This is the Executive Summary of an original vision created to inform the work of the Labour Group of Rural MPs in 1998. The vision was updated and presented at the ruralnet|2004 conference. It has been presented at many conferences since.
Access to services is crucial to reduce rural deprivation and increase social inclusion. However, access to services for rural people has been declining for many years and will continue to do so unless we inject new thinking and start doing things differently. We need new paradigms for rural service delivery that focus more on the integrated needs of service users and less on the ‘needs’ of service suppliers.
The idea of ‘multi-purpose village centres’ was first published in 1981. Since then there are many more post offices in shops but true multi-service outlets (MSOs) are so rare that they still make the headlines.
It is argued that a sole focus on location for the delivery of services is not helpful and that the current way of measuring access in terms of the distance from locations needs to be reviewed. The focus should be on ‘Integrated Service Provision’ and not on ‘Multi-Service Outlets’.
At the heart of the vision presented is the notion that successful service integration needs to be preceded by an analysis of the component parts of each service. Then services can be re-engineered and integrated. This can be done by considering the functions a service performs under the following headings:
- information function
- expert function
- social function
- physical function
Examples of this analysis are given in the full paper and applied to a whole range of services.
Analysing services in this way before integration, enables us to identify two things:
- The elements of the service that need LOCAL physical space (the physical elements and some of the social elements);
- The elements of the service that can be delivered without a local physical presence using the telephone and ICT (ie the expert and information elements and some of the social elements).
Only the physical and some of the social elements of a service need a local venue. The expert and information elements can be delivered remotely (to the local venue or to the home or business) using ICT. In simple terms, experts can sit anywhere on the end of a phone and information can be delivered using internet-based technology. A local advocate operating from a local venue could act as an intermediary to such services where required.
NHS Direct and the way the delivery of library services has changed over recent years are used in the full paper to demonstrate these principles in practice.
The paper emphasises, that despite the fact that ICT is influencing service delivery, local, physical locations are still required and will always be required to deliver the physical elements of the various services. For financial reasons and for the benefit of service users, these should be co-located in multi-service outlets.
Various forms of co-location are considered in the full paper.
A remaining significant challenge is the integration of services for the benefit of end users. NHS Direct, innovative though it is, has still to be integrated with the rest of the NHS let alone services from other sectors.
The rare examples of true service integration are generally driven by those who need the services and not by those who supply them. They require true partnership working across sectors and this, more often than not, is managed by the voluntary and community sector (VCS). The VCS has a key role in the integration of services for the benefit of service users in rural areas.