Digital Leaders Week: Digital transformation in local government

Image: Digital Leaders

Today is the start of Digital Leaders Week, a celebration of the opportunities and challenges for the digital transformation of Britain’s businesses, public services and society.

Here at the Knowledge Exchange blog, we’ve been taking a keen interest in digital developments in both the public and private sector. To celebrate Digital Leaders Week, we’re revisiting some of our digital-themed blog posts from the past, and bringing you up to date on current developments.

Several articles on our blog have highlighted the potential of digital technologies as drivers of internal transformation and improved service delivery in local government.

In May 2016, we looked at the benefits of digital for local authorities, noting that research by Nesta and the Public Service Transformation Network had suggested local councils could save £14.7 billion by moving all transactional services online and digitising back office functions. This echoed the findings of Policy Exchange, which reported that £10 billion could be saved by councils making smarter use of data and technology.

But another article on our blog also pointed to some of the reasons why local government was struggling to develop digital strategies, including limited infrastructure, red tape and funding issues:

“In theory, providing technical solutions to local government services should provide long term efficiencies. Yet, in an era of constrained budgets, finding the initial capital for digital projects can be challenging. Leaders in councils trying to fund social care services and schools may not view digital as a priority.”

Further blog posts have indicated that some councils are overcoming the barriers to digital change:

“For example, Cambridge City Council have launched Cambridgeshire Insight, a shared research knowledge base which allows over 20 public and third sector organisations to publish their data and make it freely available. We have also seen 18 councils coming together to collaborate on a project which aims to keep electoral registers up-to-date, potentially saving £20 million a year.”

Today, more councils are embracing the challenges and opportunities of digital. A good example comes from Adur & Worthing Councils, which believes that digital inclusion can greatly improve the lives of local people. Among the digital services now offered by Adur & Worthing is an online payments facility. In addition, online access points enable residents to get up-to-date information on important issues such as council tax, recycling, public transport and cultural events.

Another example is Nottingham City Council’s workflow management app, introduced to replace an inefficient paper-based system:

“The new app allows staff from customer services, highway inspectors and response teams to enter faults, such as potholes or damaged street lights, directly into the system. It then automatically allocates the fault to the relevant inspector and, once the work is completed, digitally signs it off. The council has reported that the app has created £100,000 in savings in less than one year.”

However, we’ve also underlined that there’s more to digital transformation than getting the technical aspects right:

“With digital transformation, technology is less important than the vision and leadership provided by senior officials. Encouraging data sharing across organisations, empowering employees, and importantly, investing in digital services, are just some of the key ingredients.”

It’s clear that digital transformation is a journey, not a final destination, and we’ll continue to report on the ways in which local government is embracing digital technologies for the benefit of councils and citizens.

Our next Digital Leaders Week blog post, on Wednesday, looks at digital developments in Singapore and Estonia.


With over 90% of UK local authorities as customers, Idox has built relationships that last across a varied portfolio, incorporating specialisms such as electoral management, business transformation, software solutions, managed services and front-end design and delivery. Our recent white paper explores the new digital trends being embraced by local government.

Buurtzorg: reinventing district nursing in Scotland

Buurtzorg roughly translates from its native Dutch as “neighbourhood care”. The model, used extensively in the Netherlands, has attracted international attention as a novel way to deliver community based nursing programmes. Its positive reputation and recorded successes in areas of Holland are attributed to its innovative use of locally-based and locally-aware nursing teams to deliver high-quality person-centred, but low-cost, care.

Seeking to improve core health outcomes

In the Netherlands, Buurtzorg was designed to engage three key health priorities:

  • Health promotion
  • Effective management of conditions (in a community setting)
  • Disease prevention

It focused particularly on the elderly, those who move regularly between hospital and home, and those with long term, constant care illnesses. It has also been used with patients with progressive illnesses such as dementia, with some nurses within the teams being given training to become dementia specialists where appropriate.

The model includes the following key elements:

  1. Holistic and personalised care – where assessments of need are integrated into and form the foundation of agreed care plans
  2. Mapping networks of informal care, and assessing ways to involve these networks in treatment plans
  3. Identifying other formal carers and organisations who provide care services and coordinate their input
  4. Taking steps to support the client in his/her own environment
  5. Promoting self-care and independence on the part of patients.

A number of studies of pilot sites across the UK and beyond have identified the positives and some challenges of applying the Buurtzorg model in different contexts. Some of these are outlined in the table below.

Applying the model in Scotland

In a Scottish context, the model has been applied in a number of areas, with the initial pilots making way for a wider roll out of adaptations of the model. In March 2017, as part of a wider research project, nurses and management staff from NHS boards across Scotland met in Perth to discuss learning and exchange best practice around how the model could be adapted and further rolled out in the future.

It highlighted the different stages that many Buurtzorg areas were at in their roll out, with some like Aberdeen and the Borders far more established than Argyll, who were at the time only in the earliest stages of their Buurtzorg journey. The research and learning event gave practitioners the opportunity to engage and further cement both formal and informal learning networks, which have been identified as key to the success of the Buurtzorg model both in the UK and elsewhere.

The importance of information sharing and informal learning

Rolling out the model in test sites highlighted the importance of planning and learning, and of creating a strong sense of trust between practitioners and NHS management, but also between the Buurtzorg nurses and their service users and other professionals. This change in mindset regarding ways of working, and a change in the chain of accountability was something, which, according to those practitioners who attended the Perth event, many sites have found to be a significant barrier to effective implementation.

However it was also highlighted that promoting and facilitating the creation of formal and informal learning networks and learning spaces can be an effective way to generate conversation about best practice as well as allaying some fears that may persist regarding working culture and approaches, including partnership working with other agencies and understanding risk in the working environment.

In Scotland, approaches have varied, from encouraging nursing teams to create videos and then post them to an online forum, employing more formal training plans to incorporate multiple agencies and ensure that everyone is “singing from the same hymn sheet”, or holding informal drop-in or open space events where staff are supported in their role and given advice to alleviate and find potential solutions to issues.

Practitioners also highlighted that it is important to provide a space where teams can examine what did not work well, and why. Learning from mistakes can often be as beneficial as learning from good practice, as these can provide insights into issue management and resolution as well as how to implement the programme effectively.

It is also clear from feedback, that while a strong core network of nurses and other community based practitioners is vital to the success of Buurtzorg care models, the back team support is also just as important. Creating efficient and streamlined processes leaves nursing teams free to care for patients and allows them more time to develop and deliver the person-centred care which is a key element of the Buurtzorg model.

Final thoughts

Learning from the experiences of the trial projects in Scotland has provided invaluable insights on how the model can be applied and some of the challenges that can be encountered because of the differing context. This knowledge can then be used to shelter and steer newer projects away from danger areas toward best practice and innovative collaborative working. Applying Buurtzorg in Scotland gives the potential to create and implement new models of holistic person-centred care, where practitioners with local and specialist knowledge interact at a local level with other care providers, join up approaches and create a better care experience for service users.

Follow us on Twitter to see what developments health, social and community care are interesting our research team.

If you enjoyed this blog, you may also be interested in our other articles on health care and reablement care

 

How to tackle unconscious bias: Step 1 – read this!

What is unconscious bias?

Although levels of explicit prejudice are falling, discrimination continues to be a problem for many sections of society.  One reason for this may be ‘unconscious bias’.

Unconscious bias is “a bias that we are unaware of, and which happens outside of our control. It is a bias that happens automatically and is triggered by our brain making quick judgments and assessments of people and situations, influenced by our background, cultural environment and personal experiences.”

Everyone has some degree of unconscious bias.  Unconscious thoughts are often based on stereotypes and prejudices that we do not realise that we have.

From a survival point of view, these brain ‘shortcuts’ are a positive and necessary function – they help us to make snap decisions in dangerous situations, for example.  However, in everyday life, they can negatively effect rational decision-making.

Types of unconscious bias

Unconscious bias has different forms.  One common form is Affinity bias – the subconscious preference for people with similar characteristics to ourselves (sex, age, ethnicity, socioeconomic class, educational background etc.).  In 2015, the CIPD reported that recruiters were often affected by affinity bias, resulting in the tendency to hire ‘mini-mes’.

The Halo effect involves the tendency for an impression created in one area to influence opinion in another area.  For example, a disproportionate number of corporate CEOs are over six foot tall, suggesting that there is a perception that taller people make better leaders, or are more successful. Similar patterns have been observed in the military and even for Presidents of the United States.

The Horns effect is the opposite of the ‘Halo effect’ – where one characteristic clouds our opinions of other attributes.  For example, the perception that women are ‘less capable’ in certain occupations.  A review found that female psychologists and women in STEMM (science, technology, engineering, mathematics and medicine) departments were just as likely to discriminate against female candidates as their male counterparts.

The same qualities can also be perceived very differently in different people – for example, assertiveness in a man may be perceived more positively (‘strong leader’) than in a woman (‘bossy’).

Impact of unconscious bias

Unconscious bias not only influences our body language and the way we interact with people, it can also negatively influence a number of important decisions in the workplace, including:

  • Recruitment
  • Promotion
  • Staff appraisals
  • Workload allocations

As well as being unfair, decisions based on unconscious biases are unlikely to be optimal and can result in missed opportunities.  Where unconscious bias also effects a protected characteristic, it can also be discriminatory.

How to mitigate unconscious bias

So, now you know what unconscious bias is, what can you do about it?

The good news is that it is possible to mitigate the effects of unconscious bias. The first step is to become more aware of the potential of unconscious bias to influence your own decision-making. Large organisations such as Google and the NHS are already providing unconscious bias training to their staff.

You can take this awareness further by taking an Implicit Association Test, such as that provided by Harvard University.  This will help to identify and understand your own personal biases.

Other ways to help reduce the influence of unconscious bias include:

  • Taking time to make decisions
  • Ensuring decisions are justified by evidence and the reasons for decisions are recorded
  • Working with a wider range of people and get to know them as individuals, such as different teams or colleagues based in a different location
  • Focusing on positive behaviours and not negative stereotypes

At the corporate level, ways that organisations can help to tackle unconscious bias include:

  • Implement policies and procedures which limit the influence of individual characteristics and preferences, including objective indicators, assessment and evaluation criteria and the use of structured interviews
  • Ensure that selection panels are diverse, containing both male and female selectors and a range other characteristics where possible (ethnicity, age, background etc.)
  • Promote counter-stereotypical images of underrepresented groups
  • Provide unconscious bias training workshops

Tackling unconscious bias is not just a moral obligation; it is essential if organisations are to be truly inclusive.  By making best use of the available talent, it can also help to make organisations be more efficient and competitive.


If you enjoyed this blog, you may also be interested in our other articles on management and organisational development.

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Innovation – just another meaningless buzzword?

Innovation Road Sign with dramatic clouds and sky.

By Heather Cameron

As one of the trendiest terms of recent times, innovation has become familiar across the business world. But has its excessive use to refer to anything new effectively made the term a meaningless buzzword?

Lack of meaning

Certainly, critics argue that innovation is overvalued by its promoters and that it is what follows innovation that is really important.

An article published in Aeon magazine last year discusses this view. It highlights that over the last decade questions have been raised over the intrinsic value of innovation, citing a number of statements, including:

‘Innovation is in grave danger of becoming the latest overused buzzword’

‘Innovation died in 2008, killed off by overuse, misuse, narrowness, incrementalism and failure to evolve… In the end, “Innovation” proved to be weak as both a tactic and strategy in the face of economic and social turmoil.’

Even a professional innovation consultant interviewed for the Wall Street Journal said he had advised his clients to ban the word at their companies, describing it as just a ‘word to hide the lack of substance’.

The article suggests that maintenance and repair, the building of infrastructures, the labour that sustains functioning and efficient infrastructures, has more impact on people’s daily lives than the vast majority of technological innovations.

Indeed, an idea can be argued to be of little value on its own.

Meaningless or misinterpreted?

An array of definitions can be found for innovation, perhaps the most widely referred to being that of the OECD:

‘the implementation of a new or significantly improved product (good or service) or process, a new marketing method, or a new organisational method in business practices, workplace organisation or external relations’

The important term here is implementation. Other definitions similarly refer to innovation as the implementation of such things that add value. Therefore innovation isn’t just about the new idea/technology/process, it is about the application of it and the outcomes it achieves.

As a recent blog in the Huffington Post noted, while being ‘new’ matters to the definition of innovation, ‘it is far less important than the description of what’s achieved through innovation’.

With so many definitions, it is hardly surprising that innovation has not only been overused but has often been misused. In particular, it has often been used instead of invention. The difference between these two terms is that an invention is the creation of an idea whereas innovation is an activity or process that adds value.

As the Aeon article suggests, innovation isn’t technology and that highlighting maintenance ‘involves moving from buzzwords to values, and from means to ends‘.

Final thoughts

Perhaps the Aeon article’s conclusion sums things up pretty well:

Innovation-speak worships at the altar of change, but it rarely asks who benefits, to what end? A focus on maintenance provides opportunities to ask questions about what we really want out of technologies. What do we really care about? What kind of society do we want to live in? Will this help get us there? We must shift from means, including the technologies that underpin our everyday actions, to ends, including the many kinds of social beneficence and improvement that technology can offer.

Rather than labelling innovation as meaningless, perhaps it is more accurate to say that innovation means little on its own.


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How to become a more effective coach

Teacher talking with student

Coaching can be described as the use of positive support, feedback and advice to help improve personal effectiveness.

Its use within the work environment is not a new concept.  Indeed, according to the CIPD, 9 out of 10 organisations already use coaching by line managers, and 2 out of 3 use external coaches.

However, despite its prevalence, there is very little research evidence about what makes a ‘good’ coach and whether coaching actually works.

The Institute for Employment Studies (IES) are among those working to address this.  In August, they published a report which explored the factors leading to coaching success, from both the coach and the coachee perspective.  They also examined the nature of an effective coaching relationship and set out practical advice for organisations on how to improve coaching elements of everyday work.

The key to success

They found that, according to coachees, the most important characteristics of a coach were:

  1. Communicates clearly (including the ‘ability to listen’, ‘ask good questions’ and being ‘non-directive’)
  2. Displays emotional intelligence (e.g. ‘presence’, ‘emotionally involved’, ‘awareness’, ‘connection’, ‘sensitive’, ‘empowering’, and ‘authentic’)
  3. Has experience within the coachee’s industry
  4. Is challenging but supportive
  5. Displays acceptance of the coachee

In the context of achieving successful outcomes from coaching specifically, coachees felt that successful coaches:

  1. Displayed acceptance of the coachee
  2. Were calm
  3. Displayed self-confidence
  4. Were organised
  5. Had experience within their industry

The characteristic ‘has experience within my industry’ was of particular interest.  Whether or not coaches need experience of the industry in which their coachee works is a point of contention between different coaching researchers and practitioners.  Based on this research, the IES suggest that industry experience may help to improve coach credibility, but also note that who coaches are has importance to coachees, not just what they do”.

They conclude that “the key to effective coaching lies within the coachee having respect for the coach’s ability. A coachee can also derive comfort from the coach’s experience in dealing with situations, and in the coach’s confidence and manner”.

While the characteristics perceived as important by coach and coachee were broadly similar, it was noted that coaches being organised, calm and self-confident was considered very important to coachees – much more so than to the coaches themselves.

In terms of the coaching relationship, the coach having ‘similar values’ was considered the key to success.   It is thought that such shared values may promote the sense of connection between the coach and coachee.  The coach being the same gender, age or having a similar personality was less important to the development of a successful coaching relationship.

Addressing the barriers

The majority of coachees felt that their coaching was effective.  However, there is clearly room for improvement – around 1 in 10 people felt that their coaching was of limited or no effect at allPrevious research by the IES has also shown that as many as 84% of coachees have faced barriers to their coaching experience.  These include:

  1. Unclear goals
  2. Emotions getting in the way
  3. Lack of commitment
  4. Unsupportive boss
  5. Defensiveness

Coachees also faced difficulties with:

  • Their own readiness and engagement
  • The coaching model used
  • Organisational culture/boss
  • Coaches skills or manner
  • External events
  • The coaching relationship

Awareness of the barriers commonly experienced by coachees and the factors coachees perceive as contributing towards their success is a useful first step towards developing and adopting effective coaching practices.

Improving coaching practice

According to the IES, their research on coaching is a conscious attempt to “shift away from ‘guru’- led coaching practices to research-informed and evidence-based practices”.  Based on their research to date, they offer the following advice for coaches and line managers:

  • Not to worry about having less experience than coachees – that the coachee having respect for your ability is more important
  • Weave reflection into everyday coaching practice after each session/encounter – consider how to best help your coachee, how your coaching made a difference, and how your coaching compares to that of others
  • Obtain feedback from your coachee about what you did that made the coaching successful (or unsuccessful) for them, and ask them to contribute to collective feedback mechanisms such as evaluation surveys

Follow us on Twitter to see what developments in public and social policy are interesting our research team. If you found this article interesting, you may also like to read our briefing on coaching and mentoring.

Performance appraisals – does the public sector need to be more innovative?

Innovation Road Sign with dramatic clouds and sky.By Heather Cameron

In a time of austerity, there is increasing pressure to get the best out of staff in order to improve organisational performance, particularly in the public sector.

Staff performance appraisals are a well-established practice in most organisations but there has been much debate over their effectiveness. Many say they are time-consuming and involve too much paperwork. Others say they are a key part of an organisation’s human resources strategy and align the strategy and objectives of an organisation with those of individuals, which is necessary for effective service delivery.

Why performance management?

A number of reasons have been highlighted for implementing performance management in any organisation, including:

  • to provide information on organisational and/or employee effectiveness and efficiency
  • to improve organisational and/or employee effectiveness and efficiency
  • to improve employees’ levels of motivation
  • to link employees’ pay with perceptions of their performance
  • to raise levels of employee accountability
  • to align employees’ objectives with those of the organisation

In the public sector, the aim of performance management is to motivate staff and managers to improve organisational performance and therefore effectively deliver services.

But while this may seem simple enough, is this what is happening in practice? Some would argue that performance appraisals have the opposite effect of motivating staff and lead to increased pressure and stress, resulting in poorer performance.

Concerns

A recent survey of over 25,000 civil servants highlighted widespread concern over how performance management is working in practice.  A huge majority (94%) said it was unfair that 10% of staff should be ranked as ‘must improve’, a recommendation that has been suggested to lead to discrimination against black and minority ethnic (BAME) staff, those who are disabled and part-time workers.

Performance appraisals have also been described as a “waste of time” or “tick-box exercise”.

Abhacken

The CIPD Employee outlook surveys have consistently revealed a general dissatisfaction with performance management practices among employees, with the most concern shown in the public sector. The most recent survey highlights a slump in job satisfaction and a lack of motivation among employees, and an increase in the number believing their performance management processes are unfair.

And this is not new. There have been concerns over the effectiveness of such systems in the public sector for some time. Research by the World Bank in 2003, which considered factors influencing better performance in public administration, concluded that performance management systems demonstrated remarkably little influence on anything and in some cases produced negative effects.

Lack of understanding

The literature suggests that the reasons for such criticism of performance appraisals more recently include: people generally don’t like to evaluate or be evaluated; the nature of public affairs being hard to quantify makes it difficult to develop performance objectives and measureable performance indicators; these systems tend to create more paperwork and increase both performance pressure and stress; and a lack of understanding of such systems among managers.

As a former chief executive of the Institute for Leadership and Management (ILM) emphasised:

“One of the skills that is often not developed is understanding what an appraisal is and why it is relevant to the whole organisation’s success… Being able to appraise is a fundamental management skill.”

So rather than scrapping them all together, perhaps a culture change within organisations is what is needed.

Good practice

Indeed, there have been signs of innovation within the public sector when it comes to performance appraisals.

An innovative approach to the employee appraisal form was taken by South Lakeland district council which has shown promising results. A personal qualities framework was created which was used to redesign the appraisal form. It was tested, staff were informed about it and line managers received training in how to use it.

After two years of the framework being introduced, peer reviews were good, their Investors in People award was the best yet, the staff survey highlighted many positive messages, and customer and member satisfaction had improved significantly.

Similarly, Wiltshire Council developed a successful transformation and ongoing culture change programme which resulted in significant efficiencies being delivered.

The council’s behaviours framework was developed to clarify social expectations of staff by defining ‘how’ staff are expected to approach work alongside ‘what’ they deliver. The behaviours have since been embedded into: a new on-line appraisals solution, job description templates, recruitment procedures, human resource policies and employee well-being initiatives, and corporate awards categories and selection criteria.

A training programme for all people managers also inspired new thinking and provided approaches and skills for performance managing for the behaviours, skills and objective setting.

Research by Nesta suggests that performance appraisal can also help to harness motivation to innovate in the public sector by valuing appropriate behaviours.

So perhaps staff appraisals have a future after all.


Read our previous blog post on performance-related pay in the public sector.

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

The next big thing in management and organisational development … why your organisation should be considering reverse mentoring

A jigsaw of a handshake being completed ny two hands.

Think of the modern workplace and a number of features may spring to mind: technological innovations, flexible and remote working, to name a few. However, a more social factor is also at play: the multigenerational workforce. For the first time in history, it is now feasible that a workforce could comprise employees from four different generations, i.e. the World War II Generation (born 1929-1945), Baby Boomers (born 1946-1964), Generation X (born 1965-1979) and Generation Y/Millennials (born after 1980).

The characteristics of a generation

In 2012, Ashridge Business School identified that Generation Y (Gen Y) has grown up in an environment that is very different to previous generations. Additionally, their survey of managers from around the world found that Gen Y:

  • comes to the workplace with different skills;
  • is motivated by different things;
  • thinks differently about learning and development; and
  • approaches work relationships differently.

As noted by Steve Regus, writing for HR magazine in 2012, Gen Y also take a less hierarchical attitude towards work, and place a high importance on mentoring and feedback. The trick, according to Regus, is for organisations to utilise the strengths of this diverse workforce to their advantage, by creating opportunities to learn from each other.

The technological benefits of reversing

One way that some organisations have approached this is through reverse mentoring. Rather than following the usual path of older, more senior employees being assigned a newer colleague to mentor, reverse mentoring (unsurprisingly) sees younger or newer employees sharing their knowledge with company stalwarts. An early champion of this strategy in the 90s was Jack Welch, then CEO of General Electric. Welch recognised the importance of capitalising on the skills of the company’s younger employees, and instigated an initiative that saw older employees learn how to use Netscape. Today, reverse mentoring is commonplace in global companies including Microsoft and Cisco.

Technology is an area in which reverse mentoring is particularly valuable. Having grown up in an age of constant technological change and development, Gen Y are ideally placed to offer insight into how technological innovation can benefit an organisation and its processes. Crucially, technological innovation has also opened up the possibility of working more flexibly, something that is highly valued by Gen Y employees. Senior employees who have taken part in reverse mentoring programmes have also highlighted gaining an insight into the potential benefits of flexible working as one of the positive outcomes of developing a mentoring relationship with a younger employee. Thus, opening up this dialogue between generations can potentially diffuse conflict between the traditional 9-5 generations and the less hierarchical Gen Y.

A two-way street

In practice, reverse mentoring has been found to be less ‘teaching an old dog new tricks’ and more of an exchange of information and experience. At General Electric, one of the most basic benefits for the young mentors was simply the ability to gain contacts in the upper echelons of the company. The mutual benefits of the relationship can also be seen in terms of the insight it offers each party. The older participant gains in terms of gaining new perspectives on the company’s industry, and the thinking of its workforce, while the younger gains a better understanding of the company’s strategies and objectives, and becomes better placed to recommend actions or technologies that may support these.

Reverse mentoring – how to do it

In 2013, Boston College’s Sloan Center on Aging and Work published an evaluation of the implementation of a reverse mentoring initiative by The Hartford, a leading US insurance company. The company’s CEO had identified a need for the company to become more confident in its use of digital technologies, particularly social media, and recognised that its younger employees were best placed to drive this forward. Following a successful initial pilot that went onto become a national initiative within the company, The Hartford highlighted the following factors as crucial to the success of any reverse mentoring programme:

  • the creation of a project timeline;
  • identifying the business objectives – link the reverse mentoring programme to what the business is trying to achieve as far as possible;
  • ensure that mentors are fully informed of what mentees are expecting to get out of the exchange;
  • making sure the initiative has clear agendas and timelines;
  • using the mentor role as a way of keeping younger employees motivated; and
  • encourage both mentors and mentees to be open to the relationship and gaining new knowledge, and to respect that each other approaches learning differently.

The final point is echoed by the majority of companies who have used reverse mentoring within their organisation. Initially, Cisco had issues around more senior employees adapting to younger employees’ more informal way of working. As they, and other reverse mentoring adoptees have discovered, though, the key is commitment to the programme, in recognition of the value it can bring to the business.


Follow us on Twitter to see what developments in policy and practice are interesting our research team.

Further reading: if you liked this blog post, you might also want to read Heather Cameron’s post on how entrepreneurship drives growth in the UK.

What’s preventing health and social care from going digital?

Two women using a tablet computer.

Image by Innovate 360. Licensed for reuse under Creative Commons.

By Steven McGinty

In the first of two articles focusing on technology in health and social care, I will be looking at some of the barriers organisations face in adopting digital technologies. Financial pressures such as the reduction in public spending, as well as an ageing society, mean that health and social care will be expected to meet greater levels of demand with fewer resources.

The UK Government believes that the implementation of technology is the solution to helping the health and social care system become more efficient and more effective at delivering patient care. However, before health and social care can reap the benefits of technology, a number of barriers have to be broken down.

Information sharing challenges

Integration has been a main focus of health and social care in England, as well as the devolved administrations. If integration is to work successfully, different organisations must be able to share data securely. At the moment, data is recorded in a variety of ways across a number of different IT systems. We also have a situation where the main method for sharing data securely in local authorities, the Public Services Network (PSN), is not fully integrated with either the NHS in Scotland or England. Eddie Copeland, of the Policy Exchange, suggests that full integration of the NHS with the PSN should be seen as a priority.

Financial costs

The financial costs of rolling out new technology within an organisation can be significant. These costs can include the procurement of hardware and software, internet connections, and the training of staff. For organisations which are undergoing major budgets cuts, it may seem very difficult to justify the investment in technologies, even if there is the potential for savings in the future.

Management issues

The importance of technology in organisations can be underestimated by decision-makers. For example, according to Martin Ferguson, Director of the Society of IT Management (Socitm), the ICT challenges involved in introducing the new Care Act in England are not being given enough priority. He highlights that if organisations are unable to share information safely by April 2015, they risk failing to comply with new reporting regulations.

Local authorities can also have policies that restrict the use of technology. A recent Skills for Care report into the digital capabilities of social care found that local authorities are still wary of certain technologies, including cloud based systems, which can offer low-cost solutions, and social media, which can lead to savings for local authorities if used correctly.

The health and social care workforce

The Skills for Care report highlights that over 95% of staff feel they are confident in basic online skills. However less than a quarter of managers believe that they have staff with enough skills to make use of digital technology. This mismatch means that managers may be hesitant to introduce new technologies over fears that staff may have difficulties in using the technology, as well as the costs associated with staff training.

There is also a suggestion that social care staff may be resistant to the introduction of new technologies, due to concerns that introducing technology may over-complicate things and move the focus away from the patient. As we noted in a recent article on digital services within government, a key part of introducing any new technology is changing the mindset of staff and having effective leadership in place to champion it.

These are just some of the challenges associated with introducing digital technologies into health and social care. In a future article, we will look more at how technologies can be used within health and social care and the benefits they can bring to organisations. We also look at a case study of an innovative technology partnership between Calderdale Council and Idox, which is addressing the shared services agenda in social care.


Further reading:

 

Why resilience matters for social workers

By Heather Cameron

A recent storyline in the BBC’s Silent Witness programme graphically illustrated the emotional pressures that social workers operate under. Troublingly, this was not a case of dramatic license. Stress is damaging the ability of a significant number of social workers to do their job. This is often compounded by a lack of workplace support, particularly with regard to difficult cases such as child abuse.

In a recent Community Care survey of more than 2,000 frontline staff and managers, more than 80% of social workers felt stress is affecting their ability to do their job.

A third were trying to cope with stress by using alcohol, while 17% are using prescription drugs such as anti-depressants. Despite almost all respondents (97%) stating they were moderately or very stressed, only 16% said they had received any training or guidance on how to deal with work-related stress, and less than a third had been offered access to workplace counselling.

Social workers need high levels of confidence and resilience when dealing with safeguarding issues. And these are worrying findings, given the serious emotional impact more challenging cases can have.

Lack of support

New research for the NSPCC in six local authorities, highlights that social workers are finding it difficult to deal with the emotional impact of child sex abuse cases.

Adequate support and supervision is key to moderating the negative impacts of stress and burnout. The Assessed and Supported Year in Employment (ASYE) – introduced in September 2012 – provides a support framework for newly qualified social workers. However, the research found supervision for experienced social workers continues to still be lacking, with many having to find their own informal support networks.

With reports on child abuse a regular occurrence in the media, the public pressure on social workers and other professionals involved in such cases is unlikely to subside. It’s even been suggested that politicians and the press have a common agenda in presenting ‘bad stories’ about social work to the public.

So what can be done?

With nearly 1 in 10 social workers considering leaving their jobs, its clear that addressing stress is a priority. But they are working in an environment where local authority budgets are being cut and the numbers of children subject to child protection plans increased by 12% between March 2013 and March 2014.

Back in 2009 the Laming Report emphasised the need for social workers to “develop the emotional resilience to manage the challenges they will face when dealing with potentially difficult families”. Research at the University of Bedfordshire has explored what resilience means in practice, and how individual resilience can be improved. It suggests that resilience can be learned, and is supported by reflective practice and self-awareness.

Active listening by line managers or supervisors can be an effective tool for identifying and dealing with the onset of stress within their team. And qualitative research in Scotland suggested that with the right support, social workers can retain the sense that their work is worthwhile and satisfying.

Let’s hope that Community Care’s next annual survey of social workers will show an improvement in work-related stress.


 

Further reading

Some resources may only be available to Idox Information Service members.

‘Heads must roll’? Emotional politics, the press and the death of Baby P, IN British Journal of Social Work, Vol 44 No 6 Sep 2014, pp1637-1653

Social Work Watch: inside an average day in social work – how social work staff support and protect people, against all the odds (2014). Unison

‘Bouncing back?’ personal representations of resilience of student and experienced social workers, IN Practice: Social Work in Action, Vol 25 No 5 Dec 2013

Inquiry into the state of social work report (2013). British Association of Social Workers

How to effectively sustain change

“The only constant is change” – Heraclitus

The public sector in the UK is currently experiencing unprecedented levels of change. Increased demand and budget cuts have resulted in large-scale transformation programmes. Change has become a constant feature of the landscape, and being able to effectively implement, manage and sustain that change is fast becoming a requisite skill for public sector managers at all levels of the organisational hierarchy – not just a job for those ‘at the top’.

However, despite the increased prevalence of change management initiatives, research has shown as many as 75% of organisations fail to sustain their change initiatives over time.  Poorly prepared and trained managers were found to be a key factor behind the high failure rate.

In our latest briefing, we look at ‘what works’ when implementing change initiatives, drawing on key pieces of research and the advice of prominent change management experts.

We provide an overview of the different types of change that may be experienced, set out a step-by-step framework for introducing, managing and sustaining change in your organisation, and highlight the common features of successful change management initiatives.   We also look at some of the most common reasons for the failure of change initiatives, and how these can be avoided and/or addressed.

You can download the briefing for free from the Knowledge Exchange home page.