By Richard Johnstone

20 May 2019

A ground-breaking Scottish Government drive to better link policies to outcomes has just gone through a major overhaul. Richard Johnstone went to Edinburgh to hear more about the National Performance Framework

In 2007, the Scottish Government launched a whole new way to measure the effectiveness of the nation’s public sector. The National Performance Framework – and accompanying Scotland Performs website – was intended to clarify the government’s purpose and tackle the proliferation of competing priorities as the Scottish National Party government took over from the Labour-Liberal Democrat coalition that had led the Scottish Parliament since its creation in 1999.

The framework heralded the start of a new era of governance as well as a new political one, with the 2007 Spending Review committing to a series of long-term outcomes. Beneath the overall purpose of government and public services – namely to focus “on creating a more successful country, with opportunities for all of Scotland to flourish, through increasing economic sustainable growth” – lay a set of five strategic objectives and 15 national outcomes. These set out how government would work over a decade to improve services and create sustainable economic growth, and included 45 national indicators and targets to measure progress.

In 2018, the framework was refreshed to include indicators such as gender balance in organisations, child wellbeing and happiness, and the importance of secure work. A total of 81 indicators are now being tracked by government. This came after the framework had been placed on a legislative footing after being adopted by the Scottish Parliament as part of the Community Empowerment (Scotland) Act 2015.

The NPF has been hailed by the Organisation for Economic Co-operation and Development (OECD) as the most developed outcomes-based approach by any government in the world. CSW spoke to three senior figures in the Scottish Government – Alyson Stafford, director general Scottish exchequer; Dr Catherine Calderwood, chief medical officer; and Lesley Fraser, director for housing and social justice – about how the framework has influenced the work of government over the last 12 years.

Alyson Stafford, director general Scottish exchequer: “The national performance framework is our North Star in Scotland. Its history goes back to the Spending Review 2007, but before then there was some key strategic work thinking about outcomes.

“Prior to 2007, the coalition government had somewhere between 400 and 500 partnership endeavours and activities to secure. Although most of those partnership promises were actually being delivered near the end of that administration, there was still a sense of: ‘How much have things really moved on?’ At that point there was some really innovative thinking led by the then-permanent secretary Sir John Elvidge looking at outcomes. We looked at Virginia Performs [the government performance website for the US state] and we had various presentations by people from Virginia here. That happened to coincide with a change of administration and the two things happily collided together and created the first National Performance Framework within months of a change of administration.”

From left to right: Alyson Stafford, Lesley Fraser, Dr Catherine Calderwood

Lesley Fraser, director for housing and social justice: “I was heading up the strategy and performance unit in 2007, so I was in the midst of those discussions. It was a real sea change from measuring each partnership promise to turn around and say: ‘What are the outcomes that make a difference here?’ That looked and felt very different. We then engaged in a whole programme just to help civil servants understand the difference between a particular promise on a number here or an investment there, compared to helping children have the best possible start in Scotland, which is hugely important in terms of health outcomes, education outcomes, employability, justice.”

Dr Catherine Calderwood, chief medical officer: “I’ve been chief medical officer since 2015, and the framework had been in place for a number of years before that. So I inherited what Alyson and Lesley have laid out. My role covers much more than health and wellbeing, because of course health is improved by all of the parts of this [framework] – if people are not living in poverty, if they have a nice place where their home is, if they can get outside into green space, then all of those are key contributors to a more healthy population.”

The introduction of the NPF required government to begin to gather and collate the data needed to measure broader wellbeing.

LF: “There was a bit of pooling data together. We already measured people’s satisfaction with their environment, their neighbourhood, their home, and we knew about their income levels, but we didn’t pull all of that together. The outcomes approach absolutely gave us a platform and an opportunity to do that.

“But it also showed us that we weren’t necessarily counting the things that were really important to people. Out of the National Performance Framework arose an emphasis on the importance of early years, and all children reaching their developmental milestones by 30 months. When we dug into the data to find out whether children were reaching those important milestones, we found that only something like 65% of children were actually having those developmental milestone checks, never mind whether they are reaching them.

“Then we were able to put some focus on that – not just through the health route but through education to make sure that we were reaching the kids and then getting the checks in place. That allowed us to put the improvements in to make sure that when they are being measured, kids are reaching those developmental milestones. It was really interesting [to find out] both what we were measuring but also what we weren’t.”

“It gave us some guilty knowledge that we couldn’t walk away from, like the absolute importance of the early years. In 2007, not many people were looking at that, but we realised that if you can bring the evidence together and come up with a strategy that involves all of the different bits of the system, you can demonstrate how you can change lives. But I don’t think we would have got that ‘oh my goodness’ insight without bringing these different bits of information together.”

CC: “And that drove some of the work that made us have much more specific indicators. Realising that some of what we were measuring wasn’t truly outcomes-based led us to really look at what we should be measuring, and what indicators would lead to further improvement. For example, we measured levels of physical activity but also then put in measures to increase it, and so we’re now measuring how this can actually improve health and prevent ill health.”

The framework is used to shape policymaking across the Scottish Government.

CC: “What we’re aiming to do is when there are new policies, or something a particular minister wants, is be able to say: ‘Hang on a minute, would this enable us to get towards that outcome? Are we able to measure that in our national indicators?’

“It smooths out some of those bumps and the potential for government or particular agendas jumping from one kind of policy type to another. If something is going to improve our path towards these outcomes, then we are able to say, ‘that’s what we want to do,’ and we can move away from something that isn’t going to enable us to get to those.”

AS: “We’ve seen some really good examples. Justice is one – the justice family [of all public sector bodies involved] came together to take high-level outcomes and translate them into priorities – it wasn’t just within the government, it was Police Scotland, the prison service and all of those that had an interest.

“That is an area where the government has moved from being measured on an input to talking more about safer communities and reducing crime. At one time there was this really key target of how many frontline police officers there were – I can still remember the number, 17,234, very precisely [which met an SNP manifesto pledge to increase the number by 1,000]. But that actually isn’t something the government is hanging its hat on now. If you look at the most recent budget document and the outcomes for justice and what the priorities are, they are all framed in ways looking at how society lives.”

“Realising that some of what we were measuring wasn’t truly outcomes-based led us to really look at what we should be measuring to lead to improvement” Catherine Calderwood

A similar approach was taken around knife crime, which has helped create interventions that are now being copied in London as the city battles its own rise in violence.

CC: “We’ve had a very significant drop in knife crime because we started to treat it as a public health issue. The justice system worked with the people we’ve already discussed, but we also worked with our public health colleagues to look at the prevalence of knife crime and what else was going on in terms of addiction. We took a whole system approach to that, and we’ve had visitors from all over the world coming to see how we had the massive reduction.

LF: “I think there’s a common understanding that collectively, as a civil service, we’re there to deliver better outcomes for the people of Scotland and there’s a great understanding that this is a parliament-wide ask of the civil service [as the NPF has been unanimously endorsed by MSPs]. In terms of working together, there are challenges and cultural things to pay attention to.

“I’m sitting next to Alyson who wears the finance hat and who thinks about accountability. Catherine and I are working together when I’m thinking about how to build houses in a way that promotes physical activity and mental health, but which might mean they cost a bit more. Alyson will be saying to me, ‘Hang on a minute Lesley, how are you ensuring value for money?’ So there is an interesting set of questions to understand that, in accounting officer terms, value for money means good quality houses that do more than put a roof over people’s heads in the lowest-possible cost way, but encourage thriving communities.”

‘Loved’ is not a word that was frequently used in the first part of my civil service career and now it is in the National Performance Framework” Lesley Fraser

Such policy interconnections are not new discoveries, but, Stafford says, the Scottish Government has been able to move past theory and put ideas into practice.

AS: “If you think of what’s happened on early years work, that has been a massive improvement cycle, reaching out across a whole range of different workers. I think the key is it’s given people the permission, if they needed it, to disregard the boundaries and actually work together.”

The framework does not, however, provide a direct evaluation of performance.

AS: “These don’t set targets, these are the outcomes we want to see and I think they provide the golden thread between the purpose, the particular outcomes and what it is that is going to make a difference in communities.”

CC: “We do have targets [outside the framework]. The health system has the four-hour waiting time target for emergency departments. But what’s different here is that traditionally government’s targets are process as opposed to outcome, whereas the NPF is about health in the round. It’s not just physical health, it’s mental health as well, and we’re also thinking about the longer term. It’s about looking at the prevention of ill health, and looking at poverty – at reducing poverty and ameliorating the effects of poverty. That long term element, I think, is what makes this unique.”

The NPF has been kept up to date through two technical adjustments – in 2011 and 2016 – before a more formal refresh last year, when the aims were also aligned to the UN’s Sustainable Development Goals.

LF: “In 2007, this was one of the first major outputs of the new SNP minority government. So it was really amazing to have produced a National Performance Framework in that six-month period.

“But what that didn’t allow was in-depth consultation. As civil servants, we know the partners and communities that we work with, and it was really important to know that those voices were included in the refreshed version. For that reason, it feels much more aligned with the work that we’re doing, and more aspirational.

“We were also much clearer about the importance of things like underpinning values. They appear in the original, but you can really tell that, for example, children have been involved in defining the outcome that’s about children who want to grow up loved. Loved is not a word that was frequently used in the first part of my career as a civil servant and now it is in the National Performance Framework. And of course it would be there, because if you ask children what’s important, that’s what they’ll tell you. But it takes us into new and different territory.”

CC: “There wouldn’t have been much [discussion of] kindness, either. We’ve been able to pull people together to a common goal through the purpose and values that join up across government. We still have silos, and we talk about silos with glass walls so we can see people, but we still can’t get at them. The NPF enables even the glass walls to get broken down.”

“The key is it’s given people the permission, if they needed it, to disregard the boundaries and actually work together” Alyson Stafford

Scotland’s aims

Scotland’s national outcomes are that people

• grow up loved, safe and respected so that they realise their full potential

• live in communities that are inclusive, empowered, resilient and safe

• are creative and their vibrant and diverse cultures are expressed and enjoyed widely

• have a globally competitive, entrepreneurial, inclusive and sustainable economy

• are well educated, skilled and able to contribute to society

• value, enjoy, protect and enhance their environment

• have thriving and innovative businesses, with quality jobs and fair work for everyone

• are healthy and active

• respect, protect and fulfil human rights and live free from discrimination

• are open, connected and make a positive contribution internationally

• tackle poverty by sharing opportunities, wealth and power more equally

These flow from the government’s purpose

“To focus on creating a more successful country with opportunities for all of Scotland to flourish through increased wellbeing, and sustainable and inclusive economic growth”

And values

“We are a society which treats all our people with kindness, dignity and compassion, respects the rule of law, and acts in an open and transparent way”

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