Presentation from WCVA's Annual Conference 2014

1. Developing the business case for public
engagement – exploring ‘Return on Investment’
approaches to scrutiny
Rebecca David-Knight
Centre for Public Scrutiny

2. Introduction
•Purpose of today is to stimulate thinking about ‘Return on
Investment’ models of scrutiny
•In what circumstances might they work best and why?
•Where does ‘the public’ fit into ‘stakeholder engagement’?

3. Learning Objectives
Through participation in this workshop delegates will be
able to:
• Supplement existing knowledge of different scrutiny
styles and structures;
• Better understand the links between ROI approaches
and public engagement;
• Refine ideas about the social, democratic and
financial value of the ‘overview’ role.

4. Return on investment scrutiny
• CfPS Health Inequalities Programme demonstrated that scrutiny can
be a powerful public health tool – ‘Peeling the onion’ publication.
• CfPS wanted to prove that scrutiny adds value – not just to health
but in general – so in 2011 developed a model that translated the
concept of ROI from business to health and wellbeing.
• After developed the model was tested and refined by 5 development
areas – their learning was captured and presented along with the
model in –’Tipping the scales’
• Further refined in 2012 – showcased in ‘Valuing Inclusion’

5. Potential savings identified
just under £1.7 million
Area Potential savings and return
on investment Return on investment
Newham £455,000 total
£90 for every £1 spent on the
review
Westminster £1,196,866 annually
£329 for every £1 spent on the
review
Southwark £20,930 total
£11.52 for every £1 spent on
the review
South Somerset £5,440 total
£3.40 for every £1 spent on the
review
Adur and Worthing £415 per person
£0.37 for every £1 spent on the
review (based on 1 person)
Warrington £17,389 per person
£5 for every £1 spent on the
review (based on 1 person)

6. Introducing the ROI model
What it helps areas to do!
The model is based on five
stages of a “scrutiny journey”,
utilising a variety of tools:
1. Identifying and short listing
topics
2. Prioritisation
3. Stakeholder engagement and
scoping
4. Undertaking the review,
measuring impact and
calculating the ROI
5. Making recommendations using
ROI and influencing services

7. Stage 2 –Potential impact and prioritising
2 elements:
Impact assessments – assessing the impact of the review on
high level objectives e.g. Joint Strategic Needs Assessments
And,
Scoring – using a scoring matrix to help to prioritise
•Benefits of this approach is the ‘screening out’ of projects where
scrutiny activity only likely to result in limited impact.
•Starting off with the ‘so what’ question ensures projects are
relevant and specific enough to be able to demonstrate an effect.

8. Stage 2 - Impact scoring matrix - Rotherham

9. Stakeholder
engagement
wheel

10. •ROI engagement tool inspired by ‘systems thinking’
•Systems thinking requires thinking in terms of relationships,
connectedness, and context
•Looks at how parts of a system inter-relate rather than
narrowly focusing on the parts themselves – how does access
to leisure services link to community safety?
•Whole systems scrutiny inquiry using ROI methodology can
lead to a whole system response.
•Public engagement just one but crucially important element -
essential for building legitimacy into actions of public agencies
A ‘whole systems’ approach to engagement

11. •Necessary to:
1.Help identify and refine the topic of enquiry
2.Begin to develop a whole systems response
Generate cross-section of perspectives:
• Authority – i.e. decision makers or community
champions.
• Resources - i.e. commissioners.
• Expertise – i.e. professionals and local people
• Information – i.e. data and intelligence.
• Needs – i.e. people or groups you are trying to help.
A ‘whole systems’ approach to engagement

12. •Services do not create outcomes; people do
•Outcomes often dependent on behavioural changes
•Addressing ‘wicked’ issues is fundamentally a social
process but often improperly defined
•More useful to think of ‘public engagement’ as a form of
social research
•Need for precision in identifying research
questions and relevant populations
Who do we mean by ‘the public’?

13. • Key factors include levels of involvement, degree of reliance
and frequency of interaction with service
• The higher the level of involvement / reliance with service, the
more useful the perspective - ‘experts by experience’.
• Conequently may often be the case that the views of
vulnerable groups of greatest utility.
• But what about those that are marginalised?
• Voluntary sector has a vital role in providing
data, access and representation
Is all ‘public engagement’ of
equal value?

14. Stakeholder engagement
wheel Identifying gaps and overlaps

15. Area and chosen topic Question that the review wanted
to answer
Return on investment question
Adur, Arun and Worthing
Homelessness
What is the impact of a homeless person not
having access to a GP?
What would be the ROI of enabling
homeless people to register with a GP?
Haringey
Men’s health
How do we engage men over 40 years of age in
Haringey’s corridor of deprivation in prevention
and early intervention services to close the life
expectancy gap and reduce premature death
from cardio vascular disease?
What would be the ROI if we engaged men
over 40 who were at risk of cardio vascular
disease with health and wellbeing
services?
Rotherham
Morbid obesity
How can we improve coordination between
services so as to improve the quality of life and
care of people with a BMI>50 and who are
housebound and unable to get out of their home
unaided?
What would be the ROI of better service
coordination and improving their quality of
life and care?
Sheffield
Diabetes in a South Asian
community
How can we improve and target information about
diabetes a ‘at risk groups’ in order to raise
awareness and combat myths about the
condition?
What would be the ROI if we are able to
improve and target information about
diabetes at ‘at risk groups’ in order to raise
awareness and combat myths about the
condition, leading to:
•improved case finding; and
•increased number of people who are able
to effectively manage their condition?
Stage 3 - Getting the ROI question

16. Measuring the Return
on Investment
There are two areas that the model seeks to
measure or estimate in respect of scrutiny:
•The value of the review itself as a process
– Producing a good quality report with well-argued
recommendations
– Capturing your impact on process changes
– Other outcomes such as better networking or better
awareness
•Outcome impacts
– Improving access to services
– Improving the health of individuals and communities
– Providing value for money

17. Benefits – what users thought!
• Scrutiny is well placed to influence a range of partner agencies
and promote more joined-up working
• Different way of prioritising topics - highlighting a ‘hidden’ issue
• Good stakeholder engagement looking at difficult and sensitive
issue – helps to get all of the right people together
• Explored issues ‘on the ground’ resulting in greater authenticity
and agreed a set of recommendations to help improve services
• Able to demonstrate a return on investment, including: input
and output costs, potential cost savings from improving service
coordination

18. Case examples
Westminster – Sex workers review
Tameside – NHS Health Check
Peterborough – Welfare reforms

19. Publications

20. Any questions?

21. Workshop questions
1. On your table chose a review topic
2. Generate a ROI question
3. Using the stakeholder wheel – plan who you
would invite and why
4. Consider the advantages and disadvantages of
this method

22. To find out more
www.cfps.org.uk - register on-line or via forms for:
- e-newsletters, e-digests & scrutiny exchange
- reviews library, on-line forum, latest news
- new Policy and Skills Briefings
Twitter: @CfPSCymru
Rebecca.David-Knight@cfps.org.uk or 020 7187 7362 for helpdesk
Tipping the scales:
http://www.cfps.org.uk/domains/cfps.org.uk/local/media/downloads/L12_379_tipping_the_scales_v
4.pdf
Valuing inclusion:
http://www.cfps.org.uk/domains/cfps.org.uk/local/media/downloads/L13_30_CfPS_Valuing_inclusi
on_v5_Web_final_amends.pdf
Checking the nation’s health:
http://www.cfps.org.uk/domains/cfps.org.uk/local/media/downloads/CfPS_Nations_Health_final_o
nline.pdf