ABSTRACT
Demand is rising for people-centred services in areas such as health, social care and housing. Such services generally seek to manage demand through layers of triage and assessment, reserving their specialist functions for people assessed with complex or acute needs. This article draws on the experience of managers from a range of public and voluntary sector organizations, who, as part of a postgraduate university course, used the Vanguard Method to explore demand and performance in their services. Their work suggests that excessive focus on gatekeeping and functional specialization is preventing services from understanding their users, which unwittingly helps to drive up demand. The authors discuss the prospect of designing services that reduce demand by becoming more people-shaped.
IMPACT
The question of how to manage rising demand with tighter financial constraints is a crucial one for people-centred services such as primary health, social care, and welfare support. This article explains why conventional approaches to addressing this problem tend to make services more bureaucratic and difficult to access, which negatively impacts on performance and counter-intuitively leads to higher demand. Aimed at commissioners, managers and practitioners in people-centred services, the article points towards ways in which services can evolve and adapt to meet the changing needs of citizens in these challenging times.
Disclosure statement
No potential conflict of interest was reported by the author(s).