, inefficiency, and demoralization.’ The sentiments and logic it expresses have made the quote highly popular even if no original source can be found.

The physical changes brought about by such a reorganisation may not be matched by the achievement of significant change in the culture of the organisation and in the way it operates. In contrast, what is required is for the organisation delivering services to change its own culture and working practices. Central to this, the organisation needs to invest in, and support, its staff. Investing organisation The investing organisation: • is imaginative; • is committed to long-term not short-term workforce development; • ‘plants’ and ‘feeds the soil’ of the organisation, that is, invests in staff; 210

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• is sustainable and where possible, self-sustaining; • offers staff space to develop and to be consultants within the space of their own work; • ‘welds’ training and staff development into the workforce; • provides blended staff development, that is, training in part from outside the organisation and in part through mentoring arrangements inside the organisation; • develops a culture where staff are empowered, rather than mere bureaucrats, hanging on to a job for life with no ambition to have an impact and with no commitment to thinking and acting creatively and innovatively. Culture of change and innovation Governments and local politicians may be committed to change, but this requires that managers, professionals and other staff delivering public services are able to deliver changes as part of their commitment to quality. Sustainable services and products In the 21st century, many services and products are moving towards becoming more sustainable and self-sustaining.A close comparison is in agriculture and social development, where in developing and developed countries alike there are increasingly apparent debates about the need to equate contemporary approaches to developing services to meet people’s needs in ways that do not simply consume existing resources but show awareness of their finite nature and are environmentally sensitive. A limited-scale example of such work is on p 141. Adopting the long-term view Sustainable goals are part of a long-term view. It is important to build into organisations delivering public services the capacity and motivation to act strategically. Embedding workers’ and others’ participation in an empowered organisation The embedding process is concerned with deepening participants’ sense of ownership of the process of development.The Social Work Taskforce Report (2009, p 60) refers to a healthy workplace as embodying ‘open 211

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communication systems, low levels of sickness, proactive approach to health and safety issues, good staff retention levels and effective supervision and line management support’, and argues that this workplace is likely to improve when staff feel empowered and have some ownership or feeling of influence in their organisation. In the business sector, many different approaches exist to shared ownership. Some large companies give their employees shares, which, however small the holding, not only gives them a stake and sense of ownership, in however token a fashion, but also allows them to actually vote on the future of the company.

Social entrepreneurs and social enterprise Social entrepreneurship in one sense has only surfaced in discourse about social policy since the beginning of the 21st century, but in another sense, as Gunn and Durkin (2010) illustrate, it was embedded in the notions of enterprise promoted by the Thatcher government in the UK from the early 1980s. Elkington and Hartigan (2008) explore the successes of social entrepreneurs. Nilekani (2008) analyses what is at the heart of India’s remarkable political, social and economic transformation. Thaler and Sunstein (2008) offer a prescription for change that rests on the notion of making small, lateral thinking-type decisions or changes, or ‘nudges’. Social enterprises grew from the UK Labour government’s (1997-2010) continuing promotion of enterprise and the business economy, under Labour’s banner of social entrepreneurship. It is debatable whether this represented a continuing contraction of the state, or a change in the direction of social policy accompanied by a revitalisation of public services provided by the state. Social entrepreneurs are innovators in the fields of social and environmental policy and practice, and the more enterprising among them tend to regard institutionalised structures for corporate governance as restrictive and unnecessary (Cornforth, 2003). Social entrepreneurs are the individual counterparts to organisations identified as social enterprises, which by and large exclude sole traders, and they vary widely. They include development trusts, cooperatives, social firms and leisure trusts, arts-based associations and theatres, health organisations, communications and media organisations, social care training, community enterprises and housing associations. By 2004, there were more than 15,000 social enterprises in the UK, and in 2006 this total had increased to more than 55,000. The UK government defines social enterprises as ‘businesses with primarily 212

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social objectives whose surpluses are principally reinvested for that purpose in the business or in the community, rather than being driven by the need to maximise profit for shareholders and owners’ (http://socialenterprise.org.uk/pages/about-social-enterprise.html). The objectives motivating social enterprises are primarily social and environmental. Social enterprises may contribute to one or more of the following: reducing social exclusion, tackling unemployment, strengthening training and service provision, expanding community activities or increasing community cohesion. Because of the way they were set up, many social enterprises are run more democratically than many traditional organisations contributing to public services. Teasdale (2010, p  92) distinguishes two major tensions inherent in social enterprises, however: between the focus on individuals getting the job done and the commitment to democratic and collective organisation. He also distinguishes between four main types of social enterprise (Teasdale, 2010, p  92): community businesses, such as workers’ cooperatives; community enterprises, such as local community development organisations; non-profit enterprises, such as voluntary organisations in the third sector delivering public services on behalf of the state; and social businesses that, like The Big Issue, are economically viable businesses with a social purpose. He identifies four ways in which the major types of social enterprise have a significant impact.They are: • • • •

people-focused: generating bonding social capital; money-focused: creating employment; collective-focused: developing bridging social capital; individual-focused: delivering services.

Social enterprise contributes to the broad array of public services and, however we categorise them, it is important to recognise that change may be stimulated in different ways, according to our focus. It may begin with the individual – the champion, the positive deviant unlikely innovator, as perceived by Pascale et al (2010); or it may arise from systemic changes – as the service commissioner or provider becomes a learning organisation (Silberman, 2001). Sustaining change However we categorise initiatives, it is vital that the outcomes of the work of the consultant are sustainable and sustained. In this regard, citizens receiving public services have less of a voice and occupy a more vulnerable position than that of managers and practitioners.The 213

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consultants may have no control over this aspect of their contribution. There is a tension between producing a short-term solution for the client and taking greater care and time to produce a longer-term transformation which not only has a mechanism by which the process can be sustained, but also creates a desire for the clients and citizens to sustain the process.

Conclusion For reasons stated in the final paragraph below, this is very much a conclusion without an ending. The 21st century sees policy makers, politicians, managers, professionals and citizens struggling with the questions of how far it is possible, or even desirable, to sustain public services in a time of diminishing capacity, or motivation, by the state to finance them. Consultants working in these settings are bound to become enmeshed in these debates and cannot, therefore, detach their practice from the politics of public service provision. Whatever their political persuasion, consultants working with the public services are, or should be, value-led, and to a significant extent, brave practitioners. This book has argued that the most important principle of practice should be to follow the experience and wishes of citizens receiving public services. Too often, perhaps, consultants follow the money, and hence the received wisdom and status quo-bound thinking of their clients.To some extent this is inevitable since the starting point for most consultancy will be the wish of the client to achieve a result, which for one reason or another necessitates going outside the workforce to a consultant and, of course, fundamentally, the person who pays the piper calls the tune. However, consultants should be able to manage the tension between the aspirations of clients and the present reality, or between rule following and maintenance on the one hand, and ground-breaking creativity on the other. They should be prepared to bring new perspectives to bear and apply critical thinking to their brief. Rather than developing this expertise and holding it to themselves, they should seek out citizens’ views and experiences and engage them as co-consultants as early as possible, retaining them throughout the entire process of the consultancy. We have journeyed in this book through the process of consultancy and, in this last part, through further reflections on the contexts and perspectives we have encountered in our work as consultants. We are aware that this is neither a definitive statement of what consultancy in the public services entails, nor is it final, in the sense of reaching a firm conclusion. Just as each chapter is a ‘work in progress’, so this 214

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last chapter by its nature remains unfinished. This is in the sense that consultancy will continue to change as the public services themselves undergo further transformation.The suggestions for further reading in this final chapter reflect our awareness of this incompleteness and for the need to reflect further and even more self-critically on the nature and contribution of consultancy in these uncertain and problematic circumstances.

Further reading Barclay, J. (2006) Is it a good idea? A guide for charities considering new social enterprise activity, London: Cass Business School. [Helpful advice on developing social enterprises.] Bazalgette, J., Reed, B., Kehoe, I. and Reed, J. (2006) Leading schools from failure to success: How three Christian headteachers transformed church schools, Cambridge: UIT, Cambridge Ltd. [A practical record of working with the entire school community, including professionals and pupils, to change the running of those schools in significant ways.] de Haan, E. (2004) The consulting process as drama: Learning from King Lear, London: Karnac Books. [A thought-provoking and original take on consultancy.] Elkington, J. and Hartigan, P. (2008) The power of unreasonable people: How social entrepreneurs create markets that change the world, Boston, MA: Harvard Business School Press. [An analysis of where financial opportunities for social entrepreneurial activity may be found and where those unreasonable people who are the potential or actual social entrepreneurs may be located as well.] Mawson, A. (2008) The social entrepreneur: Making communities work, London: Atlantic Books. [A useful source of material, putting the positive case for social enterprise.] Morgan, G. (2006) Images of organization, London: Sage Publications. [This updated edition of a book first published in 1986 contains a rich array of perspectives and reflections on organisations that help to provide routes for the consultant out of accepting other people’s day-to-day viewpoints.] Price, M. (2008) Social enterprise: What it is and why it matters, Cardiff: Fflan Ltd. [A short book putting the case straightforwardly for understanding social enterprise and promoting enterprising activities in the third sector.]

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Sand, M.A. (2005) How to manage an effective nonprofit organization, Franklin Lakes, NJ. [A US-based practical handbook on the main tasks facing a person setting up what in the UK we would call a third sector organisation.] Teasdale, S. (2010) ‘How can social enterprise address disadvantage? Evidence from an inner city community’, Journal of Nonprofit and Public Sector Marketing, vol 22, pp 89-107. [An article evaluating the impact of social enterprise on disadvantage, concluding that different forms of social enterprise affect social exclusion in different ways.]

Website resources Office of the Third Sector (Cabinet Office), a section of the UKbased government website that deals with social enterprise: www. cabinetoffice.gov.uk/third_sector/social_enterprise The School for Social Entrepreneurs provides training for people who are intending to work for, or already working in, the field of social enterprise: www.sse.org.uk Social Enterprise Training and Support, a resource providing information, training, publications and support concerning social enterprise: www.setas.co.uk For a global community aiming to promote social innovation, see: www.socialinnovationexchange.org/ A website for people interested in social entrepreneurship: www. seforum.sg/

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Appendix 1 Glossary of terms associated with consultancy Action research  An approach that combines research and action, by using the results from reflection on earlier actions to guide later ones, and in which the researchers engage in a spiral of planning, action, reflection, analysis and further actions that are changed in the light of the analysis. Baselining  The process of establishing the values of various measures at the beginning of a study for later comparison. Citizen-consultant  A person with the dual identity of consultant and citizen, who works on the basis of collaboration and equality with other consultants. Consultancy  The activity of providing specialist, expert or professional advice, help or support. Contingency fees   Fees paid only when specified conditions have been met by contractors, including the consultant. Contract  A verbal or written, formal or informal agreement between the parties to the consultancy about the aims of the consultancy, the work to be undertaken by the consultant, any anticipated contributions by the client and the anticipated outcomes from the consultancy. Creativity  The generation of original ideas or the use of the imagination in order to produce something. Dilemma  An unresolved and unresolvable problem or choice, between two outcomes, each of which is equally undesirable and equally unable to ‘solve’ the problem or resolve the choice. Direct payments  Payments made in cash to people to enable them to buy and manage their own care. Disengagement  The process of withdrawal by the consultant. Engagement  The early stage in the process of involvement in public services where citizens and workers begin to interact significantly. Evaluation  The process and the products of reflecting on, and making judgements about, what has gone well, what has gone less well and what can be learned from these. Governance  Structures and arrangements for running public services.

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Grounded theory  The outcomes, in terms of theories and theoretical perspectives, that can result from systematically gathering an amount of data, analysing and reflecting critically on this and using this process to generate theory. Ideology  A way of thinking and perceiving that is often based on beliefs, assumptions and principles of a moral or political nature. Involvement  The full range of ways in which citizens and staff may take part in designing, managing and delivering public services, from minimal consultation with members of the public through to them taking control of the process. Lean thinking  An improvement approach to improve flow and eliminate waste, developed by Toyota, concerned with getting the right things to the right place, at the right time, in the right quantities, while minimising waste and being flexible and open to change. Learning organisation  An organisation where change is the norm and, ideally, staff throughout the organisation are constantly re-equipping themselves to cope with change. Nudge, the  A toolkit, approach or prompt for giving a situation a push in a desired direction and achieving modest progress. Outsourcing   Putting out work to contractors, including consultants, formerly carried out by the organisation. Participation   Situations where citizens play a significant part as active contributors to decision making in policy and practice. Partnership  A set of relationships involving collaboration between two or more organisations or bodies or groups with shared interests and aims. Personalisation  Policies and practices concerned with giving the individual more choice and control over the design and delivery of the services to meet their needs. Person-centred planning  The process of developing an holistic approach to making a lifelong plan to meet the needs of adults who are vulnerable or experiencing conditions such as impairments or complex, multiple problems. Pro bono work  Work carried out for no financial or equivalent payment. Reflexivity  A term used to refer to bringing one’s own experience, emotions, assumptions and values to bear on the process of understanding and interpreting what is happening. Retainer  A regular or one-off fee paid by a client to retain the consultant’s services. Reticulist  A person committed to achieving change through their skills in crossing organisational and professional boundaries, 226

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strengthening existing networks and forming new networks with individuals and groups. Social  Social ways of understanding are frameworks of understanding that transcend individual and group ways of explaining reality, rooted in societal and other collective perspectives. Team  A group of workers who occupy the same office/s, work in the same geographical area, share significant values and working practices and carry out work with a similar group of service users, patients, customers or citizens. Theory  A system or framework of ideas which provides the basis for understanding an aspect of mental, physical or social imagination or reality.

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Appendix 2 List of abbreviations APSE CCT CQC CMR CPA CRB EOI EPAS EU FTSE GP GPCC HAZ IBC ICS IMC ISA ISO IT ITT KTP LINks MCA NVQ OGC PCT PQQ PVI QCF RSA SI SRB UNICEF

Association for Public Service Excellence compulsory competitive tendering Care Quality Commission creative management response Comprehensive Performance Assessment Criminal Records Bureau expression of interest Excellence in Practice Accreditation Scheme European Union Financial Times and Stock Exchange general practitioner General Practice Commissioning Consortia Health Action Zones Institute of Business Consultants Integrated Children’s System Institute of Management Consultancy Independent Safeguarding Agency International Standards Organisation information technology invitation to tender knowledge transfer partnership Local Involvement Networks Management Consultancies Association National Vocational Qualification Office of Government Commerce primary care trust pre-qualification questionnaire private, voluntary and independent (sectors) Qualifications and Credit Framework Royal Society of Arts Statutory Instrument Single Regeneration Budget United Nations International Children’s Emergency Fund

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Appendix 3 Intellectual property rights Intellectual property (IP) is the term used to refer to intangible but no less real assets, often touched on by consultants in their work with public services. In many ways, business and manufacturing organisations have moved away from emphasising the value of traditional, tangible inventions and product developments, towards viewing IP as the major criterion by which to assess the value of commerce.The development of new products and services increasingly depends not on the ownership of a particular machine or mechanical process, but on who owns the IP associated with it. Both consultants and the clients with whom they work need to be sensitive to the importance of IP, as well as more conventional technological innovations, as resources in the struggle to compete with rival producers of goods and services and to maintain effectiveness. The rights to IP are created and sustained by the legislation governing copyrights, patents, trademarks and designs. Other intangible assets covered by the notion of IP include the bread and butter of the office such as address lists of clients or customers, networks of contacts and professional, financial, marketing and commercial intelligence. IP may be protected in contracts, franchises and other written agreements between the parties to a commercial, creative or other activity with an equivalent investment by people of resources such as time, money and expertise. Agreements such as these may enable consultants and clients to collaborate in ventures involving each other and other organisations, where the rights of the owner of the IP are specified, but where certain of these rights may be assigned to another individual, group or organisation for a particular purpose or a specified time, in return for financial payment or other compensation, or a guarantee of a stake in future benefits, such as royalties. An example of legislation is the Copyright, Designs and Patents Act 1988 which covers the rights of authors not to have their work reproduced by any means, except with their permission.There is also a Geneva Convention covering the rights of academic authors to quote extracts of other academic authors’ work, within prescribed word limits. Ideas can, and often do, generate money for employees and also their employers. However, many people, even university researchers, for example, are so taken up with the new idea and assisting people, that they publish to the world, and accordingly miss commercial 231

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opportunities. One example we encountered involves health researchers in rehabilitation working on different forms of insoles to correct certain conditions. The research paper was published and a footwear manufacturer in the Far East has benefited without paying for the research in any way.

Website resources For a website dealing with aspects of intellectual property rights, see: www.managingip.com

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Index Note: The following abbreviations have been used – f = figure; g = glossary; t = table

A

C

‘academic’ consultants 168–72 ‘accelerated lifestyles and experiences’ 195–6 accountability 11–12, 138 accreditation schemes 88 action research 183, 191–3, 225g Adams, R. 51t, 55, 56, 107, 179, 180 adult learning model 186t, 190 agency staff 89, 166, 168, 209 analytic consultancy 183, 184 anti-discriminatory practice 10 appraisals 29–30 ‘appreciation process’ 118 APSE (Association for Public Service Excellence) 38 Archer, L. 107 armed services 5, 118 assessment 9–10 Association for Public Service Excellence (APSE) 38 assumptions 58 Atkinson, P. 114–15 Audit Commission 9, 11

capacity 27, 28f, 29, 99, 101, 136 engagement and 84, 85t, 87t, 88, 94, 95–6 induction standards 100, 104 recruitment/retention 89, 90t care homes 122, 123, 130, 136 engagement 83, 86, 96, 100–2, 104, 105f, 106, 107 Care Quality Commission (CQC) 10, 96, 136, 140 Care Standards Act (2000) 10 carers vii, xi, 3, 15, 156, 183, 197, 204, 206, 209 contracting 54, 63, 71 empowerment 24, 27, 28, 30, 116–17 empowerment in practice 133, 135, 136, 138, 139 engagement 75, 77, 78, 88, 95, 98, 108, 109 negotiation 40, 43, 50 casualised organisation 208–9 celebration/collaborative event: disengagement 151 change 13, 15, 28f, 29, 58–9, 60, 80–1, 179, 183, 197 complexity of 199–201 creating the conditions for 75 engagement and 62–3, 65–6, 74–5 identifying and tackling obstacles 16–17 individuals and 29–30, 87, 89 opportunities for 106–9 organisational culture 133, 208–12 reorganisation and 209–10 sustaining 213–14 teams and 106–9 transformative action and 195–6, 205–8 change-focused organisations 180 charities 155–6 CHI (Consensus, Homing-in and Implementation) principle 189 children and young people’s services 3, 5, 7, 48–9, 92, 106 citizen-centred governance 76–7, 205–6, 208 Citizen-centred Service, Institute of (Canada) 207

B Baldwin, M. 179 Barnes, M. 76 baselining 83, 225g Bazalgette, John ix, 205 Beecham, J. 208 Benedict, Ruth 21 Berry, J. 93 Bertalanffy, L. 175 ‘Best Value’ systems 9 Beyond the stable state (Schön) 179, 196 bidding 42–3, 47–8 Bill and Melinda Gates Foundation 170 Block, P. 163–4, 167 ‘blue sky’ thinking 107 Brady, B. 8 British Medical Association (BMA) 205 Brookfield, S.D. 56–8 Building a safe, confident future (Social Work Taskforce) 211–12 Burns, T. 178 Burtonshaw-Gunn, S. 4, 59 business plan feasibility 60

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Consultancy in public services citizen-consultants 55, 75, 129, 135, 149, 177, 178, 193, 214 definition 225g empowerment and 24, 28, 31 citizen-led initiatives 47 Citizen-led Leadership Programme (Wales) 207–8 citizens 6–7, 17, 39, 54 empowerment of 13, 24, 25, 28, 31, 35, 75–6, 205 participation 49, 63–4, 73–4, 205 Clark, J. 7 Clarke, J. 6, 39 classical tragedy 184, 185t client xi, 45–6, 191, 214 climate 180 co-consultants xi, 27, 77, 183, 214 co-option 51t Coalition government 8, 38, 39, 206 Cockman, P. 5, 63, 64, 118–19, 151, 155 collaboration 76, 77, 181 collective-focused organisations 213 Combined Online Information System (COINS) 8 Commission for Patient and Public Involvement in Health (2003) 10 common glue 203–4 Common Induction standard 99–100, 104 Community Care (Direct Payments) Act (1996) 39 compartmentalisation 16 Compendium (software) 115 ‘competition state’ 164–5 Comprehensive Performance Assessment (CPA) 11 compulsory competitive tendering (CCT) 39, 164 conflict-based sociological perspective 176 Conservative government 9, 39 consultancy xi, 3–4, 6, 7, 8, 13–14, 129, 158, 168–71, 214–15 changing nature of 161–5, 166f, 167–72, 173 criticism of 12, 13 debates about propriety of 12–13 defining consultancy 4–5, 162, 163t, 164, 225g as expert/facilitator 26, 27f five phases of 184, 185t iterative process 127f practice of 26, 27f, 131–46 quality assurance and 11–12 reasons for employing 9–11 relevancy to work of public services 7–11 top ten tools 59–60 234

ways of viewing 183, 184t, 185t working together 16, 17–18, 19f, 20 consultant trainers 121–2 consultation-focused organisations 179 contemporary consultancy 163t context: challenging importance of 58 contingency fees 149, 225g continued performance 60 continuing maintenance involvement 151 continuing professional development (CPD) 134, 143–6 contracts 31, 53–4, 84, 120, 225g anticipating complexities 68–9 completing the contract 64–6, 67t components of critical thinking 57–60 components of a good contract 70f critical/self-critical consultants and 54–7, 71 defensive contracting 138–9 techniques to stimulate creative thinking 60, 61t, 62–4 cooperatives 38, 141 Copyright, Designs and Patents Act (1988) 231 cosmetic change 186t, 188 costing 47–8 CPA (Comprehensive Performance Assessment) 11 CQC see Care Quality Commission Craig, D. 12 CRB (Criminal Records Bureau) 42, 44 creative management (CMR) 62 creative thinking 14, 19, 20, 58–9, 60, 61t, 62–4, 198, 225g criminal justice 5, 14, 29, 114 Criminal Records Bureau (CRB) 42, 44 critical analysis 19f, 20, 181 critical consciousness 181 critical consultancy 23, 54–7, 71 critical outsiders 24, 54–5 critical reflection 14, 16, 17–18, 19, 22, 178, 180, 191 critical thinking 55–60 Curtis, T. 54, 130 Customer First 42 ‘customer’ model 6–7, 203, 206–7, 208 Czerniawska, F. 25, 164, 183, 184t

D data: dealing with 151–4 Dauncey, Roger ix de Bono, Edward 14, 60, 61t De Haan, E. 184, 185t decentralisation 8 defensive contracting 138–9

Intellectual property rights Index dementia care 107 Demos 40 dentists 142 Department of Health (DH) 8, 40, 206 Department for International Development 8 DH see Department of Health DIGNITY 26 dilemma 74, 225g dilution 51 direct payments 39, 225g disabilities 24, 43–4 Disability Movement 10 disconnection: public voices of experience 51t disengagement 31, 225g evaluation 154–6, 157f, 158 forms of 149–54 Dispatches (television programme) 92 diversion 51t divisional organisation 178 doctors 141, 142 Dominelli, L. 55, 56 drama 186t, 187 drug awareness and intervention services 134 Durkin, C. 27, 39, 73, 212

E e-learning 144–5, 170 education 5, 124, 125, 134, 196, 204, 205 Education Action Zones (EAZs) 76 EHRC (Equality and Human Rights Commission) 94 Elkington, J. 212 Emerald Tablet, The (Jung) 203 employment: public sector 98 empowerment approach to consultancy vii, 13, 40, 56, 73, 77, 163–4, 182–3, 190 action research and 191–3 capable consultancy 22, 30–1 citizens and 13, 24, 25, 28, 31, 35, 75–6, 205 core argument 4 nature of 23–4 needs of people 20–2, 22 practice of 26, 27f, 131–46, 180–3 principles of 25–6, 111–12 risks to 50, 51t three key ingredients 27, 28f, 29–30 transforming organisation and 176–80 end-of-life care 64, 96, 108, 130 engagement 73–4, 169, 183, 197, 205, 225g baselining 83, 225g building relationships 90–1

change and 62–3, 65–6, 74–5 with citizens, managers and professionals 75–82 dealing with challenging situations 91–6, 97t, 98–102 with issues or problems identified by the individual 102, 103f, 104, 105f, 106–9 with leadership and management 83–4, 85t, 86, 87t, 88–9, 90t English model of public services 207 Enhancing Practice and Innovation Centre for Care (EPICC) 81–2 enterprise 169–71 entrepreneurial organisation 177 ‘entrepreneurial university’ 171 environmental protection model 186t, 188–9 environmental quality 135 EPICC (Enhancing Practice and Innovation Centre for Care) 81–2 Equality Acts (2006; 2010) 10 Equality and Human Rights Commission (EHRC) 94 Equity and Excellence: Liberating the NHS, White Paper, Cm 7881 (Department of Health) 206 ethnography 114–18 European Union (EU) 10, 41 evaluation 154–6, 157f, 158, 225g Evans, B. 5 Excellence in Practice Accreditation Scheme (EPAS) 88 ‘experts through experience’ 55 expressions of interest (EOI) 41, 43 ‘extrapreneurship’ 54

F fact-driven consultancy 183, 184t Farnham, S. 165–6 FATS (Framework Agreements for Technical Support) 6 feedback 122–6 fees 37, 42–3, 149 Ferguson, Prof. H. 92 fighting withdrawal 150 filtering process: tenders 41 final handover 150 Fincham, R. 7, 178 Fire and Rescue Services Act (2004) 5, 10 follow-on projects 153 foresighting 16–17 ‘four Ps’ 59 fractured organisation 176 Framework Agreements for Technical Support (FATS) 6

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Consultancy in public services Freedom, authority and the young adult (Bazalgette) ix Freire, Paulo ix Fun Project 63 funding 7–8, 11, 48, 95, 98, 101, 120, 128, 153

G Geneva Convention 231 gentleman’s promises 203 Glaser, B. 192–3 globalisation 195 ‘Gold Standard Framework’ (GSF) 96–7 good practice 129–30 Goodhart’s Law 200 Goodman, M. 62, 198–9 goodwill 91 Gould, N. 178–9 governance 76–7, 225g grounded theory 192–3, 226g Grubb Institute ix Guardian,The 5–6 Gunn, E. 27, 39, 73, 212

H Hammersley, M. 114–15 Hartigan, P. 212 Health, Department of see Department of Health health and safety 10 health services xii, 4–5, 6, 7, 10, 11, 66, 95, 130, 148, 182 change 59, 196 disengagement 156 employees as consultants 169 information gathering 140 personalisation 40, 134–5 promotion and development 137 reorganisation 167 service delivery 206 Health and Social Care Act (2008) 10, 11 Health and Social Care Act (2012) 206 Health and Social Services Management Programme (Advanced MESOL) 75 Healthwatch 143 hierarchy of needs (Maslow) 20–1 Higher Education Innovation Fund 169 HM Treasury (UK) 7, 8 holistic consultancy 63–4 Horton, D. 165–6 hospitals vii 12, 15, 17, 36, 96, 141, 169, 182 empowerment 130, 136, 137, 141 engagement 83, 96, 98, 100, 107 housing 5, 79, 123 human relations movement 175–6 ‘hybridity’ 39 236

I idealogy 226g If this is a man (Levi) viii imagery 185, 186t, 187–90, 191 imaginative organisation 61–2, 201t, 202, 203–4 IMC (Institute of Management Consultancy) 8 Improvement Consultancy, The 24, 207 Independent Safeguarding Agency (ISA) 42 independent sector see private, voluntary and independent sector (PVI) individual-focused organisations 213 individuals 86, 87, 91–2, 102, 103t, 104, 105f, 106 induction standards 99–100, 104 information gathering 112, 113–21, 122–4, 140, 146, 151–4, 186t, 190–1 information technology (IT) 79, 100–2, 141–5, 163–4 innovation 58–60, 80–1, 82, 142, 143, 178, 179, 186t, 187, 211 enabling 130, 131f transformation and 198–201 inspection 9–10 Institute of Business Consulting 120–1 Institute of Citizen-centred Service (Canada) 207 Institute of Management Consultancy (IMC) 8 insufficiently theorised actions 51t Integrated Children’s System (ICS) 92 intellectual property rights 82, 231–2 intentionality 56 interim reports 68 International Development, Department for 8 internet-based education 145 investing organisation 210–11 Investors in People 42 invitation to tender (ITT) 42, 43 involvement 10, 73, 128, 129, 151, 155, 185, 205, 226g ISA (Independent Safeguarding Agency) 42 ISO 9001 (quality management systems) 42

J ‘jazzers’ 202 Jung, Carl 203

K Kay, J. 199–201 Kelly, George 14

Intellectual property rights Index Keywords (Williams) 57 Kirby, P. 179 knowledge economy 201t, 202 knowledge transfer partnerships (KTPs) 169 Ko, D.-G. 120 Koch, R. 129

L Labour government 7, 9, 39, 212 lateral thinking 60, 61t leadership 15, 83–4, 85t, 86, 87t, 88–9, 90t, 137, 202 lean thinking 130, 175, 226g learning organisation 178–80, 213, 226g Ledwith, M. 25, 182 Leslie, L.L. 171 Levi, Primo viii LINks (Local Involvement Networks) 10 local authorities 16, 89, 90t, 95, 107, 152, 166 Local Government Act (1988: 1999) 9, 11, 164 Local Government and Public Involvement in Health Act (2007) 10 Local Involvement Networks (LINks) 10 Lynch, P. 195

M McGregor, D. 21 machine organisation 178 Making the Connections programme 207 management 9, 25, 123, 124–5, 137, 165–6, 208 engagement with 75, 78–9, 80, 82, 83–4, 85t, 86, 87t, 88–9, 90t feedback 126, 127f teams and 139–40 Management Consultancies Association (MCA) 8, 25–6 management consultancy 4, 12, 25, 48 management development 186t, 189 marketing mix 59 Martinson, Robert ix Maslow, A. 20–1 Mayo, Elton 175–6 MCA (Management Consultancies Association) 8, 25–6 mechanistic and organic organisations 178–80, 199 ‘micro-management’ 172 Microsoft Research Cambridge 170 Mid Staffordshire Trust Hospital 96

middle managers 9, 78, 83 milestones 43, 46, 66, 67t, 70f, 84, 120, 122, 155–6 Mintzberg, H. 177 ‘mission creep’ 67 model for strategic analysis, A (Porter) 59 money-focused organisations 213 Morgan, G. 61–2, 174, 198 Morosini, P. 201, 203, 204, 207 Mortenson, Greg 204 motivation 89, 90t, 92, 96, 98, 99, 101, 104, 136 empowerment and 27, 28f, 29, 30 engagement and 84, 85t, 86, 87t, 88 moving the goalposts 155–6 mutual organisations 38

N National Audit Office 8 National Health Service (NHS) 4–5, 37, 130, 137, 141, 142, 166, 182, 205, 206 National Health Service Training Directorate (NHSTD) 75 National Occupational Standards 140 National Performance Indicators 10 negotiation 30, 36, 37–8, 53 aims and objectives of consultancy 155–7 challenges to empowering consultancy 49–50, 51t first meetings 43–8 identifying potential areas/problems/ tasks and planning 48–9 working with people 39–43 New Labour 8 Newman, J. 39 NHS see National Health Service (NHS) NHS and Community Care Act (1990) 10 NHSTD (National Health Service Training Directorate) 75 Nilekani, N. 212 ‘no blame’ culture 179 norms 180 not-for-profit sector see private, voluntary and independent (PVI) sector Nudge, the 62–3, 212, 226g

O obliquity 199–201 observation 114 occupational embeddedness 104 Office of Government Commerce (OGC) 8

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Consultancy in public services offloading 19f, 131f older people 54, 136, 153 online support groups 143 Open public services (White Paper, Cm 8145) (HM Government) 8, 167 open systems 175 Open University (OU) 75 oppressive organisation 50 organ donation 140 organic organisations 178–80 organisational functioning 189 organisations culture and change 133, 208–12 democratisation of 17 development 15–17, 132–6 historical background 201t, 202 strong and effective social connections 205 theoretical viewpoints 174f, 175–80 OU (Open University) 75 outcome approach 183, 184t ‘outside-in’ approach 14–15, 150, 207 outsourcing 165, 226g Owen, J. 8

P Panorama (television programme) 119–20 partial outcomes 51t participant observation 114 participation 49, 63–4, 116–17, 132, 153–4, 164, 179, 181, 205, 211–12 definition 226g engagement as 73–4, 79, 93–4, 98–9, 109 participation-focused organisations 179–80 partnership arrangements 24, 76, 79, 88, 107, 116–17, 143, 226g Pascale, R.T. 16, 17, 82, 213 Patient and Public Involvement in Health, Commission for (2003) 10 Patients Association 10 pay schemes 119–20 Payne, M. 55, 56 Pedler, M. 179 peer support 180 Peey, Gerri 8 Pellegrinelli, S. 157 people-focused organisations 180, 213 person-centred planning 3, 40, 226g personal development reviews 29–30, 102 personalisation 10–11, 39–40, 79, 134–5, 172, 196, 226g PESTLE analysis 59 pharmaceutical prescriptions 142 planned retreat 150 238

Police Act (1996) 10 Police and Criminal Evidence Act (1984) 93 Police (Northern Ireland) Act (2000) 10 Police (Scotland) Act (1967) 10 police services 5, 10, 45–6, 93, 134, 137, 151 policy into practice 127–8 Porter, Prof. M. 59 positive deviance approach 16, 17, 82 Postman, N. 81 postmodern consultancy 176 power 39, 44, 91–6, 97t, 98–102, 121, 157f power relations: consultant and client 27f practitioner forum programmes 108–9 pre-contract phase 37, 38, 48–9, 50, 51, 53 pre-qualification questionnaire (PQQ) 41 Prison Service (UK) ix, xii private, voluntary and independent (PVI) sector 8, 11, 15, 80, 140, 168, 206 balance with state provision 159, 165, 166 negotiation 38, 39 pro bono work 47, 226g problem solving 128–9, 186t, 187 process-driven consultancy 183, 184t product performance analysis 59 professional organisation 178 professionals 9, 75, 78–9 project management approach 186t, 189 public sector consultants 168 public services 3, 5–6, 7–11, 164–5, 166f, 167, 205–6 Public Services (Social Value) Bill 196 ‘publics’ 39, 40, 112 purposeful mission 203 Putting People First: A shared vision and commitment to the transformation of social care (Department of Health) 40

Q Qualifications and Credit Framework (QCF) 106, 140 qualitative information gathering strategies 114–18, 125 quality assurance 11–12, 15, 35–6, 70f, 96 quantitative information gathering strategies 113–14, 125, 126 questionnaires 68, 115–16

R Rantz, M.J. 86

Intellectual property rights Index readers and ’jazzers’ 202 recruitment and retention 89, 90t, 144 Reducing bureaucracy in policing (Berry) 93 reflective scepticism 58 reflexivity 55, 116, 182, 226g reform 186t rehabilitation services 88 relationship-based services 35–6 reorganisation 167, 209–10 report writing 124–6, 152, 156 resistance: from staff 126, 127f, 128, 138–9 retainer 149, 226g reticulists 133–4, 226–7g Reynolds, P. 5 Riggs, C.J. 86 risk taking 179 Robert Francis Inquiry (2010) 96 Royal Society of Arts (RSA) 167 Russell Group of universities 170

S Sadler, P. 163 safeguarding 92, 93, 97, 144 ‘sailing craft’ analogy 177 Sainsbury Review (2007) 169 Salaman, G. 162 Saleeby, D. 21, 126, 183 Schön, D. 179, 196 scientific management 174–5, 199, 201 ‘secured by design’ 136 self-critical consultancy 22, 54–7, 71, 197 self-direction 40, 102 senior managers 9, 78–9, 83, 117, 209 service delivery 9, 10, 25, 39, 133, 196, 206, 208 service development 132 service users 24, 27, 28, 43–4, 78, 98–9, 108, 117, 135, 180 Shapland, Peter ix Shor, I. 57 Sigma Six approaches 189 Silberman, M. 163, 179 Single Regeneration Budget (SRB) partnerships 76 Skills for Care 99–100, 140 Slaughter, S. 171 sliding scale of involvement/charges 151 SMART objectives 67 social 227g social enterprise / entrepreneurship 212–14 social services xii, 5, 10, 27, 40, 54, 59, 66, 96, 99–100 disengagement 156

personalisation 134–5 promoting working together 140 recruitment/retention 89, 90t reorganisation 167 training and practice 121–2, 198 Social Work Taskforce 92, 211–12 sociality 182 sociological approach 6–7 Springett, J. 25, 182 staff 126, 127f, 128, 138–9, 177, 208–9 Stalker, G.M. 178 standards 42, 96, 97t, 140 status quo: challenges to 49–50 ‘stop and search’ 93 strategic formulation process 59 Strauss, A. 192–3 strengths perspective 21, 126, 183 structural perspective 178 Sturdy, A.J. 127f Sunday Times,The 119 Sunstein, C.R. 62–3, 212 supports 27, 28f, 29, 133, 180 engagement and 84, 85t, 87t, 94 recruitment/retention 89, 90t surprise withdrawal 150 surveys 68, 115 sustainable services and products 211, 213–14 SWOT analysis 59 synergy 21

T tactical retreat 150 task groups 24, 43–4, 94, 124 Taylor, Frederick Winslow 174, 201 Teaching as a subversive activity (Postman and Weingartner) 81 teams 9, 41, 106–9, 123–4, 139–40, 227g engagement 86, 87t, 88, 89, 90t, 94–5 Teasdale, S. 213 Teesside Manufacturing Centre 189 Teesside University 63–4, 81, 82, 114, 169, 202 tendering 41–8, 155, 164–5 Territorial Army (TA) x, 118 Thaler, R.H. 62–3, 212 theory 181, 192–3, 227g theory X/Y 21 therapy model 186t, 187 thinking hats 61 ‘thinking outside the box’ 75, 81 ‘third sector’ see private, voluntary and independent (PVI) sector Tinunacuy relationships 203 tokenism 24, 188 top managers 9, 25, 78, 82, 83, 137 trade on mindset 203

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Consultancy in public services traditional consultancy 162, 163t ‘traditional’ organisations 121 training 121–2, 130, 143–6, 190, 198 transformation 15, 23, 29, 176–80, 181, 195–201, 205–8 2020 Commission on Public Services 167 2020 Public Services Trust (PST) 167

U UNICEF 198 universities 24, 121, 159, 168–72, 192, 197 Uzbekistan 198

V value-driven approach 26, 204–5, 214 vertical thinking 60, 61t ‘virtual enterprise’ 170 virtual learning environments 145 voluntary sector 1, 7, 8, 38, 39, 80 vulnerability 49–50, 51t

W waiting times 141 Wales 207–8 Weingartner, C. 81 whistleblowers 15, 132 Whitaker, D.S. 107 Wilkinson, M.D. 180 Williams, R. 57 Wiraqocha leaders 203 ‘wisdoms’: professional and citizen 107–9 workforce development 143–6

Y York/Beverley Hotel meetings 18, 19f, 20, 64 youth services 5, 77, 95, 115, 124–6, 128

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This book has grown from the authors’ public services consultancies over the past 25 years and is rooted in relevant literature. It challenges the traditional view that consultants are brought in as experts and instead examines ways of using consultancy to empower staff, patients, service users and members of the public, so that they can take part in developing, changing, innovating and ultimately transforming these services. The authors argue that consultants should be inclusive rather than exclusive, creative rather than working within safe limits, opportunistic rather than regimented, and innovative rather than rule-following. This is a practical handbook concerned centrally with engagement in practice and, crucially, with practical implementation, dealing with all stages of the consultancy process. It promotes a range of approaches, rather than operating in a specialist area of practice. It is aimed at consultants and would-be consultants, as well as managers, practitioners and anyone interested in the practice of consultancy in public services. The book includes chapters explaining consultancy, on preparing bids, on negotiations and on the importance of assessment and review, which are geared towards the needs of those working in public and third sectors, either as or together with consultants. It includes a glossary, abbreviations, helpful contacts and websites that are valuable for quick reference and to aid further understanding. Robert Adams, Emeritus Professor, School of Health and Social Care, Teesside University, has carried out consultancies with many public sector organisations. He has researched and written widely on public services including health and social care. Wade Tovey, Assistant Dean (Enterprise) and Director of EPICC (Enhancing Practice and Innovation Centre for Care), School of Health and Social Care, Teesside University, has completed a wide variety of consultancy work in public services over the past 20 years.

Public sector/business and management

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Consultancy in public services • Robert Adams and Wade Tovey

“This invaluable book genuinely breaks new ground in the use of consultancies, showing you how to work positively with staff to develop creative solutions in order to provide effective services.” Brian Littlechild, University of Hertfordshire

Consultancy in public services Empowerment and transformation

Robert Adams and Wade Tovey 05/07/2012 16:57