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October 27, 2010

Innovation the key to a Radical Scotland

A new report from Nesta suggests that the holy grail of achieving improved public service outcomes with less money could be a realistic proposition for Scotland.  But it demands a new relationship is forged  between government, deliverers of public services and local communities with an emphasis on greater freedom to innovate locally. In return, a proportion of the savings generated would be returned to government

For a copy of the full report, “Radical Scotland”, click here

Scottish public services could save money and improve outcomes for citizens by taking a radically different approach to reform, according to a report published today by the National Endowment for Science, Technology and the Arts (NESTA).

The report, “Radical Scotland” recommends a ‘New Community Status’ that provides greater freedoms and responsibilities for leading local authorities and health boards to develop new approaches in public services that are both better and cheaper. This status would require the Scottish Government to set out bold strategies for reform in three critical areas of public services: health, justice and social care.

Without radical reform the costs of providing current levels of services in Scotland are set to rise by £27 billion over the next 15 years, due in particular to an ageing society and the prevalence of certain ill-health conditions.  In this same period, the Scottish Government will have £42 billion less to spend. To make services more sustainable, radical reform needs to become a more significant part of the Scottish Government’s strategy towards spending reductions.

Current responses to the UK Government’s spending plans are not sustainable given the limits of traditional efficiency measures and the cost of rising demand for public services. The report reviews a range of highly contentious money-saving measures discussed in the Independent Budget Review, and demonstrates that they would still require the Scottish Government to find a further £1 billion in spending reductions by 2014-15.

The report highlights a number of innovative approaches in Scotland that can save money by better managing demand and preventing problems. In the areas of health, social care and justice alone, even a small shift towards more effective approaches could make substantial savings, for example:
• In health, a reduction of 1 per cent in the costs associated with drug and alcohol-related abuse would generate savings of around £200 million.
• In Social Care, even a 10 per cent reduction in the cost of emergency hospital admissions each year would save £560 million.
• In Justice, a 10 per cent reduction in the costs of the prison system would suggest savings of £200m.
In order to achieve this, NESTA’s report envisages a new relationship between central government, deliverers of public services and local communities.  The proposed ‘New Community Status’ between certain public bodies and the Scottish Government would grant new freedoms to local service providers such as local authorities and health boards. They would have access to investment, support and greater independence to innovate, in return for a commitment to return a proportion of the projected savings from innovation to central government and to share their experiences with others.

NESTA Chief Executive, Jonathan Kestenbaum said: “Numerous examples from Scotland demonstrate how services can be refocused at a local level to prevent longer term problems. Scotland must make radical reform of its public services the driving mission.” 

Case studies
Some of the examples used in the report include:
• Pilton Community Health Project in Edinburgh – a charity that runs a number of community health projects with NHS Lothian  and the City of Edinburgh Council, promotes community engagement in targeting mental health, improved diet and physical activity.
• School, Social Work, Police and Community (SSPC) in East Renfrewshire – brings together all local agencies involved in tackling youth offending alongside the offenders and their families to address the inter-generational and social aspects of violent and anti-social behaviour.
• Partners for Inclusion – assists service users throughout Ayrshire, Renfrewshire and East Renfrewshire to access the full range of available services, including community services, local social networks and the relationships within people’s lives.
• West Lothian’s Community Health and Care Partnership –developed an electronic self assessment tool – ‘Safe at Home’ – that has expert knowledge built in to calculate and provide a prescription of services targeted to the specific service user.
• Community Initiative to Reduce Violence (CIRV) in Glasgow – a two-year intensive programme with the aim of dramatically reducing gang violence in Glasgow’s East End.
• Reaching Older People in Renfrewshire (ROAR) – a local mentoring and befriending service for older people, actively connecting them into a community and skills exchange.