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The UK public sector faces an unprecedented long-term challenge. A decade of plenty in the public finances has been followed by a decade and more of austerity. Public services are undergoing long-term annual spending cuts even as demographic changes create soaring demand in health, education and adult care. The challenge for the public sector is how to radically transform and adapt to the new era while avoiding the mistakes of previous reform programmes. In this first comprehensive 'bird's eye' account of public sector reform supported by studies from over 400 official sources, the book offers an invaluable practical guide to all those in the public, private and voluntary sectors grappling with the twin challenges of public spending austerity and the pressure to transform public services and ensure they are 'fit for purpose.'