Skin in the Game
Advocating for accountability structures that ensure those who make decisions about vulnerable people bear appropriate consequences for those decisions.
The Accountability Deficit
In many public services, there exists a fundamental asymmetry: decision-makers who affect the lives of vulnerable people often face no personal consequences when their decisions cause harm.
A benefits assessor who incorrectly denies support faces no penalty when their decision is overturned on appeal. A social worker who under-assesses care needs faces no consequence when inadequate support leads to crisis. A complaints handler who dismisses a valid concern faces no sanction when the Ombudsman later upholds it.
This creates perverse incentives: the safest course for the individual decision-maker is often the worst outcome for the vulnerable person.
" Never ask anyone for their opinion, forecast, or recommendation. Just ask them what they have—or don't have—in their portfolio. "
Core Principles
Symmetry of Risk
Those who make decisions about others should bear some of the downside risk of those decisions, not just benefit from the upside.
Personal Accountability
Anonymous bureaucratic decisions that harm individuals should be traceable to accountable decision-makers.
Alignment of Incentives
Performance metrics and incentives should align with outcomes for service users, not just process compliance.
Consequence for Failure
Repeated failures should result in meaningful consequences, not just policy reviews with no personal accountability.
Where Accountability Is Missing
Benefits Assessments
Assessors face no personal consequences for incorrect decisions that deny support to disabled people, even when overturned on appeal.
Track assessor accuracy rates and tie them to professional accountability and continued accreditation.
Care Act Assessments
Social workers under pressure to minimise care packages face no consequence when inadequate support leads to harm.
Independent scrutiny of cases where harm follows assessments, with professional accountability where warranted.
NHS Complaint Handling
Those who dismiss or inadequately investigate complaints face no consequence when PHSO later upholds them.
Systematic learning from upheld complaints with implications for those responsible for poor handling.
Reasonable Adjustment Decisions
Decision-makers who refuse reasonable adjustments rarely face personal consequences even when tribunals find discrimination.
Personal liability and professional consequences for those who make discriminatory decisions.
What We Advocate
- Transparent decision-making: All significant decisions affecting individuals should be documented with clear reasoning and attributable to named decision-makers.
- Performance tracking: Individual decision-maker accuracy should be tracked and form part of professional accountability.
- Learning from overturned decisions: When decisions are overturned on appeal or by regulators, this should trigger individual learning and, where patterns emerge, professional consequences.
- Aligned incentives: Performance metrics should reward accurate, fair decisions, not speed or cost-minimisation that harms service users.
- Regulatory teeth: Professional regulators should actively use their powers to hold individuals accountable, not just organisations.
Take Action
Help us advocate for meaningful accountability in public services.