Mutual Learning Programme 2011

Follow-up activity

CLIENT-INVOLVEMENT AND CLIENT-PARTICIPATION IN THE DELIVERY

OF SOCIAL SERVICES IN THE NETHERLANDS

Glasgow(Scotland), 19 September 2011

1.1Introduction

This follow-up activity is a result of the discussions during the Peer Review on ‘Good practice makes perfect: considering the purpose and value of the Employability Learning Network’ on 11-12 April in Scotland and the interest expressed by the Scottish Government in learning more from the Dutch experiences on client participation and involvement.

Western countries are facing developments that challenge the basis of their social security systems. Among others, immigration, an ageing population, technological changes, mobility and economic restructuringpose new challenges, including: welfare dependency, multi-problem families, skills mismatches, short-term unemployment but long-term shortages on the labour market, a shrinking labour force and a growing number of people in need of support, concentration of social problems among certain groups, etc.

In delivering policies, it is therefore necessary to address the issue of diversity, to prevent social inequalities,to contribute to empowerment as well as ensuring protection and prepare the current long-term unemployed for future job openings. There is even greater pressure on social services as a result of the economic downturn, which hasbrought to the fore the need to ‘do more and better with less’

Against this background, it is acknowledged that active client-involvement and participation can positively contribute to the improvementof the quality of social services delivery.

In the Netherlands, this involvement and participation has been formalised at two levels: at national level and at the level of the different agencies involved, such as municipalities, the department of work(UWV, Uitvoeringsinstituut Werknemersverzekeringen) and national insurance agency(SVB, Sociale Verzekeringsbank) and other agencies.

This report provides a short description of the Dutch approach and the key messages for the Scottish colleagues.

1.2National Client Council

The Dutch Ministry of Social Affairs and Employment is required by law (according to the Work and Income Implementation Structure Act, SUWI-wet) to establish Client Councils (Landelijke Cliëntenraad) to provide advice (by request or on their own account) to the national government on matters of national policymaking and legislation, as well as on the implementation of policies and legislation.

The National Client Council (NCC)consists of representatives of the local or ‘implementing’ client councils (see below). The Council provides a link with the political level and also informally monitors the LCCs and builds their capacity (e.g. training). It aims to influence policymaking, legislation and legislative procedures from a client’s perspective in order to strengthen the position of individual clients in the social securityand welfare system and labour market policies. It provides an avenue for clients to be active and more involved in decisions affecting them and to ensure that social services are tailored to the needs and expectations of theclients.

National law does not determine or specify the authority, competences or procedures of the NCC, just its establishment, composition and the need for mutual consultation between the Minister of Social Affairs and Employment and the Council on a regular basis.Legislation clearly states that it is entirely up to the Council itself to use its given position to influence the Ministry, Parliament and other National Advisory Boards (with a firmer legal position).

The NCC office is based in The Hague. Funding for the Council staff is provided by the Dutch government. The NCC’s mission and vision are stated in a policy document and the Council prepares an annual working plan, which is sent to Parliament, national government, municipalities, local authorities and agencies involved in the delivery of social services and also to all interested parties and the press.

1.2.1Membership

The NCC includes representatives of all key stakeholders involved in the delivery of social services. In the Netherlands, social security is the shared responsibility of three organisations: the municipalities, the UWV and the SVB. The Department of Social Affairs and Employment (SZW)does not have direct responsibility for the executive agencies and in general is not involved in policy implementation and policy administration, which are devolved to the municipalities. UWV is an autonomous administrative authority and is commissioned by SZW to implement employee insurances and provide labour market and data services. SVB is responsible for national insurance schemes (child benefit and pensions). On the board of UWV are employer organisations and trade unions.

Members of the National Client Council (NCC) are:

  • Trade Union for Middle and Higher Personnel
  • Christian Trade Unions
  • Disability Council
  • Central Collaborative Organisation for Elderly People
  • National Federation of Trade Unions
  • National Union of Disabled People
  • National Union of Clients in Mental Health Care
  • Representatives of Client councils at UWV and SVB
  • Representatives of Local client councils (Municipalities)
  • Representatives of Client councils of Mental Health Organisations
  • Representatives of National Union of Homeless People

1.3Local Client Councils

Municipalities, as well as the UWV and the SVB, are required by national law to establish some form of client-participation. National law does not determine or specify the design of this involvement, nor the authority, competences, procedures or the composition of it.

National laws indicate that there has to be mutual consultation between social services agencies and the chosen form of client-participation on a regular basis, but not necessarily leading to mutual agreement on matters.

It is up to the involved agencies themselves to arrange and regulate the chosen form of client-participation. National law does provide a minimum requirement though, by stating that client-participation has to be ensured in matters of policy-making and the implementation of policies.

There are differences in the way client-participation is organised at local level in the Netherlands. In general there are three options:

  • Local Client Councillors,who are individuals acting as representatives, elected by users of municipal services or the agency.
  • A mixture of elected clients, together with local intermediate organisations such as: churches, welfare funds, local social organisations, Red Cross, Salvation Army, Unions etc.
  • A local council, which consists of merely intermediate institutions, acting on behalf of clients or target-groups.

There is a tendency to move away from Local Client Councillors (established in the 1990s), who are elected individuals, to Local Client Councils (LCCs) with a more mixed composition. Thisreflects the experience of the last 10-15 years that called for broader membership, other than just service clients, and the need for continuity.

In practice, the LCCs are there to provide advice (by request or of their own accord) to the City Council or Board of Directors of the agencies involved, from a client’s perspective, on policymaking and implementation in order to ensure good quality in the delivery of social services.

The LCCs are made up of volunteers. Social services clients who volunteer are given a 10-20% exemption from their obligation to respond to vacancies. Client involvement is encouraged as it is seen to improve their employability skills. Vacancies are advertised online and a democratic election process is followed. An individual can be appointed twice for a maximum period of eight years.

1.4Dimensions of client-involvement and participation

In the Netherlands, client-involvement and client-participation apply to four dimensions:

  1. policymaking;
  2. advising on the implementation and the execution of policies and specific measures;
  3. improving the quality of services in general;
  4. customer-feedback on the service-delivery.

1.4.1Policymaking

In the Netherlands, client-participation aims at influencing policy making, legislation and legislative procedures from the client’s perspective and experience of the services, in order to strengthen individual clients’ position within the social security and welfare systems and labour market policies. As stated above, there are no legal boundaries or limits to the extent of this participation but it is up to local authorities to decide on the format, size and scope.

In general it can be said that all local authorities have arranged some form of client-participation in which advice can be given on all policy matters, except those policy measures that are required by national law. This means that the LCCs do not have the authority on matters that are not at the discretion or within the jurisdiction of the agency involved. These matters are therefore addressed at national level, through mutual consultation between the Minister of Social affairs and Employment and the NCC.

Most municipalities have given the LCC a more formal position by allowing them to participate in Council meetings when relevant client matters are being discussed.

1.4.2Advising on the implementation and execution of policies and specific measures

At local level, every political decision involves the establishment of an implementation framework. This is at the heart of service-delivery and the success of the measures is dependent upon the way those measures are introduced, implemented and executed, ensuring adequate public support.

Most LCCs hold a strong position in this respect, as this is a common interest shared with the management of the department or agency with responsibility for implementation.

Management teams and Boards of Directors often have an established working relationship with the LCC, so their advice and views are normally sought prior to taking action. However these working relationships vary greatly from following a standard procedure of official consultation to a more informal relationship with frequent mutual consultation. Usually the LCC is given an expert-role (with corresponding responsibility) to provide advice on relevant issues.

The role of the LCCs includes:

  • producing policy papers on the implementation of (new) legislation;
  • providing advice and suggestions on matters of practical nature;
  • providing a ‘helpdesk’ for clients and
  • monitoring practices (acting as a‘watchdog’).

1.4.3Improving the quality of services in general

Ensuring adequate public support is key for municipalities, local authorities and agencies that work intensively and closely with the public. In the Netherlands, the image of the organisations is heavily influenced by public opinion on the quality of the service delivery in general. This explains the establishment of a common agenda over the past years between social services and the LCCs, to setup a framework to provide alerts on any issues related to the delivery of the services. This can relate to (e.g.):

  • legibility of forms and instructions;
  • reaction-time on questions or complaints;
  • clarity of communication;
  • quality and professionalism of social workers and case-managers
  • response-time for telephone calls and emails;
  • opening-hours and accessibility of buildings.

The LCCs’ remit includes:

  • providing advice and suggestion on practical matters;
  • providing a ‘helpdesk’ for clients;
  • monitoring practices (‘watchdog’);
  • own limited role through the finance of surveys;
  • individual consultation, given their special relationship with the Ombudsman; and
  • preparation of a digital newsletter.

The LCCs support the improvement of the quality of the services by gathering complaints from customers on the service, identifying differences between the different districts and providing access to the information through the case manager. An LCC could, for instance, express an opinion on ‘target’ time for responses. They can also prepare tools and share information.

It is also possible to cluster ‘Municipalities’ so that service delivery can be structured in clusters to promote cooperation. The four main Municipalities (Amsterdam, Rotterdam, the Hague and Utrecht) have a tradition of good exchange in client matters.

1.4.4Customer-feedback on the service-delivery

The most recent form of client-involvement is the measurement of customer-satisfaction and subsequent follow-up on results. Although not required by law, nowadays most municipalities and agencies involved in the delivery of social services have adopted the Dutch INK-system (total quality system) according to the tools provided, such as frequent measurement of customer-satisfaction (and employee-satisfaction). It is common practice in the Netherlands that a questionnaire is sent to all the clients once every year on relevant aspects of the quality of the services-delivery. The participation-rate ranges from 60% to 70%. Normal practice is to publish survey results on the website ( and in the press and to notify all the clients (enclosing a ‘thank you’ letter for their participation). The LCC is also informed of the results with a view to discussing any follow-up, leading to an agenda for improvement. Results are also used in the assessment of Municipalities’ performance. This information is made available online as illustrated below.

1.5Key messages for Scotland

The presentation of the Dutch approach was followed by a discussion and the following key messages emerged:

  • Effective client involvement can improve the delivery of mainstream services by: giving service providers better local knowledge; improving client access to services; increasing awareness of the potential for joined up solutions; enhancing the motivation of front-line staff and fostering innovation in service design and delivery.
  • Client involvement and participation is particularly important, with personalised services, as ‘one size doesn’t fit all’; matching the services to individual needs is essential to ensure greater engagement.
  • Identified barriers to involvement and participation are: managing expectations - which may be too high or too low; lack of interest/understanding; negative perceptions; lack of awareness of how to get involved; lack of time to participate; lack of confidence/perceived lack of skills and scepticism about the difference it will make.
  • The process requires that clients are well informed so that they can communicate their needs and views and make informed choices. In general, clients should be consulted about the services provided and be offered opportunities to be involved in the running of these services.
  • The potential impacts on individuals are noted as: increased satisfaction; personal development; increased self esteem; increased understanding of and trust in social services; increased self confidence and as a result, increased employability.
  • Devolution has an effect on how different policies are implemented in the UK. Scotland is responsible for the ‘wrap around’ services but not welfare. However it is important to ensure consistency in the delivery of services to clients.
  • There is a need for a ‘champion’ in government toendorse the importance of the progress.
  • ‘Doing more with less’ and ensuring a ‘joined-up’ approach are challenges during the economic downturn. Tighter expenditure requires higher accountability. Bringing the client perspective contributes to a better service delivery.
  • Shared responsibility is considered a key starting point. In Scotland, the local structures are already in place and some elements of the Dutch approach could be used alongside current practices. The Scottish government has an enabling/facilitator role with the local partnerships, the approach is flexible more than prescriptive. The main action point will be to identify the existence and practice around client participation and involvement within the local partnerships.
  • Partnerships are responsible for assessing the performance of the whole system, not just the constituents, for this they need to consider client satisfaction. Sometimes this is done from the perspective of the client ‘journey’ but this is normally ‘ad-hoc’ and it should be more systematic.
  • There is a need to encourage partnerships to think regionally/sub-regionally. The issues are normally identified at district level and it is there where client participation can be better utilised to inform delivery.
  • The third sector has a role to play in the process. It is important to work closely with the third sector as clients can be apprehensive about dealing with the ‘official’ services, so third sector providers could improve the situation and secure client engagement.
  • In the Netherlands the LCC came first and then the NCC. It was felt that such a locally-led approach would also be appropriate in Scotland.

1.6Next steps

The LCCs were considered an interesting practice by the Scottish colleagues. The next step will be to identify existing forms of client engagement and participation in the Employability Learning Network; discuss with the local partnerships the benefits of this involvement and introduce the example of an institutionalised approach such as the Dutch one.

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