Challenge

Adult services is a complicated system, aiming to fulfil the complex needs of citizens. With a lack of conscious design across the system, challenges arise, people’s needs aren’t met and work is duplicated. North East Lincolnshire Adult Services, spanning health, social care, mental health and housing, faced two primary challenges. The council needed to:

• improve customer outcomes and experiences
• move towards a system focused more on early intervention and prevention

Looking at health and social care together, along with mental health, housing and public health, meant that leadership across the Council and the CCG could develop a shared lens and perspective on the problems and areas of opportunity for Adult Services. By better understanding the “as-is” interactions between services, where things are and aren’t working well, we can identify opportunities for the delivery of better, cheaper public services.

Approach

Working alongside the council, the CCG and eleven independent providers, we led design research to develop a shared lens and perspective on the problems and opportunities facing adult services. Mapping the typical routes citizens take into and through the services, and the journey of their support, helped visualize how services communicate with one another. This wider, shared perspective helped the council understand their challenges and opportunities from a strategic and operational perspective.

This was the first time Adult Services (as a whole) had purposefully taken a user-centred perspective of the challenges and opportunities facing them. Through service user research, user testing and engagement with community leads at every stage, learnt how and what it feels like for residents when they’re referred to services, when they are receiving services’ support and when they have lacked that support. We also got to know their values, goals, hopes and fears for the future. This helped us understand more deeply the people that use North East Lincolnshire Adult Services, putting the council in a better position to design for citizen wants and needs.

Stressing the importance of finding opportunities to start small and think big, we prototyped potential new solutions, spanning data, consent and governance, which helped us understand where there were opportunities for full service transformation. We tested prototypes with staff and service users to:

• develop a shared vision for Adult Services
• test the impact of gaining consent on the ability of teams to share information more effectively and better coordinate packages of care

The discovery insights provided a fresh perspective for staff, allowing them to see the bigger, systemic issues broken down into parts. In particular, introducing user journeys proved really powerful. Being able to see the primary points in someone's journey to access support, and being able to relate that to a time when something the council (as providers) did, meant staff could see the human implications of decisions and actions. This in turn allowed us to think more empathetically and imagine how the council work differently to deliver a better user experience.

Following the user research and prototyping, we developed recommendations for the shape of future service delivery and built these into a transformation roadmap, spanning governance, data, content and user experience, and broken down into manageable tasks and an achievable timeline, including:

• moving towards a common content and communication standard
• creating a user-centred data sharing policy to improve the assessment process
• making sure user needs and business goals are aligned through an outcome orientated approach to delivery

To help deliver the transformation roadmap, we developed the skills and capabilities of staff, providing them with the tools needed to get the job done. Through a series of lunch and learns and workshops, we covered everything from user research to prototyping agile delivery, including a creative thinking exercise thinking about what a future service could look like through the eight lenses of service transformation. By equipping staff with a common approach to problem-solving, they can create the conditions for change and implement the transformation roadmap.

Impact

The impact of the project can be seen at a strategic and operational level. By giving clarity to what senior leaders want to achieve, and thinking through the supporting infrastructure and ways of working that were needed to support this, we delivered:

• a shared vision for Adult Services across Council, CCG and providers
• a clear sense of the things to investigate next in a transformation roadmap
• an emotional journey map, setting out the human implications of decisions and actions
• an engaging narrative for staff, ensuring citizens are considered throughout the co-design process
• learning sessions for 39 staff from across Adult Services

We were able to understand the big, systemic issues that affect data, governance, content and user experience to make recommendations and address these in our transformation roadmap. These focused on areas such as:

• improving the use of digital technology to meet staff and user needs
• developing common content
• building deeper understanding of user needs and embedding user research
• adopting an agile governance model

We also worked closely with the Integrated Care Partnership to understand the experience of providers in trying to deliver for residents. We offered service design support to reframe the challenges they face in coordinating their work and delivering positive outcomes for service users with multiple and complex needs.