Friend or foe: integrating disrupting voices in social outcome contracts

Improving cross-sector partnerships to achieve social outcomes involves going beyond traditional frameworks of procuring and funding social services. It requires shifting away from the conventional classification of problems, and re-orienting towards person-centred approaches that aim for health, social, environmental, and economic impacts. In order to do that, we need to disrupt the status quo, break barriers, and find collaborative links. But first, we must ask “whose outcomes?”, and value diverse perspectives and hold space for disrupting voices and ideas.

Fortunately, there has been an increasing recognition of the importance of diverse perspectives and voices in public service design and provision. In fact, one key question stemming from the 2022 Social Outcomes Conference was ‘who’s not in the room?’, which highlighted a collective need for more user voice and recognition of different global contexts in this sector. This is why we’ve appointed ‘Disrupting Voices’ as one of this year’s conference themes. At SOC23 and beyond, we hope to explore a new path for practitioners and researchers, who want to see rhetoric turn into reforms. To succeed, we need to lean into the discomfort of disruption and focus on the systemic changes that are needed. This is likely both destructive and creative. Ultimately, it is unlikely we are going to solve wicked challenges with the same thinking that created them.

Recognising different global contexts

Countries outside of the high-income bracket are often subject to sweeping generalisations and lack of attention to specificity. This is clear when we lump countries into large buckets like ‘LMICs’, ‘The Global South’, or ‘developing countries’. We strip them of their unique complex identity. While classifications may sometimes be convenient, being a bit more critical and attentive to the uniqueness of certain populations and the sub-systems and processes locally is vital to moving any discussion beyond rhetoric.

Unfortunately, outcome-based contracting and social impact bonds, like many innovations, have been dominated by priorities and standardisation from Europe. Even though social impact bonds originated in the UK, and Europe and the United States still count the highest numbers of these instruments, many countries have looked to adopt them due to their perceived benefits. However, we still understand very little of the extent to which social impact bonds can be translated to different settings. It remains unclear if social impact bonds can be implemented in settings of extreme vulnerability of service users (such as fragile states, displaced populations or extreme poverty), or in cases of less reliable and prevalent data monitoring systems. Similarly, since accurately and consistently priced outcomes remains a cornerstone of this approach, more unstable macroeconomic states may face special complexities when it comes to operationalising outcomes-based payments.

Many organisations, including research centres, ‘perpetuate the very power imbalances they claim to rectify’, either consciously or subconsciously through attitudes and policies. This can also occur with the (perceived) concentration of knowledge and learnings within high-income institutions. However, at SOC23 we are fortunate to challenge these notions with a diversity of presenters who will share implementation lessons around the use of outcomes-based contracts in every continent. GO Lab commits to being ethical knowledge brokers (not just holders) and to hold ourselves as accountable, global citizens. We want robust discussions on how we can approach this field critically and how to decolonise and deconstruct our understanding…. Come join SOC23 to share your reflections and experience!

Hearing different user voices

The concept of disrupting voices is intrinsically linked with the perceived value of different voices, especially the user voice. In other words, those with direct ‘lived’ experience of social issues. We know that individuals ‘often have a relatively strong attachment to the public services they use... and ‘care about’ them being done to a standard they find acceptable’.

The recognition of the user voice has given rise to a number of important related initiatives such as co-production, citizen involvement, and service leadership. In light of this recognition, co-production represents a disruption to the status quo, built on the principle that those who are affected by a service are best placed to design it. There are some examples of OBCs that can be regarded as successful enablers of co-production, where the user voice shines. One such example that will be explored at SOC23 is the Kirklees Better Outcomes Partnership.

An inspiring example is helpful, yet if more programmes are to integrate user voice, we must reconsider how we value the deep wealth of knowledge, resources and insights communities already have, as well as move beyond the concept of ‘passive citizen client’. Co-production rejects this traditional understanding of service users as dependents of public services, and instead redefines the service/user relationship as one of collaboration and co-dependency. When done well, co-production helps ground service design in reality and is person-centred.

Barriers to encouraging disrupting voices:

• Relationship building with community partners can be often under-valued.
• Lack of recognition of the power and wealth of expertise in ‘lived experiences’.
• Difference in language and overuse of technocratic jargon keeps us apart.
• Sectors work in silos despite overlap in shared goals for improved social outcomes, and the need to overcome the traditional juxtaposition of some disciplines.
• Urgency of issues means critical reflection of which voices are not in the room are often constrained, leading to othering, invisibility or generalising across contexts.

The main barrier is that although many appreciate the need for a wide range of voices in outcome-based contracting and public services, in practice we often default to what is easy or convenient. Disruption and innovation are sacrificed for the sake of simplicity. While reverting to usual habits when facing unforeseen change is understandable and very human, it also represents a significant missed opportunity. This often also coincides with doubling down on the answers people “know,” rather than considering other possibilities. Similarly, by not reflecting the range of experiences and perspectives available within the community, we may inadvertently continue to mirror the dominant barriers and exclusions present in the social world.

For example, in 2006, the United Nations was drafting the Convention of the Rights of Persons with Disabilities. While activists, advocates and services users with different types of disabilities were encouraged to attend in person, they failed to recognise accessibility issues with the building in New York, which still exists to this day. People with wheelchairs were unable to sit anywhere besides the back due to the benches being too narrow. So even when embracing the user voice, structurally the room and the world wasn’t built for them in mind, further entrenching this divide.

Takeaways: embrace uncertainty, reflection and interdisciplinary

The Social Outcomes Conference this year invites you to be curious about disrupting voices and challenges to our norms in thought, action, and research. It has been stated before that opening yourself up to personal disruption can be deeply unsettling. The unknown is a constant with social problems. Even if a particular approach to tackle a social issue might have “worked” for several years, it is unlikely to stay that way forever. Curiosity often comes from seeing the gaps that exist and the extent of the unknown.

There is an opportunity at SOC23 to build on the momentum of 2022, to draw widespread attention to systemic challenges in public sector provision and discuss potential evidence-based solutions together. But rhetoric is far easier than reform when power and privilege are at stake. Reform will require not only identifying specific deficiencies, but also actions to radically change the prevailing systems. This entails not only encouraging different user voices and contexts but valuing them at the core.

I’ll conclude with the reminder from Professor Farhana Sultana at Syracuse University that the “Eurocentric, capitalist, patriarchal, techno-centric and racist systems have brought the world to this crisis of climate breakdown, calling for a deep decolonial process which requires alternative forms of epistemic justice by valuing other knowledge holders and their ways of knowing.”

Join us on 14-15th September for the Social Outcomes Conference (SOC23), the annual convening of the world's leading researchers, policymakers and practitioners working to improve social outcomes. Are you ready to listen to disrupting voices?