Getting service change right
In 2014, I convened a group of communicators who had led major NHS reconfiguration programmes, to see what learning we could share on how to do public service change well. The result was Reconfigure It Out, a paper published by NHS Confederation and designed as a guide for NHS colleagues working on service changes that were often contentious.
The recommendations (if not our contrivance to make each one start with ‘L’!) stand the test of time. But having run many public consultations and public involvement exercises, I think probably the key lesson is to start talking to people about your proposals as early as possible.
Many public service managers fear consultation. Having dealt with colleagues who feared talking to the media, anxiety about engaging with the public is a close second. “They won’t understand!” is the most common concern, closely followed by “People won’t listen to us!”
Ironically, these worries mirror exactly those of the people you are consulting. That not only will you not understand their concerns, you also will not listen to them. You have made up your mind already and the consultation is a sham exercise to help you tick a legal box.
The only way to address this is to disprove those fears. Share your ideas early, before they are fully developed proposals. I always recommend an ‘issues paper’ setting out the challenges you seek to address and your early thinking on what you might do. Get out and talk to your communities about the challenges you face. Actively listen. Get together a representative group to help you co-design your proposals. Test them wisely. Then consult people on them, consider their feedback and make a final decision.
When I say this to leaders, they worry it will take too long. It really doesn’t have to. There is no required length to a public consultation exercise – what matters is the amount of activity you put into it and how effectively people were involved and consulted. If you can get the process right from the start and involve people effectively throughout, you are if anything likely to get to a decision more quickly – and one that will stand up to scrutiny and challenge. Put the effort into meaningful involvement rather than responding to legal or procedural challenges to your process.
There are two important caveats to this. First, you have to listen to and consider the feedback. This should be an active dialogue, not something you go into with a fixed idea. Trying to ‘spin’ the solution you want is not just disingenuous, it’s pointless – if it’s the right thing to do, it will stand up to debate. Second, and related to the first point, you have to be honest about the case for change. Don’t tell people it’s not about saving money if it is, don’t over-sell your preferred solution by pretending everything will be better and there are no trade-offs. That approach not only patronises people, it makes them cynical and way less likely to engage in a constructive way.
At the end of the day, the decision is yours. A consultation is not a local referendum; it’s quite common for most respondents to oppose a proposal which still goes ahead after public consultation. It is about the power of arguments against or in favour, not the numbers of people making them. The best consultations offer adaptions and mitigations based on what they hear – but the really key point is to listen to and consider what the public tell you before making a decision.
