DRA FT F OR R NOT EVIE FOR WO PUB N L I C PERSONALISATION OFATION LY
SOCIAL CARE PIT STOP THE DIGITAL OPPORTUNITY Event Journal 12th and 13th March 2015
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This page not for inclusion Purpose to capture the process and the outputs and act as aide memoir Probably hyperlinks to presentations – file will be too big Ultimate production to CDEC?
Next steps •
Doug & Atlantic review •
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Fill in missing pictures etc (Emily support)
Dave Brewer, Emily & Hayley – review and agree format • •
Make any necessary changes Marketing wordsmith, improve, etc
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Team meet to talk about how to distribute
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Build into community development Design and facilitation by:
Introduction The Digital Catapult’s vision is to rapidly advance the UK’s best digital ideas from concept to commercialisation to create new products, services, jobs and value for the UK economy. To achieve this they collaborate with startups and small businesses, large businesses, the research and academic community, other catapults and the wider Innovate UK family. Specifically they help UK businesses unlock new value from sharing proprietary data in faster, better and more trusted ways. This PitStop brought together innovators with adult social care professionals, experts, academics and existing suppliers, to identify and solve some of the critical issues facing the industry. The purpose was to catalyse a group of people who, after experiencing the opportunities to be gained, would develop into a community to extend these early ideas into real solutions. The event that was commissioned by the Digital Catapult extended over two days and was facilitated by Atlantic Customer Solutions. Design and facilitation by:
Matt Stroud and David Brewer introduced the session Background, purpose and objectives
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Simon Gifford introduced the outline for the two days
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Agenda: Day 1 Morning
Afternoon
Introductions and purpose
Problem definition (contd)
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Matt Stroud: Digital Catapult
PechaKucha: Hannah Miller
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David Brewer: Digital Catapult
Problem feedback
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Simon Gifford: Atlantic
Matthew Birkenshaw: DH: Policy Coffee break (10h30) Dave Bell: Atlantic: Strategic issues Problem definition and exploration PechaKucha: Dominic Campbell, FutureGov Lunch(12h30)
Problem ranking and team selection PeckaKucha: Gary Oakfield, Merseyside Fire Announce teams Tea (16h00) Networking formal Networking informal Close Design and facilitation by:
Mathew Birkenshaw, section Head of Adult Social Care Technology and Systems Policy at the Department of Health
DH policy: technology in Social Care
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David Bell, Director of Atlantic Customer Solutions
The challenges facing the sector
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The teams then began exploring 5 key problems Assessments Data capture Optimising the use of assets Information advice and purchasing Addressing carer loneliness
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The 5 problems selected ..
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Assessments Data capture Optimising the use of assets Information advice and purchasing Addressing carer loneliness
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Work session 1: Problem definition Facilitator: Simon Gifford
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Assessments
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Data Capture
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Optimisation of the use of assets
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Information advice and purchasing
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Reducing the loneliness of carers
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Dominic Campbell, Founder: FutureGov
Technology for good
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Hannah Miller, OBE Associate, Atlantic Customer Solutions
The challenge and the solutions
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Ranking of challenges found them all to be critical – and solvable!
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Gary Oakfield, Prevention Group Manager, Merseyside Fire & Recue
From response to prevention
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Then we networked ‌
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And networked ‌
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And networked …
The day and the network sessions were separated by themed music: • • • • • • • • •
Proud: Heather Small Locomotive Breath: Jethro Tull Race against time: Ja Rule Forever Young: Alphaville Time after time: Cyndi Lauper In the end: Linin Park Time Warp: Rocky Horror Time: Pink Floyd One more time: Daft Punk
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Day 2: Problems to digital solutions
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David Brewer introduced the second day Welcome, recap and direction of travel
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Agenda: Day 2 Morning
Afternoon
Review and recap Day 1
PechaKucha: Leonard Anderson, Kemuri
PechaKucha: Joseph Connor, Expero Crede
Preparation for panel
Chirdeep Chhabra, Data Catalyser
Panel pitch and surgery
PechaKucha: David Alexander, MyDex
Problem ranking and team selection
Coffee break (10h30)
Tea (15h15)
Ideation and solution development
Community development
Solution development
Conclusions and wrap-up
Lunch(12h30)
Close
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Dr. Leonard Anderson, CEO Kemuri
Monitoring wellbeing
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Joseph Connor Founder: Expero Crede
Tracking your emotions
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Chirdeep Chhabra, Data Catalyser
Unlocking proprietary data
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David Alexander CEO, MyDex
Personal data stores
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We started exploring the problems posed on Day 1 ‌.
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Work session 2: Ideation and solution development Facilitator: Simon Gifford
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Assessments and data sharing
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Assessments and data sharing (2)
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Using community assets and information sharing
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Addressing carer loneliness
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Innovate UK Zahid Latif, Head of Healthcare
Funding sources
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Panel session Pitch and surgery
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The teams presented their solutions ‌
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With passion & persuasion ‌
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‌ while the panel probed and challenged.
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Feedback and next steps David Brewer facilitated the closing session. A decision was made to launch an interim community to further advance the ideas and process. It was also agreed to enter all three solutions into the Innovate UK call Design and facilitation by:
Frank Sinatra’s “Fly me to the moon” accompanied the move to some final networking….. The space-themed music interspersed the Day 2 sessions: Space oddity: David Bowie I believe I can fly: Ronan Keating Walking on the moon: The Police Space cowboy: Jamiroquai Rocket man: Eton John Fly me to the moon: Frank Sinatra
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Appendices Completed templates: Problem definitions
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Assessments
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Problem definition Problem reference number:
Problem name: Assessments
Customer jobs: Plot customer journey and re-
Problem: Number of assessments will increase but
design. Education, info/advice advocacy for recipient of care. (national communication strategy locally best fit). Council - informed choice, story-based selfassessment, co-produced community groups commissioned to support digital capacity/ inclusion.
ironically the assessment process is not personcentered. It is provider focused, takes time, is often not fit for purpose and is easily at risk to people ‘gaming the system’. It is top down, not bottom up (The RAS is a ruse, its only the technical system of an already skewed process).
Current solution: Different in different localities
Is it really solvable? Social workers need support to arm OBC or direct payment care. Digital part of this but need interface development.
assessments for carers who are largely hidden (largely hidden assessments, backfilled onto system, so double the work!) (Integration issues).
Visual Representation:
Current assessment system is a spider’s web made by 150 spiders…
Pains: Not timely; poor customer experience (not
personalised outcome even if F2F meeting), duplication of info: repeating story, annual assessment doesn’t respond to/ track changes in condition (no real time data); hides the real story of the person’s situation; defensive recording - it’s a legal document and process that aims to control resources, not empower people to pro-actively own their own care; lack of trust (by social workers, by recipient of care; data).
Gains: Client owned = redesign the assessment for
Current system is not sustainable but is solvable
Size: Massive - Care Act 2014 now introduces
In a strong wind with a fighter jet flying in adding turbulence ( > flimsy).
(not portable); demand outstripping current model of supply; time consuming; must be signed off by qualified social worker (but may lack specialism in specific condition e.g. dementia; councils feel anxious about meeting Care Act and JSNA targets; people in receipt of care - how long waiting period and more anxiety; responding to multiple requests for same data (poor customer experience); no sharing of data e.g. with GPs/ health workers.
end user outcomes: the user owns the data, not solely the practitioner (sharing consent); proactive ownership of care plan; real time changes (not episodic written in stone for a year). Multichannel offer - real time data - self-service outline - co-produced - informed choice.
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Yes – but at what cost? Stakeholders: - - - - -
People needing support, carers. Council - social care workers/managers Workers - GPS, occupational therapists, district nurses, benefits team, housing team. Suppliers - home care workers/agencies, voluntary organisations, lawyers. Assets - people with care needs, carers 3rd sector CVO, advocacy. Based on Alex Osterwalder’s: Value Proposition Design
Do now: new world = prevention savings
Evolution or revolution of assessment process. Reinvention? - no sharing of best practice or data.
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Data Capture
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Problem definition Problem name: Data Capture
Problem: Pressure of social workers carrying out assessments, moving to a model of self-assessment and maintaining quality and consistency of data captured. How is this info/data shared? Especially unstructured data. Consent to share?
Problem reference number: 3 Customer jobs: 1. Complete assessments, provision services, maintain care plans (LA) 2. Self-assessment need, self provision of care (service user)
Visual Representation:
Current solution: Social workers carrying out assessments on paper then updating back office systems later. Social workers carrying out their own admin. Data sharing protocols managed locally and sponsored By director of ASC. Gains: Data captured is consistent. Data captured is systematic. Some data is digested and usefully shared.
Is it really solvable?
Size: New clients: 2.1 million Completed review: 1.4 million Clients getting services: 1.2 million
Stakeholders: Service users ASC practitioners LAs (maintaining performance targets) Service providers Health practitioners Carers Based on Alex Osterwalder’s: Value Proposition Design
Pains: Backlogs/higher case loads. Poor use of resources Lack of data sharing – incorrect use of Data Protection Act People die/end up in hospital because of poor information sharing Yes – but at what cost? Design and facilitation by:
How best to develop and sustain assets
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Problem definition
Problem name: How best to develop and sustain assets Problem: - What do we mean by assets? - What assets are held? How do we maximise asset potential? - What benefit are we trying to achieve? - What need are we addressing? - How do we change patients perceptions/ expectations? - How to develop audience-base that this approach is ???? - Not being aware of what’s going on inside/outside authority boundaries. - Limited IT capacity. - Lack of understanding of voluntary sector.
Customer jobs: - Mapping existing capacity need - Connect capacity to need - Catalogue of signpost.
Size: - One authority scalable nationally
Visual Representation:
Current solution: - Uncoordinated/no sustainable models. - Evidence based corporate social responsibility. - Trials locally and nationally. - Large reliance on government funding to kick-start efforts.
Pains: - Can only approach problem from local perspective – requires local solution – can’t mandate national solution. - Sustainability requires funding - Reluctance to engage
Gains: - Faster Assessment. - Better signposting for community users. - More capacity and efficiency, return for our spend. - Increased well-being in our Local communities.
Is it really solvable?
Problem reference number: 4
Stakeholders: Voluntary organisations Service user Local authority Front line service providers
Yes – but at what cost?
Design and facilitation by: Based on Alex Osterwalder’s: Value Proposition Design
Information advice and purchasing
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Problem definition
Problem name: Information, Advice & Purchasing Problem: Data currency Information management Digital exclusion Geographic reach: parent/child Education/marketing
Customer jobs:
Current solution: Multiple info/advice providers Multiple advice solution Phone dominated No understanding of process marketing or education
YES!
Ideas/ opportunities - Recommendation engines. Third sector delivery info model. Purchasing power of market > funds delivery of info/ advice
Size: 200k enquiries/422k population. 5-30 minute call. 80% telephone contact. 10% of calls to web > £50k saving p.a. x 150 Las = £7.5m uk. 1 LA: 200k x 2.88 = £576k x 150 Las = £86.4m SOCITM call cost £2.88 Visual Representation: (Note: may wish to use separate flip chart)
Gains: X sector info sharing. Demand management Better understanding of process Informed/better choices Deflection, self-service Reduction in cost for LA & INDI Better care provision Is it really solvable?
Problem reference number: 5
Pains: More demands on individual: - Info integration - Financial management of care Education and marketing Stakeholders: Care receipients Friends/family (Healthcare) professionals Investigating care
Based on Alex Osterwalder’s: Value Proposition Design
Yes – but at what cost? X sector working innovation. Data collection and mining.
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Reducing loneliness and isolation of carers
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Problem definition
Problem name: Reducing loneliness/isolation of carers Problem: How does society support and prevent the loneliness of informal carers? - To prevent myopic vision of needs of cared for - It can happen over time - It can exclude other helpers - Leads to a secondary issue, further complications and potentially intervention and IOS & S. ??? And ??? In relation to problem. Addressed too late to change mindset.
Customer jobs: Better quality care for cared for at a lower cost and most effective.
Is it really solvable?
Size: Dementia unpaid care costs 11.6bn, 1.3bn hours. Problem is getting significantly worse. Problem is defining numbers when some carers don’t come forward.
Visual Representation:
Current solution: A statuary system fallen into disuse and need for reassessment with Care Act. - Informal carers groups - Carers information services - Carers centres funded by voluntary organisations and others - GPs services - Some potential LA financial support
Gains: Improved care for the cared for and potentially a better long term outlook for care givers reducing their dependency on system = reduction in costs/ better outcomes.
Problem reference number: 6
Pains: Potential lack of engagement. Denial there may be a problem. They don’t know how big the problem is. Data sharing. Stakeholders: Las, GPs, family trust, carers & individuals, families of carers and cared for.
Based on Alex Osterwalder’s: Value Proposition Design
Yes – but at what cost?
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Appendices Completed templates: Solutions
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Assessment & data transfer
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Problem solution – page 1 Problem name: Assessment & data transfer The solution: Shifting the market focus on care account as an opportunity for change/ transformation using: • Self funders and their contracted/commissioned providers as a cohort to command, manage and create a data set for future service planning. • Personal data sets owned by the individual • Potential users become visible (currently they aren’t known until they present at ASC door) • Data capture and store for intelligence and market for H & ASC. Technology: • Web enabled and multichannel (first filter) • Data governance and security
Reference number: 2 & 3
The solution (to users & buyers): 1. USER: • Self-service (info preassessment) • Self-assessment (or referral) YES - ‘Futuregov’ experience (Surrey CC) NO - set up care account - Personalised ‘data store’ > diagnostic + tools - needs, £, self-manage/PA - Portable by person 2. COUNCIL: • Demand management • ??? ‘source of the truth’ • View of whole market • ‘mixed market’ social value act • Visibility of self funders (currently invisible). ü Intellige 3. PROVIDERS: nce • Engaged ü Market • Visibility in market insight • Future proofed H + ISC purchasing power • Reputation 9ratings by users) ‘Amazon’ care
Assessment is massive - assessment of condition, £ assessment + H&S assessment for re-ablement. If we take evolution approach faster, consistent, accurate ??? read can be improved by AI, with tech improver/enabler.
Visual or other tangible) representation:
Care Advisor
Meets Assets
Council Assessment
Market LA
??? Account Pro v hea i ders l care th/soc ial
Services Providers Care Cape Evidence
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Assessment & data transfer
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Problem solution – page 2 Problem name: Assessment & data transfer The solution: Care advisor plus Current solution: (top 3) person owned care account. • Demand outstripping demand • Static/decreasing resource • Inefficient/unsustainable resource • Paper driven not shareable data • No view of this market/selffunder needs. Business case: Demand Management • Collated data, aggregating data ü intelligence • Saves £s (20:80 rule) • Saves time ü • Customer journey/pro-active engagement. • Provider/customer/council > health usage • Vibrant market shaping + insight • Visibility/transparency • Quality ratings
Problem reference number:
Risks and assumptions: • Consistency/standards • Pre-assessment - read across to formal??? • Info governance • Security (IlM3 & PSN) • Formal assessment is co-produced • National communication strategy raises awareness to care account • Council wants to know about and plan for future demand on service from self-funders Pain relievers: • Personal data in realm of person • Visibility: ‒ Providers ‒ Self-funders: needs, issues ‒ Access to intelligence • Council (see sheet 1) (Reduced • Care cap evidence mortality • Poor experience ‘no stone • Trust unturned’ is a distant memory)
‘’Fan Dabby Dosey’’
2&3
Competitive advantage: • Person-focused, co-owned • Not mandated by internal systems of council • Manages demand out of council Revenue model: Council/region could pump prime (Care Act). Providers pay/ subscribe? (%) Products and services: Care advisor Care account Market place Gain creators: ‘one version of truth’ • Data aggregation • Less duplication • Timely • Engaging for customer • Personalised, portable • Flexible (with changes) • Improved auditability • Market stimulated • Reducing friction of transaction • Managed services e.g. ACAS. Design and facilitation by:
Community assets; info and advice
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Problem solution – page 1 Problem name: Community assets/ info and advice
Problem reference number:
The solution:
Technology: Your voice, community
1. Problem - Gap analysis • What needs are there? • What I & A is available? 2. Is there a difference between formal and informal assets 3. How to highlight the assets to the community 4. How we can ensure someone with a need is connected
The solution (to users & buyers):
Why no one solved it before? • Barriers across structures (silo leadership, not our job, east shunting) but now replaced by cooperation e.g. MASH to fix problems. • Formal/approved signposting (LA, fire, ambulance, GPs, voluntary sector) vs. encourage community interest groups and provide (I&A) > social engagement approval.
4+5 Visual or other tangible representation:
asset A digital asset map - self-managed • Quedos approached • Galvanise the community/ local • Offer financial incentives, government to pump prime.
Digital map of everything gathered in one place populated from data already exists, your local, not council or boundaries. Walking tour of assets 1. Councils don’t do they create the conditions 2. Digital asset map - growth sources 3. Not just digital/walking maps 4. Sustainable, self-managed 5. Information about similar products 6. Together at ?
What does your customer say about the proposed solution?
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Reducing loneliness of carers
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Problem solution – page 1 Problem name: Reducing Loneliness of carers The solution: - Got to work in the home • Seamless & useable by people not tech savy • Secure, reliable (work in a crisis) - Two way interactive • Facilitate connection when they want to - Configure based on content - Ability to express themselves to drive engagement - Information access • What is available, entitlement, help, guides - Makes economic and social sense • Works for self-funders local authorities - Allows informal care networks to??? • monitor
Problem reference number:
Technology: Using TV - tech everyone is familiar with. But this is seen as the basic stage solution. Moves onto more conventional web solutions.
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Visual or other tangible representation:
The solution (to users & buyers): • Entry point - integration driven by shared events on TV which can be scheduled - TV tea trolley. • Carer based TV/film club • Connection ‒ User defined characteristics ‒ Who is watching the same? ‒ Friends and their friends • Trusted network ‒ Levels of access What does your customer say about the proposed solution?
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Issues and templates
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Brainstorm (ideas only) Do we really understand the problem?
Can we break it down to smaller problems?
Why has no one solved it before?
Are there data issues?
What are the root causes?
What might the ideal solution look like?
The problem Is it related to other problems?
What are the underlying issues?
What are the options? Draw the process – insights?
Why is it a problem?
What are the obstacles? Design and facilitation by:
Some key challenge areas 1.
Assessments & RAS
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Data capture, privacy & security
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Care accounts and use of funds
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Predicting costs and market shaping
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Information, advice & purchasing
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Safeguarding and monitoring (after direct payments)
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Optimising use of "assets” eg universal services and voluntary sector
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Alternative services eg telecare, wearables, etc
9.
Handovers and boundaries Design and facilitation by:
Problem definition Problem name: _______________________ Problem: • What is the problem (define)? • 140 characters • Fuller definition • Who does it affect? • When does it occur?
Problem reference number:
Customer jobs: • What is it the customer is trying to get done? • Rank: important to insignificant
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Size: • How big is the problem? • Quantify the benefit if solved? • How many are affected? • Is the problem getting worse? • Are there indirect benefits?
Current solution: • How is it currently being handled? • How good is the solution? • What are the problems with the solution? • Is there any group working on this at present?
Visual Representation: (Note; may wish to use separate flip chart)
Gains: • What outcomes & benefits does the customer want? • Rank: essential to nice-to-have.
Pains: • What annoys the customer when trying to get the job done? • Rank: extreme to moderate
Is it really solvable?
Stakeholders: • Who has the problem? (customers) • Customer segments • Who else is impacted? • Who wants it solved? • How are Service users impacted? Based on Alex Osterwalder’s: Value Proposition Design
Yes – but at what cost?
Problem solution – page 1 Problem name: _______________________ The solution: • Describe the solution in detail • What does it do? • How does it do it? • What makes it different? • Describe the process of use
Problem reference number:
Technology: • What underlying digital technology unlocks the solution? • What data is required / produced? • What are the data issues? • Can the TDH help?
The solution (to users & buyers): • Describe the solution in detail to the customer (user) • Describe the solution to the economic buyer (eg finance, procurement) • Describe the solution to the end-user. What does your customer say about the proposed solution?
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Visual or other tangible) representation: (may use other media) Demonstrate how it may be used to the customer eg wire-frame, prototype.
Problem solution – page 2 Problem name: _______________________ The solution: • Describe the solution in 3 lines or less. • Draw a simple picture of the product being used by customers Current solution: • In what way is it better than the current solution? • In what way is it worse than the current solution? Business case: • At the highest level, describe the benefits and costs of the solution? • Who would buy it and for how much? • How long will it take to produce? • How much and what type of resource/ skills will it require? What does the end-user say about the proposed solution?
Problem reference number:
_________
Risks and assumptions: • What are the major assumptions you have made in developing the solution? • What are the major risks? • How could you test them before developing a full product?
Revenue model: • What is the revenue model? • Who pays and how? Competitive advantage: • If you were to commercialize this, what would be the competitive advantage? Pain relievers: • How (and which) pains will we relieve? • Rank: essential to nice-to-have.
Products and services: • What are all the components of the product? • Rank: essential to nice-to-have Gain creators: • How (and which) benefits and outcomes will we produce? • Rank: essential to nice-to-have
Problem definition Problem name: Time and labour required by assessments Problem: Time required to assess; and backlog of assessments (worsened by the Care Act).
Problem reference number:
Customer jobs: Complete assessments (and reviews) for service users when required.
Current solution: S/U supported in completing application; care managers review and capture; health input sought; carer consideration given; financial assessment conducted; RAS run. Leads to development of support plan approved by panel (see drawing of process Gains: Data input accurate when done timeously; fairness to users with consistency; carers can receive an assessment; social workers used in areas that match skills; less duplication of activity ; Is it really solvable? YES
A1
Size: 200,000 assessments required pa @ £100 each is a £20m job. 10% saving is worth £2 million pa excluding indirect benefits. Visual Representation: (Note: may wish to use separate flip chart)
Stakeholders: Service user; carers; Care Managers; providers; LA management; Health services;
Based on Alex Osterwalder’s: Value Proposition Design
Pains: Shortage of care managers / social workers; admin tasks not completed; inconsistencies in results; need for panels;
Yes – but at what cost?
Problem solution – page 1 Solution name: AI based assessments The solution: Artificial intelligence based solution. Works from a common (nation-wide) input form that may be selfadministered or supported by non-qualified worker. System “learns” from all assessments conducted around country.. Produces exceptions for those requiring detailed review by qualified social worker. Data captured directly into LA Care system and Care Plan partially pre-populated. What does your customer say about the proposed solution?
Problem reference number: A1
Technology: Common software across all LA’s with data sharing at individual level Interface built to care systems.
The solution (to users & buyers): Users: a fair system that provides the same result across the country. Buyers: Reduce Care Workers review time by 60% and better data capture. System may be extended to other user groups, incorporate Health and to further populate support plans.
Visual or other tangible) representation: (may use other media)
Problem solution – page 2 Solution name: AI based assessments The solution: AI based national assessment system
Current solution: Better than current as it is less expensive, more consistent and frees up social worker capacity.
Problem reference number: A1
Risks and assumptions: Technology is possible? Will obtain national coordination Acceptable to social care Data problems can be overcome Revenue model: LA’s pay a fee per assessment
Worse: may have backlash against non-human nature Business case: Cost to produce £250k and annual cost £100k. Annual benefit £2m Many non-quantified benefits I think it is fairer and I will not get left waiting for my review
Competitive advantage: Likely resistance to a duplicated model unless significant benefits Pain relievers: Reduces cost of assessments Reduces poor data capture Frees up social worker capacity
Products and services: Standard assessment input with self –assessment capacity; AI driven assessment which improves over time Gain creators: Obtain benefit from shared data Fairer system for all Can increase number of assessments conducted