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A change in thinking: redefining
services
Services for Later Life 2012, AGE UK conference




Dan Corry
Chief Executive, NPC
July 12th 2012
What do we learn from what is
happening in the wider third sector?
About NPC: helping transform the
sector
•    We help charities and funders achieve greater impact through
     research, consultancy, and communications
•    Part think tank, part consultancy we focus on:

           Charity               Measurement              Funder
        effectiveness            & evaluation          effectiveness
    • Strategic planning      • Measurement         • Advice on strategy
    • Improving your            frameworks            and funding
      organisation            • Independent           processes
    • Reporting your impact     evaluation and      • Programme design
    • Social investment         economic analysis   • Reviews

•    Think tank work on issues that affect effectiveness in the sector
     like
        Commissioning
        Social investment
        Local civil society
                                                                           3
A tricky background: cuts hitting –
including to the voluntary sector
• Cuts to central support for council budgets of
  over 25% – very much front loaded
• From 2010/11 to 2015/16 a cumulative amount of
  £3.3bn will have been lost from the voluntary
  sector in grants and contracts (NCVO)
• This will be £1.2bn in 2015/16, with over one
  third from central government cuts. (NCVO
  Almanac 2012, p 43)
• Councils struggling - with the worst still to
  come?
• Services for older people not excused –
  although health holding up and less tax rises etc


                                                      4
Demand up: some examples
• The number of people sleeping rough in England has
  grown by more than a fifth in the past year as widespread
  local authority cuts to support services and housing
  benefits took effect
• Youth unemployment (16 to 24) highest since 1980s
  (ONS)
• More than a quarter of organisations saw more people
  coming to work ill in the past year, and almost two-fifths
  experienced an increase in mental health problems
  (CIPD)
• On an average day last year 230 women were turned away
  by Women's Aid, around 9% of those seeking refuge,
  because of a lack of space
• We know population continues to age



                                                               5
All doom and gloom?


•   Cuts in numbers employed in voluntary sector
    (c70,000 is a recent estimate)
•   Giving is flat (?)
•   Reserves being eaten into
•   Recent LGA estimate that spending on adult
    social care will exceed 45% of council budgets
    by 2019-20




                                                     6
Some recent examples of charities in
trouble

•   Up to 30 staff could go at Mencap – CEO says charity's
    plans to save £1.5m have come about because of the loss
    of local authority funding. (8 March 2012)
•   Stroke Association to axe 28 jobs - CEO Jon Barrick
    says it faced a budget deficit of £1.5m following a decline
    in voluntary income (17 January 2012)
•   59 per cent of charities expect the financial situation
    of their own organisations to get worse, with only 13
    per cent expecting an improvement. (NCVO Charity
    Forecast June 2012)
•   Children’s charities will lose £405m in government
    funding over the next five years, a quarter "likely" or "very
    likely" to shut down in the next year or so. NCB


                                                                    7
What are charities doing well and
where do they need to improve?
Overall: Resilience and efficiency
• Recent NPC survey of commissioning from third
  sector perspective (When the going gets tough)
• Starts to dig in to how charities are coping with
  cuts
• Plus new types of contract PBR; personal
  budgets
• Shows big effort to “work differently and try new
  ways of doing things”
• But worries re closures and lots of use of
  reserves


                                                      9
Creative responses too
• NPC survey showed 97% working differently or
  trying new things
• Nearly 80% plan to work more collaboratively
  with other organisations
• 75% aiming to harness the power of volunteers-
  very relevant to older volunteers
• Need to be more clear in their aim and influence
  funders/commissioners not just be at ‘mercy’ of
  them.



                                                     10
With opportunities and risks

• Community Links – transferred management of
  playground (previously supervised by play
  workers) to community parents rather than shut it
• Possible risks – health and safety when first child
  breaks a leg?
• Library and arts centre transfers to volunteers
• But will service offerings change?




                                                        11
How do third sector organisations
increase outcomes for their users
Doing better

• Clearer on outcome being achieved
• Having a theory of change
• Measuring what you can so you understand your
  impact
• Feeding back into decision making and resource
  allocation




                                                   13
Add TOC from ToC paper




                         14
Measuring what you do

• If you don’t, how can you know what you
  achieve?
• How can you improve? How can you learn?
• Many problematic issues
   •   Data
   •   Attribution
   •   Additionality
   •   Measuring what is measurable
   •   What tools to use
• But need some handle on what you do and
  problems are no excuse
                                            15
Assessing impact comes at different
levels


              Individual




                                         Certainty of Outcome
                                 Reach
            Community &
               family


        Professionals & policy
               makers



               Society

                                                                16
What do charities learn from this?
•    Do they change? (some don’t)
•    Can improve services
•    Become more efficient and effective
•    Even uncover their true value


    ‘Before the evaluation, our hospital cafés were seen
    as revenue raisers. Now they are seen as
    fundamental to the service we deliver—an
    opportunity to engage with millions of older people
    at a time of difficulty and stress.’ WRVS
                                                           17
Doing different


•   Focused more on outcomes citizens value?
•   And what is innovation?
•   Engaging staff
•   Using your volunteers in new ways
•   Co-production
•   New technology harnessed

     Balance between replicating
     (scaling up) and innovation
                                               18
New ways of working with others

• Collaboration
• Group structures
• Consortiums
• Working with the private sector
• In older people services, larger national
  organisations developing ways of working with
  smaller local services
• Issue of how devolved national organisations
  work too


                                                  19
What about funders?
Commissioners need to think hard
about how to go about their work

• When to fund replication and expansion
• When to fund innovation
• Use commissioning to drive effective
  collaboration
• Even ‘cross-silo’ commissioning (cf Total Place
  and Community Budgets)
• Think hard about smaller (and local) charities
  being squeezed out by bigger contracts and pbr
• Try and avoid over-emphasis on short term
  cashable savings


                                                    21
Charitable funders – foundations and
philanthropists

• Many of the same questions
• More room to innovate?
• And evaluate?
• But how to move on to mainstreaming?
• Issues for BIG Lottery as well as charitable
  foundations (Silver Dreams etc)
• And how do we get corporate foundations
  interested?

    Are there enough interesting projects
     to fund in the older people space?          22
Does social investment help?

• Three types of SI (at least!)
    • Basic loans and bonds
    • Social impact bonds
    • Risk capital for social entrepreneurs and social enterprises
• Very useful in areas like bed blocking etc
• Worcestershire CC considering a social impact bond to
  fund telecare, rapid response units, virtual wards (MJ 28.06.12)
• But…
    •   Need revenue streams
    •   Who is going to pay it back?
    •   Is it most cost effective?
    •   Attitudes to risk



                                                                     23
Things that will have to happen

• More innovation
• More co-production (real or euphemism for cost
  cutting?)
• More working in collaboration
• More mergers
• More working with the private sector
• More early intervention
• More joined up commissioning

‘Tweaking’ and incremental change will simply not
be enough given the task ahead
                                                    24
How will the sector look in five to ten
years time?
• Miserable?
• Very varied—with more problems in more
  deprived areas?
• Big, national and small, local charities surviving
  while middle tier is wiped out?
• Social enterprises growing and social investment
  thriving?
• Big Society really working?




                                                       25
Any of this different for older people
services?

• Don't think so!
• Needs and desires of older people are changing
  fast
• They are much less homogenous
• Society is changing
• And the roles the state, civil society and the
  market play
• Technology too
• Interventions must be financially sustainable
• And policy all over the place!

                                                   26
Managing demand has to be crucial –
innovation needed here from funders and
funded

• ‘self service’ eg Essex CC - signposting
  information and contacts to other groups so
  people can stay active
• divert demand to others (eg 3rd sector);
• intervene early.
• change expectations of what state should
  provide;




                                                27
Role for ageing related sector in
advocacy on attitudes?

• Is there a case for         •   Recent British Academy
  charities working with          Policy Centre paper
  older people to try to          “Demographic Futures”,
  change the prevailing           by Pat Thane argues we
  paradigm about ageing?          are very caught in the
• Away from idea that rapid       wrong narrative
  ageing spells doom and      •   May be leading to wrong
  gloom?                          policies and resource
                                  allocation




                                                            28
Need to get on with it

•   Sector is very resilient
•   Older people with multiple needs
•   Need to act
•   ..and campaign.
•   Good luck!
•   (and NPC can help!)




                                       29
Dan Corry
 Chief executive

 DCorry@philanthropycapital.org




www.philanthropycapital.org




                                  30

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Services for Later Life conference: A change in thinking: Redefining services

  • 1. A change in thinking: redefining services Services for Later Life 2012, AGE UK conference Dan Corry Chief Executive, NPC July 12th 2012
  • 2. What do we learn from what is happening in the wider third sector?
  • 3. About NPC: helping transform the sector • We help charities and funders achieve greater impact through research, consultancy, and communications • Part think tank, part consultancy we focus on: Charity Measurement Funder effectiveness & evaluation effectiveness • Strategic planning • Measurement • Advice on strategy • Improving your frameworks and funding organisation • Independent processes • Reporting your impact evaluation and • Programme design • Social investment economic analysis • Reviews • Think tank work on issues that affect effectiveness in the sector like  Commissioning  Social investment  Local civil society 3
  • 4. A tricky background: cuts hitting – including to the voluntary sector • Cuts to central support for council budgets of over 25% – very much front loaded • From 2010/11 to 2015/16 a cumulative amount of £3.3bn will have been lost from the voluntary sector in grants and contracts (NCVO) • This will be £1.2bn in 2015/16, with over one third from central government cuts. (NCVO Almanac 2012, p 43) • Councils struggling - with the worst still to come? • Services for older people not excused – although health holding up and less tax rises etc 4
  • 5. Demand up: some examples • The number of people sleeping rough in England has grown by more than a fifth in the past year as widespread local authority cuts to support services and housing benefits took effect • Youth unemployment (16 to 24) highest since 1980s (ONS) • More than a quarter of organisations saw more people coming to work ill in the past year, and almost two-fifths experienced an increase in mental health problems (CIPD) • On an average day last year 230 women were turned away by Women's Aid, around 9% of those seeking refuge, because of a lack of space • We know population continues to age 5
  • 6. All doom and gloom? • Cuts in numbers employed in voluntary sector (c70,000 is a recent estimate) • Giving is flat (?) • Reserves being eaten into • Recent LGA estimate that spending on adult social care will exceed 45% of council budgets by 2019-20 6
  • 7. Some recent examples of charities in trouble • Up to 30 staff could go at Mencap – CEO says charity's plans to save £1.5m have come about because of the loss of local authority funding. (8 March 2012) • Stroke Association to axe 28 jobs - CEO Jon Barrick says it faced a budget deficit of £1.5m following a decline in voluntary income (17 January 2012) • 59 per cent of charities expect the financial situation of their own organisations to get worse, with only 13 per cent expecting an improvement. (NCVO Charity Forecast June 2012) • Children’s charities will lose £405m in government funding over the next five years, a quarter "likely" or "very likely" to shut down in the next year or so. NCB 7
  • 8. What are charities doing well and where do they need to improve?
  • 9. Overall: Resilience and efficiency • Recent NPC survey of commissioning from third sector perspective (When the going gets tough) • Starts to dig in to how charities are coping with cuts • Plus new types of contract PBR; personal budgets • Shows big effort to “work differently and try new ways of doing things” • But worries re closures and lots of use of reserves 9
  • 10. Creative responses too • NPC survey showed 97% working differently or trying new things • Nearly 80% plan to work more collaboratively with other organisations • 75% aiming to harness the power of volunteers- very relevant to older volunteers • Need to be more clear in their aim and influence funders/commissioners not just be at ‘mercy’ of them. 10
  • 11. With opportunities and risks • Community Links – transferred management of playground (previously supervised by play workers) to community parents rather than shut it • Possible risks – health and safety when first child breaks a leg? • Library and arts centre transfers to volunteers • But will service offerings change? 11
  • 12. How do third sector organisations increase outcomes for their users
  • 13. Doing better • Clearer on outcome being achieved • Having a theory of change • Measuring what you can so you understand your impact • Feeding back into decision making and resource allocation 13
  • 14. Add TOC from ToC paper 14
  • 15. Measuring what you do • If you don’t, how can you know what you achieve? • How can you improve? How can you learn? • Many problematic issues • Data • Attribution • Additionality • Measuring what is measurable • What tools to use • But need some handle on what you do and problems are no excuse 15
  • 16. Assessing impact comes at different levels Individual Certainty of Outcome Reach Community & family Professionals & policy makers Society 16
  • 17. What do charities learn from this? • Do they change? (some don’t) • Can improve services • Become more efficient and effective • Even uncover their true value ‘Before the evaluation, our hospital cafés were seen as revenue raisers. Now they are seen as fundamental to the service we deliver—an opportunity to engage with millions of older people at a time of difficulty and stress.’ WRVS 17
  • 18. Doing different • Focused more on outcomes citizens value? • And what is innovation? • Engaging staff • Using your volunteers in new ways • Co-production • New technology harnessed Balance between replicating (scaling up) and innovation 18
  • 19. New ways of working with others • Collaboration • Group structures • Consortiums • Working with the private sector • In older people services, larger national organisations developing ways of working with smaller local services • Issue of how devolved national organisations work too 19
  • 21. Commissioners need to think hard about how to go about their work • When to fund replication and expansion • When to fund innovation • Use commissioning to drive effective collaboration • Even ‘cross-silo’ commissioning (cf Total Place and Community Budgets) • Think hard about smaller (and local) charities being squeezed out by bigger contracts and pbr • Try and avoid over-emphasis on short term cashable savings 21
  • 22. Charitable funders – foundations and philanthropists • Many of the same questions • More room to innovate? • And evaluate? • But how to move on to mainstreaming? • Issues for BIG Lottery as well as charitable foundations (Silver Dreams etc) • And how do we get corporate foundations interested? Are there enough interesting projects to fund in the older people space? 22
  • 23. Does social investment help? • Three types of SI (at least!) • Basic loans and bonds • Social impact bonds • Risk capital for social entrepreneurs and social enterprises • Very useful in areas like bed blocking etc • Worcestershire CC considering a social impact bond to fund telecare, rapid response units, virtual wards (MJ 28.06.12) • But… • Need revenue streams • Who is going to pay it back? • Is it most cost effective? • Attitudes to risk 23
  • 24. Things that will have to happen • More innovation • More co-production (real or euphemism for cost cutting?) • More working in collaboration • More mergers • More working with the private sector • More early intervention • More joined up commissioning ‘Tweaking’ and incremental change will simply not be enough given the task ahead 24
  • 25. How will the sector look in five to ten years time? • Miserable? • Very varied—with more problems in more deprived areas? • Big, national and small, local charities surviving while middle tier is wiped out? • Social enterprises growing and social investment thriving? • Big Society really working? 25
  • 26. Any of this different for older people services? • Don't think so! • Needs and desires of older people are changing fast • They are much less homogenous • Society is changing • And the roles the state, civil society and the market play • Technology too • Interventions must be financially sustainable • And policy all over the place! 26
  • 27. Managing demand has to be crucial – innovation needed here from funders and funded • ‘self service’ eg Essex CC - signposting information and contacts to other groups so people can stay active • divert demand to others (eg 3rd sector); • intervene early. • change expectations of what state should provide; 27
  • 28. Role for ageing related sector in advocacy on attitudes? • Is there a case for • Recent British Academy charities working with Policy Centre paper older people to try to “Demographic Futures”, change the prevailing by Pat Thane argues we paradigm about ageing? are very caught in the • Away from idea that rapid wrong narrative ageing spells doom and • May be leading to wrong gloom? policies and resource allocation 28
  • 29. Need to get on with it • Sector is very resilient • Older people with multiple needs • Need to act • ..and campaign. • Good luck! • (and NPC can help!) 29
  • 30. Dan Corry Chief executive DCorry@philanthropycapital.org www.philanthropycapital.org 30

Editor's Notes

  1. Figure 1 shows a simple example of a theory of change for a charity that intends to improve children’s grades and school work, with enabling factors, activities, outputs, outcomes and evidence. The charity identifies which children will benefit from the intervention, and it has three activities: literacy and numeracy tutoring; support for parents; and support for teachers. In the literacy and numeracy tutoring, 150 children are given one term of literacy tutoring, which evidence suggests will improve literacy for 70% of children. This is supplemented by support for parents, which will help the charity to identify why some children are struggling to learn, leading to children being able to devote more attention and the grades and school work going up.
  2. To summarise, here is an example of how NPC might develop a portfolio of charities tackling the problem of poor mental health in the most constructive ways.