Viaje a la Interfaz

8/9/2019 Viaje a la Interfaz.

1/62


2/62

Acknowledgements

We are very grateful to PricewaterhouseCoopers LLP for supportingthis project. anks in particula r go to Nick Jones, Andrew Knott,Duncan Lampard, Ed Straw and Seema Malhotra for making it such afruitful collaboration, and for offering invaluable advice, constructivecriticism and research leads throughout the project.

ere are countless individuals in the ma ny organisations we visitedwho gave generously of their time and thoughts. Our conversationswith them have provided the backbone to this piece of work. A full listof contributors can be found on pages 109111, and we are i ndebtedto them for the time they spent talking to us and participating in

our workshops. For now, thanks to Joel Levy, Jim Maxmin and DeborahSzebeko for their support in framing the project. eir insights, ideasand inspiration made all the difference in the early stages of theresearch. Also to Lynne Maher, John Proctor and Isobel Rickard forproviding us with the rich material for our extended case studies.ey helped us to see how powerful service design principles can bewhen put into practice. Alison Miller and Paul Rigg made it possibleto bring together the fantastic g roup of local authorities that weworked with.

At Engine, huge thanks to Oliver King for his advice andreassurance, and to Kate Dowling for her ongoing support and goodhumour. Elena Oliva deserves a very special mention for her patience.At Demos, we would have been lost w ithout the research andcoordination effort of Sophie Middlemiss. Her cool and calm approachkept us going throughout an intensive phase of research. As ever,Tom Bentley, John Craig, C atherine Fieschi and Simon Parker madeincredibly valuable contributions to the writing of the report andwe feel very lucky to have such a stellar ca st of colleagues.

Lastly, thanks to Claudia Boldt, Julie Pickard and Martin Vowlesfor working with us to t urn a lot of words into the good-lookingpamphlet you are now holding in your hands. As ever, all errors a ndomissions remain our own.

Sophia ParkerJoe Heapy

July 2006

Sophia Parker, deputy director of Demos

Sophia is deputy director at Demos. She works on organisationalstrategy a nd business development, which involves developing newpartnerships and research priorities. She has a specific interestin service design looking at ways in which public services suchas education and health can be designed from the user outwards,and Demoss families and parenting work, which she leads on.

Before joining Demos, Sophia was development manager w iththe Design Councils learning programme, which used design-basedparticipatory methodologies to engage with practitioners andpolicy-makers. She has also worked as a civil ser vant at the Cabinet

Office, where her projects included the consultation Equalityand diversity: mak ing it happen and the development and bringingto fruition of the Sex Discrimination (Election Candidates) Act.

Sophia is co-author ofDisablism: How to tackle the last prejudice(Demos, 2004), Strong Foundations: Why schools must be builton learning(DfES, 2006) and Te Other Glass Ceiling:Te domestic politics of parenting(Demos, 2006).

Joe Heapy, director of Engine Service Design

Joe is a co-director of the service design consultancy, Engine, a ndis an advocate of the social value of design in improving peoples lives.As a strategist, he looks at how best to marry business objectives withevolving consumer expectations and needs. Joe has worked with manyof Engines clients including Orange, MSN, BUPA, Visa, BT andthe Guardian newspaper. Founded in 200 0, Engine has approachedthe design of services by using design-led methodologies that put users

at the centre of the process. Engine recently helped Orange to developa European customer experience strategy for its retai l operationsand has been working w ith Virgin Atlantic on its developmentat Heathrows Terminal 3. Eng ine has worked with Demos and Df ES and 30 headteachers to develop Picture is!, a workshop toolkitfor use by schools in planning for a future of more personalisedlearning. Joe has also worked with si x schools in the UK to in stigatedesign projects involving staff and st udents in improving theirexperiences of being at school.


3/62

About Demos

Who we areDemos is the think tank for everyday democracy. We believe everyone shouldbe able to make personal choices in their daily lives that contribute to thecommon good. Our aim is to put this democratic idea into practice by workingwith organisations in ways that make them more effective and legitimate.

What we work onWe focus on six areas: public services; science and technology; cities and publicspace; people and communities; arts and culture; and global security.

Who we work withOur partners include policy-makers, companies, public service providers and social

entrepreneurs. Demos is not linked to any party but we work with politiciansacross political divides. Our international network which extends across EasternEurope, Scandinavia, Australia, Brazil, India and China provides a globalperspective and enables us to work across borders.

How we workDemos knows the importance of learning from experience. We test and improveour ideas in practice by working with people who can make change happen.Our collaborative approach means that our partners share in the creation andownership of new ideas.

What we offerWe analyse social and political change, which we connect to innovation andlearning in organisations. We help our partners show thought leadershipand respond to emerging policy challenges.

How we communicateAs an independent voice, we can create debates that lead to real change.We use the media, public events, workshops and publications to communicateour ideas. All our books can be downloaded free from the Demos website.

www.demos.co.uk


4/62

First published in 2006 DemosSome rights reserved see copyright licence for details

ISBN 1-84180-164-XCopy edited by Julie PickardDesign by Ispeaktoyouwww.ispeaktoyou.co.ukIllustrations by Claudia Boldtwww.claudiaboldt.comPrinted by Upstream, London

For further information andsubscription details please contact:

DemosMagdalen House136 Tooley StreetLondon SE1 2TU

telephone: 0845 458 5949email: [email protected]: www.demos.co.uk

About this pamphlet

is pamphlet grew out of a series of conversations about projects in ourrespective organisations. We realised that many of the organisations we wereworking with Demos in the public sector and Engine in the private sector faced a similar set of challenges around the provision of great service. isled us to explore whether or not there are some common principles of serviceinnovation. e Journey to the Interface brings together what Demos and Engine havelearnt from working with service organisations, along with the contributionsof over 50 professionals from private, public and voluntary organisations anda number of independent experts in serv ice design. e purpose of thepamphlet is to bring together and organise some of the langu age and concepts

of user-centred service. We have couched this work in the context of thepriorities for public service reform in coming years.

We hope that the pamphlet provides a useful resource for serviceorganisations, as well as a conceptual framework for approaches to reform.In that spirit, each of the core chapters (1, 2 and 3) concludes with a setof challenges questions people can ask to test the extent to which theirorganisation is focused on creating deep relationships with their users andsome shared language for service innovation. After each of t hese chaptersyou will find case studies of public service organisations that are putting someof the principles described here into practice. And at the end of the pamphletthere is a glossary a shared language of service that summarisesthe new concepts we introduce here.

Although many of the tools and concepts described here can be appliedto existing organisations, the transformative potential of service designas an approach really comes to life only if it i s applied at a systemic level.After the concluding chapter, which explores this in more depth, you willalso find an agenda for action that describes what service design principlesand practice might might mean for people operating at di fferent levelsof the system.

We welcome your contributions to this work as it develops. Do get in touch.

Sophia [email protected]

Joe [email protected]


5/62

Contents

IntroductionThe commonchallenge ofservice

e shift to a service

economy has not

necessarily heralded

a service revolution.Often as recipients

of services we feel

that someone else

is benefiting.

Pages 617

Learning to have more

intimate relationships

with people and seeing

service as support rather

than as a commodity may

not only generate the

outcomes we are lookingfor, but also offer the route

to securing the legitimacy

that public services in the

twenty-first century so

desperately need.

An agendafor action

Just as outcomes need to

be co-produced, so does

transformation: how

service design principlescan be applied at every

level of the system,

from local authorities

and policy-makers

to politicians.

Pages 97103

A sharedlanguage ofservice

ere is a small but

growing disciplineof service design.

is glossary brings

together key tools

and concepts of this

discipline to create a

shared language of

service that cuts across

all sectors.

Pages 104108

Chapter 4The politics ofservice design

If applied systemically,

service design can

offer a vision for the

transformation ofpublic services, as well

as a route to get there.

Pages 8096

Dont let existing

organisational

boundaries limit

demand. Find new

ways of supporting

and investing in the

in-between spacesthrough the formation

of partnerships and

social enterprises where

new models of service

have a chance to develop.

Make the systemic

challenge one of scaling

up these approaches.

Chapter 3Measuring success

Find ways of measuring

experiences as well as

systems: life is more

complicated than a keyperformance indicator.

Pages 6479

Measure success

obsessively, but not

through operational

efficiency alone. Two

other crucial dimensions

include success in terms of

reducing failure demand(the cost of not getting

things right the first time),

and success in harnessing

the underused resource

of peoples energy and

commitment.

Chapter 2Professionalsand practitioners

Find ways of enabling

professionals and people

to work together: create

spaces for simultaneousempowerment.

Pages 4463

Treat professionals and

practitioners as explorers

working things out with

users and customers

but rather than doing

this in isolation, they

should do it on behalfof the system. Put the

frontline centre stage

through designing

recruitment, appraisal,

professional development

and feedback channels

that empower staff.

Chapter 1Seeing servicesas people do

Services need to be

understood as a journey

or a cycle a series of

critical encounters thattake place over time

and across channels.

Pages 1843

See services from the

vantage point of the

interface, and constantly

seek to understand more

about how services relate

to peoples everyday lives

how we use them andhow we relate to them

rather than simply

focusing on the internal

workings of service

organisations.


6/62


7/62

investments are doing little to shift the stubborn figures whichindicate that we still have low levels of satisfaction and trustin public services overall.

Two problems lie at the heart of this disconnect between peopleand services. First, people are changing faster than organisationsare. Decades of expanding choice and growing wealth have leftpeople looking for more than simply quality products and services.e search for meaning and recognition, autonomy and control isa defining part of our collective psyche in the twenty-first century.e second problem is that service is still seen as a commodity

rather than as something deeper, a form of human interaction.Many large organisations still seek to provide service for thelowest cost and maximum profit. is, we argue, eats away at thefundamental purpose of service: to provide support and to helppeople live their lives to their full potential.

is pamphlet makes the case for acknowledging the commonchallenge of service in thinking about how to transform publicservices. Starting here leads to a different diagnosis of the problem.It is not that public services need to be more like commercialservice providers. It is that all service organisations need to findnew ways of connecting intimately with their users and customers,of listening and responding in ways that reassure us all that weare being understood. In order to develop our thinking we spenttime with a wide range of organisations from all sectors: public,private and voluntary that appear to be making inroads inbuilding strong relationships with customers and users.

Drawing on the interviews, workshops and case studies weconducted, we have generated a set of service design principles practical tools and concepts that offer fresh approaches toorganisations seeking to close the gap between what they do andwhat people want and need.

e current managerialist narrative about public service reformis out of sync with what people want and need from services atprecisely the time that a febrile political environment is awakeninga fresh debate about how people and services should relate to one

8/9Introduction

another. Progressive politicians urgently need to create a visionfor public services that puts people and places, not targets and keyperformance indicators (KPIs), at its heart. But if people aregoing to believe this vision, equally urgent is the need to refreshand renew the approaches that are taken to public servicetransformation.

In this pamphlet we argue that this common challenge, facingall service organisations, leads to two major consequences. First,learning how to create deeper forms of satisfaction and wellbeingthrough service is the long-term priority for public service reform.

Second, a distinctive approach to service design, which seeksto shape service organisations around the experiences andinteractions of their users, presents a major opportunity forthe next stages of public service reform: a route to get there.

The search for real meaningFor many people, relative material comfort is no longer enough.Twenty years ago, when asked what people looked for whenmaking purchases, the most common response was quality ofproduct. In 2004 the most common answer was honesty. 3

e result of the massive expansion in material wealth is that,in Ulrich Becks words, people demand the right to develop theirown perspective on life and to be able to act upon it. 4 e searchfor meaning, for authenticity, amid a world of brands, competingmessages and demands, now characterises the lives of many peoplein affluent western economies.

As one of the interviewees for this project put it, we are tiredof being treated as nobodies with no personality by monolithicinstitutions, we want to be recognised and understood.And as Michael Willmott and William Nelson argued in theirbook Complicated Lives, the self is now something we seekto understand and express, not something we simply accept.is raises difficult issues for individuals as well as our companiesand public services who are still struggling to escape thehistorical legacy of mass provision.5


8/62

As employees and citizens, were tired of working and want ourworklife balance; as consumers were impatient of being namelessand faceless, fighting for our needs; we want relationships nottransactions; we want real voice not meaningless choice. ShoshanaZuboff and Jim Maxmin have argued that the sheer scale of thesocial and economic shifts of the last century, combined with thenew possibilities offered by technology, add up to a wholly newenterprise model.6 In this model, it is not products or services thatwe value most: it is support. Support that helps people to lead theirown lives as they wish, and support that helps us to navigate an

increasingly complex and information-laden world where it is hardto know who to trust.

The commodification of serviceImagine signing up to a luxury sports and leisure club. In exchangefor a significant monthly fee, you are able to attend unlimitedsessions, use as many large soft towels as you wish, pick and choosefrom a range of treatments and relax in the social area. Imagine if,one day, you visit to find a large notice limiting each customerto just one towel each. When you go to the reception desk toenquire about something, you notice a printout charting profitsper month over the last quarter. e prices of refreshments havesuddenly gone up and you notice that a treatment that had oncelasted a luxurious hour now takes only 40 minutes.

Good service cannot be reduced to nothing more than anefficient operation: its value lies in the less tangible sense that the

service is supporting you, meeting your needs, working for and onbehalf of you. e real problem with service is that it is still treatedas a commodity as Will Hutton has argued, a commodity to beproduced at the lowest cost by the most sweated workers.7 ismental model of service has a long and deep legacy that coloursattitudes in both the commercial and the public sectors.

is legacy began when the first cars rolled off Henry Fordsproduction line. Although his business was focused on products,

10/11Introduction

his particular model of mass production the greatest numberof goods for the lowest cost and the largest number of people has become a defining feature of how we see service.

Fords model had three characteristics that are particularlysignificant for modern public services. First, costs were loweredthrough standardising the customer or their needs. Second,it drew a firm line between production and consumption. Goodswere created out of the right combination of raw materials,machines and people; these goods were then marketed and soldto the consumers whose interests and needs had little impact

on any activity within the firm. In other words, the value chainwas linear, and the recipients of the products were placed firmlyat one end of the chain. ird, this separation of production andconsumption created demand for managers professionals whoseprimary role was to match supply and demand in the most efficientway, and whose positions were defined through access to expertknowledge and insight not otherwise available to the customers.

For a long time, businesses sought to import this manufacturingmodel of mass production into service provision. More recently,as these organisations discerned a shift in consumer expectations,there has been a greater emphasis on personalised services andproducts. But when personalisation and manufacturing modelscollide, a very particular form of personalisation is created. isdifferentiation is based at best on mass customisation thebreaking down of a particular service or product into moduleswhich customers can then pick and choose from, or add and

subtract elements of.Despite the best efforts of public service innovators up and down

the country, our public services continue to be defined by a massproduction model. is has created a system that works againstprofessional desires to provide service in the form of supportand dialogue to people. Although there are pockets of success


9/62

around the country in genuinely providing service to people, thesesuccesses are more often thanks to professionals circumnavigatingthe formal system, rather than working with it.

is government has not been blind to the limitations of massproduction in creating public services fit for the twenty-firstcentury. Since 1997 their approach to breaking out of thisparticular model has been guided by an emphasis on thediversification of providers, finding ways of increasing competitionand contestability and combining them with central targets andpressure to perform. e almost continuous re-engineering of

services that has taken place has been driven in part by a beliefthat creating a market will bring the consumer values of customerfocus, responsiveness and efficiency into a public sector drowningin bureaucracy and paternalism.

But all the evidence suggests that our commercial serviceexperiences are, in general, not much better (and arguably farworse) than our public service experiences. According to researchby the National Consumer Council, 81 per cent of people hada bad experience purchasing services last year. Words that cameup frequently in relation to commercial service transactionsincluded distant, clinical and uncaring.8 ere is no guaranteewhatsoever that introducing private providers and marketdisciplines into the public sector will close the gap between whatservice organisations do and what it is that people are lookingfor. ere remains a common challenge of service: that largeorganisations struggle on a daily basis to build genuine and

meaningful interactions with their customers and users, andfrequently fail to build any kind of responsiveness, flexibilityor ability to adapt into their organisational forms.

Why this agenda matters for public service

organisationsCommercial service organisations that are unable to connectwith their customers risk losing business and profits. However,the risks for public service organisations are far higher. To achieve

12/13Introduction

the desired outcomes, public services need people to get involved.e notion of co-production, initially dismissed as jargon thatfeatured only in the lexicon of aspiring ministers and seasonedthinktankers, has become part of the new consensus about futureapproaches to public service reform. Contrary to Fords model,co-production demands that production and consumption arebrought together, so that both can take place simultaneously.As Sue Goss has argued:

Many of the new priorities respect, an end to binge drinking,recycling, improved public health cannot be achieved by

a smart government delivery machine; they require changes inbehaviour from the public. is means not simply reconsideringhow to deliver using public or even private resources, but how toaccess the free resources of public energy, engagement and action.9

So a child learning is both consuming an education and producinga cohort of lifelong learners. Someone attending a smokingcessation course is both consuming a health service and producinga healthy population. e idea of co-production demands thatpublic servants and politicians focus not only on the internalworkings and efficiencies of existing services, but also on howpeople engage with those services, and how they can be mobilised,coached and encouraged to participate in the common enterpriseof generating positive outcomes.

In many ways the concept of co-production is not new: ourchildren are not the first generation of students who need to be

engaged in order to learn. More, what has shifted is ourunderstanding of the role of the state. e five giants of thepostwar welfare state saw the role of the state as being limitedto developing systems that would help to avoid crises such asdestitution, and provide cures and treatments for problems suchas illness and unemployment. ere was a powerful sense thatwith benefits came duties, built into a stable institutional andsocial framework that has now unravelled. In many ways, debatesover the balance between individual responsibilities and state


10/62

intervention was the leitmotif of twentieth-century politics,generating huge debates within political parties as well as cuttingacross party divides.

e current emphasis on influencing the behaviour ofindividuals and engaging them in the co-production of outcomescould be seen simply as the latest chapter in a very long book.However, it also reflects an unsung triumph of New Labour.Even if they have not succeeded in transforming public services,they have succeeded in turning the tide of public opinion awayfrom low taxation. A significant majority of the population now

positively expects investment in public services. Politicians oweit to all of us to respond to these expectations, and frame a newstory about what public services are for, and why they matter.

The search for a narrative: people, placesand serviceDespite the governments attempts to engage people inconversations about why public services matter for example,through 2003s Big Conversation or this years Lets Talkcampaign it has in practice put managerialism over vision whenconsidering how to improve and transform public serviceprovision. Performance management, targets and public serviceagreements became the levers in the rather mechanistic worldview of new public management for improvements. Alongsidethe regular spending reviews, commissions such as Gershon andLyons have been set up to consider how to improve operational

efficiencies and service processes.10

Driving out bureaucracy,inspections, regulation and audits simultaneously indicated thatthis government meant business, and that it believed efficiencycould be wrought from a combination of digitisation, processre-engineering, back-office rationalisation and restructuring.

But in all the flurry of activity that has characterised the lastten years, we appear to have forgotten that a reform programmedesigned to improve the existing safety net was never likelyto connect to the challenge of meeting the needs of a society

14/15Introduction

in a state of perpetual change. As Peter Taylor-Gooby hasargued, the rational incentive-based system that has drivenNew Labours approach [to public service reform] risks neglectingthe relationships that are so very important in forging trust.11

is pamphlet offers some practical tools and insights from thesmall but growing discipline of service design as a first step towardsre-balancing the emphasis that has been placed on managerialism.Service designers do not see service as something that canbe reduced to a commodity. ey focus on how people actuallyexperience services, in order to understand how large service

organisations can create better relationships with their usersand customers.Experiences and relationships are the recurring themes

of this pamphlet. In chapter 1 we argue that engaging peoplein co-production does not happen through consultations, oncitizens juries or at council meetings: it needs to happen at the

point of delivery and through conversation and dialogue rather thanchoice alone. erefore, learning to understand and maphow people experience the point of delivery, the interface betweena service and their lives, is essential for creating the conditionsfor co-production. As we discuss, although smart use of datais important, spreadsheets are no substitute for people.

Chapter 2 explores the pivotal position played by professionalsin building relationships between people and services, andunderstanding how people experience services. We argue thattwo shifts one in professional identity and one in the shape

of the organisational hierarchy need to take place if serviceorganisations are to take a relational approach to service design.

Chapter 3 looks at how service innovators are learning tounderstand these experiences through the eyes of many differentand equally complex people, and how they can connect sucha diversity of need to the design and evaluation of services withoutresorting to the mass production model of standardisation.It describes how the most successful service organisations are


11/62

complementing the ways they measure overall service performancewith experience metrics to build up a much richer picture ofwhat really matters to people, and therefore where there is roomfor improvement.

e fiction writer William Gibson once said, the futuresalready here, its just unevenly spread.12 roughout this pamphletyou will find a handful of near future case studies of the publicservice innovators up and down the country who are demonstratingthe impact of relational approaches to service reform. By startingwith experiences at the interface, these case studies demonstrate

that relational approaches combine personalisation and efficiency,at the same time as challenging our current understanding of whatthese terms mean.

Finally, in chapter 4, we set out the main elements of a differentapproach to reform led by the service design principles of thispamphlet as it applies to the whole system of public services,with different changes occurring simultaneously at different levels.In doing this we pose some questions and challenges for politiciansand policy-makers working on public service reform in comingyears, and make some suggestions about where they might lookto learn more about relational approaches to service.

None of these arguments are about throwing away the positiveaspects of current approaches to public service management andreform. But engagement and co-production will grow only outof a deeper, richer understanding of how services relate in practiceto peoples everyday lives. And in learning more about these

interface spaces, it is possible that we could also uncover the seedsof a renewed sense of legitimacy for public services. Peoples levelof trust in services is far higher when they are asked about theirlocal secondary school rather than the education system as a whole:we trust that which we know. Learning to have more intimaterelationships with people and seeing service as support rather thanas a commodity may not only generate the outcomes we are lookingfor, but also offer the route to securing the legitimacy that publicservices in the twenty-first century so desperately need.

16/17Introduction

PhotobyFrankBaron


12/62

Service stories

In order to improve their UK business, BUPA relies heavilyon the concept of the end-to-end patient journey. Everyquarter, senior staff at BUPA Hospitals work with ahandful of their customers to trace what happens from themoment someone begins to feel unwell often some timebefore that person gets in touch with BUPA. As AlisonPlatt, head of BUPA Hospitals, says:

Doing this exercise immediately colours how you think

youll treat that person the language, the anxiety, thebureaucracy.

Having traced this, BUPA then maps its own processes,technology and interventions to the end-to-end journey.Senior staff ask themselves what each interaction lookslike, what transactions are possible, what information anypatient really needs. Finally, they add a third line onethat looks at behaviours. As Alison says:

A call isnt just a transaction, we need to ask: How do Iwant to make you feel?

A tangible change that has emerged from doing thisexercise regularly is that customers calling to discuss theirhospital visit are now offered a checklist of things that

other people in similar situations have asked. This wasintroduced after BUPA realised that people often didntknow what to ask when the call finished with the questionis there anything else I can help you with? Alison, again:

You have to do as much as possible to manage gettinginto peoples shoes psychologically, emotionally,physically.

18/19People

1

Seeing services as people doServices need to be understood as a journey ora cycle a series of critical encounters that takeplace over time and across channels.

e biggest mistake that large organisations can make is to assumethat they know what their service users and customers want. ecommon challenge of service the emotional distance between theboard and its customers, between local authorities and their citizens is reflected in low levels of trust and satisfaction. People ingeneral do not often believe that their needs are met by large serviceorganisations in either the commercial or the public sector.

If the primary cause of dissatisfaction people have with serviceorganisations is that they feel misunderstood, ignored, and treatedas faceless and nameless, then service organisations need to find newways of getting to know their users, in all their messy complexity.

e attitude here at BUPA about customer research used to be likethat of the interested spectator now we use it to drive decisions.

In recent years, public sector organisations have demonstrateda growing interest in the tools of the marketing and advertisingindustries in a quest to learn more about how insights about people


13/62


14/62

Attitudinal segmentation seeks to understand the meaningfuldistinctions between the values and beliefs of users with respectto a particular service. is type of segmentation might identifysubgroups by statements such as, Im fiercely independent and wantto be treated so, or Ive paid for this service Im entitled, or I dontwant to be a bother.Behavioural segmentation groups the practical reasons why peopleare using a service or channel as the basis for understanding whatis required. A behavioural segmentation model might group usersby statements such as, I need help, I need some support, I need

to complain.

Journey segmentation recognises that there may be many routesto a single destination such as achieving a healthy body weight.As a nation we need to eat less and do more exercise but simplyreminding people of the consequences of not doing this is notgoing to have a huge impact. Services need to be accessible, butthe designers of services also need to have understood the breadthof starting points and the complex emotionaljourneys that peoplewill need to be motivated to embark on.

ese responses to the challenge of complexity reveal newinsights that go beyond what to provide? and begin to answerhow to provide?

Increasingly service providers are using what they know abouttheir users to create segmented service propositions based loosely

around customer types but inviting customers to self-segment tochoose from a small number of similar offers and channels basedon what they think best matches their own needs. e sameoffer may be packaged in a number of different ways so thatit is not about the choice of which service but the choiceof which experience. e customer takes control of the choice.

Self-segmentation is one response to the realisation that peopleincreasingly defy segmentation and do not like to be told who theyare by big organisations. People exhibit what marketers call multiplepersonas. We can be professionals, parents, pleasure-seekers and

22/23People

PhotobyGrahamTurner


15/62


16/62

And it is hard to escape these prisms. e mobile phonecompany, Orange, knows from experience that making the journey[to see services from a customers eyes] is very hard, as peoplehave a job within an organisation. eir concern is usually withdelivering their part of the service, not putting themselves inthe position of the user. Experiencing services from a personsviewpoint is very difficult.

Seeing your services as your users do is not, unfortunately, aroute to simplifying the picture, but it enables organisations to seea different kind of complexity, a complexity that sheds new light on

how best to prioritise operational, organisational and policy change.For service designers, the building blocks of service are not episodesand institutions. ey are the touchpoints, channels, architecturesandjourneys that describe services from the starting point of theinterface. It is those concepts that the following sections explore.

The tangible elements of service: touchpointsTouchpoints are the people and tangible things that shape theexperience of services (see pages 2829). e interest in touchpointsoriginally grew out of organisations seeking to reinforce their brandin ways that went well beyond marketing and mass advertisingcampaigns. In practice, this recognises that as customers of anairline, we are more likely to remember something about the brandfrom our interactions with cabin staff, for example, than we are fromlooking at the design work on the tailfin.

Everything we do should be characterised by obsessive and

uncompromising attention to detail. We know that any journey ismade up of many little experiences and that it doesnt take much toturn a happy customer into an unhappy one. We cannot afford thisand we must not let this happen.17

Although branding may not be the top priority for many publicservice organisations, there is a crucial principle here. Touchpointsare the places and spaces where people experience serv ices. eextent to which their brand invites people in or frustrates themdetermines the extent to which those people are engaged. And

26/27People

the level of dissonance between what an organisation says it caresabout (for example, personalisation or user empowerment) andhow people experience that organisation lies at the heart of whetheror not people trust such services. People become suspicious ifexperiences do not match the expectations created by rhetoric,customer charters and organisational commitments.

e need to map public service touchpoints and explore theextent to which they support the commitment to personalisationand co-design is illustrated by the comment of one of ourinterviewees about a recent hospital experience he had:

You get the feeling they dont want you there, that they think yourethe problem . . . they seem to be saying my life running this hospitalwould be so much easier if you werent here. . . . My experienceis that hospitals perpetuate my anxiety; when I find myself inthis system I feel helpless. ere is nothing you can do to ease

your anxiety. Information provision is appalling theres nohand-holding. You find yourself asking several dumb-soundingquestions to various people behind desks it seems as thoughthe system somehow requires you to do so.

In this comment, it is possible to identify a whole range oftouchpoints people, desks, information provision, the hospitalbuilding itself that together combine to disempower the personneeding the service.

The forgotten touchpoint: service environmentsAlmost all public services have an implicit association witha designed and built environment. Some of the most profound andemotionally charged interactions with public services happenbetween four walls where furniture, fixtures, fittings and the designof information play a significant role in shaping peoples experiences.Yet so often, they are treated as neutral spaces where stuff happens.

In fact, our behaviour is shaped by the environment. Chris Gerry,head of New Line Learning Federation in Kent, told us thatthe kids behave differently in here [the school] to out there andyet the rules arent written up, theyre embedded.


17/62

28/29Touchpoints


18/62


19/62

customers. Service blueprints are developed alongside buildingblueprints. In this way organisations can design environments thatare both instructional and inspirational to a diverse group of users.

Greater access through the proliferation of service channelsIn the past, the customers of services tended to stick to a singlechannel. People booked holidays by sitting in front of a desk ina travel agents, they bought bread from a baker and got their milkfrom the doorstep. Public services have in recent years begun toexpand the number ofways in. Andy Carroll, a strategy managerat the Pensions Service, told us thatweve made a huge investment

in moving from a local paper-based organisation to a nationalcontact organisation. e goal for the Pensions Service is to moveaway from office-based services, instead supporting people overthe phone, or via one of the 2500 outreach workers who arenow working to support such a majorchannel migration.

e story of the Pensions Service is mirrored all over the publicsector. To access health support people can attend a medical drop-incentre, go online or call NHS Direct which now receives 600,000calls per month in addition to making an appointment with theirgeneral practitioner (GP). is trend is likely to grow: last year,the Cabinet Office published Transformational Government wherethey argued:

Over the next decade, the principal preferred channels for thedelivery of information and transactional services will be thetelephone, internet and mobile channels as well as increasingly

important channels within the digital home . . . government willinnovate its services to take swift advantage of new technologiesas they emerge.19

In this proliferation ofchannels, ofways-in to services, thereare two key questions all service organisations need to address.First, how can they understand the different channel needs andpreferences of a diverse set of users; and second, how can theyunderstand the different interactions and relationships betweendifferent channels. Any attempt to create an integrated channel

32/33People

strategy (as set out in the Budget earlier this year) needs to startwith peoples experiences and preferences for different channels,rather than efficiencies alone.

Today, it is no longer possible to assume how a user will accessand use a service once many channels are available for them to doso. erefore every channel needs to some degree to accommodateevery kind of user and must be joined-up so that users can moveeasily between them. Orange, for example, uses a single customeraccount, which enables them to provide a consistent experienceregardless of whether customers decide to call up, go online

or visit a store on the high street.is is important because channels are not simply new routesfor delivering services. ey remain ways of engaging users, ofdrawing them in, of helping people to look after themselves.erefore individual channels and the relationships betweenthem need to be mapped onto peoples lives. As a member of theTransformational Government team told us, solutions need to beabout services, not IT.

To make this real, the government is going to need to do morethan promote responsible channel choice by telling people howmuch the use of more efficient channels saves, and what that savingcould achieve in terms of reinvestment elsewhere in the publicservices.20 Building the functionality of e-government must notdistract government or users from the more difficult challengesof improving services. Technology is of course part of this, but itis by no means the only part.

The interaction of different touchpoints: journeysGreg Nugent from Eurostar told us:

Mapping the customer journey brings together serv ices, productsand experiences . . . its the only way you can see how they interactand how the brand adds up to more than the sum of its parts.Doing the journey made people admit where it was going wrong,because they could see it all in front of them.


20/62

Earlier in this chapter we noted that often service experiencesare treated as episodes interruptions to peoples everyday lives.By starting with people and asking them to describe their experiences as BUPA does, in the example that began this chapter the focusshifts from looking at episodes, to thinking aboutjourneys: how allthe touchpoints and channels come together over a period of timeand interact with peoples lives, needs, interests and attitudes.

When someone enters prison, they are assessed seven timesin the first three days for level of risk, for health, for learning anddevelopment and so on. Each of these assessment touchpoints could

be perfectly designed; however, for many prisoners it is frustratingto provide the same information time and time again. It serves todisempower them, to leave them as little more than a figure on anassessment sheet. Focusing on individual touchpoints and exploringthe extent to which they live the brand of user empowerment is avital part of a relational approach to public service transformation.However, equally important is the need to understand theinteractions between different touchpoints and channels. Equally,if the information taken about these different needs is not pulledtogether by the organisation, how can it ever provide an integratedservice to the prisoner?

Services need to be understood as ajourney or a cycle a seriesof critical encounters that take place over time and across channels.is is key to integrating the organisation of services around theiruser, and to combining distributed organisational resources tocreate experiences and outcomes.

e concept ofservice journeys is familiar to designers. As atechnique it was pioneered and trialled extensively in Scandinavia;it has been used to design everything from aeroplane cockpits tofinancial trading systems and is increasingly being applied to servicesin the public and private sectors. As a method, it enables peopleto create a rich picture of how service experiences play out in thecontext of everyday life. e objective here is not to understand andoptimise operational processes but to determine the best experientialjourney for the users of a service.

34/35People

As the example of BUPA demonstrates, mapping a user journeyis a far more powerful way of understanding where services couldbe improved and how engagement could be better encouraged thanany kind of large-scale customer satisfaction survey.

Butjourneys can be used for more than simply identifyingproblems or points in the service where there is room forimprovement. As the users of services are given more choice, andare empowered to make decisions that may previously have beenmade by experts, it will become more important to include toolsto help people manage the uncertainty associated with choice.

Talking about equipoised choices in healthcare, Bernard Crump,chief executive of the NHS Institute for Innovation andImprovement argued:

We need tools to help what need to be sophisticated and pacedconversations about decisions to be made these decisions dontlend themselves well to the seven-minute outpatient model . . . weneed to surround that consultation with tools to help people decidewhat to do.


21/62

A service journey is often characterised by a series of choices,which in some instances may have life-changing consequences.Well-designed service journeys should first anticipate and design-out the likely errors that users could make when using services many of which can be put down to poor information design and reduce the negative effects of any errors that are made.When possible, service users should be able to undo choices andre-choose without incurring penalties. Another strategy to reducethe uncertainty of choosing is to provide the means for users tosimulate choices to play out scenarios and to experiment with

the options available. rough the simulation of futurejourneys thelikelihood of making the right choices increases, and the risk andinefficiencies associated with making the wrong choices are reduced.

The new building blocks of serviceInsights, segmentation, touchpoints, channels, environments,journeys. It is these, not data, functional institutions and episodes,that constitute the building blocks of services from a usersperspective. If the commitment to creating user-centred servicesis going to add up to any more than hollow rhetoric, then serviceorganisations need to become experts in the methods, tools andways of seeing service that ensure they can genuinely make thejourney to the interface, and see their services as their users do.

e picture of service is no less complex from the interface asit is from a systemic perspective. What is different, however, is thatthe interface focuses on how people and services relate, not simply

the shape of existing services. In tackling the common challengeof service that this pamphlet is focused on, we need to recognisethat generating positive outcomes requires engagement, and realengagement comes through experiences. erefore, being ableto map and shape those experiences is the only way that publicservice organisations will be able to create strategies for genuineimprovement and ultimately the transformation of services.

36/37PeopleChallenges

How are you segmenting your users? What combinations of datado you use to create insights?

Who is responsible for user intelligence? How are they connectedto the management of your organisation?

Are you genuinely looking at your services from the vantage pointof the interface?

Can you map all the touchpoints of your service? Do you knowhow people feel about these touchpoints?

How do the different channels of online, phone and face to faceinteract for different kinds of service users?

How are you designing in deliberation, dialogue andopportunities for co-creation to the touchpoints and channelsof delivery?

A shared language of service

Journeys

ChannelsSegmentationPropositionTouchpointsArchitecturesService environmentsPersonas

Definitions on page 104106


22/62

38/39Case study

Luton and Dunstable Head and NeckCancer Services

e multidisciplinary team meeting at the Head and Neck CancerClinic starts at 8.30am where some patients cases are discussedby the team to make decisions on treatment and care. At the sametime patients start to arrive at the clinic waiting room. is is an

anxious time for patients and sometimes parts of the clinic processheighten that anxiety rather than reduce it. e way the chairs arearranged in the waiting room leaves patients facing a wall full ofofficial notices or looking directly at others; the number of differentprofessionals that seem to be around can be bewildering as are someof the processes. is often leads to a feeling of helplessness, andthinking if only the experience could be different:

You have to get there early to claim a seat otherwise youre standing. . . by the time the consultants arrive at the clinic it is already busyas the clinic shares its waiting area. ere are patients and carersstanding all over the place, waiting quietly to be seen.

e consulting rooms at the clinic are much like a dentists; thepatient sits in the chair and stares upwards, surrounded by anaverage of seven members of staff, and it is in this situation that

most patients are given their diagnosis.Across the NHS patients are rarely involved in healthcareimprovement beyond mechanisms such as focus groups andquestionnaires. Luton and Dunstable Hospital Head and NeckCancer Services has been taking an innovative approach to theongoing re-design of their service, which is putting patients andstaff right at the centre of the process.

Photobythinkpublic


23/62

e project has been sponsored and supported by the NHSInstitute for Innovation and Improvement and is co-producedwith the service design consultancy, thinkpublic, anthropologicalresearchers from University College London and, importantly,patients and staff from the hospital. e objective has been notto solve any specific problem of service delivery, but to achievean improved experience of the service by involving staff and patientsin the process of re-design. To do this, a range of techniques hasbeen used to help patients and staff describe their experienceswith a specific focus on the touchpoints.

A project team was brought together that comprised patients,carers, healthcare staff, researchers and improvement leaders. ecore project team knew that the initial engagement with patientcarers and staff would be critical, so in the build-up to the projectthey engaged with their audience through a range of communicationmedia including posters, leaflets and a low-tech newspaper to createinterest. Patients and staff were invited to become involved inexamining the service in ways that were unfamiliar to most of them.

A participatory design project like the one at Luton andDunstable is not something that staff can be coerced or targetedto get involved in. Vital to its success is that those who take partare willing and energised participants. As a subtle mechanism ofrecruitment onto the project, all staff were invited to keep log booksand to note their own thoughts, frustrations and ideas about theservice they were providing. Deborah Szebeko, a member of theservice design team, told us:

We had a strong sense that patients wanted to get involved becausethey felt that they wanted to give something back to the service. Staffwere excited to work with patients in a way that was different fromtheir usual relationship with patients.

Insight was generated in a number of ways including further workwith the log books and patient interviews. e patients and staffmapped a set of touchpoints that they felt formed their experienceof Head and Neck Cancer Services and re-played their emotional

40/41Case study

journeys through the service. ese touchpoints then formedthe key focus for re-design. Many of the touchpoints that wereidentified can be re-designed very easily and would makea huge difference to the patient experience. For example, staffmoved weighing scales out of sight of the waiting room theyhadnt noticed how embarrassing patients found it to be weighedin front of everyone.

Film was also used as a way to encourage involvement literallyhanding over the lens through which the service was viewedto patients and bringing their lived experiences to life for others.

Patients found this process to be an incredibly powerful wayto share their stories and be heard. When patients films wereshown during working sessions it immediately created a sharedunderstanding and a new empathy for the deeper needs of patients.e effect was to connect and energise the group towards a commonpurpose to improve the patient, carer and staff experience.As Deborah told us:

While we did have some concerns that re-living and sharing thesetypes of experiences might be difficult for patients, the majority

felt that it was invaluable in helping them to move forwardand in building relationships with other patients, carers and staff.

Many patients suggested that the project methodology offilmmaking that they had been invited to work on should becomepart of the patient journey itself an example of how handingcontrol over to users in the context of a designed methodology

becomes an aspect of service in its own right:

Weve had one patient working closely with us and visiting ourstudio to edit his film; he has helped bridge a gap and get staff onboard with film. He is extremely passionate and just really wantedto help; he has taken time off work to get involved withthe project. He also feels he is learning new skills.


24/62

In this example, service design, service delivery and insightgeneration happen simultaneously and collaboratively at theinterface. As one patient of the service said:

I enjoyed meeting everyone feeling I was eating properly for thefirst time, possibly because I was in company.

is type of participatory design intervention led the teamto conclude that the principle of building continuous serviceimprovement mechanisms into the everyday experience for bothpatients and staff rather than being an independent activity canadd an incredible amount of value to the service. And importantly,it helps to improve communication between patients and thosestaff who are providing care.

rough mapping user journeys, patients articulated clearly thatthis clinic represented a pinprick in comparison to their wholejourney, which involved many other departments and hospitals aswell as touchpoints outside of the formal system. is demonstratesthe wider challenge for health services in working together acrossthe whole patient journey.

e process so far has opened up a new dialogue between staffand patients. e project which now has its own active blog has connected people with the same interest in improving thetouchpoints of the service and has given permission and a structureto make small but significant changes happen. Lynne Mahar at theNHS Institute for Innovation and Improvement commented:e process so far has challenged traditional views and experiences

of service improvement, giving patients and staff a new energyand commitment for change. Together they are trialling how theclinics space is used; instead of the consultants having rooms,which patients move in and out of, patients now have roomsand staff move to see them. e clinic is now building a closerrelationship with neighbouring Mount Vernon Hospital, whichprovides radiotherapy, to build a better understanding of thewider patient experience.

42/43Case study

e project is still work in progress but staff appear to be moremotivated to work with patients. Patients are calling staff toarrange times to meet; they appear to be mobilised and active inco-designing and trialling ideas. e perceived risk expressed bysome staff that involving patients in this way would unfairly raisetheir expectations and lead to disappointment has not transpired.As one member of the team pointed out:

Patients and staff are not asking for gold taps, in fact most of theirsuggestions are quite achievable with a little budget. I would say oneof the most important things is providing space for relationships to

build and supporting that with communication.

e experience of connecting patients and staff in this way hasproved to be extremely valuable in changing beliefs about what theycan achieve. is combination of experience and belief has led topositive action, resulting in change that will actually improveexperiences.


25/62

Service stories

Peter Gilroy, now chief executive of Kent County Council,told us that the quality of interactions is my obsession . . .relationships are the glue that hold everything together.In his previous job, as strategic director of Kent SocialServices, his first step towards achieving 3-star status wasto work on improving the experiences of his staff working atthe council: If we cant look after our staff, they arenot going to look after our customers. He produced a

ten-point plan that focused on two dimensions: peopleswork on the job and their quality of life overall.Training and career progression was a major focus, as wasworklife balance and staff health. But Peters approachwent beyond simply making life better for his frontlineprofessionals: he took that focus and used it to demand thatpeople re-imagined the shape of the organisation:

I wanted to create a paradigm shift to show that the frontof our business was more important . . . youve got to takevery seriously the behavioural and care aspects of theworkforce and I dont mean of your senior people, yourpriority must be the front of the business . . . transformationisnt just about things, its about behaviours and mindsets.

High expectations are rewarded with recognition and

validation for good work. Kent has regular Oscarceremonies for frontline staff, and employees from anyarea of the council can qualify for exchange trips aroundthe world if they have performed excellently. Under Petersleadership, Social Services reached 3-star status and Kentis now one of four 4-star councils suggesting that hisdetermination to put the frontline centre stage reaps powerfulbenefits not only for the people working there but also forthe citizens of Kent.

44/45Professionals

2

Professionals and practitionersFind ways of enabling professionals and peopleto work together: create spaces for simultaneousempowerment.

Richard Elliot, former manager of a drugs action team in Bristol,found himself dealing with a tangle of 44 different funding streams,nine planning grids and 82 different objectives. By his estimation,he and his team spent little more than 40 per cent of their timeactually working to tackle drug issues. Unsurprisingly he resigned,writing that monitoring has become almost religious in status,as has centralised control . . . the demand for quick hits and early

wins is driven by a central desire analogous to the instantgratification demands made by drug users themselves.21

Richards story is echoed in a wider complaint about the impactof targets of professional autonomy and identity. Public serviceprofessionals and practitioners are growing increasingly vocalabout the unintended consequences of targets, arguing that theircumulative impact adds up to disengaging, frustrating andalienating experiences for service users. Practitioners recognise thatmany people approach a service organisation and are made to jumpthrough a set of complicated hoops in order to meet an apparently


26/62


27/62

user interests and producer interests at odds, future approachesto reform need to focus on how people and service staff can worktogether to create outcomes.

When Richard Duvall founded the online bank Egg, he set outto create a bank that could dance with its customers a bank thatcould respond to changing needs, expectations and preferences.Similarly, the most successful service organisations are finding waysof recognising peoples professionalism through being expertsin designing support collaboratively with people. Professionalexpertise continues to exist, but it is deployed differently: rather

than solving problems or telling people what to do, this expertiseis used to uncover needs and help people navigate a complexnetwork of possible support.

The professional as expert but not as we know it

e collective good is made up of millions of different, sometimesintimate decisions and experiences about the way people lead theirlives. ese decisions depend on relationships more or less equal,more or less deep, more or less extended, but always a two-wayexchange between public and professional.27

e tension that on the one hand, professionals feeldisempowered by targets, and on the other, dominant models ofprofessional identity keep the power on the side of the serviceorganisations, not the users, will not be resolved through settingstaff and users against one another. e challenge, instead, is to

focus on how professionals and people can work together to createoutcomes. Service innovators have focused on creating spaces whereprofessional and personal autonomy can grow simultaneously.ey have done this through fostering a form of professionalidentity, vested less in expert knowledge and more in capabilitiesto provide deep support to individuals, to motivate them to helpthemselves. As Charles Leadbeater has argued, professionalsshould serve people in a way that builds up distributed capacityfor coping.28

48/49Professionals

Photoby

Linda

Nylind


28/62

If outcomes are more likely to be achieved when reform to publicservices starts with the experiences and interfaces between peopleand services, it is clear that frontline workers are an essential partof the jigsaw puzzle. Despite expanding options for self-service,many of the most complex problems people face go beyond theboundaries of DIY serv ice. However, the insights put forwardin this chapter apply just as much to the fleeting interactionsbetween people and service professionals as they do to longer-termrelationships. Relational approaches to reform are not all aboutforming long-term relationships over time; instead they are about

a set of qualities empathy, recognition and understanding and a consequent focus on dialogue. As one participant froma local authority said to us: We aspire to create relationships withour customers but at the moment we barely give them a one nightstand. Whats important isnt the length of the relationship but theextent to which I feel understood and listened to at that moment.

Putting the frontline centre stageChapter 1 has already described how hard it can be for largeorganisations to genuinely see their services from their usersperspectives. Equally, making the case for empowering staff to workcollaboratively with users is far easier than creating organisationswhere all the surrounding systems and processes align with thoseprofessional values and expectations. A common theme in all theorganisations we met is that an unerring focus on creating highlysatisfying customer experiences has to be sponsored from the top.

Similarly, such a focus can sometimes lead to short-term losses inorder to make long-term gains. For example, in 2005, BUPAprocessed 90 million of ineligible claims. It did so because itsfrontline staff had worked with the customers and decided that,for whatever reason, there was a good case to process the claim.By doing this, BUPA is effectively communicating to its staff thatlistening to the customer is more important than enforcing the rulebook. Customer satisfaction and loyalty, rather than immediateprofit, is an important part of BUPAs long-term commercial

50/51Professionals

position and the management communicates this effectively tostaff and customers alike when it goes ahead and deals with thoseineligible claims.

e remainder of this chapter outlines how successful serviceorganisations have taken a simple principle that professionalismneeds to be rooted in empathy, support and dialogue andthreaded it through every layer of their business, from individualaccountability, to shared values, to organisational systems, benefitsand processes. It is this Russian doll approach that ensures thatthis is about far more than simply overlaying old models of service

with new indicators of customer service. Instead these organisationsdemand a lot from their people-facing professionals; but in returnthey put the frontline the interface centre stage and shapethe organisation around the pursuit of high-quality interactionsbetween people and services.

Accountability for experiences: definingprofessionalism for individualsRecruiting for empathyfirst direct, judged to be the number one bank in terms of customerservice, explicitly hires empathetic people and interestingly, manyformer nurses and teachers can be found on the payroll. John LewisPartnership speaks of the importance of recruiting partners whoare experts but as Patrick Lewis, their supply chain managerpointed out, we need to be careful that people are experts incustomers not products. ey recruit predominantly on attituderather than experience; this is reflected not only in how they bringin new recruits, but also by the fact that many of their seniorpositions are filled through internal promotions.

Large organisations need to find new ways, not only ofencouraging, but of making inevitable a focus on the extent to whichstaff respond to and support people seeking service. e dialogueand conversation that sits at the heart of relational approaches isabout more than listening. It requires staff to be empathetic, to havean intuitive unity with people that is driven by their recognitionof the emotional, social and cultural context of service experiences.


29/62

Guardians of the customer experienceMany of the organisations we met over the course of this researchhad introduced performance frameworks that evaluated everymember of staff on the basis of their contribution to positivecustomer experiences, in addition to some other more traditionalmeasures of job performance.

For example, at Virgin Atlantic staff are appraised on the extentto which they perform as guardians of the customer experience.Angus Struthers told us:

Staff have to remember that they are not just working for Virgin

Atlantic, but theyre working for the passenger and they have got tobe able to put themselves in the shoes of the passenger, and ensurethat passengers receive the kind of experience they would like toreceive, as corny as that may sound.

And as Alex Popple at MSN UK said:

Were incentivised around doing things that are ground-breaking. . . everybody is supposed to have an objective around improvingthe customer experience.

Open and shared professional valuesand behaviourse most successful service organisations have understood that theycannot simply legislate for how staff relate to customers throughperformance frameworks. ese organisations have also focusedon how to keep relational values alive, to stop them from ossifyingin company mission statements or job descriptions that get buriedin human resources folders. ey are experimenting with new waysof distributing capacity for holding staff to account on respondingto peoples needs. ey are permanently looking for new waysof fostering a sense ofmutual accountability.

BUPA and Tesco have invested considerable company timein working with staff to develop the values that guide relationshipswith customers. For example, at BUPA Hospitals, the seniormanagement team worked with all staff to answer the question:

52/53Professionals

If you were doing your job brilliantly, what would it look like?Significant organisational time was put aside to consider thequestion. e result is not a fixed set of job descriptions, but rathera series ofexcellence profiles for all staff, ranging from cateringmanagers to consultants, that represent a shared set of valuesto which people can be held to account. Everyone is able to accessany excellence profile they wish through a central system. Ratherthan defining a specific set of activities, the profiles are aspirationaland are firmly grounded in the organisations mission to take careof the lives in our hands.

Similarly, about five years ago, Tesco held a series of day-longseminars for literally thousands of staff. e purpose of thesesessions was to start a conversation about what Tesco stood for,and what it should stand for. e results were boiled down intotwo simple, memorable lists: four things we do for customers andsix things we do for each other. In developing these lists, Tescosuccessfully created a shared agenda, used and owned by staffup and down the country.

Pret a Manger uses its recruiting process to remind staff of itsvalues and encourage them to own them. Every applicant who wantsto work at Pret i s invited to an experience day a day where theygo and work in the store to which they have applied. At the endof the day, the rest of the staff vote on whether or not the applicantmet the criteria of customer focus that all Pret employees are heldto account on. If fewer than 90 per cent of staff believe that thisis the case, then the person does not get offered the job.

Experiences at the interface drive organisationalpriorities tooe story of Peter Gilroys ten-point staff plan outlined at thestart of this chapter illustrates another common theme from theorganisations we spoke to over the course of this research. All hadhigh expectations of staff. But they also tried to provide a lot inreturn, both in terms of recognition and support. As Peter Simpson,former commercial director at first direct, said, people are people


30/62

54/55Professionals

the only difference between a person working here and a person notworking here is that were paying one of them.

Another important characteristic of these organisations is thatthey sought to learn from their staff about how organisationalsystems and processes stood in the way of being able to providesupport, or about which rules worked against positive experiencesbetween services and people. Good service organisations treat theirstaff as the eyes and ears, able to advocate powerfully for howthings can be improved for users or customers.

Training and celebrating

e organisations we spoke to spent disproportionate amountsof time and money on supporting staff to achieve more. Forexample, Pret spends virtually nothing on advertising. Instead,they take the 67 per cent revenue that would normally be spenton marketing activities, and reinvest it in training and fun. Pretstaff are offered free English lessons and regular parties. For Pret,as with many other good service organisations, they do not believeit is possible to ask staff to focus on empathy and relationshipswith customers without building in a people-centric culture to theorganisation itself.

Similarly, Peter Gilroy in Kent fought hard to invest 2 per centgross every year on training and research despite widespreadconcerns about deficits. He remained firm, however, arguing thatsuch investments always bring better returns. He backed up thisinvestment by insisting on regular celebrations of and rewards

for staff success. e awards celebrations they hold, which seniorstaff are expected to attend, celebrate staff who have been judgedexcellent by users. High-performing teams and individuals arerewarded by funding for study trips around the world. As Peterargued, the total cost of these activities adds up to little more thana single national advertisement for a new post, and yet they are keyto empowering, enthusing and ultimately retaining his staff, whohe regards as his most valuable asset. In his words, the training andmentoring schemes, as well as the parties, became part of the ether,part of the gold dust that have contributed to the organisationimproving its services so successfully in recent years.Ph

otoby

DavidManse

ll


31/62

Such anecdotal evidence about the impact of training issupported by larger-scale studies. Bassi Investments chartedthe performance of a share portfolio of companies with highinvestments in training over five years, against the Standard &Poors 500 (a US equivalent of the FTSE 100). e findings wereclear: the US firms that made the largest investments in employeeskills made the largest returns (16.3 per cent per annum) comparedwith the average return (10.7 per cent) across the index. In otherwords, investors received a 52 per cent higher return over five yearsfrom shares in companies that make high investments in training.29

Quality of workProfessionals should be paid fairly for their work, but not at theexpense of the working conditions themselves. Increasingly, weare recognising that control over working time and conditions,self-management and forms of democratic control over theworkplace are as important as the traditional trade union agendaof pay and conditions. Research in the UK has found, for example,that autonomy ranks higher than hours and pay as a factor indetermining job satisfaction.30

Building lateral capacityAsk most people-facing staff who they could learn from most andthe response will usually be other people doing their jobs elsewhere.For too long, public service workers have been trapped within theirown zones of practice whether thats the classroom, the district orthe GPs surgery. e continuous process of professionals learning

how to respond, and taking on a mantle of solutions-assemblersor advocates as part of the shift in professional identity describedabove (see page 48), can be sped up and supported by a focuson fostering lateral connections through the development ofcommunities of practice or action learning groups.

Organisations that seek to facilitate and support such lateralnetworks are effectively communicating to their staff that theyrecognise that knowledge, ideas and expertise are not located inthe central office, but instead at the frontline. In spelling out and

56/57Professionals

backing up this message, organisations can demonstrate theirsupport for staff from whom they are demanding high levels ofempathy and entrepreneurialism in meeting peoples needs. Onerespondent said to us: Organisations need to give people mirrorsto compare themselves to others. is is the only way youllovercome the temptation of command and control.

ere are two further benefits to fostering peer networks ofpeople-facing staff. First, innovation no longer happens in isolation,but instead through teams. Encouraging people to work togetherand experiment with fresh approaches to meeting peoples needs

can increase staff satisfaction and create more positive serviceexperiences. Second, finding ways of sharing knowledge can createefficiencies and prevent people from inventing the same wheelmany times over.

Learning from people-facing professionals

Our success is built on insights from individuals on the frontline.

Chapter 1 discussed the importance of opening out the channelsby which data and insight can be used to drive organisationalpriorities and development. Alongside gathering insights fromusers and customers directly, the service organisations we spoketo created the time, space and expectation that staff insights wouldalso drive the process of priority-setting and problem-solving forthe organisation.

For example, John Lewis Partnership holds weekly consultation

half-hours where staff are able to share insights about whatsworking well and what is working less well in each of the stores.ese are discussed at the individual store level as well as at thenational office. Last month, Peter Gilroy sent out a message viapayslips to all his employees, asking them each to take five tothink for five minutes about new ways that Kent could generateincome for its work.

Insights about service improvements are valuable by-productsof interactions between professionals and users, and organisationsneed to ensure that they develop the mechanisms and channels


32/62

that are able to capture and use these insights. Just as settingup communities of practice underlines to staff that they are theones likely to have the best ideas, creating these opportunities forfeedback and demonstrating that this feedback can have animpact on strategy is a crucial part of creating a culture that putsactivity at the interface centre stage.

Relational approaches to service put frontline professionalsat the centre stage, alongside users, as key characters at the interfacebetween people and services. is has implications both for theprofessionals themselves and for the way in which the frontline

is connected to the rest of the organisation. For the successfulservice organisations that feature in this report, professionals theirroles and identities play a crucial role in focusing on experiencesand engaging people. e challenge, in their terms, is to createthe space and capacity for people and professionals to grow theirautonomy simultaneously and to shape an organisation thatactively supports this.

58/59ProfessionalsChallenges

What are the key aspects of professional identity in yourorganisation?

Do your job descriptions, recruitment strategies and performanceframeworks reflect a firm commitment to improving userexperiences of service?

How have you invested in training and recognition for your staff?

How are you connecting frontline professionals to each other?

What are the natural points of common interest and socialcontact?

Which aspects of organisational routine offer opportunities forgarnering staff feedback?

What connections to organisational structure and strategyneed to be made in order for staff ideas to flow into corporatepriorities?

Where does your organisation learn its collective lessons?

A shared language of service

Guardians of the customer experienceMutual accountabilityExcellence profilesCommunities of practice

Definitions on pages 106107


33/62

60/61Case study

Birmingham OwnHealth

Pfizer Health Solutions is working with NHS Direct and twoprimary care trusts (PCTs) in Birmingham to create an innovativeapproach to service. Launched earlier this year, BirminghamOwnHealth will support up to 2000 people with diabetes, heartfailure and/or cardiovascular disease. It draws on healthprevention models used in the USA where the focus is less onefficiency of existing services, and more on changing projectionsand trends. John Procter, who leads the Pfizer Health Solutionsteam working on the scheme, argues that there is a need to investin the value of health, and move beyond simply looking at the costs.He sees the work in Birmingham as an opportunity to demonstratewhat this looks like in practice:

Innovative partnerships such as this one can play a crucial rolein helping the NHS shift from being a sick care system towardsbeing a patient-centred health care system. It will deliver benefitsto all individuals and the ir families, clinicians and healthcare

professionals, and the wider NHS.

At the heart of Birmingham OwnHealth is the ambition to reducethe number ofnon-scheduled visits to secondary care by far themost expensive element of health services through enabling

people to better manage their conditions and prevent them fromescalating:

Programmes like this dont save money immediately but theydo reduce the growth of t rends over time . . . its as much aboutwhat you dont spend as what you do.

Photoby

Duncan

Phillips


34/62

Birmingham OwnHealth has innovated in terms of the channelthey use: it is a service delivered entirely over the telephone, on thebasis that phones are in peoples homes and part of their everydaylives, even if they are not very mobile. To make the service asaccessible as possible, it is offered in two languages (English andPunjabi) and all supporting patient information has two versions one for high literacy and one for low literacy.

e schemes success also rests on how the frontlineprofessionals are trained: the focus is on their professional role

and interactions with the patient and the need to build relationshipswith the people they are supporting and the surrounding servicesthat each patient may wish to access. Rather than using theirclinical expertise to instruct people, the NHS Direct nurses aretrained to use that expertise to guide people to reach their ownconclusions instead:

Its totally different to an inbound system that uses algorithms. . . it s about coaching and support and conversation.

is alternative model of professionalism is supported bythe design of the schemes knowledge management and needsassessment system a digital platform developed by Pfizer HealthSolutions. In the first conversation, the care manager will ask somesimple questions for example about diet, exercise and so on andthe system will highlight areas where the patient needs to do somework. Together, the care manager and the patient will talk in order

to understand which issues are relatively straightforward to tackle,and those where the patient feels they need more support to tackle.ey then set some targets not based on system performance butinstead on the goals that the patient feels they can achieve throughthe conversations and coaching offered by the nurses. e ultimategoal is for each individual to begin to have a positive impact on theirhealth and wellbeing through taking action built on the confidence,knowledge and understanding they have gained through workingwith their care manager. In time people will eventually graduate

62/63Case studyfrom the programme, with the graduation criteria being focused

on capacity to self-manage, rather than a pre-defined set ofoutcomes that may mean different things to different individuals.

Birmingham OwnHealth has also begun to knit together thewhole range of local services for their users. ey are mapping whatthey call the local service ecology noting the locations for specificservices to help guide users towards what they are looking for. Intime this map will help the PCT in collaboration with GP surgeriesto ensure that services are evenly distributed. Staff work with people

from specific GP surgeries to enable them to build up relationshipsand provide regular feedback on the patients on the scheme to helpensure continuity across different service channels.

John talks about how hard it can be to measure the impactof their work, particularly for the handful of patients at riskof developing cardiovascular disease who are not yet sufferingbut are highly likely to have an incident in the next ten years.Using Prochaskas model of behaviour change,31 he says, movingsomeone from pre-contemplation to contemplation to action overthe course of the year or more may represent real progress towardsprevention, but theres nothing in it that can be reflected on abalance sheet. Yet, as he rightly points out, the savings generatedby reducing the impact from these kinds of diseases, even by1 per cent, are far higher than any figure saved through rationalisingexisting services.

Its early days yet for the scheme but John tells us that local staff

in the PCT are already excited:

Birmingham OwnHealth is not about replacing services at a locallevel, its about enhancing and improving whats already there.Weve learnt that you should just start somewhere, anywhere, andlet the rest of it grow and develop over time . . . its the hardest thingto get started, but once you have its possible to see what else could

grow from it .


35/62

64/65Measurement

3

Measuring successFind ways of measuring experiences as well assystems: life is more complicated than a keyperformance indicator.

Seeing service as a delivery mechanism rather than a transformativeexperience has led to a particular form of information gathering andsystem measurement. Existing targets have tended to focus energyon underperformance in operational efficiency, at the expenseof underperformance in the transformation of peoples lives.Being able to assess the quality of the experience is as importantas knowing the efficiency of the operations: both are necessaryforms of measurement. As Patrick Lewis from John Lewis

Partnership told us, youve got to run the organisation at a morecomplex level than that of KPIs.

Chapter 1 explored the sorts of insights successful organisationsgather from their customers and users. e insights theseorganisations seek to collect go beyond demographics and evenattitudes they are also interested in what people think aboutsomething, how they felt about a particular experience or product.What this reveals, therefore, is that by gathering information aboutcustomers and what matters to them, service organisations alsobegin to gather a form offeedback, which itself provides measures

Photoby

DavidLevene


36/62

of success. Rather than this success being measured at a systemiclevel (such as progress against targets), such insights represent themeasurement of success from an experiential perspective fromthe vantage point of the user themselves on the service they areaccessing. is matters because, when it works, users themselvesexperience success directly, with obvious consequences for theirsense of satisfaction and trust.

In other words, successful service organisations have foundways of measuring success and improvement at more than thesystemic level. e infor

Documents

Viaje a la Interfaz