Local authorities in the Midlands are facing an unprecedented challenge to deliver 'more for less' and must look beyond simple spending cuts to secure the best possible outcome for people living and working in the region, according to public sector specialists at PricewaterhouseCoopers LLP (PwC).

Many local authorities were left reeling by recent announcements in the Emergency Budget, requiring spending cuts of up to 40% and fear the worst for when the Chancellor makes his spending review announcements in October. Many are only now coming to terms with the full impact of the cuts and the radical measures needed to achieve them as they begin to consider their budget plans for 2011-12. To compound this, local authorities are starting to plan for the new responsibilities they will inherit for the delivery of public health services, following the planned abolition of Primary Care Trusts (PCT) and Strategic Health Authorities (SHA) by 2014. In the Midlands, this means all PCTs and the region's two SHAs are due to be abolished.

As advisers to a number of public sector service providers in the region, PwC is urging local councils to take a long term view of their roles and responsibilities and to think radically about how local outcomes can be achieved. This will mean doing different things, not just the same things differently. It will also mean working more closely with partners and the public to secure local outcomes in different ways.

Michael Kitts, partner and public sector specialist at PricewaterhouseCoopers in the Midlands, said: "Local authorities are effectively being asked to deliver more for less and while this is challenging, they shouldn't lose sight of the opportunity that exists for them to re-draw the map of public sector services in the region.

"By staying focused on a long term strategy that seeks to secure local outcomes rather than adopting traditional service delivery models, it is possible for them to deliver the required spending cuts at the same time as securing better outcomes that will win the support of local communities. As examples, our groundbreaking work with Optimal Care projects in the region is seeking to predict and avoid problems, rather than waiting for them to happen. This partnership-based approach combines prevention with streamlining support where it is needed."

Getting to this point has not been easy, according to the firm's public sector experts. Councillors and officials responsible for the delivery of specific public sector services have been understandably reluctant to accept that the spending cuts will mean drastic changes and, in some cases, removing services altogether.

Michael Kitts, partner and public sector specialist at PwC in the Midlands, said: "Local authority managers are having to face some unpleasant truths and think very differently. Some of the tough decisions have now been taken in principle and it is time to focus on ways to make the most of the money they have to spend. However, just how challenging things are will not become clear until October."

As a further challenge, local authorities are beginning to prepare for the delivery of public health services in the region. There is an opportunity to put the 'choice' or 'personalisation agenda' at the heart of their plans. In doing so, it may be possible to deliver services that are more efficient and effective.

Michael Kitts, partner and public sector specialist at PwC in the Midlands, concluded: "Many experts believe that the choice agenda, which gives individuals and communities a much greater say about the health services they receive could be enormously beneficial to local people. Until now, the choice agenda has been very much at the periphery of thinking about care and health, but there is now an opportunity to adopt it more widely. Doing so would require careful management, however, to avoid incurring additional rather than lowering costs."