Improvements for value creation in public services

Licentiatavhandling, 2022

The demands on public services are constantly increasing and the public sector has, over the years, been subject to several management approaches trying to improve it. These new approaches have been criticized lately for an overly emphasis on market forces, specialization, and an intra-organizational focus, resulting in fragmented services and a poor system understanding for both citizens and employees of public organizations. Moreover, the problems faced by today’s society often require collaboration among multiple actors, not speaking in favor of these new approaches that tend to separate professions and functions into silos. To problematize further, the beneficiary of a public service is not always clear, and there are occasions when the wishes of a service user and the society might diverge. Here, value might be perceived to be destroyed for one actor, but created for another.

This thesis seeks to increase the understanding of improvements for value creation in public services by investigating the case of the Swedish public service of sick leave. A public service consisting of multiple actors in need of collaboration to succeed in delivering the service. Two research questions (RQ) are used to guide the research. The first is: “How can service user improvements be described and facilitated in public services?” The second is “How is value created and destroyed with service users among actors in public services?” Three papers serve as the foundation for the thesis and answer the RQs. The first paper is a systematic literature review that aims to increase the understanding of customer-related improvements and thereby consolidates knowledge for further use in the thesis, mainly contributing to the first RQ. The second paper goes further into the multi-actor context of public services and investigates how improvements can be facilitated in terms of how to identify, understand, and align improvements, contributing to both the first and second RQs. The third paper regards the perspective of the frontline employees of the public service organizations involved in the sick leave system and how they can improve the aspect of value creation in the public service, mainly contributing to the second RQ. The findings show a complexity of improvements, where mandate to initiate/start an improvement, capabilities to perform the improvement, and the benefits from an improvement could be separated among different actors and dispersed over hierarchical levels and organizational and professional borders. The improvements are also found to be conditioned by a sequence of improvements to realize benefits, contributing to the need for a system understanding to enable improvements in the system. In this context of public services, it is also found that the root cause of the problems the service aims to solve can reside outside of the scope of the public service, leading to only symptomatic treatment of the problem, making it difficult to improving the service per se. It is also found that value can be created at different loci of the system, even with actors that are not typically a part of the public service. To counter these problems, ‘gaps’ in rules and regulations should be addressed. However, this approaches the aspect of standardization, which could also improve the situation, but might also create problematic situations due to the professional context requiring autonomy and risks, decreasing motivation and creativity of the employees. The thesis hereby contributes to the area of public management by infusing it with aspects from change management and quality management to increase the understanding of improvements for value creation in public services.