Exploring value creation from a public service ecosystem perspective: Evidence from the Covid-19 mass vaccination programme in Scotland

Emerging public management theory seeks to understand public services as ‘services’. At the core of such understanding, public services should be judged upon their ability to facilitate the creation of external value rather than upon internal performance (Osborne et al., 2021). However, despite significant work emerging, existing research still fails to capture the 'complexity' of value creation in public services. They have concentrated on either one separate service stage (design, delivery, consumption, etc.) or one group of actors (providers, users, coordinators, etc.), while overlooked the interplay across organizations and processes.
This paper adopts a Public Service Ecosystems (PSE) approach as our analytic framework and in an attempt to counter this disaggregation. It conceptualizes public service context as a complex and interactive ecosystem, comprising the key actors and processes of value creation, as well as societal institutional values and rules (Osborne et al., 2022). Empirically, we investigate the Covid-19 mass vaccination programme in Scotland. Globally, this has been the biggest mass vaccination programme in history. Through analyzing qualitative empirical data, this paper explores the tensions between operational logistics and broader societal objectives (such as inclusiveness and equity) and their impact on citizen engagement with the programme. This article is the first to systematically examine the value creation process across different dimensions rather than in a linear approach.
This article is in four parts. It commences with an exploration of the public health and public policy context of the mass vaccination programme. The second part explores the extant literature on value creation and is used to develop a conceptual framework through which to evaluate the impact of the Covid mass vaccination programme. Part three then presents our empirical data on the extent to which the Covid mass vaccination programme was successful in creating individual and societal value and the contingencies of this process. The empirical evidence includes focus groups with citizens impacted by the mass vaccination programme, key stakeholders interviews, and documentary analysis. We found that the motivations behind vaccine uptake varied dramatically, but trust-in-government was a common precondition. More importantly, we identify that anti-vaxers’ resistance was firmly rooted in their own values and mindset, further complicated by their differentiated life conditions and experiences. The frequent changes in policy/service design in Scotland, unfortunately, also exacerbated anti-vaxers' distrust and resistance.
In the concluding part of the paper, the implications of these findings for both theory and policy/practice are reviewed. Our evidence emphasizes the important of engaging with both individual and societal values and value creation processes in order to successfully carry out such a mass vaccination programme, rather than focusing on logistics only. It also emphasizes that an understanding of how such individual values and value creation are situated within the prevailing public service ecosystem is essential to understand anti-vaxxer behavior and to seek to change it for societal benefit.