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How ‘experts by experience in poverty and social exclusion’ improve access and the quality of public services in Belgium

Introduction

In Belgium, the Federal Public Planning Service for Social Integration (FPS SI) embarked on a highly innovative co-production approach in order to close the gap between public services and the poorest citizens in the country. Since 2004 the FPS SI has been employing trained ‘Experts by Experience’ (EbE) in poverty and social exclusion’ to harness the specific experience of people living in poverty to improve public services. This case study illustrates how EbE have improved public services for people living in poverty and experiencing social exclusion and how this co-production approach has been scaled up over time.

Objectives

In 2004, the Council of Ministers in Belgium adopted an ambitious vision: “We aim to guarantee a dignified existence to all people who live in poverty, including those who fall through the cracks of social security”.  

This was preceded by an extensive action research project, piloted by the King Baudouin Foundation, which focussed on the issue of how to reduce the divide between institutions, public policies and the most vulnerable citizens. The key finding was reflected in the following words: "There is much talk about poverty, but few conversations with the people who live in these situations." Moreover, the study suggested that this led to a number of inappropriate actions, and created an increasing gap between public institutions and the weakest citizens.

There was agreement and political willingness to experiment with a new co-production approach to put the new vision into practice. The idea was that public services would work with people affected by poverty and social exclusion as ‘experts by experience’ in order to co-design better public services for the target group.

In particular, the project aimed at achieving two specific objectives:

  • To improve the accessibility of public services at the federal (national) level;
  • To guarantee fundamental social rights for all people living in Belgium.

Fundamental social rights are those included in the Belgian constitution, directly inspired by the Universal Declaration of Human Rights, which was proclaimed in 1948. They are intended to ensure a dignified life for every person.

Leadership and change management

The FPS SI is a federal public service created in 2003 that strives to guarantee a dignified existence for all those living in poverty. For more than 10 years, the FPS SI has been defending the right to social integration by trying to ensure that those who fall through the cracks of social security and live in precarious conditions can have a dignified existence. The objective of the FPS SI is to prepare, implement, evaluate and follow up on an inclusive federal policy for social integration, guaranteeing basic social rights for everyone on a lasting basis.

The Belgian Government charged the FPS SI with the implementation of this innovative project in 2004. Julien Van Geertsom, Chairman of the Board of Directors, is responsible for the project coordination within FPS SI and partner organisations.

As a result, the FPS SI took the project lead and applied for EU funding, working in partnership with a wide range of public agencies and non-profit organisations, whose work affects the quality of life of people in poverty. In 2004, it was granted funding by the European Social Fund to implement this new programme from 2004-2008.

In the first phase of the project, the FPS SI recruited two ‘experts by experience’ (EbE) from a pool of people with lived experienced in poverty and social exclusion. These experts had been specifically trained to develop their empathy, analytical ability grounded in their experience, and communication skills.

These first two EbE helped the staff of the FPS SI to shape the framework of the project, which also involved the development of training courses and support for the EbE. After this scoping phase, the FPS SI recruited more EbE to work on the basis of secondments in other federal services. The FPS SI, as the project lead, ensures the coordination of the project, provides support to the EbE and other involved actors and facilitates the collaboration with the EbE. The EbE, who are seconded to federal partner organisations, are provided with a mentor and a coach to ensure their integration in the respective organisation. While the mentor provides support on a personal level the coach focusses on work-related issues.

Typically, EbE follow training tailored specifically to their tasks, developed in partnership with the responsible authorities and the training unit of the Federal Public Service. They are employed on a full-time employment contract. The salary they receive is comparable to the salary of a public servant. The work of the EbE mainly focusses on improving access to public services which are relevant to people living in poverty. This includes:

  • Redesigning the interface with the target group by allowing time for storytelling and providing more privacy – for example, this meant the creation of closed rooms in the building of the Belgian Auxiliary Illness and Disability Insurance Fund.
  • Better support for the target group in dealing with administrative issues – e.g. helping them to fill in administrative forms and to apply for help during and after hospitalisation; and accompanying them if they have issues with the administrative justice system.
  • Improving the quality of public services delivered for the target group. This aspect mainly focuses on administrative simplification and brings in EbE to assess and propose changes to documents and other communications.
  • Informing the public about the rights of homeless people.

When the first programme came to an end, the FPS SI managed to secure funding from the European Social Fund for a second programme from 2008-2014.

The second ESF program aimed at strengthening and professionalising the role of the EbE. The focus moved to change management, building on the alternative perspective of the EbE. During this second programme, the FPS SI also strengthened the support available to EbE within partner organisations. In particular, officials working with EbE now receive training.

At the end of the second programme, the experimental project phase was completed. The results achieved proved to be strong enough for the methodology to be made permanent, as part of a service in its own right. The future will see the mainstreaming of the ‘experts by experience’ co-production approach within federal public services. This will mean the development of a pool of both regional and thematic EbE.

As a result, this will not be a “project” any more but a service devoted to reducing poverty and social exclusion and to modernising public administration. In particular, it is expected to strengthen the values of diversity and innovation within FPS SI. 

Obstacles

The development and scaling of the EbE project and mainstreaming into a bespoke service encountered a number of obstacles, including:

  • The policy of austerity in public spending. This leaves little room for experimentation and innovation, as the focus is on ensuring the delivery of statutory services.
  • Resistance to change within the public organisations. In particular, many public professionals find it difficult to recognise the expertise and non-academic knowledge of EbE. Furthermore, many staff are not familiar with service co-design methods.
  • Difficulty of measuring the impact of collaboration with the EbE. For example, it is often obvious that the perspective of EbE has been taken into account during the adaptation of public services. However, their effect on these changes is often not easily quantifiable, nor are the improvements to the quality of the public service offered or improved access to public services. Nevertheless, the results are valued by the organisations, which have changed their processes and services – and by the users of these services. Nor is it easy to measure the significant organisational culture change resulting from the collaboration of staff with EbE.

Despite these difficulties, the methodology has been evaluated through five different evaluations (four have been undertaken by the universities of Leuven,  Brussels, Ghent and Liège and one evaluation by the consulting company Key-CONSULT). The evaluations have always demonstrated that the EbE approach produces positive results. The proposed improvements suggested by these evaluations have been considered in the further development of the methodology.

So far, the project has only been rolled out in the Belgian Federal Public Service but it has not been implemented at the regional or local levels of government. However, in 2015 a pilot project was launched within the healthcare sector, with financial support by the National Institute for Health and Disability Insurance (NIHDI). This project focusses on improving healthcare access for people living in poverty, increasing ‘health litteracy’ and reducing ‘medical truancy’. The projects employs the EbE approach within hospitals and public social welfare centers and is coordinated by the FPS SI.

Outcomes

  • Partner organisations have become much more aware of the difficulties experienced by people living in poverty in trying to access public services. The quality of front-line services has improved considerably. For example, at Federal Public Service Finances, an EbE is now available at the Information Centre, so that visitors who are in a difficult situation can ask the EbE for relevant advice. This is valuable both for the service users and the public service organisation, which can deliver the service more efficiently. Furthermore, the information provided in the waiting area has been reviewed, clarified and simplified. A movie clip with icons was produced to help people with reading difficulties to find out which services are available (and are not available) at the Information Centre. This allows service users to be better informed and to reduce their waiting time, as some people realise that their question would be better addressed elsewhere.
  • Staff consider service users as people, rather than as ‘cases’ who are legally entitled to a service. There has been more focus on easy reading and simplification of documents provided to citizens. Furthermore, there is now better online and offline communication with service users.
  • Due to the initiative of the FPS SI and the EbE working for the Crossroad Bank for Social Security (CBSS), some rights are now automatically given to people who are entitled to them, without asking the person concerned for evidence, which would require paperwork or appointments with public officials. Many people have regained their rights to social security due to EbE interventions with the Auxiliary Illness and Disability Insurance Fund (AIDIF), Federal Pensions Service (FPS), House of Justice, Saint-Pierre University Hospital in Brussels and Federal Public Service for Health, Food Chain Security and the Environment. At the regional branch in Charleroi (Wallonia) of the Pensions Office, the EbE goes out to meet the people where they are (in the street, food bank, community centre, etc.).

Below are the profiles of two experts by experience, which give an insight into the work they do:

Damien Fritz, ‘expert by experience’ at the Crossroads Bank for Social Security (CBSS)

What is my job?

My main task consists in meeting different users of electronic services and in identifying their needs for services provided by the Crossroads Bank for Social Security (CBSS). The CBSS organises the digital data exchange between different actors in the Belgian social security system. I therefore meet with different users of electronic data flows and identify their needs for CBSS services. At a later stage, I submit the comments that I receive from the users to my project managers or to workgroups in the CBSS. In most cases, those comments lead to modifications and improvements of the services provided.

What are my tasks?

  • To inform both current and potential future users about the role and functioning of the CBSS.
  • To visit Public Social Assistance Centres, associations and other services related to poverty and social exclusion, to identify their needs and problems when dealing with the CBSS.
  • To identify the needs of partner organisations and feed them back to CBSS project managers.
  • To suggest solutions that take into account the users and the insured persons’ point of view.
  • To work in a network of EbE placed in other organisations using the CBSS work flows. For example, the EbE of the Directorate General of People with Disabilities recently brought in the EbE of the CBSS. He observed that the reception of the Directorate General of People with Disabilities was overloaded with a high number of income certificates demanded by different organisations. His report, which was also sent to the FPS SI, helped different institutions to understand the extent of the problem and to come up with pragmatic solutions (e.g. targeted communication about the dataflows already available to some organisations, contacting other organisations with a view to improve cooperation with them and to provide access to the relevant dataflow).

Maria Hebbelinck, ‘expert by experience’ in the Ministry of Economy

What is my job?

I have been assigned to the Vulnerable Groups Unit in the Ministry of Economy. Its mission is to raise awareness of poverty and its consequences and to improve access to fundamental social rights for everyone.

What are my most important tasks?

  • To inform: I meet with different departments that come into contact with vulnerable groups such as welfare centres, debt management services, not-for-profit organisations and associations. With the help of the useful brochures published by the Ministry, I inform these services about the various federal support programmes. During these encounters, I also explain the role of the EbE network in the federal administration and the tasks of this network. The objective is to make sure all citizens, and especially those who are poor, are aware of useful publications from th e Ministry that can help them, including addresses where they can find extra support.
  • To flag problems on the ground to my unit during meetings or in reports (e.g. abuse of suppliers, supplier misconduct, poor application of the law, illegal extra costs). I also work with the networks of EbE and PPS Social integration on other themes in relation to poverty.

To collaborate with various services to improve communication and information, so that everybody gets the right information about their rights. For example, I’m actively involved in the simplification of various brochures and websites of the FPS SI and Ministry of Economy, based on feedback from people in the field. I also look for ways to bring people back into the system, if they have fallen through the social security net and have lost their rights or are not asking for them. Put simply, I find out where these people can go to make use of their rights.  

Performance indicators

In September 2005, 16 EbE had been employed and were seconded to nine federal public services. In May 2008, 12 new EbE were taken on and five new federal agencies joined the project. In 2016, 15 EbE were hired in the framework of the ‘Health Care Accessibility’ project, funded by the National Institute for Health and Disability Insurance.

Government agencies have also hired EbE using their own funds: the Federal Public Service Finance hired three experts and the National Employment Office has hired one.

Currently, there are 37 active EbE: 20 French speaking and 17 Dutch speaking. There are 8 men and 29 women. The youngest expert is 25 years old, the oldest is 58, with an average age of 40.

Costs and savings

The approximate costs of an EbE depends on their role and consequent rank in the civil service system:

Salary of a coordinator (level A),
including holidays paid and year-end bonus:
(typically, there is one coordinator for 5 EbE)
€55,000
Average travel expenses/individual:€2,000
Salary of an EbE (level C), including holidays paid and
year-end bonus:
€36,000
Cost of coaching individual EbE (1 per month):€306
Cost of supervision of EbE (1 per month): €612

 

 

 

Lessons learnt and next steps

  • This co-production methodology of ‘experts by experience’ has enabled a number of public sector innovations, in particular, public service improvements which have facilitated the access of people living in poverty to Federal Public Services.
  • The tasks carried out by the EbE in the Federal Government departments and agencies where they work are not ‘peripheral’. This means that the work of the EbE is not just an add-on to the public services provided but rather helps to transform the core services provided for the target groups.
  • The EbE are integrated into the team and recognised as equal colleagues in the exercise of their work responsibilities.

The next steps in the development of an ‘experts by experience’ service and the methodology is to integrate the tasks of the ‘experts by experience’ in a more sustainable way into the Federal Civil Service. This means

  • more formal recognition of the status of ‘experts by experience’ (making the function statutory within public services);
  • greater involvement of organisations in the process of change related to the methodology (financial and contractual);
  • development of local networks to respond better to specific problems;
  • enlargement of the tasks of the EbE in the framework of a specific project with defined goals and within a set time period.
About this case study
Main Contact

Julien Van Geertsom
Président, SPP Integration Sociale, Lutte contre la Pauvreté et Economie Sociale WTC II, Boulevard Roi Albert II 30, 1000 Bruxelles
E-mail:
Julien.VanGeertsom@mi-is.be

Frédéric Lemaire
Coordinator of the French Programme, Federal Public Service for Social Integration, Fight against Poverty, Social Economy and Urban Policy
E-mail:
Frederic.Lemaire@mi-is.be

Maria Hebbelinck
Expert by Experience at the Ministry of Economy
E-mail:
maria.hebbelinck@mi-is.be

This case study was written by Julien Van Geertsom, Frédéric Lemaire and Elke Loeffler in October 2017

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