SustainGov is a mission-driven programme within Impact Innovation that is a joint effort of the Swedish Energy Agency, Formas and Vinnova. SustainGov's mission is to achieve a reformed public sector by 2035 that holistically promotes and facilitates health and well-being for all residents regardless of geography and socioeconomic status, and ensures society's sustainability transition within the limits of the planet.
A reformed public sector with a systems approach
To achieve the program's mission, the public sector needs to fundamentally change. SustainGov advocates for a shift from today's reactive, organization-bound, and process-driven ways of working to more proactive, personalized, and impact-focused solutions.
The move involves many interacting changes in working methods, responsibilities and approaches within the public sector. The following starting points are central to SustainGov:
- Move from managing problems as they arise (symptoms) to preventing and anticipating them (causes), enabling a more sustainable and efficient use of shared resources.
- Move from an organization-oriented approach (inside-out perspective) to designing solutions that are based on the individual's needs and life situation, where the individual and other actors are given the opportunity to collaborate and take responsibility for common solutions across organizational boundaries (outside-in perspective).
- Recognizing residents as active co-creators of solutions. By involving those who have first-hand experience of the challenges to be addressed, the public sector can develop more sustainable, relevant and effective interventions.
- Shift focus from being process-driven and only measuring short-term results with simple indicators to assessing long-term effects that contribute to societal development. Act based on a systems view and public accountability to ensure that no one falls through the cracks in the system.
- Ensure active involvement of, and shared responsibility between, multiple levels of government within the public sector to achieve increased systemic effects.
- Create new ways to engage equally and co-create solutions where the public sector, business, the nonprofit sector and individuals come together around common system challenges in aim to achieve the mission.
- Increase system capacity to develop, scale up, distribute and utilize new solutions.
- Act with strategic responsibility and active support from both political leadership and organizations to enable the desired transfers.
With these starting points, SustainGov intends to contribute to long-term shifts in how the public sector works, collaborates and creates value for society and its citizens. Fundamentally, it is about a reformed public sector with a systems perspective.
Program focus areas
This call for proposals covers two of SustainGov's four focus areas:
- System-wide collaboration for complex care needs.
- An inclusive society for all.
Focus area 1: System-wide collaboration in complex care needs
Swedish healthcare and social care are facing major challenges in meeting complex and future needs. Many municipalities assess that the current financing model is not sufficient to cope with elderly care and the healthcare ambition levels require annual efficiency improvements equivalent to several billion kronor to be maintained until 2040. At the same time, expectations from residents remain high, with eligibility requirements for the development of and access to new treatments and technologies.
One of the biggest problems is the lack of coordination and coordination, both within the health and medical services and between regions and municipalities, but also with state authorities and other actors. This leads to duplicated efforts, delays or, in the worst case, no care, quality deficiencies and insecurity for patients. Relatives often have to shoulder the responsibility for holding the efforts together, and for those without active relatives, access to high-quality care is made more difficult. The fragmentation of the health and social care system contributes to inequality, inefficient use of resources and increased costs.
Groups with large and complex care needs, such as the elderly with multiple illnesses, people with comorbidities and children with chronic diseases, are particularly affected. A small proportion of patients account for the majority of healthcare costs, but their needs are often handled by different actors without efficient collaboration. Fragmented care chains, strong financial management and different regulations make it difficult to find comprehensive solutions and contribute to individuals “falling through the cracks in the system”.
The public sector is expected to perform significantly more with fewer resources in the future, which requires new ways of working and better capacity for interaction between principals and other actors. Although preventive and coordinated efforts can reduce costs and improve results, incentives and joint governance to realize these are often lacking. Organizational and governance models focus largely on the organization or business itself in terms of both assignments, compensation and follow-up, which makes joint working methods difficult.
The problem, however, is not that there is a lack of collaboration forums between, for example, the region and municipality, but that these too rarely lead to concrete and lasting results for patients and residents. At the same time, in many cases there is a lack of working methods to support patients and residents' opportunities to contribute to their own health and well-being.
The challenge is to create a more person-centred and coordinated care system, where the actors work together to meet the needs of groups with the greatest need. If we fail to do this, it will be more difficult to ensure sufficient resources and capacity in welfare, and residents risk receiving lower quality care services, which can increase ill health and in turn undermine trust in welfare.
Focus area 2: An inclusive society for all
Sweden has a long tradition of striving for equality and social justice, but despite this, there are large groups in society that are at risk of being left out. Vulnerable groups, such as people with disabilities, people with low education, foreign-born people, young people at risk of exclusion or crime, and the elderly in involuntary loneliness, often face major obstacles to fully participating in society.
These barriers can be both structural and psychosocial. They can involve lack of access to education or other social interventions, difficulties in establishing themselves in the labour market, but also social norms and discrimination that make it difficult for people to feel part of society. At the same time, these groups often tend to be seen as passive recipients of support rather than active co-creators of solutions in their own lives, based on their own experiences and resources.
The challenges vary depending on the geographical and socio-economic context. In metropolitan areas, for example, residential segregation can affect opportunities for social cohesion, while some municipalities and rural areas may have difficulties in maintaining a wide range of welfare services. Differences in access to social services and opportunities for participation can thus affect social cohesion and lead to increased social disparities.
The public sector has failed to address recurring systematic causes of exclusion, such as lack of integration, discrimination or stigmatization. The tendency to focus on short-term solutions that do not address the underlying societal problems means that the effects of the interventions are too rarely sustainable in the long term.
The target group is individuals who face particular challenges in society and are at risk of social exclusion. This includes, for example, people with weaker socio-economic status, foreign-born people who face barriers to integration, or people with disabilities who may have limited access to support and fewer opportunities to participate fully in society.
Many in these groups are affected by factors such as interrupted schooling, unemployment, health problems or lack of social networks, which can make it difficult for them to participate fully in society. Organized crime and discrimination pose additional risks. At the same time, shortcomings in support- and social systems can make it more difficult to get the right help in a timely manner. By strengthening these groups and creating better conditions for inclusion, interventions can contribute to a more equal and cohesive society.
More information about SustainGov
For further information about SustainGov and the efforts the program is implementing to achieve systemic changes in the public sector, see SustainGov's website.
More information about Impact innovation
Impact Innovation is Sweden's major innovation initiative to tackle the challenges of our time and the future. In collaborations between actors in the private, public and non-profit organizations, Impact Innovation meets real technical and societal needs with groundbreaking solutions. On the way to a sustainable and competitive Sweden, attractive to live in for everyone. Together we show what is possible, and are ahead internationally.
Impact Innovation works with new methods, approaches and tools to meet societal needs with groundbreaking solutions. More information about mission-oriented working methods and concepts such as systems innovation can be found at Impact Campus.