In defence of Total Place

What I consider to be one of the biggest strengths of Total Place is that – though it has benefitted from the leadership of a number of key individuals – it belongs to no one person or group. The result is that there is not a definitive version of Total Place, and so my perspective and understanding of it is just one of many.

But I feel that John Seddon’s recent criticism of the initiative misses the point of Total Place. This paragraph sums up his position:

“As people become obsessed with costs, more of the wrong-thinking dominates action. Total Place initiatives that count the cost of activities but say nothing about value will cause people to leap to the wrong conclusion – that economy will follow from scale. By contrast, studying value – the nature of demand from the citizens' point of view – shows how and where resources are wasted, duplicated, or being spent on things that are of little value to the service user.”

I do not disagree with Seddon over systems thinking – we do indeed need to understand services from the perspective of citizens and their wants and needs – but I do challenge the implication in his article that Total Place is the antithesis of this. I believe that Total Place is fundamentally about viewing public services as a system from the perspective of citizens; not, as has been the case in the past, from the top of siloed delivery chains.

I would suggest that the apparent focus on cost through the counting exercise and deep dives is a bit of a red herring. The starting point to achieve systemic change must be to understand the current system, as this shapes the culture and perspectives of those who operate within it. And like it or not, the current system is concerned with money and cost. Total Place therefore started from the pragmatic position of demonstrating just how much the current system is costing us in financial terms, and just how ineffective it is at tackling complex social problems.

While I agree with Seddon that this counting exercise offers little real practical benefit, what it has done is much more powerful. It has started a conversation in localities and between local and central government about the consequences of the current system of public services and the opportunities presented by a new paradigm. The value of this should not be underestimated; it has provided a catalyst for public servants in localities to understand exactly what Seddon says we must: “demands from citizens in their terms and the flow of activity that ensues whenever the demands occur.”

Total Place has demonstrated that public services managed centrally along siloed chains are both ineffective and costly, as they consider citizens as a series of separate problems to be dealt with in isolation by fragmented services. The system has meant that:

• The needs of citizens are not holistically met;
• They are often pushed from one service to another;
• There is little incentive for public services to tackle the root causes of social problems or to prevent them in the first place;
• They therefore focus on dealing with the consequences (fire-fighting);
• This has massive human, social and financial costs for individuals, families and wider society.

With this in mind, the Total Place pilots have started to go about reorientating services around the needs of citizens, families and communities, rather than the structures of government institutions. This is encapsulated by Croydon’s assertion: “We believe that thinking in systems not services is the key to shifting public service outcomes.”

Pilots spent time engaging with citizens, mapping customer journeys and conducting ethnographic research in order to understand the citizens they serve. They’ve considered how services can be more integrated at the front-end to meet their needs holistically, how they can provide intensive support to those who need it, how they can prevent problems or intervene early before they worsen, and how citizens can interact with public agencies on their terms.

As Seddon argues, it is by organising services in this way and avoiding failure demand that costs can be removed from the whole system. There is much evidence that the Total Place pilots understand this and as a result they are estimating some significant savings.

Therefore, in short, my perspective on Total Place is that it is not about economies of scale, but it is entirely about studying “the nature of demand from citizen’s point of view” and then ensuring that services are integrated to meet these demands in a holistic fashion.

The success of Total Place must be judged on the extent to which the ambitious and sometimes radical intentions of the pilots are seen through and implemented. There is a big risk that public sector cuts draw us back into a narrow conception of value for money, to the detriment of public value. This must be resisted, as Total Place has shown us, the only way to achieve better outcomes for less cost will be to make public services more citizen, family and place focused.