Appendix 1
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PEOPLE SCRUTINY REVIEW OF USE OF DIGITAL AND TECHNOLOGY IN ASCH – ACTION PLAN 6 Month Review |
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SCRUTINY RECOMMENDATION |
DIRECTOR’S RESPONSE AND ACTION PLAN |
Update Notes |
TIMESCALE |
RAG (red, amber green) rating |
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R1. |
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.
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The department will continue to ensure that feedback is collated on usage of the online forms for financial assessments (and other transactional forms).
For our digital offer to be successful it is important that we take an approach of iterative improvement. One advantage of digital is the range of measurable data that can be captured passively – so we will explore how we can look at the statistics around how many people started a form, how many completed, at what stage they dropped out, etc.
Likewise, we have already added in active feedback mechanisms to our assessment pages by way of ‘customer thermometers’. These widgets enable users to rate their experiences and, should they choose to do so, leave free-text comments.
We will continue to use these methods to monitor performance of assessment forms and will explore how monitoring can be enhanced to understand any barriers to their completion. For example, we will look at opportunities to collect qualitative data from clients around the barriers to usage or completion of the OFA forms. |
A new operating model for financial assessments went live on the 12th of June 2023. In this new model the Online Financial Assessment (OFA) will be offered as the default by which clients share information about their finances with ASC&H. Crucially, it will not be the only option – merely the first one offered.
Uptake statistics will continue to be captured on our portals dashboard, where we expect to see a marked shift towards more Online Financial Assessments being commenced and completed.
We continue to monitor feedback through customer thermometers, complaints and compliments; and responses will be used to make changes to tools and processes as needed to ensure that our digital tools and processes are user friendly and being appropriately utilised. |
Ongoing as
of December 2022
March /
April 2023 |
Green |
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R2. |
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Data on
take-up of the Online Financial Assessments (OFAs) and related
feedback is currently captured and routinely circulated within the
department via a portals dashboard. We will update the People Scrutiny Committee in monitoring reports of this review with this data and commentary to assist with interpreting the information.
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As both a proportion of total incoming forms, and as a proportion of all financial assessments, those received via online portals has been low.
A change in process, in December 2022 saw these forms removed from the public section of the portal pages. Instead they became accessible only via a link sent out by practitioners. This is because for an OFA to be meaningful, eligibility for services needs to have been established first.
In the
year to date, 290 links have been sent to clients and 86 returned,
representing a completion rate of 30%. Recent insight has shown
that the vast majority of OFC submissions take place between 11am
and 5pm on weekdays – although almost one-third of all
submissions take place outside of this time frame. It is anticipated that the new operational process for financial assessments that went live on 12 June 2023, which places much greater emphasis on asking clients whether they are able to provide their financial information through the portal, will see this figure increase further. We will continue to monitor this through our dashboard and customer feedback.
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Ongoing as of December 2022 |
Green |
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R3. |
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.
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The department will continue to follow the best practice of learning from the successes and challenges of other local authorities who have implemented similar improvements.
Where Online Financial Assessments (OFA) in particular are concerned, we have looked into the detail of other local authorities’ improvements to financial assessment protocols. Our focus will be to look at areas for improvement where the other authorities use the same case management and payment systems as us.
Robotic Process Automation (RPA) opportunities are being explored in relation to online financial assessments, including the automation of tasks such as accepting assessments, matching submissions with client records, managing workflows for staff and sending reminders to clients to send further documentation where a submission is incomplete.
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In developing the new financial assessment operating model (referenced earlier), work was completed to explore how OFAs are processed by other authorities, and we will continue to explore opportunities for wider learning moving forwards.
In terms of seeking to emulate local authorities, Surrey County Council have initiated some reforms in terms of their processes which they report has brought down assessment wait times significantly. We have attended information sessions and demonstrations about what they have put in place, which includes a series of automations that have introduced efficiencies into their workflows. Specifically, these have reduced the need for human intervention to move submissions into correct work-trays, and to automatically send reminders to clients who have submitted incomplete supporting evidence.
As part of the new financial assessment process that has been implemented options for robotic process automation have been explored. For these to be successful they need to build on an established workflows and as such we will need to allow some time for the new process to embed before any automations are put in place; however, opportunities for RPA will continue to be a focus moving forwards. As of June 2023 the same checks apply whether we complete the financial assessment online, on the telephone or a paper form sent in the post:
If we have concerns about the legitimacy of the information being provided, we will escalate the case to our internal counter fraud team.
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Ongoing as
of December 2022
July to September 2023 |
Green |
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R4. |
The Department should continue to explore opportunities to simplify operational processes alongside implementing the Being Digital programme.
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The department will continue to ensure that digital developments are informed by and support operational requirements, and are implemented alongside improvements to operational processes.
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The programme priorities are led by operational requirements, and any digital developments being taken forwards need to have a clear operational business case and operational sponsor / lead in order to be considered. It is important to ensure that there are realistic expectations about where digital can be used and where practice or process changes are needed, often it is a combination of both of these things that is needed. The Being Digital team continues to work with operational teams to understand their current priorities and how and where digital developments can support practice and processes through continued engagement and communication. Ongoing engagement with services is critical to ensure that any digital developments are driven by and can meet their needs, although it is also important to recognise that there is no guarantee that automation or digitisation will solve problems they face; and there may be a need for business process improvements before and digital developments can progress. |
Ongoing as of December 2022 |
Green |
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R5. |
The People Scrutiny Committee should be informed of progress against Being Digital programme targets as part of the monitoring of this Scrutiny Review.
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The Departmental Management Team (DMT) have agreed a number of targets relating to the strategic decision to go ‘digital by default’.
Each of these targets will be reported against and progress will be presented back to DMT on a quarterly basis. We propose that the progress against targets can also be submitted to the People Scrutiny Committee at times aligning with reporting to DMT.
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Progress against targets are below:
50% of all online financial assessments done online, and 100% of eligible clients offered an Online Financial Assessment: The new operating model embedding online financial assessment as the first option to clients went live on 12th of June 2023, when we expect to see an increase in the volume of OFAs being submitted. An update will be provided in the next report.
Online form is default route for members of the public to raise a safeguarding alert: Currently, the safeguarding form is the most used online form, accounting for 44% of all submissions in April 2023. Usage is up by 34% on April 2022’s figures.
However, through engagement with Health and Social Care Connect, our thinking on placing an emphasis on members of the public raising online safeguarding alerts has changed.
Professionals remains the single highest user of the form: of the 688 safeguarding alerts raised since the beginning of January 2023, 665 came from a professional.
It is pleasing to see this form being used so widely (and its take-up mirrors a wider trend of professionals becoming the dominant users of online forms).
Initially we had wished that more members of the public would use this form. Nonetheless, professionals are most comfortable reporting safeguarding concerns this way as they are more likely to have knowledge and guidance as to what information is needed within an alert. Members of the public are generally less aware, so a guided conversation with an HSCC colleague – most likely a telephone call – remains the best guarantee of a good quality of alert.
25% year-on-year increase of occupational therapy referral form: Occupational therapy referral form submissions are up by 45% compared to May 2022, averaging 28 a month in the year to date.
In addition to support a Being Digital approach targets were set around active records that have an email address and mobile phone number attached to them. To support this significant system cleansing has been required and is currently underway, as such the percentages will be subject to change whilst this work is completed.
75% of active records have an email address attached to them: 43% as of April 2023
85% of active records have a mobile phone number attached: 60% as of April 2023
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Quarterly basis from March 2023 |
Amber |
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R6. |
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.
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Work is
currently underway with UCL to identify potential areas of change
to support new ways of working.
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Work continues with UCL to put together a set of interventions that are designed to empower practitioners and frontline workers to promote the use of online resources. An intervention plan is being developed at the time of writing.
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September 2023 |
Green |
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R7. |
The Department should reflect feedback from residents who have benefited from digital and self-service options in communications to staff.
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We are currently collating information through customer thermometers and analytics on our forms and as additional self-serve options are implemented, we will evaluate the impact of these developments through residents’ feedback and share this with staff as appropriate (see R9).
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Feedback in terms of usage and satisfaction continues to be gathered in the form of analytics and customer thermometers; the latter are administered in the Department by the Information, Guidance and Insight Team, and are sent to service managers for information and/or when a response is required.
In addition, where achievable, Being Digital is collating feedback from individual projects. For example, we are, as of May 2023, beginning to receive qualitative feedback from carers and practitioners involved in the TECS robotic pet pilot trial.
A new communication plan for Being Digital is being developed based on feedback received. |
From March 2023 |
Amber |
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R8. |
Information on Being Digital and the digital and self-service platforms on offer in ASCH, should be included in all new ASCH staff inductions.
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The Being Digital Team will work with the Training, Workforce and Organisational Development Team to explore how the training offer can be enhanced to include reference to digital practice and self-service; this will include our ‘digital by default’ direction of travel being reflected in the appropriate induction e-learning modules.
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Discussions are underway with the Training, Workforce and Organisational Development Team as to whether it will be possible to include any information about ‘digital by default’ in e-learning induction modules.
Being Digital, and ‘digital by default’, now forms part of the quarterly Welcome Morning session for all new starters in ASC. |
From March 2023 |
Amber |
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R9. |
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).
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The department is planning on circulating positive messages and case studies to demonstrate the value of clients, partners and providers taking advantage of our digital offer.
In the majority of instances, 1-2-1s and supervisions for practice staff are given over to discussions about caseloads. However, in discussions where wider departmental issues are discussed – for example, in team meetings – it would be appropriate to discuss ‘digital by default’. Guidance will be created by the Being Digital team for managers of teams and services to help shape discussions.
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Business Development & Insight’s work with UCL on behaviour change has affirmed that, for the vast majority of instances, 1-2-1s are not the appropriate time to talk about digital transformation.
However, the circulation of positive messages and case studies is an activity that has been highlighted as potentially useful in the work taking place with UCL, and a more formal framework for embedding digital transformation within departmental communications is being developed within Being Digital.
For now, Being Digital continues to publish messages about individual projects in publications such as To The Point and Brief Encounter. |
From March 2023 |
Green |
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R10. |
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.
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The department will continue to work with the One Council Digital Inclusion Programme, which Being Digital is involved with through membership of the programme management group.
Information around digital inclusion resources will be shared with appropriate services both within ASC and with external partners, such as the NHS Digital First programme, which concerns itself with Sussex-wide digital transformation in primary care.
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At the time of the initial recommendations report, ASC continued to work closely with the One Council Digital Inclusion programme – the Being Digital Delivery Manager was a member of the working group and regularly attended programme board meetings.
However, in March 2023, the One Council Digital Inclusion programme has discontinued. Funding had only been agreed up until October 2023, but the programme manager’s decision to move on to another role hastened its conclusion. Therefore, further consideration needs to be given as to how digital inclusion can be taken forwards within ASC&H. |
January – March 2023 |
Green - closed |
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R11. |
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.
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Once the
mapping of digital inclusion activity has been completed, the
department will ensure that digital inclusion resources will be
made available. |
As per the answer to recommendation 10, the One Council Digital Inclusion Programme has been concluded.
However, there are still local and national digital inclusion resources to which clients and carers can be signposted and work is underway to make these resources easier to search and find on directories such as East Sussex 1Space and ESCIS. |
Ongoing – commencing March 2023 |
Amber |
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R12. |
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The department will continue to work closely on shared aims and outputs with NHS-led programmes such as Our Care Connected and Digital First.
The department acknowledges that more can be done in this area. The One Council Digital Inclusion Programme will lead on some of this work. Project managers will be asked to include voluntary, community and social enterprise (VCSE) organisations in communications plans to enable more proactive promotion of ASC’s digital offer.
We will also explore the option of resurrecting the digital engagement sessions which began prior to the covid-19 pandemic but were put on hold shortly thereafter.
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Again, the conclusion of the One Council Digital Inclusion Programme means we cannot fulfil all our ambitions in this area.
One output of the OCDIP has been a digital inclusion checklist for anyone starting up any project with any significant focus on digital. Amongst the considerations are the role that VCSE organisations could perhaps play in supporting clients to access
No headway has yet been made in re-starting the digital engagement sessions with partners that took place pre-covid; time, prioritisation of other activity and capacity to organise have proved barriers to this work taking place. |
Ongoing as of December 2022 |
Amber |
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R13. |
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.
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The department will continue to monitor the NHS Digital First programme’s Digital Ambassador Pilot alongside consideration of other models.
Once the pilot has concluded we will request closure, benefit realisation and evaluation reports. We will use the conclusions from NHS Digital First to help inform any decisions that Being Digital makes around a similar scheme. |
The pilot of the NHS Digital First’s Digital Ambassador project has now finished and an evaluation was published in May 2023.
Digital First have made the decision not to continue funding the project; however there will be resources in place and a toolkit planned to support practices to implement the role and to find other funding streams.
The Digital Ambassadors were contactable either face-to-face, over the telephone or in group sessions. Between August 2022 and March 2023, DAs recorded a total of 1,382 contacts with patients.
By far their biggest involvement was with the NHS App, with 533 instances of helping to set it up on people’s devices, 80 requests to help with proxy access to the app, and 175 instances of helping with the NHS App Access Record. Another task the DAs assisted with were repeat prescriptions, totalling 122 interventions.
In terms of lessons learned, the Digital First programme have noted that if a DA was not based within a GP practice it took longer to build relationships with receptionists and practice managers than those who were connected to practices. Another observation was that, as DAs performed their roles part-time, and fitted it around other duties, sometimes they lacked sufficient capacity to deliver as planned.
Being Digital would recommend that ASC do not pursue a similar scheme for the following reasons:
· The NHS serves a far larger proportion of the local community than ASC – if our offer was social-care focused the take-up would be nowhere as high · It would be difficult to ascertain exactly where ASC DA resources would be located · There is currently no evident route for funding such a resource
Instead, the Being Digital recommendation would be to potentially utilise existing or planned NHS Digital Ambassador resource, with an offer to upskill them on signposting to ASC resources. |
March 2023 |
Green - closed |
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