Nominal value in people-centred services: reconceptualising value for adaptive public services

In the UK, public services face growing pressure to deliver efficiency while meeting the complexity of demands placed on them by citizens. Despite decades of critique, New Public Management (NPM) continues to dominate Public Administration and Management practice and policy, meaning that standardised solutions and compliance tend to crowd out any emergent relational or adaptive alternatives. This thesis explores whether the concept of nominal value, which had its origins in the mid-20th century period of rapid economic growth in Japan, can be reconceptualised as a guiding principle for People-Centred Services (PCS).

Nominal value is reframed to become a context-sensitive, relational heuristic for designing services around ‘what matters’ to citizens. By drawing on systems thinking and an interpretivist/constructivist epistemology, this study positions PCS as complex adaptive systems where outcomes are emergent rather than the product of a linear process. Adopting a qualitative, exploratory single-case design, the research investigates a Welsh local authority’s domiciliary care service as it experimented with new approaches to meeting citizens’ needs and goals.

Seventeen semi-structured interviews were conducted with professionals and management in a cross-section of roles. Thematic analysis was used to analyse findings and revealed six defining characteristics of nominal value in PCS: dynamism to track changing goals; dialogue to co-define priorities; measurement for learning rather than compliance; ethical orientation around doing what matters; a holistic approach to see interconnected needs and assets; and experimentation to innovate. Together, these features allowed for the development of requisite variety in response to citizen goals, in contrast to prevailing time-and-task, target driven practices. The thesis identifies conditions necessary for systemic reform, including redesign of the commissioning process, to better develop relational services. Nominal value goes beyond a critique of NPM and instead offers the basis for public services that can be built around helping citizens to live their version of a good life.