Managing Demand – a collaborative approach
Dr Henry [email protected] @h_kippin
20 Nov 2015, CIPFA Annual North East Conference
Context: why are we talking about managing demand?
The Groucho Marx challenge for public services
What do we mean by managing demand?
Before we go further…five inconvenient truths?
1. We can’t manage what we don’t understand!
2. Demand isn’t always bad…
3. Effective delivery is vital, but it needs to be collaborative
4. Nudging is not enough
5. Devo won’t stick without building readiness…
Types of demand - a ready reckoner
Is demand rising as a result of public service failure or poor design?
Is service demand arising from certain behaviours that could be changed?
Is the state providing more than is needed, or inadvertently creating demand through dependency?
Are there opportunities to provide services that are a better fit with what is actually needed by citizens?
Are citizens accessing services they don’t strictly need?
To what extent is demand arising from causes which could have been addressed earlier?
To what extent is demand unintentionally reinforced by service dependence?
Excess Demand
Is the state providing too much?
Are citizens accessing what they don’t need
Are we inadvertently creating demand through dependency?
Avoidable Demand
Is demand arising from behaviours that could be influenced or changed?
Do we have the right level of insight about why this might be the case?
Failure Demand
Is demand arising as a result of service failure?
Are we creating demand through poor service design?
Are we experiencing demand through creating market failure?
Preventable Demand
Is demand arising from problems that could have been prevented earlier?
Do we contribute to demand through misunderstanding the root causes?
Are shunting demand through addressing symptom not cause?
Co-Dependent Demand
Is long-term demand being entrenched through service dependence?
Do we create demand through poor relationships between front line workers and service users?
Do we sustain demand through poor understanding of what communities can do?
Ways to Manage Demand - some organisational levers
Better use of data
Hard levers e.g. enforcement, compliance
Comms & ‘nudge’
New behavioural insight
Commissioning & procurement
PayMechs, co-payment
Co-design with citizens
Apply : What levers do we have or need to shape demand
Group 1:Levers in ASC/Health
Lever
Describe existing
lever
Is it working?Y/N
Existing lever but new to us
Lever we need to de-
velopY
N
Y
Y
N
What other levers could we use? What levers need de-
veloping?
For ‘N’ levers, how improve?
From emerging science to whole system, whole place: a long term approach
Cost
s
Current Demand ‘Real’
DemandOther
ways of meeting demand
Future demand
Eliminate excess
demand
Redesign services w customers
Early intervention, prevention, resilience
PPayback Short term Medium term Long termSystem change
Re-shaping the system – what will it take?
But remember: behaviour, culture & relationships drive delivery…
“Read my Lips: no new legislative and policy frameworks…”
“It’s the behaviours, stupid….”
Building readiness – what happens next?
Collaboration: no pain, no gain?