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1 In 1995 the tertiary education graduation level in the USA was 33% of the population; this had grown to 36% by 2006. In Poland, graduation level was 34% in 2000, and this had grown to 47% by 2006. In Denmark the equivalent graduation level was 25% in 1995, and this had grown to 45% by 2006. In the Netherlands the equivalent level was 29% in 1995, and this had grown to 43% by 2006. Source: Education at a Glance, OECD, 2008.

2 Budget 2009, HM Treasury, 2009.

3 The Gershon Review has already generated savings of over £23 billion.

4 The Department for Business, Innovation and Skills is working with other government departments to support them in understanding how to promote and enable innovation in public services.

5 Wherever possible, we have included any efficiency savings resulting from the international innovations we have highlighted. However, it should be noted that not all countries start from the same baseline as the UK, so these figures may not be exactly comparable to the UK context.

6 For example, in PSA indicator sets.

7 The Prime Minister has asked Tim Berners-Lee, the renowned MIT academic who led the creation of the World Wide Web, to help drive reforms that will get public information into the hands of citizens.

8 Calltrop, J. Sweden’s 0-7-90-90 care guarantee: Where simplicity meets pragmatism? Presentation to ‘The Taming of the Queue’ Conference, 2007.

9 From Citizen’s Charter to public service guarantees: Entitlements to public services, Public Administration Select Committee, 2008.

10 The child care transition: A league table of early childhood education and care in economically advanced countries, Unicef, 2008; Blanden, J., Gregg, P. and Machin, S. Intergenerational mobility in Europe and North America: A report supported by the Sutton Trust, 2005.

11 Such as the Comprehensive Area Assessment.

12 Performance Art, Institute for Government, 2008.

13 Mulgan, G. and Bury, F. (eds) Double devolution: The renewal of local government, 2006.

14 Mooney A. et al. Early Years and Childcare International Evidence Project, 2003.

15 The new universal childcare entitlement for three and four year olds in the UK works on a similar model, with the free entitlement being provided by a mix of public and private providers.

16 A similar approach to guaranteeing a place in education or training for those under 18, and apprenticeship places for every suitably qualified young person, has just been announced in the UK.

17 Personal budget: Purchase your own care in eight steps, College voor zorgverzekeringen (CVZ), 2005.

18 Poelmans, M. ‘Reinventing public service delivery by implementing the e-Citizen Charter’ in Cunningham, P. and Cunningham, M. Expanding the knowledge economy: Issues, applications, case studies, 2007.

19 Administrative redress: Public bodies and citizens, The Law Commission, 2008.

20 See for, example, the Swedish Quality and Efficiency Reports highlighted in chapter 3.

21 Chabra, S. Performance management case study: The Government of Canada, Institute for Government, 2009.

22 For example, Australia’s Service Charter, 1997; Canada’s Service Standards Initiative, 1995; France’s Service Charter, 1992; Belgium’s Public Service Users’ Charter, 1992; Spain’s Quality Observatory, 1992; and Italy’s Charter of Services, 1994.

23 Feinstein, L. and Duckworth, K. Development in the early years: Its importance for school performance and adult outcomes, 2006; Effective Provision of Pre-School Education (EPPE) Project: Final report - A longitudinal study, Institute for Education, 2004.

24 Next steps for early learning and childcare: Building on the 10 year strategy, HM Government, 2009.

25 Citizen redress: What citizens can do if things go wrong with public services, National Audit Office, 2005.

26 Citizen redress: What citizens can do if things go wrong with public services, National Audit Office, 2005.

27 When citizens complain, Public Administration Select Committee, 2008.

28 Measuring government service delivery in Canada: Performance under pressure, Accenture, 2005.

29 See, for example, a recent independent review of redress in local government, Getting it right, and righting the wrongs, Department for Communities and Local Government, 2009.

30 Mapping the local government performance reporting landscape, PricewaterhouseCoopers for Department for Communities and Local Government, 2006.

31 When citizens complain, Public Administration Select Committee, 2008.

32 Bringing wider public benefit from individual complaints: Annual report 2007-08, Parliamentary and Health Service Ombudsman, 2008.

33 Citizen redress: What citizens can do if things go wrong with public services, National Audit Office, 2005.

34 Working together: Public services on your side, HM Government, 2009.

35 Building Britain’s Future, HM Government, 2009.

36 Office of Management and Budget, USA.

37 While it is clear that services users value high-quality advice and expert knowledge provided by professionals, they also want to make decisions for themselves - information will be required for citizens to make informed decisions. See Real trends: Living in Britain 2008, Ipsos MORI, 2008.

38 Strategic challenges, Cabinet Office, 2008.

39 The proposed report cards will also recognise partnership working between schools, and between schools and other partners; and place each school’s outcomes in context so that fair comparisons can be made between the performance of schools with different intakes and challenges.

40 Ofsted is looking to provide some information of this type on its website by 2010.

41 Through Spain’s IDEE initiative, maps can be re-used for non-commercial purposes (usually with no charge) and put on websites with authorisation from the National Centre of Geographic Information. This authorisation can be requested by fax or email and, on average, it takes two days to get a response.

42 For example, in a European survey of patients, 80% of UK respondents thought they should have a free choice of hospital, 79% a free choice of specialists and 87% a free choice of GP (Coulter and Magee, 2003).

43 MORI 2004.

44 MORI 2006.

45 Improvements to public services can themselves fuel higher expectations, but this is not a reason for simply maintaining the status quo.

46 Light, D. and Dixon, M. Making the NHS more like Kaiser Permanente, 2004.

47 Whelan, F. Lessons learned: How good policies produce better schools, 2009.

48 Report of the machinery of government committee, Cmd 9230, Ministry of Reconstruction, 1918.

49 Service transformation agreement, HM Treasury, 2007.

50 http://epress.anu.edu.au/anzsog/centrelink/mobile_devices/ch09s03.html

51 The Tell Us Once pilots in England are already testing this out for people who have suffered bereavement, given birth or changed address, but services may be able to go further.

52 www.statistics.gov.uk/CCI/nugget.asp?ID=8

53 www.culture.gov.uk/what_we_do/broadcasting/5631.aspx/

54 Realising Britain’s potential: future strategic challenges for Britain, Strategy Unit, 2008.

55 www.hm-treasury.gov.uk/d/cyp_supportingfamilies290307.pdf

56 Lead professionals have always characterised primary care and are becoming increasingly common in other services, but are not universally developed. For example, lead professionals are still rare in support for children with disabilities and are under-developed in offender management. The Social Exclusion Taskforce is already looking at ways in which such approaches can be developed further for those with complex needs.

57 The evaluations of Family Nurse Partnerships in the USA suggest, for example, that nurses had 50% better outcomes than paraprofessionals.

58 Evidence indicates that to empower citizens most effectively, one-off ‘high stakes’ choice, such as which school or hospital to use, should ideally be supported by a series of ongoing choices and decisions. Examples of ongoing choices include deciding which courses to study at school, which interventions to opt for as part of a chronic disease management personal care plan, or which services to commission through a personal budget. For example, evidence on the use of personal budgets for mental health care in Florida shows that ongoing choices helped individuals derive high levels of patient satisfaction by being able to quickly and easily combine clinical and non-clinical treatments to meet their own needs (Florida Peer Network). Evidence also indicates that ongoing choices are associated with increases in individuals’ sense of personal control, self-efficacy and feelings of intrinsic motivation (see, for example, Deci and Ryan, 1985) and may help improve equity in the exercise of choice (see Burgess and Briggs, School assignment, school choice and social mobility, 2006).

59 Waterplas, L. and Samoy, E. Personalised allocation: the cases of Sweden, the United Kingdom, the Netherlands and Belgium, 2005.

60 Raising the profile of long-term conditions care, Department of Health, 2008.

61 www.kingsfund.org.uk/research/topics/longterm_conditions/index.html 62 www.oecd.org/dataoecd/57/14/40324263.pdf

63 Confronting the epidemic of chronic disease, The Oxford Health Alliance, 2006.

64 www.oecd.org/dataoecd/57/14/40324263.pdf

65 Future strategic challenges for Britain, Strategy Unit, 2008.

66 For example, the Washington State Institute for Public Policy reported that some offender rehabilitation programmes can lead to a total benefit (minus the costs) of up to $13,738 per participant. Offender re-entry initiative: Recommended criteria for the community transition coordination networks, 2007, www.wsipp.wa.gov/rptfiles/07-08-1202.pdf

67 Some preventative interventions in Finland were cut back in the 1990s, especially services focused on children and childcare.

68 An understanding of behavioural, economic and social psychology is increasingly being used to improve mass participation, for example NHS social marketing programmes such as smoking cessation advertising. These approaches show impressive short- and medium-term impacts, although sustaining change in the long term may require more profound cultural developments and economic and social incentives, rather than just ‘nudging’.

69 Coulter A. and Richards N. Is the NHS becoming more patient centred?: Trends from the national surveys of NHS patients in England 2002-2007, 2007. This paper found that up to half of patients in the UK currently feel under-involved in decisions about their care.

70 Self care support, the evidence pack, Department of Health, 2007. This survey also found 50% of patients were ‘not often’ encouraged by health professionals to self care, and 33% were never encouraged by health professionals to self care.

71 Loeffler, E. et al., If you want to go fast walk alone, if you want to go far walk together: Citizens and the co-production of public services, October 2008.

72 William, D. Does assessment hinder learning?, 2006.

73 Self care support: The evidence pack, Department of Health, 2007.

74 The Access to Health Records Act, which established in law a patient’s right to access their own medical records, came into force in 1990.

75 As part of the Policing Pledge, from January 2009 every neighbourhood policing team is organising monthly public meetings and by the end of 2009 every member of the public will have had the opportunity to attend monthly meetings held by each of the 3,611 neighbourhood policing teams in England and Wales to agree local policing priorities.

76 Building Britain’s Future, HM Government, 2009.

77 Anti-social behaviour intensive family support projects: An evaluation of six pioneering projects, Department for Communities and Local Government, 2006.

78 Occasional papers OSI - US Programmes: Volume 3, No 3, Open Society Institute, 2003.

79 In No more throw-away people: The co-production imperative, 2000, Edgar Cahn argues that many organisations providing public services fail to achieve optimum outcomes because they do not tap into the resources of users themselves. He calls this a deficit-based approach, where organisations view service users only in terms of their needs, as opposed to an asset-based approach, which focuses on the contributions that everyone has the capacity to make.

80 OECD PISA results indicate that the Australian school system has good to excellent features and that although there are differences between states and territories, many of these are not statistically significant. Overall Victoria’s system performed in line with the national average. See Improving school leadership volume 2: Case studies on system leadership, OECD, 2008.

81 See Improving school leadership volume 2: Case studies on system leadership, OECD, 2008.

82 See, for example, How the world’s best performing school systems came out on top, McKinsey, 2007.

83 The British Social Attitudes 2007/8 study found that in 1997 22% of public sector workers thought it was ‘very important’ that their job was useful to society; by 2005 that had risen to 32% and compares with 15% in the private sector. The effect is most marked among the youngest generation of public service professionals - in 1997 28% of 18-34 year olds said it was ‘very important’ for their job to be useful to society; by 2005 this had risen to 49% and compares with 19% in the private sector.

84 See, for example, OECD advice to Finland in 2005 that the status of nurses would have to be raised if they were to continue to maintain the high professional standards which characterise the Finnish health care system as a whole.

85 Office for Personnel Management, USA.

86 Aspiring teachers in France are required to take a highly competitive public examination to be admitted as a trainee teacher (post Bachelor’s degree) - only around 18% of candidates passed this examination in 2008, but all of these are offered teaching posts. There is a higher-level examination to become a teacher at Lycée level - in 2008 only 11% of candidates were successful in passing this examination and securing posts. Sources: National Ministry of Education, France; Tchibozo, G. Institutional organisation, performance determinants and success strategies in secondary science teacher preparation in France, 2005.

87 There is a developed tradition of benchmarking of clinical performance in the USA. Studies in the mid-1990s in New York indicated that where surgeons benchmarked themselves against one another in key performance criteria, the result was an overall increase in performance. See, for example, Do cardiac surgery report cards reduce mortality?, 1995.

88 See chapter 2.

89 See discussion in Gawande, A. Better: A surgeon’s notes on performance, 2007.

90 In the UK the National Leadership Council has a wide-ranging work programme focusing on developing leaders at all levels of the system and across all roles. The programme aims to ensure that every member of staff demonstrates leadership. An ‘emerging leaders’ programme and a leadership for quality certificate will be a new standard in health care leadership, including for clinicians and non-clinicians who wish to be future leaders.

91 There is a long tradition of professional peer review in modern professions across the world. Quality Registries are a simple way of broadening and validating these processes.

92 This is further explored in NHS Mutual, a recent paper published by the Nuffield Trust which highlights the long tradition of employee ownership in the private sector; for example, in partnership models.

93 The recent Schools White Paper encourages the development of clusters of schools and Accredited Schools Groups: chains of schools overseen by a single high-quality provider. This builds on developments seen through the Academies programme, whereby a number of Academy sponsors have set up chains of Academies; sometimes in one local area, for example the Harris Federation in south London, and sometimes more widely across the country, as in the case of the United Learning Trust.

94 See, for example, The NHS Next Stage Review: High quality care for all, Department of Health, 2008 - ‘quality at the heart of everything we do’.

95 The Innovators Council, established in May 2009, will support such learning and development.