Paula Hyde & Huw Davies. Service Design, Culture and Performance: Collusion and Co-Production in Healthcare. Human Relations 57 (11). Available online until June 30
The immediate conclusions of the research (carried out in a mental health setting) was that attempts to improve service provision had largely failed, because although there were some surface changes in the organization, the fundamental relationships on which the service provision was based remained unaltered. There were some profound forces (explicable in terms of organizational psychology) that inhibited real change. [See also POSIWID post on Locking In].
During the discussion, several areas of healthcare and social care were mentioned where there appeared to be some conflict between the following service design objectives:
- to accord primacy to the service user in the design of the service
- to reduce the service user's dependency on (or abuse of) a given service
- to minimize various forms of risk (or uncertainty) to the service user, to the service provider, and to others
- to establish measurable improvements in service delivery (the dreaded targets)