Challenge

In December 2018, Essex County Council’s (ECC) Adult Social Care service (ASC) began conversations about the need to change. Essex recognised their current model was unlikely to be sustainable to meet the challenges and demands of the future. There was a need for a clear and consistent change approach, alongside a desire from leadership for a more compelling 21st-century vision.

We helped Essex define the social, financial and political case for change and what ECC’s future vision and mission for adult social care should be. This new model has been designed using evidence from across our work in the county, based on engagement with residents, community organisations, council staff and partners.

Approach

Discovery, February 2019 to May 2019

Collaboratively we undertook research and engagement with the ASC team, senior stakeholders, residents, providers and partners to understand the challenges and opportunities of ASC in Essex.

To understand these needs we carried out ethnographic interviews, facilitated community workshops, held vision and strategy workshops with commissioners. Research also included attendance at provider forums and joining the people of Epping Forest on a walking group.

Prioritisation, January to February 2019

In January and February, we prioritised a change portfolio to simplify and consolidate change activity and a change approach. It was widely accepted that:

• the change portfolio in ASC was not coordinated
• it was not clear how work began, was assessed, governed or finished
• there was too much work happening and lots of duplication
• there was not a consistent approach to measuring and reporting on common outcomes

Through five workshops and leadership team sessions, all work was categorised according to four categories (system transformation, discrete problem solving, get it done and future focused). We then prioritised our work within these categories according to agreed criteria, by reaching consensus across the leadership teams and with commissioners on a renewed approach to prioritisation.

The prioritisation activity reduced the number of projects from 70 to 36. We created and structured their work around five priority programmes and for the first time, there was explicit recognition that some projects required a different kind of resourcing and focus on outcomes.

Articulating a new vision, mission and model, September 2019 to February 2020

In summer 2019, we articulated a new vision, mission and model for Adult Social Care in Essex, and designed archetype journeys for residents interacting with the system in 2030.

These artefacts were Version 1.0 - a way of helping ECC’s ASC directorate test its own appetite for change, and begin the conversation about its future. They brought together a wealth of evidence from research and internal engagement about Essex’s appetite for change and our (as of then) best guess around what a 2030 model for adult social care in Essex might be.

Running two experiments in Harlow and a series of stakeholder sessions, we tested the desire for change across the borough, which also helped develop an outcome framework and iterate the vision, mission and model.

In June 2019, we formulated our first ideas about how to structure change in adult social care in Essex. This diagram became the anchor point, explaining how, through testing and learning aspects of a new model, we can gradually switch our approach and resources. It also outlined the need for a wide-ranging programme of organisational design and change to support the switch.

Impact

Getting change started, February to March 2020

In our latest phase of the project we created a document which sets out:

• what we know about the challenges and opportunities of ASC
• the future direction and standards to guide all ASC activities
• the role ECC could play in the ASC ecosystem and ways to devolve power
• the approach to get change started

In March 2020, we presented an approach to change in Essex, alongside a refreshed strategic framework for ASC. We recommended an approach to change that’s built around a set of change beliefs and a twin-track that aims to modernise legacy operations whilst building a new model of adult social care.

2030 Future Model

The 2030 future model will spread resources across the community to shape a more diverse, responsive and preventative market. Essex will be able to offer the right kind of help to all residents and work to create a system that’s networked and adaptive, with distributed accountability.

We’ve provided Essex with our recommendations based on our insights of the desire and barriers to change going forward:

• a set of change beliefs to embed a shared DNA
• a twin-track approach and step-by-step guidance to sequence change activities
• different ways to organise delivery and embed new ways of working