Abstract

In this article Darren Murinas and Andy Meakin explore how, learning from the private sector, Expert Citizens are establishing the lived experience of consuming public services as the benchmark for performance and continuous improvement. They argue that public services need to pay more attention to how the act of consuming public services make people feel about themselves and the world. To do this, they contend, we must shift the power to decide what good practice looks like from the professionals to the consumers. They offer a quality framework, called the Insight Services Standards, designed and evaluated by people with lived experience for that purpose.

Insight through experience

Expert Citizens is an organisation staffed and managed by people with lived experience of homelessness, mental ill-health, addiction, or offending behaviour. Our work began in Stoke-on-Trent as an advisory panel helping Brighter Futures and its partners develop a proposal to the National Lottery Community Fund as part of the Fulfilling Lives programme. That proposal was successful in attracting funding for a large-scale project which became known as VOICES. Over the following two years, with the support of VOICES, we developed into a non-incorporated community group and then, in the summer of 2016, we became incorporated as an independent Community Interest Company. We exist to champion the value of lived experience in the governance, evaluation, continuous improvement, design, and commissioning of products and services as they relate to people experiencing multiple needs.

Consuming public services: Learning from the private sector

Advertising for products and services showers modern households in a deluge of images from every conceivable media outlet. Like never before, social media delivers tailored content based on complex algorithms that discern your likely preferences based on specific on-line behaviours. Facebook, Twitter, YouTube and other channels abound with multimedia content intended to set products or services in the context of your other lifestyle choices. The products and services themselves are often the outcome of extensive consumer testing through prototype after prototype before exposing a refined product to the test of the consumer market. As well as the quality and technical specifications of the products or services, there is another key question. What is the experience of using the product or service like? Or, what and how did that experience make you feel?

In a consumerist market where we all take quality and conformance to specification as a given, these are crucial questions that help marketeers understand their target demographic as well as the key messaging. As a result, the advertisements we see often skip over the technical specifications. Instead, they are rich in metaphor. The positive feelings that a product or service is intended to instil in the consumer are instead the subject of activities, actions, or expressions. If you want to emphasise dependability or trust, then perhaps try putting your product or service in a story involving a close relationship between good friends or a firm handshake with positive eye contact and a smile. If you want to emphasise a feeling of freedom, then try a story involving surfing, rollerblading, mountain climbing, cycling no-handed, or the trip of a lifetime. We are so used to modern products and services being of high quality and doing what they are designed to do, that it is simply not enough to focus on functionality and process. To get the engagement of customers, a modern organisation must pay attention to how the experience of their product or service makes people feel. Not just about the product or service of itself, but also about the world and about themselves.

Arguably, this trend began in earnest in 1962. At this time, motorcycles had a gathering reputation of being noisy, dirty, and anti-social. They became associated in the emerging popular culture with gangs and criminality through movies like The Wild One and Easy Rider. However, this association was not good for sales of new motorcycles. So, in 1962 Honda began a campaign that lasted for 12-years and helped the company to become the largest manufacturer of motorcycles in the world. It was called, “You meet the nicest people on a Honda.” The campaign emphasised fun and relationships through activities associated with ‘nice’ people. Like an image of a parent taking their child to the zoo – on a Honda. In 2020, this emphasis on feeling and experience persists in Honda advertisements with messaging like “the power of dreams” and “safety for everyone”. So, the private sector knew the importance of how products and services made people feel from as early as the 1960s and continue that emphasis to this day.

“Honda is passionate about the safety of not just everyone who gets into one of our vehicles, but of everyone who shares the road with them too – from other drivers, to bicyclists, to pedestrians. But that’s only the beginning. Because when you’re able to prevent a collision, you’re not just protecting the lives of everyone on the road, you’re also protecting the lives of everyone who cares about them.” (Honda YouTube Channel, 2019).

Another way of expressing this is that Honda, like many other manufacturers of the time, began to appreciate the value of ‘lived experience’ in product development as well as the engagement of new customers through marketing lifestyle choices.

Of course, we must acknowledge that this approach to ‘selling’ has been the subject of criticism. Both sophisticated and clumsy marketing is often guilty of more than a little hyperbole in the claims made about the positive impact of their product or service on the mental wellbeing or social popularity of its consumers. And, therefore, it must be conceded here that the claims made about the elixir-like qualities of products and services on our wellbeing rarely live up to the hype or quickly wear off. However, our key point is that as well as solving practical problems in our lives, like how to get the kids to the zoo, marketeers are also concerned with the experience of the solution and how it makes us feel. Therefore, starting with Honda, manufacturers and their marketeers are also concerned to help us visualise how the consumption of their products fits in with our preferred lifestyle, how others perceive us, and how we perceive ourselves.

Compare this emphasis on the lived experience of consumer products and services to that of many public sector service models. Even today. Right now.

The emphasis in many public services is on the process. Consumers of public services move from workstation to workstation for processing by operatives. Like parts in a machine. At each stage in the process, questions scrutinise whether the person meets the eligibility criteria for that service. In many ways, just like in a manufacturing process, technicians inspect each part arriving at their workstation and judge it against the systemic tolerances. The questions are often very similar at each workstation. Name? Address? National Insurance Number? And often personal. How did you become homeless? Why did you lose your job? Are you able to manage toileting yourself? In some circumstances people may even be asked to demonstrate or otherwise evidence their worthiness as an applicant.

It is hardly surprising that people get frustrated at answering similar, sometimes difficult, personal, or embarrassing questions again and again. However, others experience much worse than irritation with the street-level bureaucracy of public services. This can include levels of debilitating anxiety about being subject to these processes that prevent people seeking help altogether. Or, worse still, interventions may retraumatise people unconsciously. So, while many public services are entirely free at the point of delivery, they too often ignore the hidden personal and psychological costs of engaging in the systems of access. Similarly, the costs to wider society of services failure to be welcoming and keep people engaged in a process of accessing help can be high. Chronic ill-health, persisting homelessness, recidivism, economic inactivity, and the bottomless opportunity cost of lost potential.

In public sector services, we see little of the focus on customer experience that so characterises commerce in the private sector. Perceptions of quality and quality management in the public sector seem to focus too heavily on a ‘conformance to specification’ model taken from manufacturing where people are merely a component of a process. Public sector services pay too little attention to framing ‘quality as excellence’ as seen through the eyes of the consumer. From the micro-business of a hairdressers that offers customers a drink and a magazine while they wait, through fancy folded napkins at an expensive restaurant, to emphasising the feeling of freedom that adds value to travelling by motorcycle, this is something that the private sector ‘gets’ and from which the public sector could learn much. 

Expert Citizens would be the first to acknowledge that many people tolerate this dynamic and emerge relatively well with the services that they were seeking in place; e.g. housing, social care, or a mental health assessment. Stoicism or relief is a likely feeling for those who succeed in attracting the services they need. But, what about those whose measure does not pass scrutineering?

Changing the consumer experience: The Insight Service standard

Many public services involve no exchange of money at the point of delivery, this is because the cost of public services is socialised through taxation to supply a safety net for everyone. It is an acknowledgement that we are all mere flesh and bone. Almost everyone is inherently vulnerable to the winds of economic change and in the end we all succumb to our failing bodily chemistry and gathering entropy.

Therefore, what is it that Expert Citizens do promote positive change in the consumer experience of many public services?

Typical quality standards, for example Investors in People and the inspection framework of the Care Quality Commission, evaluate conformance to professional standards or compliance with regulatory requirements. However, while these models do touch on customer experience, this tends to be a relatively small element in the overall framework. Instead, they focus mainly on technical competence and compliance with bureaucratic processes.

While recognising the financial constraints on public sector services, we believe that there is a lot of scope to improve people’s experience when approaching state or voluntary sector services and asking for help. Like the hairdressers that provides a drink and a magazine, such interventions need not break the bank but serve to get the clear message across to people that they are welcome, valued, and important.

To that end, Expert Citizens and VOICES have co-created a quality standard designed to focus on and evaluate the customer experience of using public services. We call this an “Insight Evaluation”. The Insight Service Standards have seven characteristics of services that promote a positive customer experience.

Each characteristic has four levels of performance as follows:

• Welcoming – Services achieving the welcoming standard show that they greet people warmly and with unconditional positive regard.
• Listening – Services achieving this standard show that they use active listening to understand how their services need to change to promote an even more effective customer experience.
• Learning – Services achieving the learning standard show that they implement the results of their active listening to make changes designed to improve the customer experience and then evaluate the results.
• Leading – Services achieving this standard put people with lived experience in the lead of their organisational development and share their learning generously with others to promote improvement externally.

Expert Citizens worked with Staffordshire University to develop a training package to help people with lived experience to become service evaluators. Therefore, the Insight Evaluation framework is unique in that people with lived experience designed and implement it. Evaluators, customers, and service staff coproduce the evaluation itself. At the heart of the Insight Service Standards there are also key concepts taken from theory. Trauma and psychologically informed practice allied to a solution-focus grounded in a strengths-based approach to the personalisation of services.

An Insight Evaluation is not, however, an inspection that is looking for or highlighting areas of non-compliance with ridged standards. Instead, we adopt an appreciative inquiry model that looks for and highlights positive practice. In that way, Insight is a journey towards system leadership in which Expert Citizens and the Insight Evaluation Standards are a companion that helps services to navigate the route from waypoint to waypoint, heading in the general direction of customer experience excellence.

Insight Evaluators consider a range of evidence. This begins with a self-assessment by the service which, in the very best examples, customers lead. Expert Citizens evaluators will then go on to interview customers, staff and managers. Evaluators may also consider documentary or other evidence such as the website. Once the initial evidence gathering is complete and compared against the Insight Service Standards, the Expert Citizen Evaluators complete a report that highlights the strengths and areas for development. This includes recommendations for the actions necessary to consolidate the current performance and advance to the next level. In addition, where the service evidences the necessary standards, one of the following logo’s is awarded.

Services have found the process useful in recognising what they are doing well and the areas for further development. We have found that the act of evaluating has the effect of helping services to better visualise and articulate lived experience as an asset creating a multiplier effect. As customers feel more welcomed and listened to, they are more motivated to get involved in continuous improvement.

There have also been some positive ‘problems’ with the implementation of the Insight project. As Expert Citizens have trained people to carry out evaluations as volunteers, this has increased their skills and confidence, and many have moved relatively quickly into employment or fulltime education. This dynamic has been a limiting factor on the number of evaluations we have been able to conduct using the current model. Albeit this is a problem about which we are in many ways delighted.

“The communication was 100%. It was a positive experience for me and the other people who took part. The report was comprehensive and fair and overall a good assessment.” (Staffordshire Police)

Part of the philosophy of Insight is sharing and celebrating positive practice. Every year Expert Citizens organises and hosts an Insight Conference and Awards. Since 2015, this has grown to be a national event attracting prestigious keynote speakers with lived experience. The Conference in 2018 included the lived experience testimony of Sammy Woodhouse, campaigner and author of the bestselling book “Just A Child” which chronicles her experience of surviving abuse in Rotherham and bravely becoming a whistle-blower to help others. In 2019, Expert Citizens were delighted to welcome poet and author Lemn Sissay MBE who spoke with passion about his experiences as a child in the care system. Our annual celebration of the value of lived experience culminates with the Insight Awards. A panel of people with lived experience considers nominations for the awards from across the country. The award categories mirror the Insight evaluation standards of welcoming, listening, learning, and leading. They aim to celebrate champions of lived experience as an asset, like Kevin Wright who is a Support Worker at Brighter Futures and was nominated by a former customer. The nomination for Kevin read as follows:

“Kev’s insight and understanding are inspirational. He encouraged me to overcome my social anxiety by using public transport. He convinced me to get stable on my methadone and motivated me to beat my addiction to sedatives…. When I had difficulty registering with a GP, Kev helped me to register and attended appointments with me. My fear of hospitals was a result of my parents being admitted and, sadly, never being discharged. Kev took time to go with me….He taught me to see my past experiences as an opportunity and, to use my experience to help others in their recovery..” 

In another example, Expert Citizens received a nomination for Julie Norton, a Consultant in Emergency Care at the University Hospital for the North Midlands. Julie wanted to see if there were any ways in which Expert Citizens could help her department to better support people experiencing homelessness, who would repeatedly return to the Accident and Emergency Department following treatment:

“Julie has taken the lead in her department to bring people with lived experience into staff sessions to share their experiences to promote insight and learning. As a result, the department is now distributing improved information to staff; this includes information that highlights the barriers to accessing primary healthcare and other services….Julie and colleagues strive to maintain the dignity of these people by providing clean and warm clothing. As a result of Julie’s work, the department is now actively engaging in a citywide learning programme for services supporting people experiencing multiple needs.”