How will demand have changed when we emerge from the crisis?
The Covid19 crisis is likely to create a New Normal pattern of demand for public services – expressed both in the nature of support needed and in the way that support is accessed.
Much is said of the “cost of the cure”. The economy will have taken a hit with extensive business failure, unemployment and increased debt. The cost of getting people and businesses through the lockdown will result in huge levels of government borrowing, which will need paying back – maybe over an entire generation. As with austerity, it will be the poorer elements of society that will feel the burden most.
People already on the brink may well be pushed over the edge into homelessness, insurmountable debt, financial distress and ill health – both mental and physical. Inevitably this will flow through to the nature of demand presented to local authorities and other agencies.
How will demand change?
1. Poverty and financial insecurity will increase
People in this situation will seek support through the benefits system, however this will only be the tip of the iceberg as people will experience increasingly fragile housing options and possibly homelessness. Landlords will be in increasingly difficult situations and may well seek to evict tenants and raise rents to help manage risk. Debt will increase with people experiencing increased instability in the labour market. Maybe council tax arrears will be the first sign of a problem indicating a much more complex set of needs that need to be resolved.
2. Vulnerability will increase
This may play out in many ways, but it is highly likely that social care will be under increasing pressure with increasing needs presented through troubled families, distressed elderly, increasingly vulnerable children, mental health issues and domestic violence. We have seen a huge operation put in place to support the shielded group of people identified by the NHS as at-risk. This was primarily based on health vulnerability, but adopting the principle of identifying at-risk citizens and proactively tailoring services to their needs may well accelerate the early intervention and prevention agendas that have been so difficult to realise.
3. Business failure
This will put a completely new light on economic growth – something that appeared in pretty well every corporate plan, but was not always backed up with resources. The need to create jobs, provide opportunities for young people (and displaced workers) to build new skills, to rescue high streets and regenerate town centres will be immense. While central and devolved regional government will help there will be a huge need for local solutions to be found. It is far from clear how economic recovery will be led with so much collateral damage being inflicted on small and medium sized businesses. Local government has a huge part to play.
4. Complexity of demand
It is likely that citizens presenting for one service will be in need of a wide-ranging package of support. This will require integration across service functions within unitary authorities and across council authorities in two tier areas. Bringing together health and police with local government will be essential if we are to prevent people bouncing around the system looking for a solution. There will be an argument for a different, more integrated front door that may need to go beyond the current MASH approaches in place.
5. On-line demand
The current crisis has also meant that people needed to find new ways to access services. If this is continued it may mean that demand goes underground and is difficult to spot. While there will be an inevitable increase in on-line access and remote service provision, where face to face access becomes less of a norm, there will be an increasing need to find ways to assess the complex needs that will emerge. There will be an argument for increasing focus on life event approaches where specific trigger events give people access to the integrated provision that is likely to be needed.
6. Proactive outreach
The creating of at-risk lists of citizens, the proactive contact with them and the provision of basic services could potentially be the basis for a very different approach to demand management. It is not that risk-based approaches or outreach did not exist, but the scale of response and mobilisation of resources has shed a new light on the opportunity. Combining the increased involvement of the community, flexible and integrated resources, reliable data and intelligence and coordination of an appropriate intervention could transform service provision. What is unclear is whether a proactive approach like this would result in better outcomes or lower cost. There is a view that prevention is better than cure and evidence from around the country that the approach would work.
The challenge is to create New Normal ways of working that recognise that demand will be different, more complex and need an enhanced level of organisational flexibility and integration to resolve.
There will be increasing pressure to move away from service silos to a more integrated approach with a single front door to quickly evaluate the full extent of a need. There will be an argument to create life-event based approaches that genuinely address the whole life challenges that will be presented in the future. And there will be an argument to adopt a proactive outreach approach to demand management that builds on the impressive approach to shielded communities.