Creating genuine place-based collaboration offers a long-term route out of the current crisis facing public services, but national policy needs to recognise and enable it.
Momentum is growing behind the idea of revisiting Total Place principles, which informed largescale pilots 15 years ago. These seek to understand the totality of public spend in a place and create flexibility for public services to align or pool resources in the pursuit of collective outcomes.
This is a strong foundation for a wider shift across the public sector towards meaningful collaboration with communities to shape provision around their priorities.
Anyone who experienced it first-time round will feel a nostalgia about the ambition and radicalism of the approach, which didn't survive the 2010 General Election.
For those new to the concept, there is an enduring logic which holds strong. To date, despite rhetoric and small-scale initiatives, public service integration has largely failed. There is widespread understanding that we need to shift towards preventative, whole-system working for sustainability, but there remain institutional barriers: the NHS being the most oft-cited example of being impervious to place-based collaboration.
The logic of our Whitehall model reinforces siloed working, a mindset which doubles down in times of scarce resource. Councils are subjected to productivity plans and Oflog's narrow output performance measures. National NHS targets force it to chase the demand side of hospital treatment times, rather than address the supply of ill health due to burgeoning health inequalities.
The next government will have two options for public service reform. Either continue squeezing out efficiencies for short-term cost control at the expense of a long-term focus on prevention. Or create a cross-government framework for place-based collaboration that shifts the emphasis from individual services to system working around communities.
Jessica Studdert is deputy chief executive at New Local
X – @jesstud
