Donna Hall: the Wigan story

Chris Ham: So Donna, perhaps you could start by telling me the story of the journey that Wigan has been on?

Donna Hall: Okay, Chris. It's a long story and it's been going on for about seven years altogether and we're not finished, so that’s the first thing to say and we're quite humble about the progress that we’ve made. We're really excited though to share some of the great work that we’ve done.

So, the background to the Wigan deal was back in 2010. We were told by the Institute of Fiscal Studies that Wigan was the third worst affected place by austerity with all of the cuts that were about to descend upon us. So, £160 million altogether has come out of our budgets as a local authority, and so we realised at that time that we needed to do something radically different and kind of re-invent our relationship with residents, with citizens and not just the council but the whole of the public sector, the NHS, the police, DWP, everybody within that locality, within Wigan.

We're the ninth largest metropolitan borough in the whole of the UK, so quite a substantial population and part of Greater Manchester.

Chris: Can you say a bit more about the Wigan deal and how that works in your programme?

Donna: So the Wigan deal is in its essence very, very simple. We've managed to freeze council tax as part of is, so that's one element of our part of the deal, because people pay a lot of money as part of their council tax. People work really hard to pay that money. It's the largest proportion of tax a lot of our lower-paid residents actually pay, so making sure that we keep to our part of the deal and freeze it as we have done over the last five years, and that's been really important to my politicians to make sure that we keep to that part of the deal. And I think it's looking likely that politicians will freeze it next year as well, despite all the pressures that there are in local government.

The residents' part of the deal is very much around behaviour, so it's about recycling, It's about looking after your neighbours, keeping fit and well and it's something that I think The King's Fund has said should be applied really to the NHS in the new ten-year plan, but it’s very much a partnership with, between citizen and state rather than everything being able to be fixed at no, with no limit on the cost. We need to explain to residents that costs are finite, you need to help us and work with us to make sure we spend money where it should be spent.

Chris: What are the results of this transformation programme? Are you really bringing about some benefits for your residents?

Donna: Well the first thing is, it's managed to take out a lot of money from our system. So, it sounds quite fluffy when you describe it in kind of anthropological, social terms, but there is an economic dimension to it as well. So far we've saved around £130 million, still about another £30 million to go, but ironically our outcomes have improved over that time as well.

So we've got one of the best-performing hospital systems in the whole of the UK at the moment, with one of the lowest levels of delayed transfers of care, something like, I think we're number five in the whole of the country. We've got balanced budgets for both adult's and children's [social care], which is unheard of really, in local government at the moment. We've got waiting lists of social workers wanting to come and work with us because we give our staff permission to innovate on the front line. We've got reducing numbers of children looked after.

We're the happiest place in Greater Manchester and that for me is really important – we measure happiness as well as health and wellbeing. We've got 14,500 children doing the Daily Mile in our primary schools and secondary schools now and their parents joining in as well. So I think we've got as well, a seven-year improvement in healthy life expectancy between where we were and where we are now. So over that five year period, despite the fact we’ve had no money, we've actually managed to improve health and life expectancy massively within our population, within our more deprived communities, by working differently.

Chris: I know from what you've said that there have been some hard decisions about cutting back on services, so, say a bit more about how you've done that and the alternative services you put in place?

Donna: We have and the way that we've saved all the money is by stopping the things that don't work and they tend to be things like expensive day centres where people sat in the same room with people they don't know. You know, maybe we put on a little bit of activity for them but they don't know the person there, the people that they're sat with.

So we've stopped doing things like that and we've got much better outcomes by connecting people into local groups. So whether it's a language group, a French group or you know a knitting group or something like that, we've got a fantastic partnership with our sporting clubs.

So Wigan Warriors has a rugby memories group for people with or without dementia where people can listen and talk and tell their own stories about the games and things that they've seen in the past, or their favourite rugby players and it brings people to life really rather than being sat in a municipal expensive solution. We've seen packages of care come down from £2,000 a week to nothing.

Chris: You've mentioned that you've trained staff in the council to go out and have different conversations with residents, what does that really mean?

Donna: Well basically we have something called the 'Be Wigan' experience, which every member of staff, whether you work in the police, whether you're a GP, whether you work in a hospital or you work emptying the bins for the council, you go on the 'Be Wigan' experience.

So it's a place-based, organisational development tool, and basically we get people to challenge their own thinking about how they view residents, how they view communities and try to really rebuild that relationship back up with our public servants working in that place, to try not to judge them, but to try to help them, to support them, to be the best that they can be. So everyone's been on that. The board of the hospital, consultants in the hospital, all the elective members have really heavily bought into it and it's taken us eight years to get here Chris, so it's not an easy fix. It does, it's a long process to get there, building trust between organisations but it really does work.

Chris: Let’s move on now to talk about the role of NHS colleagues and the contribution they've made to the improvements you've been describing.

Donna: The NHS has been really pivotal I think in driving it forward to this next more mature stage. So the two largest sources of expenditure in Wigan are the council and the NHS and you know we spent a lot of money on processes and systems that are not effective, or we used to do.

Now we've started to really strip that back and think about the Wigan pound, how do we get better value for that? So that's the Department of Work and Pensions, the NHS, and the council working in the place, wrapping services around residents but yeah, it really has made a phenomenal difference to our residents.

The NHS I think has been probably one of the most passionate advocates of it – along with the community and voluntary sector – they have been absolutely, they've embraced this and they've loved the trust that we've given them, shown that we can just, you know trust them as equal partners. That we're not going to spend £100 monitoring a grant of £25 as we used to do in the olden days. We will give them the trust and the autonomy to go out and spend that money to help us take demand out the system.

Chris: It's remarkable listening to you what you've achieved and the surprise to me is that more councils haven't followed your lead and tried to do the same, why do you think that is?

Donna: I think there's a little bit of a 'not invented here' philosophy sometimes, where people think if we didn't think of this, then we can't apply it. We've got to create our own different way of doing things. Our model isn't a model basically that isn't unique to Wigan.

We've kind of beg, stole and borrowed little bits of it and pulled it together, from the Nesta work, from Hilary Cottam’s work, from the fact we've got no money, so we had no choice really. We had to create something different, but the passion has really come from the community, from the way it's been embraced by our residents.

82 per cent of residents support the principles of the Wigan deal, which is absolutely phenomenal. When we got that figure through, I said to Molly, can you just check that again because I don't think that's right. That seems too good to be true, but it is true and people really understand that we can't do things in the way that we used to do in the kind of paternalistic top-down way that Wigan Council used to operate. We need a much more modern, a much more listening, much more intuitive and in touch model for public services.

Andy Burnham, our mayor in Greater Manchester has kind of taken the principles of the Wigan deal and he’s now creating a new model for public services in Greater Manchester built on the basis of the Wigan deal.

Chris: Let me ask you about what it's meant for you as the council's Chief Exec, as a leader, have you had to change during the work?

Donna: It's been the most exciting period of my working life. I'm due to retire in February as well coming up, but it's been an absolutely brilliant eight years. I think it's really how services should be designed around people, around communities, around what people enjoy doing. No-one wants to be seen as a unit of need, to be fixed by the state, that's not why public servants come into the jobs that they go into as well. So I think the elements of leadership to make this work, are having a whole-system, big picture vision for where you want to be and that's what the deal is really.

Chris: If you look back, what's been the biggest mistake you've made during this journey?

Donna: I've made many. I think we should have gone for the kind of rollout of the whole approach with the NHS sooner Chris, being honest. We stumbled around for a couple of years and I think it was more we were all a bit nervously dancing around our collective organisational handbags and not really grasping it and a lot of places do that, don't they? But I think we've got to go forward with boldness, with courage because if we don't, we're letting our residents down. I wish we'd done it two years sooner than we actually did.

Chris: Donna, thank you very much for coming down and talking to me about what Wigan has been doing. It's a fascinating story that I'm sure lots of people would be interested to hear about. Thank you.