Yesterday, I attended and spoke at a Community Care event on ‘Commissioning for Community Services’. There were some interesting speakers, perhaps particularly those drawing upon their experience of practice. My theme was on ‘Co-production and Risk Management’ – topics I would not claim to be an expert on. But we, the audience and I, engaged in a little co-production to draw on their experience of risk and of how to manage those risks. I asked them to recall an occasion when they took a risk to achieve an outcome for a client – what happened, who was involved, what were the risks? They were then asked to discuss this experience in groups and identify their tips for managing risks. The responses fall into some common themes:
- be brave – trust your instinct; have the courage of your convictions.
- take risks – encourage positive risk taking; accept risk as normal; make a balanced assessment of risks; what are the risks of doing nothing, of continuing to do as you’ve always done?
- be led by the client – build trust; show respect; listen and understand; focus on an holistic understanding off their lives.
- build relationships – get support; share the risks.
- be flexible – know the system and rules to interpret/bend them to meet client needs; think through all the interdependencies and wider impacts; don’t take no for an answer; keep asking ‘why?’ and ‘why not?’; challenge the blame culture.
- communicate – consult and involve at the outset and throughout; on-going evaluation and openness; manage expectations
- don’t underestimate the personal cost.
Probably a better list than I would have come up with and underlined by some of the later presentations about: Community Matrons and the Virtual Ward in Croydon; about a Local Authority Trading Company in Essex; and about developing provider capacity to deliver changes in services.
If we were to believe everything we hear from ministers or read in the paper, the public sector is moribund, the problem etc. But there is still life out there.