Recommendation		Page
1	The Department should ensure the planned implementation of Online Financial Assessments being the default route for financial assessments collects feedback from users on the form, including on any barriers to completing it, and why those who were asked to complete an online assessment and did not, chose not to.	11
2	The People Scrutiny Committee should be informed of the progress of take up of Online Financial Assessments, and feedback received, as part of the monitoring of this Scrutiny Review.	11
3	The Department should continue implementation of learning from other local authority Adult Social Care departments to improve take-up of Online Financial Assessments and turnaround time of financial assessments, particularly considering introducing Robotic Process Automation.	12
4	The Department should continue to explore opportunities to simplify operational processes alongside implementing the Being Digital programme.	16
5	The People Scrutiny Committee should be informed of progress against Being Digital programme targets as part of the monitoring of this Scrutiny Review.	16
6	The People Scrutiny Committee should be informed of the outcome of the third phase of the Department’s Behavioural Change work with the UCL as part of the monitoring of this Scrutiny Review.	18
7	The Department should reflect feedback from residents who have benefited from digital and self-service options in communications to staff.	19
8	Information on Being Digital and the digital and self-service platforms on offer in ASCH, should be included in all new ASCH staff inductions.	19
9	Digital transformation should be included as a discussion point in team and 1-2-1 (where appropriate) meetings within areas undergoing rollout of a new digital or self-service platform; and in ongoing departmental communications (such as Yammer, To The Point and Brief Encounter).	19
10	The Department should continue to work with colleagues through the One Council Digital Inclusion programme to map the digital inclusion offer in East Sussex, and, where appropriate, share this with adult social care and health staff and partners.	21
11	The Department should ensure it is promoting to staff, and utilising, the range of national and local digital inclusion resources and schemes available in moving to being digital by default.	21
12	The Department should explore opportunities for partners, including voluntary sector organisations, to support engagement with and signposting to ASCH’s digital offer.	23
13	The Department should consider whether a Digital Ambassador Scheme could provide added value to Being Digital, informed by learning from the NHS Digital First Digital Ambassador pilot when it concludes, and consideration of other models.	24

Introduction

1. The Adult Social Care and Health (ASCH) Department has an overarching medium term digital strategy, the Being Digital Strategy (2020-23). The Strategy was developed in autumn 2020 to provide the Department with a more structured oversight of the range of digital developments and innovations taking place; and to set a vision for the Department to have in place digital capabilities that meet the range of needs of the ASCH community and workforce, in order to support and enable effective service delivery.

2. The People Scrutiny Committee was made aware at its March 2022 meeting that although the ASCH Department has an established digital strategy for the medium term, there is a need to look further ahead at how digital technology and other technological innovations can maintain provision of a high standard of care and support sustainability of ASCH services in the next five-to-ten years, and the Department welcomed the Committee’s input on this.

3. A Scoping Board met on 5 July 2022 to consider whether to proceed with a review of this topic. In addition to hearing about the range of work underway to deliver the Being Digital Strategy and discussing additional opportunities technology offered for meeting the needs of ASCH clients, the Board heard that the Department had recently agreed a future direction of travel for its digital work.

4. In line with the approach being taken by other councils, the planned direction of travel includes encouraging greater use of self-service options, such as online financial assessments and needs assessments; and linked to this, working towards implementing a ‘digital by default’ approach whereby digital and self-service means of contacting, accessing services from, and transacting with the Department are encouraged to be used as the primary route by those who are able to do so. ‘Traditional’ means of accessing services and contacting ASCH (in person or via telephone) will remain in place for those who require them.

5. The Scoping Board heard that introducing the digital capabilities to support this direction of travel is expected to result in better and simpler experiences for clients and carers in their interactions with the Department (particularly in being able to manage their care and access services at a time that works for them), as well as improvements in the efficiency and accuracy of work with partners and providers. The approach will also ensure ASCH resources are being used most effectively given ongoing demographic, resource and workforce pressures, and anticipated increased demand arising from the planned care charging reforms. However, the Department knows that significant cultural and behavioural changes are required to move to being ‘digital by default’. These changes relate to both the way staff work and to clients’, carers’ and providers’ behaviour and attitudes towards use of digital services and channels.

6. The Scoping Board concluded that based on the discussion with officers about the strategic challenges being ‘digital by default’ would help with, including the Department having capacity to deliver the planned care charging reforms, the topic would benefit from closer examination by People Scrutiny.

Terms of Reference

7. On the recommendation of the Scoping Board, the People Scrutiny Committee agreed at their July 2022 meeting that this review should explore what cultural and behavioural changes are needed to support greater use of online services, self-service options and adoption of a ‘digital by default’ approach by the Department, with a focus on the following service areas to avoid the Review being too broad:

· Financial assessments

· Reviews (especially carer reviews)

· Information, advice and signposting

· Carer assessments

8. Members agreed that this would be explored through the following key lines of enquiry:

1. Within the service areas outlined above:

a) To what extent are residents, clients, carers and/or providers currently using online services, self-service options and/or digital communication channels?

b) If there is high or low use, why is that?

c) Why do people choose to use the channels they do to communicate with ASC in these areas?

d) What cultural and behavioural changes are needed to support greater use of online services, self-service options and/or digital communication channels?

e) How can that cultural and behavioural change be encouraged?

2. The review should also look more broadly at:

a) What insights are there from other councils that have a high take-up of online services and have implemented a ‘digital by default’ approach on the cultural and behavioural changes needed?

b) How have they encouraged those?

Background

Being Digital Strategy and Programme 2020-23

9. The Being Digital Strategy 2020-23 is published on the East Sussex County Council (ESCC) website. The Strategy is supported by an ambitious programme of work, spanning some 35 projects, focussed on deploying digital technology to improve the way clients and carers transact with ASCH, improve efficiency of business processes and support smoother and enhanced partnership working within the broader health and social care system. A Being Digital project team is leading delivery of the Strategy and Programme and this work is overseen by a Departmental Being Digital Steering Group.

10. The Programme is underpinned by a detailed roadmap, setting out the projects underway to deliver the Strategy’s ambitions. Some Being Digital projects that will deliver more self-service options within the services in the scope of this Review include:

· Online Financial Assessments – Most ASCH services are chargeable and most people will pay something towards, or for all, the costs of their care. Where a social care assessment determines that a person has eligible needs under the Care Act, a financial assessment is completed to determine the level of contribution the person will need to pay towards the cost of their care and support. The Department already has an online portal in place that enables people to complete financial self-assessments once they are assessed to have eligible needs.

· Client Finance Portal – This portal is being procured by the Department and will enable clients with eligible needs to track their client contributions relative to the planned care charging cap once introduced. This is a key tool for the Department implementing the processes to support the planned charging reforms.

· Client Account - Another tool that is planned to be provided to enable clients to see documents relating to their care, communicate with practitioners and sign documents electronically. This will give clients greater control of their care.

· Carer’s Assessments - All unpaid carers have a right to a carer's assessment. The assessment looks at their needs and what support is available to help them to continue in their caring role. The Department already has an online self-assessment form that carers can complete in their own time and send to ESCC.

· East Sussex 1Space – This is an online directory of care and support services which has long been a pillar of ASCH’s digital offer. The site has been online for almost ten years, but work is underway to ensure the site is more prominently displayed on ESCC’s webpages.

· Artificial intelligence (AI) chatbots - a chatbot (called a Digital Assistant) is already in use on the ESCC website to answer questions about blue badge applications. Being Digital will explore other opportunities to employ this technology on the website.

11. The Department’s current public facing, self-service offer can be accessed through online forms available on the Adult Social Care Portal on the ESCC Website.

Graphical user interface, text, application, email Description automatically generated

Figure 1. Adult Social Care Portal – Website Screenshot

Local and National Context

12. The context to the ASCH Department introducing more self-service and digital options, and encouraging those to be the primary route into the Department for those able to use them, is:

· Changing expectations – the Department is aware of the growing number of activities and services people are able to undertake and access online in managing their day-to-day lives, from applying for a passport to buying a house to having a doctor’s appointment, and that this trend was rapidly accelerated during the coronavirus pandemic. The Department is seeking to anticipate growing expectations that residents will be able to access a similar digital offer from ASCH services, given the increased flexibility, accessibility and control such an offer can provide for residents trying to find information about our services and/or manage their care.

· Ongoing rising demand from demographic changes – East Sussex has a growing elderly population, already at levels that will not be reached nationally for decades. While our local population is ageing, the needs of people requiring support are also increasing. This has increased demand for ASCH services which requires the Department to make best use of stretched resources.

· Workforce pressures – the Department experiences a range of challenges in recruitment and retention of staff which stretches capacity. The Department must ensure staff time and resource is being used in the most effective way, with repetitive and process-based work limited wherever possible to free up staff time to focus on other work, including with clients.

· Planned charging reforms – the Government is planning to introduce reforms to the way people pay for social care, including introducing an £86,000 lifetime cap on the amount an individual has to pay for personal care, introducing a more generous means-test for local authority support and equalising the costs between people who fund their own care (self-funders) and local authority clients. At the time this review was conducted, the reforms were intended to be introduced from October 2023, although the Government has since announced that implementation will be delayed until October 2025. The Department has assessed that implementation of these reforms will result in an increase in the number of people approaching the authority for a Care Act assessment of their eligible needs and a financial assessment. This will further increase demand on ASCH services and greater use of digital and self-service options is expected to be a significant enabler of the Department meeting this demand within restricted resources.

13. Nationally, the Government has made a commitment to ensuring that the opportunities presented by use of digital technology, for improving independence, quality and sustainability of social care are fully realised. The Department of Health and Social Care has published a Plan for Digital Health and Social Care (June 2022) which outlines the recognised benefits from digital transformation of health and social care and a national vision for embedding digital technology and achieving a digitally transformed health and social care system by 2028. The People at the Heart of Care White Paper (December 2021) also made a commitment to invest to drive greater adoption of technology and to achieve widespread digitisation across social care, building on the way digital technologies transformed delivery of care achieved during the coronavirus pandemic.

Review Board Findings

Part 1: Understanding the current offer and uptake

14. In addressing the Review’s first three lines of enquiry, the Review Board sought to understand the current position in provision of digital and self-service options by ASCH within the service areas covered by the review; take-up of those options; and any barriers to their greater use.

Online Financial Assessments

15. One of the areas in which the Department has made notable progress in implementing a self-service approach is the provision of online financial self-assessments (OFAs). The Review Board heard that the delivery model of the financial assessment service has undergone quite significant change in recent years, moving from a service that was mostly delivered face-to-face including in people’s homes, to being offered via remote assessment, to now encouraging those who can to complete self-assessments using a digital form.

16. While all residents can complete a financial eligibility checker on the ASC portal to determine if they are likely to pay the full cost of - or make a contribution to - their care, residents need to have been assessed as having eligible needs under the Care Act to be sent a link to the full OFA. This requirement has been introduced within the last year and has improved the acceptance rate of self-assessments, but is reliant on practitioners sharing the link to the form. The Review Board heard that while consistency in practitioners sending the forms has improved, and the number of forms completed has increased over time, sending the link is perhaps not yet fully integrated into practitioners’ standard approach. The Department has a programme of behavioural change work underway to encourage more active sharing of the link which is covered in section two of this report.

17. The Review Board heard from the Head of Service for Hospitals, Finance and Continuing Healthcare that a new Financial Services offer is currently being designed in which the digital offer is seen as core to delivery in future, and it is planned for a team within ASCH to pilot making OFAs the default route for individuals requiring a financial assessment in winter 2022/23. The service is also looking to streamline the process for financial assessments to reduce the amount of information required to undertake an assessment.

18. The Review Board heard that in the Head of Service’s experience, ESCC is advanced in its digital offer, as some councils are not yet able to offer an online assessment. In terms of take-up, between January and August 2022, 330 links to the OFA form were sent and 68 forms returned; a return rate of 21%.

19. The Review Board asked whether the Department knew whether people not completing a form were choosing not to complete an assessment outright or defaulting to the non-self-assessment route. The Head of Service responded that while staff will follow up with anyone who does not use the link sent to ensure they have access to a financial assessment if they require one, the service does not currently collect feedback on whether individuals are choosing not to complete an online self-assessment or are not completing an assessment at all. Feedback is also not currently collected by the service on what might be preventing people completing a self-assessment or, more broadly, on the online form. The Head of Service thought that this could be addressed in the planned pilot to make OFAs the default route for financial assessments. The Review Board agreed this would be beneficial and asked that the Department ensure that any insights from feedback that could support and encourage take-up of online financial, and other, self-assessments were captured and responded to.

Recommendation 1

The Department should ensure the planned implementation of Online Financial Assessments being the default route for financial assessments collects feedback from users on the form, including on any barriers to completing it, and why those who were asked to complete an online assessment and did not, chose not to.

Recommendation 2

The People Scrutiny Committee should be informed of the progress of take up of Online Financial Assessments, and feedback received, as part of the monitoring of this Scrutiny Review.

20. The Review Board noted that, in terms of delivery of these recommendations, the move to OFAs being the default route of assessment was part of a wider programme of changes to the financial assessment service, and timescales for implementation of this whole programme of work may fall beyond the People Scrutiny Committee’s period of monitoring of this Review.

21. While the Review Board heard that ESCC is relatively advanced in its digital financial assessment offer, the return rate of 21% cited above and other evidence considered showed there are opportunities to improve take-up of OFAs. The Review Board asked what proportion of all financial assessments are currently completed online and heard that as of October 2022, just under 1% of all ESCC’s financial assessments are currently conducted online. Comparatively, other local authorities have reported to ESCC a much higher rate of financial assessments being completed online, up to 60% in some areas.

22. Other local authorities have been successful in encouraging people to use OFAs as the primary route of assessment and both ESCC and a large number of other local authorities have sought to learn from their approach as a result. Learning is of particular interest where the same IT systems and providers as ESCC are in use, as replicability should be simplified. The Review Board considered detailed learning from the approach taken by others and were updated on how this is being applied in ESCC. This included that:

· Considered thought has been given to messaging – website content sets expectations of clients undertaking assessments online where possible and senior managers have signed up to a ‘Digital First’ approach and actively promote it with staff. The language used to describe the increased use of self-assessments has also been carefully considered to ensure the change is described positively and to reduce anxiety about the change. The Review Board heard that in ESCC, the ASCH Department Management Team has also agreed to and supports a ‘Digital First’ approach and message.

· Staff are equipped with scripts or calling cards – this supports them to encourage clients to complete the online assessments and to determine who can complete assessments online and who may need support or lack capacity to complete them. These people may be offered traditional pathways (a phone call or visit). As mentioned above, in ESCC the approach to equipping staff to encourage take-up of OFAs has been considered through a behaviour change programme covered in section two of this report.

· ‘Live Agents’ are available during standard office hours - to respond to queries which reduces emails and phone calls regarding the forms and increases timeliness in responses. At the time the Review Board considered their evidence, another local authority was also looking to introduce a chatbot to answer frequently asked questions about OFAs. The Review Board heard that ASCH is also considering how use of chatbots in ESCC could support people with the process of completing OFAs.

23. As part of this evidence, the Review Board heard that another local authority had achieved a much shorter average turnaround time for financial assessments than is currently being achieved in ESCC. The Board heard that application of Robotic Process Automation (RPA) to the back-office finance system helped speed up the processing of financial assessments. The Scoping and Review Board heard that ASCH is exploring implementation of RPA at ESCC, including in support of processing financial assessments, as it has the potential to free up hundreds of working hours spent on repetitive, administrative tasks every year. ESCC is also implementing a change management project to improve turnaround time for financial assessments as part of the broader programme of work referenced above. The Review Board was supportive of and reassured by the range of actions the Department is seeking to take to improve take-up of OFAs and turnaround time of financial assessments.

Recommendation 3

The Department should continue implementation of learning from other local authority Adult Social Care departments to improve take-up of Online Financial Assessments and turnaround time of financial assessments, particularly considering introducing Robotic Process Automation.

Chatbots

24. As outlined in the background to this report, a chatbot (known as a Digital Assistant) is already in place on the ESCC website to answer questions about blue badge applications. The Review Board heard that the chatbot is thought to work well in the blue badge service because there are a relatively limited set of questions that can be asked. The Being Digital Team have experienced some scepticism and challenge around whether chatbots can be used more widely to respond to more complicated queries in other service areas. The Department is looking to other local authorities that are using chatbots more broadly in order to learn from the effectiveness of this and opportunities it presents for ESCC. The Review Board supported the opportunity to learn from this.

25. In light of the potential for chatbots to be utilised more by ASCH in future, the Review Board explored both the reliability and limitations of chatbots. The Review Board asked officers about accuracy and usability of the blue badge Digital Assistant and heard that the service did a lot of work when implementing the chatbot to ensure the information on the website is clear and easy to follow; audits of chat logs are undertaken for accuracy; and the chat bot will check whether the information provided is useful and provide ‘hand-offs’ to a member of the team or signpost to other sources of information if needed. Between October 2021 and late September 2022, 3342 questions were asked of the chatbot, with a 93% success rate on it providing the information users required.

26. The Review Board heard that there is a current limitation on use of the chatbot in that cookies (small blocks of data created by a web server while a user is browsing a website) have to be enabled for it to be visible on the webpage. The Review Board also heard evidence from an East Sussex resident and Lay Member of the Being Digital Inclusion Group (see paragraph 66 below for more information about the Group) that in their experience providing support to older people and people with learning difficulties to use digital tools and services, chatbots can be challenging for some people to use. The Lay Member said that the challenges can arise as older people and people with lower levels of literacy sometimes do not know that keywords or phrases can be required to trigger the responses needed for the chatbot to work. This correlated to evidence the Review Board received that the accuracy of the blue badge chatbot results will vary depending on the way the question is phrased and that work is underway to improve this. It was also noted that the use of Artificial Intelligence (AI) in the existing blue badge digital assistant does enable the chatbot to ‘learn’ from the information it receives (such as colloquial phrases). The Review Board sought assurance that chatbots, and broader ASCH website content, were accessible for those with English as an additional language and had confirmation from officers that language used on the website, and by the blue badge digital assistant, was intentionally simple and accessible so that it could be easily translated by online translation tools.

27. The Review Board concluded that on the basis of evidence they have considered, particularly the 93% success rate of the digital assistant on the blue badge webpages, they are supportive of the Department exploring greater use of chatbots on the website; and recognise the role chatbots could play in supporting people to access the Department’s future digital offer. The Review Board acknowledge that there are some limitations to their use and initially had some reservations about their effectiveness and accessibility, but were reassured by officers' responses to questions asked throughout the Review, particularly recognition that chatbots had to be designed so that they used the most simplified, accessible language possible.

Carer’s Assessments and Reviews

28. Another area in which the Department has put in place the technological capabilities for people to self-serve is carer’s assessments. As outlined above, these can be completed completely independently online. Those who require assistance with completing the form can ask for help from Care for the Carers (CFTC), a charity commissioned by ESCC and the NHS to be the Carers Centre in East Sussex and provide support for anyone who cares for someone who would not be able to manage without them. ESCC monitoring shows that use of carer’s self-assessment forms on the ASC Portal is high but this is influenced by a project involving use of the forms by CFTC (see paragraph 31 below).

29. The Review Board heard evidence from the Chief Executive of CFTC which covered that CFTC is seeing an increase in demand for support for carers, and that the charity is therefore supportive of the opportunities digital provides to work differently with partners to meet this demand and to provide options to help carers help themselves, where it works for them.

30. The Review Board asked about feedback CFTC has received about the digital Carer’s Assessments offer from ESCC and the Chief Executive outlined that there is a mixed picture among carers with how much they want to engage with a digital offer. CFTC has heard clearly from some carers that they do not want to use support via digital means whereas others are supportive. The Board did hear from both the Chief Executive of CFTC and the ESCC Strategic Commissioning Manager for Carers that carers are often busy, managing lots of different demands and can be reaching out for support in a time of crisis. In these circumstances, being asked to complete an online form to assess their needs may not always be appropriate or welcomed. The Review Board heard it is therefore important to maintain an alternative option for accessing support and the Chief Executive of CFTC did not feel that encouraging greater use of the online self-assessments was the greatest opportunity digital presented for carers.

31. Instead, the Review Board heard from the Chief Executive of CFTC that digital presented an opportunity for enabling the system that interacts with - and provides support to - carers to work more effectively together, in a joined up way. CFTC has seen the potential for this in being commissioned by ESCC to undertake Reviews of Carer’s Assessments; whereby CFCT are commissioned for two members of staff to conduct reviews over the phone, input information directly into the Carer’s Assessment form on the ASC Portal and then submit that to ESCC. The Chief Executive of CFTC expected planned further developments to this approach to reduce administration time and duplication of work for both CFTC and ESCC. It was also noted that the particular commissioning arrangement CFTC has with ESCC has enabled smooth information sharing, as well as a range of other benefits in how support for carers is provided in East Sussex.

32. Being Digital knows that digital presents a significant opportunity to better join up services and, while not considered in detail as part of this Review, the Programme has a strand of work focussed on delivering projects that will put in place the digital platforms and enablers to support the health and social care system to work better together. These include:

· Delegation Portal - this system allows ASCH practitioners to delegate parts of forms to other practitioners and professionals to complete (e.g. part of a form to be completed as part of a safeguarding investigation), and is intended to be the default route for seeking some information from third parties in future. There are a number of benefits to the portal including reducing the need for transcription from current media, such as email, as information will be entered straight into ESCC’s ASC case management system; it is secure; there is less risk of incomplete information being provided; and it creates a digital audit trail.

· GP to Local Authority referrals – Health and Social Care Connect (HSCC), the telephone contact centre for ASC services in East Sussex, receives thousands of referrals from GPs per month which are currently manually inputted into ASC’s case management system. This project is looking at how these referrals can flow from primary care (using their patient record service) directly into ESCC’s case management system.

· Plexus – this is a project to connect health and care records for practitioners across Sussex.

The current position elsewhere

33. The Review Board also considered take-up of self-service and digital options in other areas. The Review Board heard that account registrations on the ASC Portal have increased year-on-year but are perhaps not yet at a level that could reduce demand from queries to the HSCC team. Form submissions on the ASC Portal have also increased in the last year but there is not a uniform rise across all form types because not all business processes align with the forms on offer, which the Department is seeking to address in the broader move to being ‘digital by default’.

34. In terms of HSCC, the service has seen a natural shift towards people using digital means to contact them. When HSCC was established in 2016, the access point saw about 4,000 contacts a month. Around 20% were by email, 70% by phone and another 10% were by various other methods including fax. Now HSCC see around 7,000 contacts a month, 7% of those are from the ASC portal, 49% by phone and 44% by email. The Review Board queried whether the reduction in use of phone is due to callers not being able to get through, and the service manager explained that while the rate of ‘dropped calls’ was higher than the Department would want it to be, they were not being flagged as a reason for a high number of complaints to the Department at the time of the Review. The service also has an arrangement where if there are long wait times for calls, there is an option for the caller to leave a voicemail and a member of the Team will follow up.

35. Applications for a blue badge can also be completed online (using a GOV.UK form that is processed by ESCC) via ESCC’s webpages and 70% of Blue Badge applications are now conducted online (of approximately 550 applications per month). Blue badge reviews can also be completed online and there is an upward trend in the number of people completing reviews that way. The Review Board heard from the service manager that the pandemic encouraged this shift to a certain extent.

Rationale for moving to ‘digital by default’

36. In reviewing the current position, the Board received a range of evidence on the Department’s rationale, and considerations it had made, in deciding to encourage greater use of digital and self-service options.

Benefits

37. As covered in the introduction, the Scoping and Review Board heard that ASCH anticipate there to be real benefits of the approach for residents, clients and carers in being able to access information and apply for and assess their eligibility for services at a time that suits them and that matches broader expectations of how residents should be able to manage their lives online. During their evidence session, the Lay Member of the Being Digital Inclusion Group confirmed they would expect to be able to undertake more administrative and process-based tasks, such as financial assessments and applications for documents such as blue badges, online. Implementation of further technology to support faster processing of applications and assessments submitted is expected to also improve the experience of clients and carers.

Digital and Internet Usage

38. The Review Board heard at its Scoping Board meeting that in considering setting its direction of travel to encourage greater use of digital and self-service options, the Department has considered whether it is reasonable to expect the ASCH community to be able to self-serve.

39. Figures from the Office for National Statistics (ONS) on internet usage suggest that to a certain extent this is a reasonable expectation, as internet usage has grown, including in age groups that make up a larger proportion of the ASCH client base and may typically be perceived as less likely to use the internet:

· From January to February 2020, 96% of households in Great Britain had internet access, up from 93% in 2019 and just 57% in 2006.

· Internet connections in households with one adult aged 65 years and over had increased by 7 percentage points since 2019 to 80%.

· Internet usage is almost universal in adults up to 64 years. Perhaps expectedly, adults aged 75 and over was the lowest group of internet users in the UK. However, this group has shown the highest increase of internet use, over and above any other age group, at an increase of +13 percentage points between 2018 and 2020.

40. It should be noted that these figures are also pre- the coronavirus pandemic which widely drove increased use of digital and the internet to undertake communication and day-to-day activities such as shopping and accessing GP appointments.

Limitations

41. The Department recognises that there are limitations to use of self-service and digital options in providing services. The Being Digital Strategy highlights national data suggesting that people aged 75 and older and disabled adults are more likely to be non-internet users and, given that these demographic groups form a large proportion of the ASCH client base, digital inclusion is a core consideration in delivery of the Being Digital Strategy and Programme. This is covered in more detail in the second section of this report.

42. There was also recognition in the evidence heard of the distinction between digitisation of process-based transactions, such as completing a blue badge application, and digitisation of the processes people use to contact ASCH services to reach out for support at a time of unexpected change, or of potential crisis, when they may be really concerned for the welfare of their loved ones. The Department is clear about the importance of maintaining an option for residents who need it to be able to access services via a ‘human’ conversation, whether that be over the phone or face-to-face, while also recognising that increasing the digital and self-service offer has considerable potential to free up staff time and resource to focus on providing that human support for those most in need.

Conclusions and support for the planned direction of travel

43. Informed by all the evidence considered above, the Review Board has concluded that it is supportive of the work the Department is undertaking to deliver more self-service options and the planned direction of travel to move towards being ‘digital by default’. The planned direction of travel builds on a natural trend in people choosing digital means to contact and transact with the Department, demonstrated by the shift in methods of contact to HSCC, in growing registrations to the ASC Portal and use of blue badge forms, and the Board also recognises that general expectations of what people should be able to be do online have shifted in recent years, particularly following the coronavirus pandemic.

44. There are opportunities to increase use of OFAs and opportunities to grow use of other self-service forms on the ASC portal and there are expected to be benefits of the approach in making best-use of ASCH resources. While not a core motivation of the Department’s work, the Review Board noted in considering learning from approaches taken by other local authorities that shifting people’s method of engaging with services online has the potential to deliver financial savings.

45. The Review Board particularly welcomes the balanced approach the Department is taking to this planned direction of travel, and the recognition of limitations in the approach. The Review Board were reassured by the recognition throughout the review that ‘human options’ for interactions with ASCH services must not be lost and that digital inclusion is a core consideration of the Department’s work.

46. More broadly, there are clear benefits to use of digital for joining up service delivery and the Board are very supportive of ambitions Being Digital has to deliver this. The Review Board also concluded that it is supportive of any future efforts to streamline processes, such as that planned for financial assessments, particularly in light of evidence that time may be a limitation to carers, in particular, completing self-assessments and assessments on behalf of others.

Recommendation 4

The Department should continue to explore opportunities to simplify operational processes alongside implementing the Being Digital programme.

47. Finally, as part of its evidence gathering, the Review Board asked if the Being Digital Programme has metrics or targets to measure success. It was confirmed that at the time of the Review, the Programme was working to put in place a range of measures to track success of its projects with clear, ambitious, but realistic, targets wherever possible. The Review Board asked for the People Scrutiny Committee to be kept up to date on progress against those targets.

Recommendation 5

The People Scrutiny Committee should be informed of progress against Being Digital programme targets as part of the monitoring of this Scrutiny Review.

Part 2: Ways to support behavioural and cultural change

48. To address the remaining key lines of enquiry for the Review, the Review Board considered evidence on the behavioural and cultural changes required to support greater take-up of online and self-service options and how that change could be supported.

Behavioural change programme

49. The ASCH Department has a programme of work underway with the University College London (UCL) Centre for Behaviour Change to look at behavioural changes required to support delivery of the Being Digital Programme and the move to becoming ‘digital by default’. The work is applying behavioural science to better understand the factors that influence people to act and, with that understanding, to identify what interventions could support the shift to people using new digital channels. A particular benefit of the programme is that it is upskilling staff to apply behaviour change approaches to support other future transformation work.

50. The Review Board held an evidence session on the Department’s work with UCL, and heard that the work is taking place in three phases, with phases one and two complete at the time of the Review. The first phase involved initial capacity building sessions with attendees from ASCH learning how to use the behaviour change wheel.

The behaviour change wheel: A new method for characterising and designing behaviour change interventions | Implementation Science | Full Text

Figure 2. Behaviour Change Wheel

51. Phase two focussed on applying UCL’s approach to the topic of maximising completion of OFAs, identifying key actors (including staff in HSCC, ASC practitioners and clients) and target behaviours required to support this ambition (including HSCC always asking for and recording email addresses of clients and carers, ASC practitioners promoting and always sending the link to the OFA, and clients using the link to complete and submit the OFA). Influences on these behaviours were then considered, such as - in the case of staff - emotions and habits they may have formed based on perceptions of clients. A range of interventions were then identified to support behaviour change of ASCH staff as an initial outcome of the work, including producing guidance on OFAs for staff, which the Department is taking forward. The third phase will involve UCL providing in-depth consultancy support for the application of the behaviour change wheel to a broader, more complex area that supports the Department’s move to being ‘digital by default.’

52. The Review Board asked clarifying questions on the work with UCL as part of the evidence session and concluded they were supportive of the work underway. The Review Board were encouraged to hear in evidence received that work with the UCL’s Centre for Behaviour Change is considered best practice. The Review Board also noted that this work will enable the Department to consider many different aspects of encouraging behaviour change, such as considering the role of language and ways to talk to people’s aspirations, rather than their deficits, in encouraging use of digital services.

53. The Review Board asked about the focus and timeline for the third phase of work with UCL and heard that the focus was being agreed and that the phase was due to be delivered in the next six to nine months (by the end of summer 2023). The Review Board asked for the People Scrutiny Committee to be updated on the outcome of this final phase of work.

Recommendation 6

The People Scrutiny Committee should be informed of the outcome of the third phase of the Department’s Behavioural Change work with the UCL as part of the monitoring of this Scrutiny Review.

Staff engagement and communications

54. The Review Board considered a range of evidence that suggested well thought-out communication and engagement with ASCH staff is required to support behaviour change by ensuring staff understand, are convinced of, and are able to promote the benefits of digital and self-service options.

55. As outlined in part one of this report, another local authority shared learning with ASCH that giving careful consideration to the way increased use of OFAs was described to staff reduced anxiety about the transformation. Similarly, the ESCC Head of Service for Hospitals, Finance and Continuing Healthcare gave evidence that staff in their service have mixed views about the move to increased use of OFAs, with some very keen to move to self-assessments and others more sceptical. They therefore suggested it is important that the benefits of a digital approach are understood and shared among staff. They suggested the Department needs to have a clear understanding of what the benefits of online and self-service processes are for residents, clients and carers, with the ability to share case studies and place personal voices centrally as much as possible in communications about the change. They felt this would help reduce scepticism and support a shift in staff mindset and culture to recognise that many people are able to carry out self-assessments online.

56. The Review Board also heard evidence from the Programme Manager for the NHS Digital First Programme in Sussex, a four-year NHS England programme working to increase the availability and use of digital options in primary care services. In their evidence session, the Programme Manager explained that early and good staff engagement that highlighted the benefits and ensured staff had the skills and knowledge to support the changes underway had been key to implementing the transformation Digital First has undertaken. Finally, learning from a range of national research and case studies on the approach taken by other local authorities to encourage behaviour change to deliver ‘channel shift’ (where service users access or interact with services via channels other than those to which they normally choose) emphasised the importance of considered, proactive staff engagement that demonstrates the benefit of the change.

57. Having considered this evidence, the Review Board identified that, beyond being able to promote the benefits, staff will also play an important role in identifying the digital capabilities of the clients, carers and/or residents they interact with to determine which channel they should use and ensuring they get additional support with using technology if needed (see digital inclusion section below). They may also play a role in helping people to build their digital skills by talking them through ASCH’s digital processes so that they are able to undertake such processes themselves in future. The Review Board also noted from the evidence considered that some preconceptions about people’s, particularly older people’s, digital abilities may need to be challenged. The suggestion of producing case studies and centring personal voices in communications may assist with this.

Recommendation 7

The Department should reflect feedback from residents who have benefited from digital and self-service options in communications to staff.

58. The Review Board asked how ASCH officers plan to communicate the move to being ‘digital by default’ to staff and the Being Digital Delivery Manager explained that the Department is in the process of developing the approach. There will not be one single communication exercise and instead Being Digital will be working over the next year or so to bring staff, particularly in teams that are rolling out new digital platforms and self-service options, on a journey where the intention behind, and benefits of, the platforms being put in place are better understood. This would build on the learning about engaging with and supporting staff to increase take-up of OFAs that had been identified by the work with UCL outlined above. The Review Board noted that staff in services rolling out new platforms may themselves require new training and development to be able to support clients, and heard from officers that work is taking place to ensure staff are trained on the digital tools and platforms being introduced. This includes incorporating training on digital options as part of the mandatory training of all new ASCH staff.

59. The Review Board heard as part of the Review that new HSCC staff already receive ‘digital inductions’ on East Sussex 1Space and the digital offer of other services and partner organisations to ensure they are able to promote and signpost to these. The Review Board suggested that, building on this approach, information on Being Digital and the Department’s planned direction of travel to being ‘digital by default’, as well as the digital and self-service platforms on offer, should be included in all new staff inductions. The Review Board also supported a suggestion that for those staff who are in an area undergoing transformation in rollout of a new platform, the topic should be included in team meetings, and individual supervision meetings where appropriate, as an opportunity to identify any training or support needs and as a mechanism for staff to raise any concerns about implementation. The Review Board also agreed the topic should also be included in regular departmental communications.

Recommendation 8

Information on Being Digital and the digital and self-service platforms on offer in ASCH, should be included in all new ASCH staff inductions.

Recommendation 9

Digital transformation should be included as a discussion point in team and 1-2-1 (where appropriate) meetings within areas undergoing rollout of a new digital or self-service platform; and in ongoing departmental communications (such as Yammer, To The Point and Brief Encounter).

Design and testing

60. The Review Board also considered a range of evidence that suggested design and testing of digital platforms is key to ensuring their take-up and to building people’s confidence in using them.

61. Key learning from case studies from other local authorities that have encouraged behaviour change to drive channel shift showed that considerable focus on good design of webpages and online services is a fundamental first step to encourage take-up of the services put in place. The Review Board also heard in evidence from ASCH service managers that they know the Department’s online offer needs to be stable, reliable and as easy to use as established channels (e.g. picking up the phone) to encourage people to use it and have confidence in it.

62. In light of this evidence, the Review Board sought assurance that ASCH’s digital offer is simple, accessible and well-designed. The Review Board heard that ASCH works closely with services to design self-service forms and that they are designed to emulate best practice, such as GOV.UK forms; ensuring they are easy to fill out with lots of blank space and use simplified language. An officer in the ASCH Information, Guidance and Insight Team ensures ASCH’s online offer is accessible and the ASCH webpages have passed an assessment of digital accessibility against Government standards, including website usability. In terms of testing, a user testing system is used to test the navigability and user-experience of online forms before they are made live. It was also confirmed that ASCH do use tester groups to test new forms or platforms being developed by the Department, although this may not be conducted in person.

63. Snapshots of the Online Financial Assessment process were circulated to the Review Board the Board confirmed that it looked to be a reasonably designed process. The Review Board also discussed with officers ways that learning from the behavioural change work with UCL could be incorporated in designing future forms, to ensure they are Easy, Attractive, Social and Timely (EAST) (e.g. including checklists and checkboxes at stages throughout the form to provide a sense of accomplishment and progress while completing forms).

Digital inclusion

64. Digital inclusion involves ensuring that the benefits of the internet and digital technology are available to everyone. Enabling digital inclusion is a county-wide ambition that a number of organisations in the public, voluntary and private sector – including ESCC – play a role in delivering. This is achieved through a range of strategies, schemes and projects that work to increase access to digital devices, the internet, and digital skills and literacy training opportunities. It is a complex issue to address, with a multitude of factors - ranging from deprivation to skills gaps to internet connectivity – all impacting on risk of digital exclusion.

65. Digital inclusion is one of three main principles of the ASCH Being Digital Strategy and the Review Board heard from officers throughout the Review that they understood the importance of digital inclusion for enabling residents to take advantage of online and self-service options. This is particularly the case because, as covered in part one of this report, national research shows that the demographic groups that form a large proportion of the ASCH client group (older people and adults with disabilities) are less likely to use the internet.

66. Being Digital has in place two key strands of work to enable digital inclusion. Governance of the Being Digital Programme includes a Being Digital Inclusion Group which has been established to consider inclusion and accessibility of Being Digital projects, particularly for clients with disabilities. Officers confirmed for the Review Board that the group will consider the inclusion implications of the Department moving to being ‘digital by default’ in detail at an upcoming meeting. The Review Board considered the Terms of Reference and work of this Group and concluded they were very supportive of it and its work to ensure no group is disadvantaged by Being Digital developments.

67. The Department is also involved in a One Council Digital Inclusion Programme. This programme is working to join up and scale up the digital inclusion offer in different areas of the Council. Through this, Being Digital are establishing a formal referral route from ASCH to a pilot, targeted scheme being run out of the Library Service that can loan devices/ allocate data or offer skills training to those with an identified digital inclusion need. Other work that the programme is undertaking includes gathering a list of all providers offering digital inclusion interventions to East Sussex residents in 2021 and 2022 to produce a Partner Management Database. This database is helping to build relationships and collaborative delivery of digital inclusion, with a longer-term ambition to identify gaps in provision to be addressed through either restructuring existing offers or considering the case for new provision. The programme is also working to show places to get online on a map on East Sussex Community Information Services.

68. The Review Board heard from witnesses about a wide range of other national and local work taking place to increase digital inclusion. This includes:

· Locally - county-wide IT for You computer skills sessions run out of East Sussex libraries and a scheme local to Hastings run by the Education Training Consortium proving IT support sessions.

· National organisations - the Good Things Foundation works across the country to address the ‘digital divide’ through a national community network, databank and device bank for people in need; and AbilityNet provides free online resources and a network of over 300 community-based volunteers to help individuals with any disability, of any age, to use all kinds of digital technology.

· Targeted resources – including Digital Inclusion programmes funded through NHS Sussex to support digitally excluded people to access healthcare using digital tools; and specific resources for carers, such as Computer Help at Home, an ESCC commissioned service from the Association of Carers where volunteers provide one-to-one support to carers in their own home to help them learn how to use technology.

· Private sector – the Review Board heard that as many banks and utility companies have moved their interactions and access to their services entirely online, they can play an important role in upskilling people. The closure of some high-street banks was noted as potentially limiting this as an option for some people to access.

69. In considering this, the Review Board identified that while there are clearly a range of resources and support available, there is potentially a need to ensure there is good awareness of the support available among residents. This was supported by evidence given by the Lay Member of the Being Digital Inclusion Group who suggested that people who are reluctant to use, or may struggle with, digital technologies may not know about the range of support that is available to them. The Lay Member suggested that this support could be promoted to younger people who can update older relatives on the support available. The Review Board also felt there is a need to ensure the those working with people who may be digitally excluded are aware of support on offer and able to sign-post to it. The Review Board encouraged the Department to ensure it was promoting and taking advantage of the range of digital inclusion resources that were highlighted by witnesses in implementing the move to being ‘digital by default’.

Recommendation 10

The Department should continue to work with colleagues through the One Council Digital Inclusion programme to map the digital inclusion offer in East Sussex, and, where appropriate, share this with adult social care and health staff and partners.

Recommendation 11

The Department should ensure it is promoting to staff, and utilising, the range of national and local digital inclusion resources and schemes available in moving to being digital by default.

Trust

70. The Review Board considered evidence that suggested lack of trust is also a barrier to using online and digital services, and to digital inclusion more generally. The Programme Manager of the NHS Digital First Programme shared engagement that the programme had undertaken with the patient population in East Sussex which found that while people may be willing to use digital technology for activities such as online shopping, emails, online banking and booking holidays, they were generally more concerned with it being used for healthcare. Reasons people gave included a lack of trust in the reliability of technology and not knowing what the ‘official’ app to use was, alongside issues with internet access and uncertainty about whether they had the digital skills necessary. These reservations about using digital technology for healthcare may translate into lack of trust in the reliability of technology for accessing digital ASCH services.

71. Being Digital is aware that trust may be a potential barrier to take-up of digital options and the Being Digital Inclusion Group has initiated a project looking at how to improve trust in digital applications, including considering safeguards that could be put in place to ensure vulnerable people interacting with the Department’s digital applications and platforms know that they are legitimate and can be trusted (similar to the way banks provide advice on how customers can know they can trust digital communications or an online banking app). There may also be opportunities to explore ways to improve trust through the ongoing behavioural change work with UCL.

72. The Review Board took the opportunity to discuss ways to build trust in ESCC’s digital services with two witnesses who gave evidence to the Review. The Board asked the Lay Member of the Being Digital Inclusion Group - who also undertakes work to support older people and people with learning difficulties to use digital tools and access digital services - how they build trust with the people they undertake support sessions with and they explained they ensure the details of the registered charity they work for is displayed on promotional material they use. The Review Board and Lay Member recognised that ESCC as a large organisation can face distinct challenges in building trust with residents that smaller charities and community organisations can overcome. The Lay Member suggested that learning could be taken from a past digital inclusion scheme they knew of where a service provider (a housing association) had partnered with a recognised charity to deliver the scheme. The involvement of the recognised charity had acted as a bridge between the community and those working for the service provider, to achieve the aim of increasing digital inclusion.

73. This suggestion was supported by evidence the Review Board heard from Eric Kihlstrom (Chair of the London-based charity OpenAge, UK Ambassador to Aging 2.0 - a global network focussed on improving the quality of life for older people, and former Interim Director of the UK Industrial Strategy Challenge Fund on Healthy Ageing). OpenAge is a London-based charity working to provide physical activity and learning, arts, culture and social opportunities for anyone aged over 50. The charity moved its programme of activities online in the pandemic and had success in encouraging just under 40% of its 4000 active members to take this up. The digital offer has been so popular that post-pandemic, OpenAge has a hybrid model of delivery and many of its online sessions are oversubscribed. OpenAge found that key to enabling this transition was that their members trusted the charity, which also provided support with ‘How to use Zoom’ sessions via phone to help members access its digital offer. Eric Kihlstrom recommended that leveraging existing, local ‘trusted networks’ could be key to increasing digital inclusion and, thereby use of digital platforms and take-up of online services. Such ‘trusted networks’ could be the NHS; large national charities present in East Sussex, such as AgeUK and the Citizen’s Advice Bureau; smaller decentralised charities such as the Good Neighbours Scheme; and the digital inclusion charities outlined above which often have networks of volunteers that could bolster existing digital inclusion schemes.

74. The Review Board recognise that there could be a number of benefits to using partnerships to support and enable the increased take-up of digital services. This includes potential opportunities to promote and signpost to ASCH’s digital platforms; and to signpost into organisations that could improve the digital skills and inclusion of those that come into contact with partner organisations. The opportunity for better signposting to ASCH’s digital offer is supported by evidence the Review Board heard from the NHS Digital First Programme Manager that there may opportunities for ASCH to better signpost to the digital offer in primary care and vice versa.

Recommendation 12

The Department should explore opportunities for partners, including voluntary sector organisations, to support engagement with and signposting to ASCH’s digital offer.

75. Eric Kihlstrom shared other resources with the Review Board that he suggested may support ASCH in addressing the challenge of encouraging greater take-up of digital ASCH services, including joining the Healthy Ageing Challenge Community of Practice, which shares knowledge and innovations across sectors to support healthy ageing in the UK; and considering opportunities to work with the University of Sussex Innovation Centre. The Review Board encouraged officers to take advantage of these suggested resources and officers committed to do so.

Digital ambassadors

76. As part of this Review, the Review Board has considered the role that a digital ambassador scheme might play in supporting take-up of the digital and self-service offer from ASCH. The Review Board acknowledge that there are a number of different models that could be considered. Case studies of other authorities that have delivered channel shift through behavioural change that the Review Board considered showed that some councils have asked members of their workforce to act as ‘digital champions’ for channel shift, who can be powerful advocates for digital channels amongst their staff peers, clients and other residents, as they are often residents in the council area themselves.

77. Rather than a champion scheme, the model of digital ambassador mostly discussed by the Review Board involves employed staff or volunteers (either specifically recruited, or part of an existing voluntary organisation) supporting residents, clients and/or carers to use digital platforms. The Review Board considered there to be a number of benefits to such a scheme, including identifying digital exclusion and referring people to support available; and providing peer-to-peer, in person opportunities to learn how to use digital technology and services.

78. One local example of such a scheme is the Digital Ambassador project implemented by the NHS Digital First Programme. The Review Board received a detailed presentation on this project from the Project Manager which covered that the project is a Sussex-wide pilot to evaluate the impact of having a funded staff member in Primary Care Networks that meets with patients to demonstrate the benefits of, and how to use digital healthcare tools. Ambassadors are currently employed in nine PCNs and are employed directly by GP practices, typically one day a week, to demonstrate the benefits of and provide information and training on digital healthcare tools such as the NHS app, online consultations, NHS111, GP practice websites and the Patient Access System. In addition to supporting patients and practices, ambassadors have a network to share ideas, best practice and learning. Different delivery models have been used by the various digital ambassadors, with one ambassador partnering with a local community group and another working closely with a digital inclusion partnership in Brighton & Hove.

79. The project has had positive feedback from patients who have said they are grateful to have a person to sit with them face to face to show them how to download, register and understand the scope and benefits of digital healthcare tools. GP practices have said the demand for the scheme is evident and the scheme has helped address a need that reception staff do not have time to assist with. The pilot will be evaluated this winter and the outcome of that evaluation is expected in Spring 2023.

80. The Review Board concluded that there were clear benefits to a digital ambassador scheme and to the approach taken through the NHS Digital First Programme. The Review Board asked that officers evaluate the benefits and costs of establishing a digital ambassador scheme in ESCC. This should be informed by learning from evaluation of the NHS pilot Digital Ambassador project, including the benefits and achievements of the different delivery models used. The Review Board also asked that the Department consider other models used elsewhere to identify what could work best for ESCC.

Recommendation 13

The Department should consider whether a Digital Ambassador Scheme could provide added value to Being Digital, informed by learning from the NHS Digital First Digital Ambassador pilot when it concludes, and consideration of other models.

Conclusions

81. The Review has considered a broad range of evidence and concluded it is supportive of the Department’s ambitions to be ‘digital by default’ and the balanced approach the Department is taking to this planned direction of travel. The Review Board has identified that there are opportunities to capture learning from other local authorities and from ongoing rollout of digital services to ensure the offer being put in place is taken advantage of by residents, clients and carers.

82. There are a number of positive projects and programmes already underway - including one on behavioural change this is specifically working to address the lines of enquiry for this Review - and the Board asks that the People Scrutiny Committee is kept up to date on progress and outcomes of those.

83. The Review Board has identified areas where activity, both internally in ASCH and with partners, could support greater use of the platforms and innovations being put in place that it is recommended that the Department now explore in greater detail.

84. Overall, throughout the Review the Board has found the Department to be very open to questioning, challenge and consideration of alternatives. The Board has been encouraged to find that the Department is taking an iterative approach to this area of work and constantly developing, adapting and improving its approach in response to feedback and consideration of learning and best practice.

Appendix

Scope and terms of reference of the review

The Review was established to consider and make recommendations on the following:

What cultural and behavioural changes are needed to support greater use of online services, ‘self-service’ options and adoption of a ‘digital by default’ approach by the Department.

The Scoping Board agreed that considering the above in all service areas within the ASC Department would be too broad. Instead it was expected that the review would particularly focus on the following service areas:

· Financial assessments

· Reviews (especially carer reviews)

· Information, advice and signposting

· Carer assessments

1. Within the service areas outlined above:

a) To what extent are residents, clients, carers and/or providers currently using online services, self-service options and/or digital communication channels?

b) If there is high or low use, why is that?

c) Why do people choose to use the channels they do to communicate with ASC in these areas?

d) What cultural and behavioural changes are needed to support greater use of online services, self-service options and/or digital communication channels?

e) How can that cultural and behavioural change be encouraged?

2. The review should also look more broadly at:

a) What insights are there from other councils that have a high take-up of online services and have implemented a ‘digital by default’ approach on the cultural and behavioural changes needed?

b) How have they encouraged those?

Board Membership and project support

Review Board Members: Councillors Penny di Cara (Chair), Nuala Geary and Wendy Maples.

The Project Manager was Beth McGhee, Senior Policy and Scrutiny Adviser with additional support provided by Melanie Funnel, Business Partner HR&OD and Patrick Major, Scrutiny and Policy Support Officer.

Paul Hussey, Interim Assistant Director, Planning, Performance and Engagement; Jacqueline London-Willis, Head of Business Development and Insight; and Alex Callaghan, Being Digital Delivery Manager provided ongoing support to the Board throughout the review.

Review Board meeting dates

Scoping Board meeting – 5 July 2022

First Review Board meeting – 21 September 2022

Second Review Board meeting – 7 October 2022

Third Review Board meeting – 2 November 2022

Fourth Review Board meeting – 14 November 2022

Final Review Board meeting – 2 December 2022

Witnesses providing evidence

The Board would like to thank all the witnesses who provided evidence:

ESCC officers

Sonny Butler, Head of Service – Hospitals, Finance and Continuing Healthcare

Alex Callaghan, Being Digital Delivery Manager

William Harvey, Performance and Planning Officer

Jaqueline London-Willis, Head of Business Development and Insight

Alison O’Shea, Operations Manager, Health and Social Care Connect

Tamsin Peart, Strategic Commissioning Manager

External Witnesses

Calvin Humphries, Lay Member of Being Digital Inclusion Group

Jessica Kaye, Head of Programme Sussex, Digital First – NHS England and Improvement

Eric Kihlstrom, Chair of OpenAge andUK Ambassador to Aging 2.0

Jennifer Twist, Chief Executive, Care for the Carers

Amanda Waller, NHS Sussex Digital First Project Manager

Evidence papers

Item	Date considered
Adult Social Care & Health digital strategy 2020-2023	July and September 2022
Being Digital Roadmap	September 2022
Being Digital Projects overview for scrutiny	September 2022
Adult Social Care Portal Dashboard – August 2022 Key Data	September 2022
NHS Digital First Primary Care – Overview	October 2022
Summary of national research and case studies: · Rochdale Borough Council: A behavioural approach to digital channel shift (2019) · Engaging Citizens Online Briefing – Promotion of online services (2016) · LGA Digital Experts Programme channel shift case study: Dacorum Borough Council (2017) · Suffolk County Council: LGA Design in Social Care Programme (2019) · Lincolnshire County Council: Social Care Digital Innovation Programme (2021)	October 2022
Behavioural Insights activity in ASCH	October 2022
Online Financial Assessments – learning summary	October 2022
Being Digital Inclusion Group Terms of Reference	November 2022
Role description – Being Digital Inclusion Group Lay Member	November 2022
ASC Portal registrations by job title and organisation	November 2022
Online Analytics in Adult Social Care and Health – a summary for scrutiny	November 2022
An introduction to A Categorisation Of Residential Neighbourhoods (ACORN)	November 2022

Contact officer: Beth McGhee, Senior Policy and Scrutiny Adviser Telephone: 01273 335828
E-mail: beth.mcghee@eastsussex.gov.uk