Service Design and Culture

At the Tavistock Institute yesterday evening, to discuss some recent research on Service Design, presented by Paula Hyde based on her recent paper.

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)
  

Similar design conflicts can be found in some commercial settings, especially for services that are "unwanted", in the sense that companies would prefer not to have to provide these services, and the consumers would prefer not to need them. Many call centre operations deliver services that are unwanted in this sense, and these operations are often highly dysfunctional. [See my earlier post on Emergent Dysfunction.] Not so very different to the mental health systems described in the paper.