Insight 4: Australians want easy to use services with tailored support where needed

Survey respondents widely supported the need for simpler, streamlined and more user-friendly human services as well as tailored support for our most vulnerable. There was recognition that recent reforms were moving in this direction.

Simpler, streamlined and more user-friendly human services

People want services that are easy to use and give them what they are after. Satisfaction with human services is affected by the experience people have with services, as well as people’s expectation of the kind of help services will provide.⁹⁵ Five of the top seven factors that Australians identified as improving their satisfaction with services relate to ease of use (Table 3).⁹⁶

Table 3: Factors Australians identified as most important to satisfaction with government services

Tailored support for our most vulnerable

During the workshops there was broad agreement that people experiencing vulnerability should receive tailored assistance designed to meet the specific needs and goals of individuals.

Tailored support, also known as integrated services or people-centred case management, involves collaborative goal setting, flexibility from service providers and empowering clients to participate meaningfully in decisions that impact them. Integration of services is also achieved in the way government structures, commissions and administers service delivery.

Tailored support is particularly effective for Australians with needs that cut across service delivery silos. For example, tailored support for First Nations Australians with complex challenges could involve addressing not just immediate health needs but also housing, employment, cultural and emotional wellbeing, and involving family and community where appropriate.⁹⁷

Monash University identified best practice attributes that were constants in successful person-centred health care as: comprehensive care delivery; strong partnerships; person-centred technology; clear purpose, strategy and leadership; and person-centred governance, capability and culture.⁹⁸ Developing the right workforce culture in service delivery organisations precedes changes to processes and services, and involves making a shift in focus from being task-driven to person-centred.

Place-based approaches provide a fully integrated service

Tailored human services can also be conceptualised for communities bound by place. Place-based solutions often bring together multiple human services to achieve the goals of local communities. Where place-based approaches succeed, they adapt to community need as it evolves.⁹⁹

A core principle of a place-based approach to human service delivery is that all communities and places are different and thus, the needs of community in-place are contextually defined. For example, First Nations First is a key principle which guides the work of Logan Together. It reflects the fact that place has always been central to Aboriginal and Torres Strait Islander cultural ways of knowing and being.¹⁰⁰

Unable to be ‘scaled up’, place-based approaches are instead ‘scaled out’. Connecting through national networks, there is opportunity for communities to share learnings. The government enablers that support place-based approaches such as policy settings, funding and governance models can be scaled to embed place-based practice as a core service delivery method.

Community capacity and capability can also be enabled and built through collective impact projects as knowledge, tools and resources are shared. For an example of a successful place-based approach to service delivery see Case Study: Logan Together.

Hubs offer wrap-around support for vulnerable Australians

Sometimes the support that people require is a safe and welcoming place. Hubs provide wrap-around support by acting as a single integrated point of access to multiple services. A community organisation working closely with formerly incarcerated Aboriginal and Torres Strait Islander people proposed hub models as a future solution when the primary issue is lack of connection.

Safe, easy access to hubs for those who experience marginalisation and potentially exclusion from universal services is critically important. Community organisations described their purpose as ‘a connector and an advocate’. Some community service providers articulated how hubs can offer a unique space of safety through a deep understanding of local circumstances and the cultural context, as well as the ability to offer wrap-around support. Some community organisation-designed spaces, co-designed with community, facilitate knowledge sharing and community connections, improving community experiences.

Community organisations agreed that having an accessible, community-owned space could rebalance power dynamics. A representative from another community organisation analysed how community participation in the co-creation of space is important for trust, which is an enabler of meaningful outcomes in service delivery.

Insight 5: Australians want trusted partnerships and genuine collaboration

The delivery of effective and integrated services is enabled by building valued and trusted relationships and working in partnership with communities, service delivery organisations and all levels of government.

Community members highly value collaborative working relationships with their service providers. Trusted partnerships lead to improved transparency across the system and shared accountability for outcomes.

Build valued and trusted partnerships

Trust is a critical foundation for effective human service delivery.¹⁰³ The community told us that trust was needed on both sides to build effective working partnerships. When the government engages after decisions have been made, feelings of mistrust are perpetuated.¹⁰⁴

Community leaders identified their vision for high-quality, trusted relationship between government and community, including the critical factors for success (Figure 7).

Figure 7: Factors required to build valued and trusted partnerships with communities

Trust increases between communities and government when there are genuine partnerships, demonstrated through ongoing commitment to shared priorities, regular engagement over the long term and shared achievements.¹⁰⁵

Genuine partnerships are critical to shifting the relationship between government and community from that of ‘funder and recipient’ to ‘parties with a common goal and shared funding and accountability.’

Partnership agreements, and other formal frameworks for engagement, help to scaffold relationships between communities, organisations and government, allowing for consistency through changes.¹⁰⁶ The Strong Partnership Elements outlined under the National Agreement on Closing the Gap articulate the requirement for clear definition of roles and responsibilities, the purpose and objectives of partnership, the scope of shared decision-making, and reporting arrangements, timeframes, and monitoring, review and dispute mechanisms.

Lift capability to achieve successful partnerships

Strong collaboration and engagement capabilities are essential to working in genuine partnership with Australian communities.¹⁰⁷ Government employees reflected that there are highly variable degrees of engagement capability in the APS and that an ongoing capability uplift is needed to enable effective two-way relationships with Australian communities.

The APS Charter of Partnerships and Engagement sets out the principles for improving the way that the APS engages to put people and business at the centre of policy, implementation and delivery (Figure 8).¹⁰⁸ During the consultations we heard that these types of genuine partnership do already exist but are not common.

Figure 8: The APS Charter of Partnerships and Engagement¹⁰⁹

Public servants who have the capability and expertise to work in partnership with community are inhibited when their senior executives have low risk tolerance.

Consultation also identified opportunities to build strong relationships through expanding the role of local governments in human service delivery and providing mechanisms for real-time feedback on human services. While these suggestions aren’t novel, there is further action needed to make good engagement practice the norm and provide a strong foundation for human service delivery partnerships into the future.

Community leaders and organisations explained that government has expectations of them which go unrecognised and are not adequately resourced. Government expects community organisations, particularly backbone organisations, to create ‘the glue’ that supports a more connected, effective and accessible service system, but doesn’t invest in the mechanisms required to support this level of coordination and integration.¹¹⁰ Community leaders identified the importance of backing community leadership frameworks and building their capability to engage with government.

The value of investing in community leadership frameworks

Community leaders outlined the value of strong and empowered community representation for enabling self-determination. They argued that investing in leadership structures, particularly in areas experiencing entrenched disadvantage, could facilitate more efficient use of resources and greater potential for enduring outcomes.

Aboriginal Community Controlled Organisations and backbone organisations shared the view that in many cases, there is enough funding directed towards services in communities, but it is not allocated in the most effective way to meet community need. In the future, community leaders and backbone organisations could ensure funding is allocated to the right areas to achieve outcomes, creating long-term savings and efficiencies.

Community members agreed with the role of community leaders and organisations, noting this is not a substitute for direct community input. Placing the focus on community priorities rather than organisational priorities can help to maintain the focus on achieving outcomes for the community.

Importantly, services controlled and delivered by First Nations people are culturally safe, respectful, and responsive to the unique needs of Aboriginal and Torres Strait Islander peoples. For example, Aboriginal Community Controlled Health Organisations (ACCHOs) empower communities by ensuring that health services are controlled and delivered by the people they serve, addressing inequities and improving health outcomes for First Nations people.

Greater collaboration and shared decision-making

A theme from the consultation was that governments and communities can’t solve big issues on their own, they need to come together.

Collaboration across the human service system creates opportunities for governments, organisations and communities to coordinate efforts, share resources and expertise, and minimise duplication. Establishing collaborative frameworks and ways of working across the system results in human services which are more effective, culturally appropriate and meet the needs of individuals and communities. Greater collaboration could involve government engaging directly with Australians and investing in structured collaborative models, such as co-design, place-based models, collective impact, local leadership frameworks and community hubs. Community representation in services and organisations, such as through place-based initiatives, is important for holding community intelligence and for building trust.

Opportunities for participatory democracy include deliberative polls, citizen’s assemblies, public consultation surveys, client satisfaction surveys and engagement forums.

Government providers noted the supply-side constraints to equitable access to human services in regional and remote Australia. Challenges include workforce shortages, poor infrastructure and funding models that fail to account for higher delivery costs.

Communities told us they wanted to make decisions about what human services are required in their local area. Participatory budgeting was proposed as a useful model for the future; see case study below on Porto Alegre, Brazil.

Workshop participants promoted the government taking a community-centred and holistic approach to service design and delivery. International examples were raised to demonstrate the effectiveness of holistic services embedded in the local community; see case study on the Bronx Defenders.

Community organisations and service providers reported that the conditions imposed by a market-based commissioning model of human services can drive behaviours and ways of working that are at odds with the purpose and values of the organisations providing services. People-centred care requires comprehensive support and collaboration, where people and/or organisations step in or adapt as needed. We heard that market competition can result in service providers, who are working in the same community, working in opposition or not sharing information, to the detriment of service recipients. In this way, marketisation of human services can promote a transactional approach to service delivery which fragments local communities through competition and dis-incentivising a collaborative approach.

There are a range of complicating factors associated with the marketisation of human services, including rigidity in funding structures and the kinds of incentives that are built into the system. While the goal of competition in New Public Management is to improve efficiency and reduce costs, in practice, there is often a cost-quality trade-off. As short-term costs are easier to measure than quality and long-term impact, service providers are incentivised to cut the quality of human services to a minimum level.¹¹³

Co-design services to meet unique needs of communities

Co-designing services between the service provider and service user has been demonstrated to deliver effective service outcomes. However we heard that co-design is not appropriate for every circumstance, and there are practical challenges associated with co-design. Firstly, the timelines for Budget processes were recognised by community organisations, service providers and public servants as often not conducive to the time needed for a co-design process. Secondly, co-design of services requires a high-level of capability from both the service designers and to support decision-making within the community.

There were diverging views among community organisations and advocates about how consultation, collaboration or co-design should occur. Some organisations believe they are an integral bridge between community members and public servants and should be empowered to play a greater role in decision-making. Others placed more emphasis on the need to engage with individuals and listen to their lived experiences.

Public servants highlighted successful place-based initiatives and other collaboration efforts as examples of the level of effort being invested in co-design. Community organisations and advocates, particularly those working with vulnerable groups or doing place-based work, called for a significant increase in co-design and collaboration in the future.

Insight 6: Australians want equitable access to human services

Communities want equitable access to human services regardless of socio economic and geographical disparities.

Vulnerable groups and people living in regional and remote areas of Australia reported higher barriers to accessing human services, including increased waiting time, workforce shortages, language barriers, transport issues and higher costs.

Address service accessibility and workforce challenges in regional and remote Australia

Australians living in remote contexts told us they are engaging with services that are more expensive and less accessible than their urban equivalents.

Community organisations want the unique needs and strengths of regional and remote communities reflected in service design and delivery. Accessibility, workforce capability and retention, and a lack of understanding of the unique challenges faced by those living in remote Australia are contributing to lower quality services.

Pursuing a market-based approach to human service delivery in regional and remote communities can produce particularly adverse outcomes. This is because the assumptions that underlie market-based principles are often not applicable in remote contexts where there may be only one service provider within the region.

Australians identified the opportunity to leverage emerging technologies to deliver digital, mobile and hybrid models of care in remote contexts to bridge workforce capacity and capability gaps.

Build the capability and capacity of human services workforces

Communities shared a vision for the future where community workforces have the capacity and capability to operate effectively and meet expectations around service quality and availability.

Governments should consider capability and capacity building as part of its role under a stewardship model. Identifying and leveraging strengths in community and complementing those with skills uplift will have the greatest impact.

Public servants noted that larger national organisations were often the preferred service delivery partners given their ‘readiness’, as the time required to build local community service delivery capability was seen as too great a barrier under the pressures of a reactive and resource-constrained system. A short-term focus was seen as undermining working relationships across the system, increasing uncertainty for service providers, and creating barriers to provider capacity building, effective longer-term planning and innovation.

Limited investment in community workforce capability is exacerbated by the commissioning model, as service outputs are linked to grants, with no consideration of the sustained quality of service delivery. As short-term grants are awarded based on output, government offers no commitment, career pathway or investment in employees at community organisations, which ultimately translates to poor service delivery. Capacity building within community organisations, enabling them to strategically plan for the future of their local communities, was also seen as limited by the lack of an authorising environment to take risks and innovate. Where funding is short-term, service providers may not invest in capacity building if their ability to get future funding is uncertain. Community organisations provided examples of challenges they experience to design and deliver programs that meet community needs, while balancing strict reporting requirements and funding limitations.

Community organisations and service providers reported that smaller organisations, who are often also operating in rural and remote areas and with fewer resources overall, are less able to absorb the administrative costs of applying for funding. Some public servants interviewed perceived that agencies are currently inadequately resourced to be able to support service providers, while others suggested rigidity (for example in how grant funding can be used) prevents providers from using resources that are allocated to them to build capability. Community organisations reported feeling unsupported or inadequately resourced to build staff capability and their overall capacity to serve their community.

Further, community organisations perceived part of their role as engaging in building a sense of community as part of providing care and support to people. They expressed that their efforts were being strained by a rigid approach to funding and accountability that limited their opportunity to do things that would work for their community. Without community-building being recognised as a critical contribution, activities that support community cohesion aren’t considered as a metric of success, nor adequately funded.