Challenge

Camden Council recognised early that while doing everything possible within the powers of their current service delivery remit, there would be even more that could be done to respond to the entirely new and unique circumstances of the COVID-19 crisis. When dealing with such a community-wide and potentially long-term challenge, they knew a radically different approach was needed.

Commissioned by Camden’s leadership, FutureGov worked with council colleagues from 23 March to 1 May, enhancing the council’s existing service offer in the context of COVID-19. With a focus on early intervention and prevention, strengthened through partnership working across council services and with the voluntary and community sector, FutureGov supported Camden Council to plan and execute a two-week design sprint focused on meeting resident food needs and to identify other opportunity areas to potentially explore in the future as a direct result of the COVID-19 crisis.

Our primary focus was ensuring that Camden’s shielded residents receive the support they need, with an initial focus on providing implementation support to Camden’s Shield Hub and related food offers. Our work has gone beyond this, with a commitment to understanding who the wider group of residents are that could be potentially vulnerable as a result of COVID-19, the nature of their anticipated need and potential service responses required to address these. The work was extended an additional six weeks to address wider needs within Camden’s crisis response. Through this collaborative work, we’ve supported Camden to seek and actively support the most vulnerable, guide people to support, ensure residents receive the essentials they need, support the organisations, groups and businesses within our communities to maximise their impact and prepare for the long-term now.

Approach

Working as a blended team with staff from Camden Council, including representatives from the Inclusive Innovation Network, Digital Transformation Team and Inclusive Economy Team, we used agile methodologies, approaching our work with daily stand-ups and end of day check-outs, weekly retrospectives and regular show and tells. We iterated not only on our work, but also the way we organised ourselves as a programme team - recognising the rapidly changing context we were working in and thereby the need for us to adapt our team structure and roles accordingly. Using a learn-test-deliver model allowed us to better understand the needs of those we aimed to serve and adjust our approach based on the feedback we received from Camden colleagues and our own team.

Understanding resident needs

COVID-19 has exposed deep social and economic inequalities within our society. Beyond its impact on our physical health, it is impacting people’s everyday lives. With a considered approach, we needed to widen our definition of vulnerability beyond the government’s shielded group in order to design services that meet the needs of all vulnerable residents.

Together, we identified characteristics and situations that could lead people to become vulnerable as a result of the pandemic, recognising that residents are being made contextually vulnerable by COVID-19. Meaning that there’s a large group of people facing external pressures and changes who have not required council support before. Some people's needs will change, whilst others will not. New potentially vulnerable groups will also emerge as we move into the recovery.

To better understand the changing needs of Camden residents during and after the COVID-19 crisis, we created several tools that will be useful for redeployed staff interacting with residents in a new way, for Camden staff considering wider resident needs and those making decisions about the ways the council can support residents in the future. These included:

• personas of known and newly vulnerable families to understand which families are at increased risk of vulnerability, their needs, gaps in the current support offer, and to guide decisions about where to focus future support
• Resident Needs Framework to understand how resident needs are changing over time & to identify important gaps in support
• a backlog of opportunity areas to continue work around understanding resident needs both during COVID-19 and after

We defined resident needs in groups as:

• shielded people: the 1.5 million people at the greatest risk of severe illness from COVID-19, including people who have self-referred, the elderly and the clinically extremely vulnerable. This group of people is represented in the blue circle.
• people in contact with wider services: people who require additional support from the council and who, as a result of their situation, are at risk of becoming more vulnerable or requiring an additional level of support during the crisis. This group of residents likely have an existing relationship with some part of the council and are represented by the yellow circle.
• people who may require support: the third group of people who are or may be made vulnerable as a result of COVID-19, the ‘contextually vulnerable’. This group of people likely do not have an existing relationship with the council and are new to navigating council services. As a result, they may need more support with service navigation and understanding how the council can support them.

From the shielded to the contextually vulnerable

When considering the multitude of needs and associated support required to address these needs in light of COVID-19, we recognised core aspects of support required both during and beyond the crisis by all three groups including food and essentials, medical supplies, physical & mental health support, shelter, education, employment support, financial support, childcare support and domestic violence & abuse support.

Considering existing services being delivered and activities that were underway, FutureGov partnered with Camden to focus on 3 areas to augment Camden’s response to increasing and evolving resident need as a result of COVID-19. One of these areas was implementation support for Camden’s food response to the shielded. The other 2 focussed less on direct delivery, rather enhancing access to the existing support available. This was achieved through the development of the Camden Covid-19 service directory and the Beacon platform.

Food response

In the context of COVID-19, increased financial insecurity and reduced ability to move around and secure food, Camden recognised that food poverty was set to worsen during the crisis. Following a rapid, two-week design and implementation sprint to understand and augment the needs of vulnerable residents around food provision, we worked with Camden’s Shield Hub team delivering essential goods, including food to Camden’s most vulnerable residents. We then supported the team to increase their existing capacity and improve the offer through things like diversifying the food options available to residents to ensure their dietary requirements, and mobility and accessibility needs were met.

Food Support Service Routing Logics

Mapping of the various food support services that the council have in place as part of the immediate fulfilment to prevent food poverty as part of the crisis response. The routing logic was developed to support the service mapping to respective needs being captured during contact agent engagement with residents. It identified service gaps vs needs and supported prioritising what new services needed to be created.

• Hot Meals to Home: Shielded residents have been unable to leave their property for weeks, increasing the risk of people not accessing healthy food choices. In partnership between the London Irish Centre and Emily Eats Catering, we developed the Hot Food Delivery service, designed to deliver hot meals at a reduced rate for people who do not have access to cooking equipment, such as a hob or oven. Building a partnership between businesses with the facilities, capacity and capability to prepare, cook and package nutritional meals and charities who can identify people in need in a local area, we can ensure that people receive the healthy foods they need.
• Heat-at-Home Meals to Home: We established a partnership between London Irish Centre and Sands Catering to deliver freshly prepared meals that can be microwaved at a reduced rate. This was established to support those who are shielded and do not have access to cooking equipment, such as a hob or oven, but do have access to a microwave. A prototype was run with a cohort of individuals to test the model which has now been set up.
• Smart Card Financial Support for Food Purchasing: We established a partnership with Co-Op to provide eligible individuals and households financial support via auto-top-up cards to purchase food and essentials from Co-Op stores. This was established to support those who are able to leave their homes (are not shielded) but vulnerable or at risk of a cash crisis and struggling to access or afford food due to the current COVID-19 pandemic. A prototype was run with a cohort to test the model.
• Supermarket eVouchers: We developed a partnership with Sodexo Exchange to provide eVouchers that can be used within the big 4 supermarkets (Sainsbury’s, Tesco, ASDA, Morrisons) for buying food (as a school meal service alternative whilst the service is disrupted) or other financial support (e.g. purchasing academic supplies, home good such as a microwave, over-the-counter medication etc).

Service Directory

As COVID-19 began to affect Camden residents and the services within the borough, there was an emergent need to help residents understand what services remained open during the crisis, and what they could access based on government guidelines. While Beacon currently serves and focuses on residents with complex, urgent needs, the Service Directory is aimed at the wider resident population. It is a tool that residents can use to understand what services are available to them, based on geographical location and their particular need with the option to self-refer when possible.

The directory is a service offer for residents to find the best community service for their current situation. The resident is supported to help themselves with an interactive web-based tool to reduce demand and save staff time.

At first interaction residents who present to the COVID-19 landing page are signposted to the service directory that will help them resolve their situation, so that they receive their chosen level of support. This data has always been on the Camden webpage (Cindex) but we have made it easier for the COVID-19 crisis.

Thus far, the Service Directory has gone through two iterations and will continue to be updated.

Beacon

Beacon is an application that enables local authorities to keep a combined list of vulnerable people in their borough, record their needs, and keep track of their fulfilment. With Beacon, we can capture resident needs and connect them to the right support to ensure these needs are met through council and voluntary and community services.

Conceptually, Beacon is similar to a CRM or case management tool: its data model has contacts (referred to as people in need), and contacts can have needs associated with them (referred to as support actions but are treated a bit like tasks), which are assigned to users, who can mark them as completed and leave notes on the needs. While existing software options were evaluated, we chose to build our own innovative solution.

Who's using Beacon?

• shield outbound team: We have now trained 30+ agents to make calls using Beacon to capture the needs of vulnerable residents. This includes 4 team leaders and 1 team manager who are also taking on the ‘Simple needs’ referrals.
• Camden Council multidisciplinary team: Each day a multidisciplinary team (MDT) made up of 5-10 professionals representing council services are using Beacon to review cases that have been referred through to them and advise on the best way to support these residents.
• Food Hub: The Food Hub is now exporting data directly from Beacon multiple times a day to capture all new food deliveries to be made. This has allowed callers to spend more time on the phones each day contacting shielded residents, as spreadsheets no longer need to be collated.

Track and trace capability

As COVID-19 continued, the support residents needed has changed and the capabilities of Beacon needed to evolve to meet these needs. Together we developed time-consuming manual workarounds and adaptations specifically to accommodate Track and Trace requirements.

These new adaptations include:

• test and trace ID field and updated relevant forms
• improved search functionality that includes postcode, NHS number, test and trace ID and address
• a ‘Contact Camden’ team
• the ability to re-activate users that had been deactivated previously

We’ve also built in the ability to import data provided from central government. Previously, each field was copied and pasted for each contact. Beacon is now able to support staff by reducing their time spent on manual tasks as it uses the most recent data available on residents.

To date, the team has utilised this new feature through 17 imports, with 1670 contacts added and 175 contacts rejected as duplicates. As 14 fields are added for each contact, this process has saved approximately (14 * 1670) 23,380 copy & pastes. Alongside time saved having to check each one for duplicates.

Beacon has allowed staff to coordinate and deliver support at scale, with functionalities to collaborate with VCS organisations they have increased their capacity to support Camden residents through the crisis.

Impact

Total number of people on the Camden NHS shielding list which have been contacted and triaged through Beacon as of 11 May: 3097 (from initial upload of 3650 residents). A new list of approximately 3000 shielded residents has been uploaded to Beacon on 12 May and outreach calls are currently underway.

Enhancing wider resident support beyond COVID-19

A blended team of FutureGov and Camden Council staff provided support to the initial launch and operating model of the Shield Hub (a Community Hub response to deliver essential food and medical supplies to those who are shielded). We identified optimisation opportunities and plugin initiatives that we have been working on to date with other services across Camden as part of the COVID-19 response. These enable the Shield Hub to operate sustainably, as well as prepare for demand and service support offering growth.

Looking beyond the immediate crisis, we recognised the medium and longer-term effects of the crisis on residents and developed a future vision to articulate a holistic approach focussed on early intervention: we understand people‘s needs holistically and make sure they get the right support from the right service or organisation at the earliest opportunity.

Testing a multidisciplinary team to identify and address needs as early as possible

In order to realise this vision, we designed a multidisciplinary team approach - a group of experts who gather together daily to focus on a family’s needs and respond to them in the best way. The team would be comprised of representatives from Adult Social Care, Children’s Social Care, Welfare Rights, Early Help, Housing, Camden VCS, Employment Advice and Public Health, working together to review the changing needs of residents and families to develop what is currently an emergency model into a more sustainable, holistic model that focuses on a family’s needs and can respond to them in the best way.

The referral process

Referral processes have been established to help meet the needs of vulnerable residents being captured in the Beacon platform. An interim escalation process has also been developed in cases where there are safeguarding concerns for residents.