Tag Archives: service design

Giving service users a say: how self-directed support is shaking up social care service delivery in Scotland

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Image courtesy of Time To Change campaign

Image courtesy of Time To Change campaign

by Laura Dobie

Back in 2010, the Scottish Government and the Convention of Scottish Local Authorities (COSLA) published a ten year self-directed support (SDS) strategy, with proposals to give individuals real choice and control in the health and social care services that they receive. The strategy is part of a broader reform agenda, and supports current health and social care policy to deliver improved outcomes for individuals and communities.

Halfway through the ten-year strategy period, it seems timely to consider the impact that implementing this transformation in service delivery is having on local authorities in Scotland.

What is self-directed support?

SDS allows individuals to choose the way in which their support is provided, and allows them as much control as they would like over their individual budget. It is not the same as personalisation or direct payments. SDS is a means of delivering personalisation, while direct payments are one of four options for delivering SDS:

  • Local authorities make direct payments to individuals which they can use to arrange their own support;
  • The local authority allocates funding to the provider of the individual’s choosing;
  • The local authority arranges a service for the individual; or
  • A combination of all three.

The benefits

An advantage of SDS is that it gives individuals the freedom to purchase the support that is best suited to their requirements. Some of the benefits highlighted in a review of self-directed support in Scotland are:

  • Flexibility, control, choice and independence;
  • The sustained delivery of personalised, quality, hands-on care;
  • Enabling clients to continue living their lives as they wished, such as by remaining in work or keeping up long-established activities, instead of conforming to rigid routines of care;
  • Helping families to stay together and family carers to continue in their caring role.

Implementation and impact on councils

SDS has required considerable change from service providers, who have had to alter the way in which they design, deliver and market services. Challenges in the implementation of SDS include training for social workers, dealing with the loss of economies of scale associated with personalisation, and achieving a greater degree of consistency in the approach employed by local authorities. There have also been concerns about costs and administration.

An Audit Scotland report last year, which reviewed local authorities’ progress in implementing SDS, has noted that SDS will have a considerable impact on social care at a time of growing demand and financial pressures. Professional staff are required to work in partnership with service users and their families, where appropriate, to identify services that will meet their needs. This approach is sometimes called co-production. The report found that council staff meet regularly with users, carers and organisations providing care, but have not always worked together with them in planning SDS.

The SDS strategy is a ten-year strategy running from 2010 to 2020, and it is not anticipated that councils will change the way in which they plan and deliver social care immediately. The Audit Scotland report found that councils have started to make substantial changes to social care, although progress has been slower in some areas.

Its case study councils expect to take between one and three years to offer the SDS options to all eligible individuals. They expect that fewer people will opt for day care centres and respite care but it will be challenging to shift away from this form of service provision – some people will want to continue to receive this form of support, however lower uptake may threaten the financial viability of these services.

The Audit Scotland report also found that some councils have underestimated the extent of cultural change required and the need for effective leadership. SDS is also changing the way in which councils are managing their social care budgets, and it is necessary for them to manage financial risks when implementing SDS.

Achieving successful co-design

The Institute for Research and Innovation in Social Services (IRISS) Pilotlight project has explored effective pathways to self-directed support (SDS) and ways of achieving successful co-design. The project website launched in May and contains useful SDS resources, lessons learned and a toolbox for successful co-design.

One of the project’s objectives was to explore how services can be delivered differently, in particular by engaging goups of service users and their families who can be excluded from participation. These groups could include people with mental health problems, vulnerable adults, disabled people of working age, and young people with additional support needs.

The project found that co-design could help councils develop more effective pathways to self-directed support for people who previously faced barriers. In a case study of the project, one service manager reported:

“Seeing the service users who have been involved in the process, I have known a lot of them for a long time and to see them take control and flourish and for their ideas to be taken on board has been a great success.”

Looking to the future

It is clear that self-directed support has required councils to make significant changes to the ways in which they work and deliver services, and that this transformation has occurred at a time when social care services are facing challenges related to demand and budget pressures.

Projects such as Pilotlight offer lessons and resources which can help councils and providers to plan and deliver support in conjunction with service users.

In June, the Scottish Government announced the award of funding to continue building the capacity of provider organisations to provide self-directed support, help develop the workforce and to ensure that support and information is available to individuals throughout Scotland to assist them in making informed choices. This three-year funding programme should help continue the major culture shift in the way health and social care services are delivered.

The Idox Information Service can give you access to a wealth of further information on social care services – to find out more on how to become a member, contact us.

Further reading

Self-directed support, Audit Scotland (2014)

Self-directed support: preparing for delivery, IRISS (2012)

Self-directed support: a review of the barriers and facilitators, Scottish Government (2011)

 

Social labs … tackling social problems through collaboration and design

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Crossing out problems and writing solutions on a blackboard.

by Laura Dobie

Nesta’s LabWorks 2015 global lab gathering kicks off today in London, bringing together innovation labs, units, offices and teams working within and with government to address social challenges.

Today on the blog we look at social labs, their potential to improve public services and a couple of social labs who are carrying out innovative work in public services.

What are social labs?

Social labs are platforms for tackling complex social challenges.

Zaid Hassan highlights the following key characteristics of social labs:

  • They are social, facilitating participation by a broad range of stakeholders
  • They are experimental, taking an iterative approach to problem-solving
  • They are systemic, seeking to address the root cause of a problem, and not just its symptoms (Hassan, 2014, p.3)

Social labs draw inspiration from design thinking, which is centred on the following principles of design which were promoted by design firm IDEO:

  • A user-centred approach to problem solving
  • Using direct observation as a main source of learning
  • Moving quickly to creating prototypes as a means of generating additional knowledge
  • Learning from failures to refine and redevelop

Social labs in the public sector

The public sector is making increasing use of design, policy or social labs as a means of complementing and reinforcing skills in public policy, programme and service design. They contribute a different perspective to challenges and use a range of research methods and facilitation techniques to foster ideas and insights that attempt to incorporate many different points of view.

Recent Canadian research on a What Works Lab, which was established to develop approaches to increase employer engagement in workplace training, found that using lab methodology enhances the ability to generate insights into potential policy responses, and that lab techniques can also substantially reduce the transmission cycle between research, policy and service delivery. The research also highlighted how experimentation in a lab setting can be used to de-risk an initiative before wider implementation, and demonstrated that labs are an effective means of generating high-quality policy work.

Social Innovation Lab Kent (SILK)

SILK is a small team based within Kent County Council established in 2007 to ‘do policy differently’. They consider that the best solutions come from people who are at the heart of an issue, those with lived experience, families, friends, volunteers, and front line workers, and they ensure that these groups are involved at all stages their projects.

Projects are broken down into the following phases:

  • Initiate. Involve the right people, create a project plan collectively and decide who needs to be informed about the project.
  • Create. Collect as many insights as possible, involve a broad range of stakeholders and generate ideas for testing in the next phase.
  • Test. Test the ideas which were proposed during the create phase, and continue testing until a model that woks is identified. Trial runs, prototypes or ‘mock ups’ can be a part of this process.
  • Define. A model which has been tested and known to work is defined and consolidated.

SILK has delivered a variety of projects across the themes of future services, service (re)design and sustainable services, and tackled a range of social issues, including accessible and affordable food, the resettlement of offenders and creating a dementia-friendly community.

MindLab

Based in Danish central government, MindLab employs a human-centred design approach to address public sector challenges. Its board sets its strategic direction and approves its portfolio of projects, ensuring that their work is aligned with their sponsors’ priorities. Its emphasis on human-centred design helps to forge links between the perspectives of end users and government decision making.

MindLab’s team has a variety of skills which are indicative of its ethos and method, including social research, design, public administration, project management, organisational development and creative facilitation.

In one project MindLab worked with National Board of Industrial Injuries (ASK) to increase the number of people who remain in employment after suffering an injury at work. MindLab highlighted the potential in strategic working across working across public, private and non-governmental organisations and a change in attitude in helping these people return to the labour market.

MindLab interviewed people who had suffered industrial injuries and put together service journeys, which mapped the different stakeholders involved in a work injury case from a citizen’s perspective. They demonstrated through a case study how cooperation between the municipality, the insurance company and ASK improved an injured person’s employment prospects. MindLab also conducted internal workshops with ASK management to support a change in strategic focus from case resolution to employment outcomes for injured people.

It is clear that social labs are taking a different approach to policy and service delivery, focusing on the experiences and needs of service users to devise innovative solutions to a range of social challenges.

The Idox Information Service can give you access to a wealth of information on economic and social policy and public service delivery. To find out more on how to become a member, contact us.

Further reading

Hassan, Zaid (2014). The social revolution: a new approach to solving out most complex challenges. San Francisco: Berrett-Koehler Publishers, Inc. (Available for loan from the Idox Information Service Library)

The What Works Lab process: report for the Skills and Employment Branch, Employment and Social Development Canada

Digital transformation: rethinking the plumbing of government

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Last summer, the Daily Telegraph reported on the Home Office decision to abandon its flagship immigration computer system. One respected IT contractor told the newspaper:

“I just don’t think the UK government should be allowed to buy IT at all. Maybe give them abacuses, but they could still get those wrong.”

Which might seem comical. But ditching one £350m system and commissioning another at taxpayers’ expense is no laughing matter. As Margaret Hodge, chair of the Commons Public Accounts Committee observed:

“Given its poor track record, I have little confidence that the further £209 million it is spending on another IT system will be money well spent.”

Unfortunately, the Home Office is not alone in its difficulties managing IT initiatives. And while private companies such as banks can encounter technological problems, public sector technology projects seem especially prone to failure. From the BBC to the NHS to the Department for Work and Pensions, publicly-funded organisations have acquired an unenviable reputation for implementing and managing IT.

According to the authors of a new book, Digitizing Government, the underlying challenge facing the public sector is to view digital transformation as being less about technology and more about organisational change. In short, they contend, it’s about “rethinking the very plumbing of government.”

In reviewing three decades of visions, strategies and initiatives, the authors attempt to understand why government has struggled to achieve technology-based public service transformation. The answer, they conclude, lies in “outdated management culture, processes, capabilities, an idiosyncratic procurement model and a supply chain that discouraged innovation and impeded competition.”

The book contrasts the closed, top-down, bureaucratic and paper-based approach of governments with commercial digital services that have emerged to provide an increasingly digitally-savvy public with fast, customised and personalised interactions.

The book’s authors go on to propose a “new normal” to remake public services for the digital age. Once again, they stress the importance of taking a broad view of digital transformation that requires: “…redesign and re-engineering on every level – people, process, technology and governance.”

Some of the proposed ideas take a common sense approach:

  • Use ‘lean thinking’ to move away from meetings, paperwork, discussions, bureaucratic rivalries, and towards more efficient and effective ways of delivering high-quality, timely relevant services to citizens and businesses.
  • Break down the silos separating services, such as policing, courts, the probation service and housing, to enable clustering of similar components together.
  • Bring in and cultivate the right skills.

Smart digital thinking applies not only to central government departments, but to local councils, our closest and most common interaction with government. According to the book’s authors, by adopting common ways of doing things – along the lines of Google, Apple and Toyota – local authorities, their residents, partners and suppliers would all benefit.

The book provides an example of this approach already being practised by the London borough of Hounslow. Rather than embedding new technology into old processes, the emphasis is on standardising processes, an approach that offers opportunities for process improvements and for information sharing across councils. Culture change is also at the heart of the support that Idox offers to the local authorities which buy its software and managed services – in areas such as online planning, environmental health and licensing – as efficiencies are unlikely to be achieved if existing processes are just replicated for an online world.

The authors acknowledge that the journey to digital transformation will not be easy, especially for organisations that are complex, use security concerns as barriers to agility, and have low levels of understanding of digital ethos.

But they make a strong case for digitising government, arguing that it offers the prospect of citizens benefiting from a more seamless approach to government services, and less wasteful administration and duplication of resources.

Members of the Idox Information Service benefit from access to a range of research and intelligence support, including a library of books on public sector policy and practice.

Putting the “Smarts” into Smart Cities

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Liverpool Albert Dock

by Rebecca Riley

Last week I attended a workshop organised by Red Ninja Studios, bringing together a wide range of place based organisations, to explore what a technologically integrated future for Liverpool would look like. We spent the day exploring the three main domains of economy, health and transport, what the issues were in the city, what data was available and what innovative ideas we had to solve the issues through technology.

The discussion was interesting and lively but throughout the sessions I kept coming back to ‘why?’. Technology seemed to be the answer but what was the question, what were we trying to achieve?

Smart Cities is the latest policy buzzword – our briefing earlier in the week highlighted the wealth of research and development which is going on in this area and how great leaps in technology are changing the way we live and work in cities. The danger with looking at developing Smart Cities is that the opportunities and options are boundless, and this came through in the workshop. Smart travel systems, integrated health care, environmental measurement, technology development, graduate retention, high quality jobs, access to learning –  all could be tackled through integrated next generation technology. So how do we prioritise and get the highest impact we can in a city such as Liverpool?

One of the participants asked “what connects all these ideas, what integrates them?” the simple answer is people, not technology.

So on returning to my desk (or rather my kitchen as I am one of the nation’s 4.2m home workers) I started to think about what ‘people’ would want from a technology driven environment, rather than what the technology will deliver to the people.

A guide on service design in smart cities highlights that we have to start with the ‘business proposition’; people have to be willing to ‘buy’ the service on offer. It highlights two reasons for improvement:

Improving customer service

  • Increasing the take up of services among key groups to achieve targets
  • Making it easier to access services
  • Giving a better service
  • Giving a service targeted to individual needs
  • Giving access to a broader range of services

Improving efficiency

  • Increasing take up among key groups to increase income
  • Increasing early take up and reducing more expensive interventions later
  • Improving processes to streamline services and reduce costs
  • Switching customers to more cost efficient channels

These business imperatives should be at the heart of any technology implementation and technology can impact across all these goals but, form should follow function.

When people were asked by Steer Davies Gleave what words describe a ‘Smart’ city their response was surprising. Although there were a wide range of answers (reflecting the diversity of the term), ‘clean’ and ‘technology’ came out top, followed by ‘transport’, ‘friendly’, ‘connect’, ‘internet’ and ‘eco’. Overall people said smart cities should aim to be ‘a pleasant place to live, work and socialise’ with a ‘healthy, vibrant economy’, and sustainability was at the bottom of the list. When answers were normalised for population, Oxford, York, Bath and Cambridge were seen as the most ‘smart’ cities – all areas with higher ‘smart’ populations as well as ‘nice’ places to live. The priorities for making cities smarter were seen as availability of facilities and services (shops, places to eat and drink, sports and entertainment), modern public transport and safe, secure travel. People want good quality of life experiences.

Future Everything presented a series of essays aimed at shifting the debate on future cities towards the central place of citizens and open urban infrastructures. The essays focus on how cities can create the policies, structures and tools to engender a more innovative and participatory society. Dan Hill discusses the idea that “smart citizens make smart cities” and a city cannot be ‘managed’– it’s a living organic response to people’s lives, where people are often invisible in the management of transport or infrastructure systems. As Hill says, smart cities do not exist, but smart citizens do. The city is its people and technology should enable people to come together.

Can we harness the power of the citizen as an ‘organic sensor’ to improve services, drawing them in to actively engage with improving society? Can a ‘smart city’ be one where active, participatory, citizenship becomes central to the development of infrastructure? If a cities’ smart citizens applied their Instagram, TripAdvisor and Twitter engagement to the transport network or the health centre they use would it drive more responsive services? The answer is yes, but only if those services are listening or care. How can technology help citizens reclaim their space; would we all share information if it improves our quality of life?

The challenge for technology is to respond to the smart citizen, the millennials and generation Alpha will have very different demands, ones we cannot conceive of now. The challenge for government and large technology firms is not to emphasise top-down solutions but to respond to the issues, aspirations and abilities of individuals and make personal and civic responsibility core to a Smart City Vision.

Further reading

Smart cities – the who’s, what’s, where’s?

Accenture Survey 2013: What Travellers Want from Public Transport Providers

Smart Cities and Smart Citizens

Understanding Smart Cities: An integrative Framework

Smart Citizens

The Smart City Market: Opportunities for the UK

Using service design for user-focused, cost-effective public services

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business people reviewing plans

by Laura Dobie

Faced with growing demand and reduced budgets, public services are increasingly looking for innovative ways to meet user needs with declining resources. Ahead of this weekend’s Global Service Jam, here’s a quick look at how service design can transform public services. Continue reading →