By Stephen Peckham, Mark Exworthy, Ian Greener and Martin Powell.This article examines the continuing debate about, and inter-relationship between, the NHS, decentralization and local participation. The focus of the article is the experience of decentralization and participation over the past 25 years and, drawing on a new conceptualization of decentralization, it identifies the extent to which the NHS supports decentralized approaches to participation.

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This survey by the Social Exclusion Unit was designed to assess how the innovative use of Information and Communication Technologies can be used to promote equality of opportunity and improve service delivery and outcomes for society’s most disadvantaged groups as well as those who live in deprived areas. It found that the majority of respondents (77%) agreed that current trends in ICT are likely to widen the digital divide and increase levels of inequality faced by socially excluded groups. Despite this view, one in five respondents felt that there are currently initiatives in place that aim to address the digital divide through, for example, providing socially excluded groups with ICT training.The main factors for the digital divide are the costs of ICT equipment, lack of access to ICT, lack of training in the use of technology and market issues such as the tendency for ICT developers to focus more on more profitable mainstream markets than disadvantaged groups.

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This resource from the Improvement and Development Agency gives links to support the role that local government is playing in improving the health of the nation.The Healthy Boxes project from West Cornwall aims to change a lifetime of poor perception of eating fruit and vegetables, by making them easily accessible to families and residents who need it most.

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This first report on practice identifies a mixed picture in the progress of local authorities towards more efficient and effective procurement mechanisms in the pursuit of delivering better services to citizens. There has been progress in many areas, particularly those where there are clear policy drivers for improving procurement performance. In other aspects of procurement, local authorities still have opportunities to make real improvements, because the majority of councils are not rigorously challenging the current pattern of services, effectively comparing their performance, or fully utilising competitive procurement practices.The National Procurement Strategy for Local Government provides a set of policy arguments and targets for better local government procurement. Over 90% of respondents consider the Strategy ‘important’ or ‘very important’. Respondents also recognise the role of the Regional Centres of Excellence in assisting them meet the Strategy milestones. The survey indicates that progress towards meeting the milestones varies between local authorities and between types of authority.

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This Guide from the Improvement and Development Agency focuses on raising service planning to a higher level. It looks at addressing customer needs and describes the importance of a route map to the positive outcomes prioritised by the council and the community. It also helps to identify and mitigate risks to planned service levels and improvements. The Guide is designed to be used with existing service planning arrangements, such as meetings with groups of officers and Members who work with different services.The Guide is available at: http://www.idea-knowledge.gov.uk/idk/aio/973256

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By Caroline Glendinning, Bob Hudson and Robin Means.Relationships between the NHS and social care services over the past 25 years have a poor history. This article examines the strategies that have been used by central government and by local NHS and social care organizations to overcome difficulties of service co-ordination. The authors conclude that policies reflecting ‘networked’ modes of governance may stand the best chance of success, although evidence of improved impact and outcomes still remains scarce.

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This Guide from the Improvement and Development Agency looks at the fundamentals of customer service. It explores the options for customers to contact a council from enquiries being dealt with by someone responsible for a service, to the use of a single point of access to all services, through to joint enquiry centres dealing with calls about district and county council issues. It also deals with the various methods of measuring customer satisfaction. There is a warning that sample surveys and questionnaires can be unrepresentative because they will include some people who do not use services.The Guide concludes with a look local government culture. It stresses that thinking of the people councils serve as residents or council tax payers is not helpful in raising standards of service. Council officers working on the front-line need to think of the people they deal with as customers. Although people who use council services cannot walk away and take their business elsewhere, they need to be treated as if they can do so.

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Rob BaggottPublic health is currently high on the political agenda, perhaps at its most prominent for a generation. Yet various policy initiatives to improve public health have been regarded as unsuccessful, while the National Health Service is still seen as a ‘sickness service’. This article explores the development of public health policy in England and asks whether it is likely to become a key driver of policy and service provision in the future.

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The Innovation Forum was created to promote dialogue between central and local government and its partners, on new ways of working to deliver better services to local communities. The Forum is ‘jointly owned’ by central Government and the councils with excellent CPA scores and it seeks to develop, explore and test new ways of working to deliver improved outcomes for local people.The Forum brings together local authorities and their partners with Government Ministers and their officials. It is facilitated by the ODPM and LGA who help to co-ordinate the respective interests of Government and local authorities, to shape the Forum’s work programme and processes and to link the work of the Forum to other Government initiatives and areas of policy. The current programme covers early years and school improvement; community safety; reducing hospital admissions for older people; and integrated public services.

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By George A. Boyne and Jennifer LawPublic agencies in the UK and elsewhere are increasingly required to set outcome targets as a strategy for improving their services. A crucial element of this ‘results orientation’ is a clear definition of the desired outcomes and a specification of appropriate performance indicators. A recent example of this policy in the UK-Local Public Service Agreements is examined in this article. The authors’ analysis of the first generation of LPSAs shows that just under half of the indicators used were measures of outcome. The authors explain the ‘wicked’ issues in outcome measurement that emerged from the research.

Read more on SETTING PUBLIC SERVICE OUTCOME TARGETS: LESSONS FROM LOCAL SERVICE AGREEMENTS…