Developing the business case for public engagement – exploring ‘Return on Investment’

approaches to scrutiny

Rebecca David-KnightCentre for Public Scrutiny

Introduction

•Purpose of today is to stimulate thinking about ‘Return on Investment’ models of scrutiny

•In what circumstances might they work best and why?

•Where does ‘the public’ fit into ‘stakeholder engagement’?

Learning Objectives

Through participation in this workshop delegates will be able to:

• Supplement existing knowledge of different scrutiny styles and structures;

• Better understand the links between ROI approaches and public engagement;

• Refine ideas about the social, democratic and

financial value of the ‘overview’ role.

Return on investment scrutiny

• CfPS Health Inequalities Programme demonstrated that scrutiny can be a powerful public health tool – ‘Peeling the onion’ publication.

• CfPS wanted to prove that scrutiny adds value – not just to health but in general – so in 2011 developed a model that translated the concept of ROI from business to health and wellbeing.

• After developed the model was tested and refined by 5 development areas – their learning was captured and presented along with the model in –’Tipping the scales’

• Further refined in 2012 – showcased in ‘Valuing Inclusion’

Potential savings identifiedjust under £1.7 million

Area Potential savings and return on investment Return on investment

Newham £455,000 total£90 for every £1 spent on the

review

Westminster £1,196,866 annually£329 for every £1 spent on the

review

Southwark £20,930 total£11.52 for every £1 spent on

the review

South Somerset £5,440 total£3.40 for every £1 spent on the

review

Adur and Worthing £415 per person£0.37 for every £1 spent on the

review (based on 1 person)

Warrington £17,389 per person£5 for every £1 spent on the review (based on 1 person)

Introducing the ROI modelWhat it helps areas to do!

The model is based on five stages of a “scrutiny journey”, utilising a variety of tools:

1. Identifying and short listing topics

2. Prioritisation

3. Stakeholder engagement and scoping

4. Undertaking the review, measuring impact and calculating the ROI

5. Making recommendations using ROI and influencing services

Stage 2 –Potential impact and prioritising

2 elements:

Impact assessments – assessing the impact of the review on high level objectives e.g. Joint Strategic Needs Assessments

And,

Scoring – using a scoring matrix to help to prioritise

•Benefits of this approach is the ‘screening out’ of projects where scrutiny activity only likely to result in limited impact.

•Starting off with the ‘so what’ question ensures projects are relevant and specific enough to be able to demonstrate an effect.

Stage 2 - Impact scoring matrix - Rotherham

Stakeholder engagement wheel

•ROI engagement tool inspired by ‘systems thinking’

•Systems thinking requires thinking in terms of relationships, connectedness, and context

•Looks at how parts of a system inter-relate rather than narrowly focusing on the parts themselves – how does access to leisure services link to community safety?

•Whole systems scrutiny inquiry using ROI methodology can lead to a whole system response.

•Public engagement just one but crucially important element - essential for building legitimacy into actions of public agencies

A ‘whole systems’ approach to engagement

•Necessary to:

1.Help identify and refine the topic of enquiry2.Begin to develop a whole systems response

Generate cross-section of perspectives:

• Authority – i.e. decision makers or community champions.• Resources - i.e. commissioners.• Expertise – i.e. professionals and local people• Information – i.e. data and intelligence.• Needs – i.e. people or groups you are trying to help.

A ‘whole systems’ approach to engagement

•Services do not create outcomes; people do

•Outcomes often dependent on behavioural changes

•Addressing ‘wicked’ issues is fundamentally a social process but often improperly defined

•More useful to think of ‘public engagement’ as a form of social research

•Need for precision in identifying research questions and relevant populations

Who do we mean by ‘the public’?

• Key factors include levels of involvement, degree of reliance

and frequency of interaction with service

• The higher the level of involvement / reliance with service, the more useful the perspective - ‘experts by experience’.

• Conequently may often be the case that the views of vulnerable groups of greatest utility.

• But what about those that are marginalised?

• Voluntary sector has a vital role in providing data, access and representation

Is all ‘public engagement’ of

equal value?

Stakeholder engagement wheel Identifying gaps and overlaps

Area and chosen topic Question that the review wantedto answer

Return on investment question

Adur, Arun and WorthingHomelessness

What is the impact of a homeless person not having access to a GP?

What would be the ROI of enabling homeless people to register with a GP?

HaringeyMen’s health

How do we engage men over 40 years of age in Haringey’s corridor of deprivation in prevention and early intervention services to close the life expectancy gap and reduce premature death from cardio vascular disease?

What would be the ROI if we engaged men over 40 who were at risk of cardio vascular disease with health and wellbeing services?

RotherhamMorbid obesity

How can we improve coordination between services so as to improve the quality of life and care of people with a BMI>50 and who are housebound and unable to get out of their home unaided?

What would be the ROI of better service coordination and improving their quality of life and care?

SheffieldDiabetes in a South Asian community

How can we improve and target information about diabetes a ‘at risk groups’ in order to raise awareness and combat myths about the condition?

What would be the ROI if we are able to improve and target information about diabetes at ‘at risk groups’ in order to raise awareness and combat myths about the condition, leading to:•improved case finding; and•increased number of people who are able to effectively manage their condition?

Stage 3 - Getting the ROI question

Measuring the Return on Investment

There are two areas that the model seeks to measure or estimate in respect of scrutiny:•The value of the review itself as a process

– Producing a good quality report with well-argued recommendations

– Capturing your impact on process changes– Other outcomes such as better networking or better

awareness

•Outcome impacts– Improving access to services– Improving the health of individuals and communities– Providing value for money

Benefits – what users thought!

• Scrutiny is well placed to influence a range of partner agencies and promote more joined-up working

• Different way of prioritising topics - highlighting a ‘hidden’ issue

• Good stakeholder engagement looking at difficult and sensitive issue – helps to get all of the right people together

• Explored issues ‘on the ground’ resulting in greater authenticity

and agreed a set of recommendations to help improve services

• Able to demonstrate a return on investment, including: input and output costs, potential cost savings from improving service coordination

Case examples

Westminster – Sex workers review

Tameside – NHS Health Check

Peterborough – Welfare reforms

Publications

Any questions?

Workshop questions

1. On your table chose a review topic

2. Generate a ROI question

3. Using the stakeholder wheel – plan who you would invite and why

4. Consider the advantages and disadvantages of this method

To find out more

www.cfps.org.uk - register on-line or via forms for:- e-newsletters, e-digests & scrutiny exchange- reviews library, on-line forum, latest news- new Policy and Skills Briefings

Twitter: @CfPSCymru

Rebecca.David-Knight@cfps.org.uk or 020 7187 7362 for helpdesk

Tipping the scales: http://www.cfps.org.uk/domains/cfps.org.uk/local/media/downloads/L12_379_tipping_the_scales_v4.pdfValuing inclusion: http://www.cfps.org.uk/domains/cfps.org.uk/local/media/downloads/L13_30_CfPS_Valuing_inclusion_v5_Web_final_amends.pdfChecking the nation’s health:http://www.cfps.org.uk/domains/cfps.org.uk/local/media/downloads/CfPS_Nations_Health_final_online.pdf