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Policy Pilots as Public Sector Projects
The Projectification of Policy and Research
Stefanie Ettelt and Nicholas Mays
LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE
Policy pilots are an intellectual cornerstone of evidence-based policy (EBP) as they hold out the promise, at least ostensibly, that policy will be rigorously tested before being rolled out more widely. Pilots are thus usually accompanied by evaluations designed to establish whether the policy change being tried out has the potential to generate the intended effects and is worth the investment. In England, national policy pilots have been promoted as an important instrument for central government, in particular, to better inform policy formulation and to manage the risks arising from new policy. While much attention has been given to the role of evaluation in generating the evidence from pilots (Cameron et al., 2011; Craig et al., 2008; HM Treasury, 2011), policy pilots have yet to be analysed as a specific type of policy project.
There is now a substantial literature analysing, and critiquing, the role of projects and project management in the public sector. Projects have become the dominant mode of organising activity in the corporate world and, in countries such as England, are widely used in the public sector. By now, some sectors are entirely organised through projects, notably international development. The European Union exercises a large swathe of its policy influence through project funding, either in regional development or through funding of the arts and sciences (see Fred and Mukhtar-Landgren, Chapter 10, and Jalocha and ÄwikĆa, Chapter 11, this volume). Nowadays, scientific research is almost exclusively organised through competitively acquired funding in the form of project grants and commissioned research. In innovation policy of all kinds, projects are ubiquitous, with policy-making itself also becoming increasingly âprojectifiedâ (see Hall, Chapter 2, this volume).
Policy pilots share many of the characteristics of projects discussed in the project and project management literature. Like other public sector projects, pilots promise to accelerate change (Jensen et al., 2013), and to combine âcontrollability and adventureâ (Sahlin-Andersson and Soderholm, 2002), qualities that are highly desirable in policy-making. They offer the prospect of enabling policy-makers to control the risks of new policy while also creating a space for policy experimentation. They also operate within a set time frame, usually compatible with electoral cycles, occupy a particular space as a âtemporary organisationâ (Lundin and Soderholm, 1995) within a permanent (host) organisation, and are normally funded through distinct budgets rather than mainstream funding. Thus, there are boundaries drawn between the pilot as a project and the routine work of the host organisation, aimed at focusing energy on achieving project goals by prioritising specific activities aimed at facilitating a desired change from usual practice. Policy pilots also seem to share some of the problems attributed to projects and projectification, including concerns about short-termism, the difficulty of sustaining change beyond the duration of the pilot, and the potential for de-politicisation (Parsons, 2002).
This chapter aims to contribute to the literature on projects and projectification by considering the role of policy pilots in policy-making as a form of public sector project. Our observations are derived from our research on policy piloting and our experience as evaluators of policy pilots in health and social (long-term) care in England (Ettelt et al., 2015a; Ettelt et al., 2015b). The first part examines the conceptual overlap of projects and pilots, and identifies the project characteristics of policy piloting, drawing on the literature on project and project management. In doing so, we draw attention to the dual structure of pilot programmes since they typically comprise one or more implementation projects (i.e. pilots implemented in pilot âsitesâ) and a linked research project (i.e. the evaluation of these pilots).
In the second part of this chapter, we make three observations based on our research on policy piloting in health and social care in England that resonate with the literature on projects and projectification. These are: (1) the relevance of the centreâperiphery relationship as the governance context in which policy piloting takes place; (2) the importance given to evaluation and generating evidence; and (3) the difficulty of sustaining achievements and âscaling upâ efforts after the end of the pilots that explains their limited contribution to policy change. We conclude by reflecting on the political implications of policy piloting in health and social care in England, arguing that piloting is politically convenient as it shifts the responsibility for potential failure to local actors while reflecting positively on the aspirations of central government.
Policy Pilots as Projects
Policy piloting is a type of policy project. Pilots have a deadline, budgets, a project management team, and a declared goal of promoting policy change. In instrumental terms, they are a change management tool that policy-makers can use when, or before, introducing policy change more widely. In English policy-making, pilots typically come in clusters, as pilot programmes, which then consist of a number of projects that are embedded and layered in a pilot programme, and are given a distinctive name such as âdemonstratorsâ, âpioneersâ or âtrailblazersâ. We here distinguish three layers within a national policy pilot programme: a national policy project that is the pilot programme; pilot projects through which the policy is implemented (and tested) locally; and a research project that aims to find out whether the policy âworksâ by evaluating the local policy pilots (occasionally, this includes evaluating the effectiveness of national level management of the programme). In this model, drawing on Jensen and colleagues (Chapter 6, this volume), policy piloting often combines characteristics of the âchange projectâ, intended to change existing organisational practices, with those of the âexperimental projectâ, aimed at testing new activities to be added to an existing practice.
In England, central government initiates and funds policy pilots with the stated aim to test policy before it is rolled out more widely.1 Such programmes typically consist of several local pilots, but the number of sites per programme varies widely. These are implemented, for example, by local authorities, local organisations within the National Health Service (NHS) or other organisations in the public, private or voluntary sector, often in combination (e.g. local authorities working with NHS Clinical Commissioning Groups and care homes that are owned by private businesses or voluntary organisations). National policy-makers, in this case usually officials at the Department of Health and Social Care or one of its armâs-length agencies such as Public Health England or NHS England, also commission an evaluation, typically involving a research team, often, but not exclusively, based in academia.
Lundin and Söderholm (1995) distinguish âtaskâ, âtimeâ, âteamsâ and âtransitionâ as central dimensions of projects and we will use these attributes to further disentangle the organisation of health and social care policy pilots. The task of pilot sites is to implement the policy that is being piloted, meaning that their task is to operationalise policy and put ideas set out in policy papers into organisational practice. In this sense, implementation in pilot sites can be seen as a âsingle project as unit of analysisâ that is âunderstood as a manageable and researchable item whose intrinsic mechanisms were to be uncovered in pursuit of project successâ (Packendorff, 1995; Packendorff & Lindgren, 2014). Project success, however, is typically not clearly specified ex ante and pilot sites can vary hugely in how they interpret national policy aims and what they aim to achieve. Instead, it is often the task of the evaluators to define clearly the outcomes sought and the related indicators that help specify and measure these outcomes, and it is their responsibility then to establish whether these outcomes can be attributed to the policy that is being piloted.
The task of implementing policy in pilot sites is usually presented as orderly and straight-forward, but inevitably turns out to be as messy and complex as implementation in any other policy âswampâ (Argyris & Schön, 1978). Pilot implementation includes a large number of decisions, trial and error, and eliminating alternatives. It also involves âunlearningâ previous ways of working and typically relies on actors within the host organisation and its wider network of public and private sector organisations to come together and agree on a course of action, especially in those pilots that aim for âintegrationâ between sectors. Policy implementation is complicated by the fact that it is sometimes not clear what is to be implemented. A broad policy idea may appear plausible in a Green Paper in which a government consults on its plans for future policy, but remains aspirational if there is no clear idea of how it can be operationalised in practice.
The research project is also broken down into a number of sub-projects, usually an outcome evaluation, process evaluation and an economic evaluation, to establish whether the policy can produce certain outcomes, how these are produced, and whether it constitutes value for money. The task therefore is to complete the evaluation and produce findings within given timeframes and budgets. Compared to the task of implementing the pilots, the research project is significantly more structured ex ante with a predefined sequence of tasks (e.g. research ethics and governance approvals, development of tools, data collection, data analysis, etc.) set out in a proposal or protocol. There is space for adjustments, but this depends on the research design with some designs being more flexible than others (e.g. randomised controlled trials rely on a stricter protocol and a more narrow definition of the nature of the policy as an âinterventionâ than, say, case study research).
It is interesting to consider what constitutes the âtaskâ from the perspective of national policy-makers who initiate pilots and commission their evaluations. Their task usually includes clarifying policy objectives, selecting pilot sites, and developing implementation guidelines. However, as our research has shown, objectives of pilots are rarely stable and are likely to change over time, especially in an environment in which policy-makers change frequently, with ministers being replaced and civil servants reorganised or made redundant to reduce the governmentâs administrative headcount (Ettelt et al., 2015a). After the end of a pilot programme, the tenets of evidence-based policy assert that policy-makers âmake useâ of the findings from the evaluations and deliberate on their implications for the roll-out of the policy. In some cases, evaluation findings are instrumental in informing policy decisions. Yet, in other cases, priorities for policies have shifted during the life of the programme. If findings are less favourable than expected, policy-makers may be inclined to drop the policy, postpone its wider implementation, or try to find solutions to overcome problems identified by the research. Alternatively, they could âcherry pickâ findings to make them sound more positive in pursuit of wider policy goals (e.g. in the case of the evaluation of the Whole Systems Demonstrators2, which were testing the use of assistive technologies for people with long-term conditions, the government highlighted the positive findings in order to justify further technological investment) (Ettelt et al., 2015b).
Time is of obvious relevance to policy pilots, which are time-limited by definition. Since it is the declared purpose of policy pilots to inform policy decisions, the programme needs to be organised in a way to allow for the evaluation to report when the findings are needed. Thus, pilot programmes often depend on political schedules (e.g. legislative cycles) to determine their endpoint. The problem is that this can leave too little time to implement the pilots, let alone to evaluate them, especially if the pilots need to produce a sufficient number of observable outcomes. There is an increasing recognition by policy-makers that more time needs to be allocated to allow pilot programmes to be set up. However, it is often hard to predict how much time is sufficient for pilot sites to operationalise the policy and when a programme is mature enough for its evaluation to capture the policyâs true potential (Ogilvie et al., 2011). It is sometimes claimed that policy pilots would have produced better outcomes if they had been allowed more time and that this explains why very similar pilot programmes are frequently mounted in swift succession (Bardsley et al., 2013). Yet while it seems obvious that programmes should be allowed to âbed inâ, this is often not realistic within the time constraints that come with national policy-making. Lurking behind this empirical problem is an unresolved question as to how much time is enough to be able to judge whether a programme has generated sufficient evidence to determine whether the policy is worth persisting with or should be discontinued.
The pilot projects and their research projects are typically executed by separate teams. Staff implementing the pilots may be recruited from the permanent workforce of the organisation or employed on temporary contracts, with pilot managers often having other responsibilities within the host organisation. The project literature emphasises that the project team simultaneously anchors the project in the structure of the host organisation and separates it from its routine operations (Lundin & Soderholm, 1995; Jensen et al., 2013; Godenhjelm et al., 2015). This resonates with pilot projects that typically rely on project managers to collaborate extensively with other members of the organisation and with other organisations, while at the same time keeping the team focused on implementing change. In addition, many contemporary pilot programmes in England aim to improve the collaboration between different organisations (e.g. to promote âintegrationâ of health and social care). In such programmes, pilot teams can sit between existing organisations, making it more difficult to maintain links with the existing structures and secure their support. Typically, such pilots do not sit within a legal entity, nor do they form their own one, which means they are not allowed to hold their own budget, which arguably exposes them even more to tensions between, or simply lack of interest from, their participant organisations.
The research project is also organised around a team, typically brought together for the purpose of the evaluation and based on individual competencies. Temporary contracts are the norm for the majority of research staff with the exception of senior researchers, who tend to work on other projects alongside contributing to a particular evaluation. There are different schools of thought with regards to the separation of implementers and evaluators (more about this below), yet evaluators are typically expected to be independent from policy-makers, for example, by limiting the ability of policy-makers to influence, or prevent, the publication of findings, although this varies across different policy fields with health being the most wedded to independent evaluation.
The stated purpose of national policy piloting is to promote policy change and thus facilitate transition. While this is in line with other types of public sector projects (Jensen et al., 2013), policy piloting, at least in theory, aspires to a different route to transition: policy change based on evidence produced from evaluation. The assumption is that findings from evaluation will be used by policy-makers to inform future policy decisions, so that these decisions are taken on a more informed basis, which then leads to decreased opposition and increased support for the policy change. However, this instrumental logic is problematic. Findings appear to be most palatable when they confirm a decision, rather than challenge it. They are also not always conclusive enough to support a specific decision. Frequently, more research is needed, for example, because the pilot sites have taken longer than expected to implement the intervention and more time is needed to measure patient/client outcomes in comparison with some sort of âcontrolâ group. In most cases, it is difficult to generalise beyond the remit of the programme and questions arise about the transferability of findings to other prospective areas.
More familiar from a project perspective is the idea that pilots are used to âpump primeâ change nationally by initiating projects locally from which other places can then learn. This intention is reflected in programmes in which pilot sites are selected based on their experience with, and success in, implementing existing policy. However, this approach generates concerns about a potential lack of sustainability of local change and the difficulty of ârolling outâ the programme to less âexpertâ sites, especially if pilot sites have been selected primarily to be able to âshow offâ their achievements (Ettelt et al., 2015a). There can also be substantial confusion about the mechanism of change that policy pilots are expected to promote, which in turn can have an impact on the options and opportunities for evaluation. For example, if pilot sites are selected because of their experience, it will be difficult to organise a trial that measures the likely costs and benefits when sites start implementing âfrom scratchâ (Hendy et al., 2012).
To summarise, policy pilots share many of the characteristics of other types of public sector projects, but there are also some qualifications. The task of implementing policy pilots is often less clear in operational terms than it appears in policy documents. Pilots also sit within a political environment that both enables and compromises the tasks ...