In 2014, Stockport Council Adult Social Care (ASC) service commissioned a range of prevention and early help services to support residents to live safe, healthy, happy, and independent lives at home in the community, improve their emotional and economic well-being and reduce isolation. They aimed to:
- identify and support vulnerable people
- provide effective interventions earlier to stop problems from emerging in the first place
- or, if issues have arisen, to help people to address them
- alleviating and delaying demand on ASC, Stockport Family and the wider health, homelessness and criminal justice systems
These services worked well to achieve the aim of supporting independent living within the community. However, there were gaps in service provision and some duplication of services, leading to confusion amongst staff who referred people in. As the contracts approached their end, it was felt a review of services would help commission future services that would benefit the residents of Stockport.
It was also important for the services to be inclusive and align with:
- the One Stockport Borough Plan
- the One Heart Health and Care Plan
- the Prospectus for All Age Living
- the new ASC Operating Model in Stockport
An ambitious piece of co-design and co-production work began with colleagues and stakeholders in ASC, Public Health, neighbourhoods and the Clinical Commissioning Group, and with Stockport residents and service users with lived experience.
The process began in November 2020 with a thorough review of services. A presentation was pulled together outlining the ethos behind prevention and early help services and the need for them, including details of current services, where we envisaged there might be gaps, and our wish list for the future. In addition, we pulled together a spreadsheet of current prevention projects to ensure that we were clear on the current services in scope and the level of investment in them and a project steering group was established to lead on the initial priority activities.
With such a lot of ground to cover to get the new services in place, it was difficult to know where to start. At this point we brought in the council’s digital transformation team. Having worked with them in the past, we knew they would be vital in helping us to pull together all the information, and to support a consultation with staff, stakeholders and service users. The team used the double diamond approach for this project.
The starting point for the team was to support us to define a problem or statement and who we needed to involve. After discussion we began with this statement.
“Is the prevention and early intervention offer in Stockport good enough?
Do we catch people early enough to stop them escalating to being in crisis.”
We held a collaborative remote discovery in March 2021 to begin scoping the project. Using the Miro board and with discussion amongst attendees we addressed the following questions through a myriad of post it notes.
- What do you want to learn/gain from this discovery process?
- What would you like to see at the end of the design process?
- What key dates should be noted?
- Who is our audience?
- Which internal stakeholders should be included?
- What external stakeholders should be included?
We followed this with in-depth discussions with colleagues in ASC, Public Health and Stockport CCG. Deep dives were carried out with colleagues in the Public Health substance misuse service, ASC’s current preventative services, The Prevention Alliance and the Wellbeing and Independence networks.
One to one interviews with different services allowed us to create a service offer map detailing current provision that helped us to:
- understand the gaps in service provision
- understand what is working well so we can build on this in the future
- listen to any frustrations/problems they were experiencing
The next discovery workshop was with key stakeholders including existing providers, the wider voluntary sector, council departments including neighbourhood services, ASC (at operational and strategic levels) and Public Health, to address the following questions:
- Who does what? – which teams are working in which area – to help create stakeholder & model diagrams
- What’s not working so well? – to establish frustrations & gaps in services – to help identify changes required
- What works well? – to ensure we build on what is working well & to learn what great things have been achieved so far
These tasks helped us to:
- better understand the current offer
- identify pain and gain points therefore improving services going forward
- identify what is in scope and what is out of scope for recommissioning
- understand how these services would fit together and collaborate
- identify the gaps and opportunities for future provision.
This in turn would help us to better manage current and future demand post pandemic and effectively spread resources across services.
In June the focus turned to the data. What were we currently collecting and what we may look to collect going forward. Staff surveys already undertaken and quarterly reports of current services were taken into account. A workshop was held to establish:
- Are people confident in sharing data?
- How useful is the data you are sent?
- What do you use the data for?
- Who is the audience for the data?
- Is the format working for you?
- Are there any gaps in the data you receive?
- How would you like to see data sharing in the future?
We gained knowledge on what data was collected, in what format, as well as how it was interpreted. We learnt the importance of case studies and collecting data over longer periods of time in order to map movement and outcomes. The session highlighted a consistent format of data collection was needed that going forward and that it could be presented in a way that enabled visual representations.
Service safaris were also carried out on the digital and printed offer of current services looking at how did we reach our target audience and how effective was our promotion. This included a walkabout survey of TPA and WIN promotions in cafés, corner shops, libraries, charity shops, post offices, leisure centres, community centres, job centres, council buildings, hospitals, pharmacies, Stockport Homes buildings and public transport. And an equivalent survey of online presence including websites, social media and other listings found through online search.
The next stage was for the design team to carry out persona workshops with the current providers. Personas are based on real case studies and research and are created to represent different user types that might use the service. The outcome of this workshop was then played back to the project team. This process enabled us to understand:
- Who our users are
- What the service offers residents
- What are the referral pathways in and out of services
- What frustrations end users experience
- Any gaps in services
We created user journey maps for each persona with the current providers. Journey mapping helps create a map of the customer’s journey through the service, so we can understand that journey and the support they are offered. It is a visual story of the customer’s interactions with the service and helps service providers step in to their customers’ shoes and see their business from the customer’s perspective.
Interviews were held with service users to gain their insights on current service provision, to understand their experiences, and to see if they matched up with what we had discovered so far. It helped us establish how they accessed support and communicated with the service, what was working well and what wasn’t, had they been referred on and if they felt there was anything we could improve with the service.
We held a final evaluation workshop to help those involved in the process share their views, own insights, experiences and feedback on the research and insights. Throughout this process, there were regular check-ins with the digital transformation team, who kept us on track with the process, what the aim of each stage was and what was coming next. It allowed us to explore the process with them, to ask any questions, ensuring we were getting what we needed out of the experience.
The steps taken during this discovery process helped us to achieve our goals of developing an initial specification for the prevention offer and being in a position to engage further with all stakeholders who will help shape our ambitions. The procurement process started in September 2021, and the contracts were awarded to the successful providers in January 2022. Part 2 of this blog will talk about the Delivery of the new Stockport Support Hub, the umbrella organisation for the range of Early Help and Prevention Services commissioned as part of this tender.