Appendix 1
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PEOPLE SCRUTINY REVIEW OF USE OF DIGITAL AND TECHNOLOGY IN ASCH – ACTION PLAN 12 Month Review |
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SCRUTINY RECOMMENDATION |
DIRECTOR’S RESPONSE AND ACTION PLAN |
Update Notes |
RAG (red, amber green) rating |
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R1. |
The Department should ensure the planned implementation of Online Financial Assessments (OFA) 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. |
Feedback continues to be actively collated through online reports, customer thermometers and verbal feedback from clients.
A range of measurable data is reported on and used to inform developments, including ‘drop out points’ for online tools, as well as feedback from users being obtained.
From this the following barriers have been identified and are being addressed: - secure mail system issues: exploring alternatives including a pilot of a new portal to enable communication with clients without using email - user error: improved user guidance including ‘how to’ videos are being developed - technical issues: fixed as they arise - expectations for a visit / telephone assessment: expectations are being actively managed by the assessment team - lack of awareness of the OFA: opportunities for wider promotion continue to be explored
Usage stats continue to show an increase in online financial assessments as per R2 below. Uptake statistics are reported on and shared with managers monthly.
Feedback continues to be monitored closely. Responses are used to inform continuous service improvements and accessibility. A recent example is development work on 1Space to support navigation, based on user feedback. |
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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 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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Take up continues to be tracked and shared with managers. Scrutiny has been updated in January 2023 and July 2023.
2024 has seen a 57% increase in OFA links being sent and an average return rate of 42% as per R5 below. However it is recognised that delivery against these targets will be ongoing as more East Sussex residents become digital users. These targets will continue to be monitored and reported on.
Information on the feedback received is listed as part R1. |
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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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Changes to pathways, processes, guidance and practice (for example, conversations with residents to encourage OFA use) have been implemented, in line with learning from other Local Authorities.
The Department continues to look at opportunities for wider learning, for example a recent meeting with Kent County Council to explore their innovation activity and becoming members of the Association of Directors of Adult Social Services Technology Enabled Care group for shared learning regarding digital developments and opportunities.
Robotic Process Automation (RPA) has been successfully developed and deployed in March 2024 to move uplift letters into our case management system and automatically generate a case note. The service has fed back that ‘The implementation of the RPA has been a massive leap in record keeping and productivity…by having the RPA upload the letter automatically and note on the system that it is done we will save many, many hours in searching and even writing off debt where we have been unable to locate [this evidence] in the past’.
Further opportunities for application of this automation to our online financial assessment (and other) forms is being investigated. Automation opportunities are actively being explored as part of continuous service improvement activity across the Department. |
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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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Reviewing and simplifying processes is a key focus across the Department and in all service improvement activity.
Recent examples of digital developments to support operational processes include: - the implementation of new Deprivation of Liberty Safeguard (DOLS) portal forms to streamline the process of receiving and managing DOLS referrals, reducing the administration required in processing these referrals - engagement with NHS to streamline the health referral process managed by HSCC; - piloting a new live online sign language service which enables resident BSL users to engage with services remotely, with appropriate and immediate support.
The Being Digital programme concluded at the end of March 2024. The programme has been replaced with a mainstream approach, with digital opportunities explored through ongoing service development activity across the Department. This embeds digital in all service improvement activity, working with operational teams to explore opportunities do this alongside changes to processes and pathways. |
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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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Departmental performance reports now include virtual activity volumes and the portal dashboard tracks usage of online tools. Any new digital activity implemented includes ongoing measures and tracking as appropriate. Performance reports are reviewed by DMT members at a bimonthly Performance Board, which assesses performance across the department.
The latest portal dashboard showed a 126% increase in portal forms being submitted for Q1 in 2024 (2131) vs Q1 2023 (937), continuing the upward trend. While portal forms remain low as a proportion of overall departmental activity, this is starting to shift as digital approaches become more familiar to some residents. Portal forms have increased from 2% of contacts in 2022 to 4% in 2023 and 8% so far in 2024, showing a positive trend of doubling year on year. We continue to actively pursue ideas for increasing the rate of take up.
100% of suitable clients offered an OFA and 50% completed online: 2024 has seen a 57% increase in OFA links being sent, demonstrating an increase in the identification of potential OFA users. In 2023 the average return rate was 39% and this has increased to 42% so far in 2024. While this is currently lower than the 50% target, we recognise that this was a long-term target and note the continued positive upward trend in usage.
Barriers have been identified as per R1, and work continues to address these to maximise take up in future.
Online form is default route to raise a safeguarding alert: Currently, the safeguarding form is the most used online form. At the point of reporting it accounted for 47% of all portal submissions.
Professionals remain the single highest user of the form. This is currently different for members of the public, where feedback tells us that most members of the public currently prefer a guided conversation over the telephone.
25% yearly increase of occupational therapy referral form: In 2022, we recorded 235 submissions and in 2023 we recorded 364. This equates to a 55% increase, exceeding the target.
To support a digital approach, targets were set around active records that have an email address and mobile phone number attached to them. However, this requires significant cleansing of records in the system. This work is underway and will continue through 2024.
We will continue to monitor these targets and use this data to inform future improvement activity. |
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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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With the support of UCL, a select group of staff have been trained in behaviour change, specifically the use of the COM-B behaviour change tool.
Areas of focus identified for future interventions include: - opportunities to use persuasion – such as promotion and advertising; - education – including changes to guidance and training; enablement – such as sharing case studies; and - environmental restructuring, for example posters and promotional material being available across sites. It is intended that behaviour change will become embedded in ongoing project delivery. To support this, all Service Improvement Project Managers will receive training on behaviour change and project management documentation will be updated to include behaviour change models, to maximise the benefits of any service improvements. |
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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 as per R1 and shared with managers through a dedicated dashboard, who cascade to their teams as appropriate.
Project specific feedback is obtained as part of the evaluation process, and where this involves client facing developments user feedback is also sought.
Based on customer thermometer responses on the portals available to users since June 2023: · 66% of users rate their experiences with the portal as either good or excellent · 14% of users rate their experience as poor (we are considering how to understand more about this groups experience and what improvements could be made as a result of this feedback). |
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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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Digital tools and our digital offer are now part of the induction session for all new starters in ASC.
A HSCC digital induction is in place to support staff who are the first point of contact for our residents. This allows HSCC staff to know what online tools are available, giving them confidence to signpost to these and the opportunity to explore and discuss barriers to use. This training is available for other teams on request.
As the Being Digital programme has now concluded, there is no dedicated team to develop digital training. However, further digital-focused training is currently being considered both corporately and within the ASC Training, Workforce and Organisational Development Team. |
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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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A checklist for managers has been developed to support managers in discussing digital in team meetings and supervisions and the Being Digital delivery manager attended a range of meetings and 1:1 sessions with managers and individuals to discuss digital by default. As the Being Digital programme has now concluded, this engagement will no longer continue in its current form. However, workshops will continue to be offered by officers working on digital innovation issues. In April 2024 a workshop on the use of Artificial Intelligence was delivered, with over 100 ASC staff attending to share their ideas on how AI could support the delivery of ASC in the future.
A closure report for the Being Digital programme is in development and will be shared with teams and published on the intranet. This will include case studies and examples of the impact of some of the digital developments delivered.
As detailed in R8, the new staff induction session now includes reference to digital tools and their appropriate use, and a digital induction is in place for new HSCC staff which is available to other teams on request. |
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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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The One Council Digital Inclusion programme concluded in March 2023. In March 2024, the Digital First team in NHS Sussex announced work has been completed to establish a ‘digital inclusion baseline’, which has been signed off at Integrated Care Board (ICB) level. The next step is to produce a digital inclusion strategy which ESCC ASCH will contribute towards.
Information relating to digital inclusion resources has been shared across the Council, and there is ongoing sharing of information through joint working with the Health Digital delivery programme team. Relevant information will continue to be shared moving forwards. |
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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. |
A range of local and national digital inclusion resources are now available on the East Sussex 1Space and ESCIS online directories to which clients and carers can be signposted, and development work has been completed on 1Space to make these options more navigable for users.
Although the One Council Digital Inclusion Programme did not continue, digital inclusion remains core to all digital developments and it is expected that all Project Managers identify any potential risks and mitigations to support inclusion. Local and national resources will continue to be shared moving forwards and the Innovation Manager will ensure that opportunities to develop and promote digital practice continue to be identified and shared. |
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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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The Department has continued to work with NHS-led programmes, including the implementation of initiatives such as: - Digital Social Care records within Milton Grange; - the sharing of client information with health colleagues to support care delivery through a new viewing platform called Plexus; and - exploring options to streamline the health referral process managed by HSCC on behalf of community health services.
As per the six-month update, the One Council Digital Inclusion Programme concluded in March 2023. However, Project Managers in ASC consider communication, promotion and wider engagement in all projects. They actively seek opportunities to work with the VCSE to promote and engage with ASCs digital offer, for example: - recent work with ETC in the robopets project; - recent work with ESFRS on linked smoke alarms; - work with Care for the Carers in trialling our delegation portal; and - work with DeafCOG to help develop our real-time British Sign Language interpretation offer.
All future project delivery will engage with partners to deliver shared aims and outputs. |
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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. |
As per the six-month update, the NHS Digital First Ambassador pilot ended in April 2023. The learning from the pilot recommended that ASC should not pursue a similar scheme.
It had instead been intended to look at working with NHS Digital Ambassadors to upskill them on signposting to ASC resources. However, these NHS posts did not continue.
Although these posts did not continue, as per R12, we will continue to look at opportunities to work with partners to support digital developments and take up, in line with continuous service improvement activity. |
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