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Total Transformation

Author: Simon Duffy

The process of transformation is complex and multi-layered, however it is possible to identify an underlying logic and phasing.


In 2006 there was intense debate about whether individual budgets and self-directed support were the way to reform adult social care in England. In Control developed the concept of Total Transformation, which provided a framework for a minority of motivated local authorities to begin the process of redesigning their whole service systems around the ideas of citizenship and personalisation. Ultimately this movement helped bring about the publication of Putting People First and the idea of wider system transformation became absorbed into central government rhetoric and guidance.


The process of Total Transformation was built around early experiences of the key building blocks for wider systemic change. 

At the most abstract level these were:

  1. Building foundations - creating the management context for effective change.
  2. Developing tools - there are a set of systems, structures and processes necessary for change.
  3. Making the changes - change needs to be introduced systematically and different strategies apply to different parts of the system.
  4. Embed deeper - the new systems needs to integrated with, and in turn change, other parts of the welfare system.

It remains to be seen how far current government policy is capable of bringing about total transformation in adult social care and in other parts of the welfare state.

The publisher is the Centre for Welfare Reform.

Total Transformation © Simon Duffy 2010.

All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.