CMM: What prompted TSA and the Association of Directors of Adult Social Services (ADASS) to create this blueprint and what does it aim to achieve?
Paul Berney: A common issue experienced by local authorities is a focus on getting investment to purchase technology solutions, without first considering everything else it takes to deliver real service transformation. To tackle this issue, ADASS and TSA have spent the last eight months collecting proven approaches and benefits cases to create a free-to-use, practical blueprint for planning, implementing and scaling digital proactive and preventative care services.
Local authorities who have developed their services beyond just pilots and trials have shared everything about the approach they used, the services they have developed, the business cases they built, their return on investment (ROI) and more. They also explained to me their entire development process.
These insights are being used to create a three-part blueprint, which covers:
- A step-by-step guide based on best practice from councils already running successful proactive and preventative services.
- An overview of services already launched with exemplars from the councils using them.
- A financial tool allowing commissioners to estimate financial returns based on models elsewhere.
More than 100 people working in and drawing on social care have been involved in designing this practical tool. Throughout are stories of lived experience to ensure this work is supporting people to live the lives they want to lead.
The blueprint highlights the development and roll out of services and solutions that provide data and insight to local authorities to support making better informed care decisions. The emphasis is heavy on the services, rather than the tech. We were happy to move away from trying to define a particular technology or a particular device because there are so many different uses of data that come from technology. Ultimately, it must be about whether you can provide data and insight that helps make better informed care decisions.
CMM: How important is co-production to unlocking the power of proactive and preventative care services?
PB: Co-production is essential for the development of all social care services. If you want to be people centric in the delivery of services, you must involve those people in it at every stage, from the point of deciding what you are trying to achieve on behalf of people. There were three people with lived experience on the commission, including Debra Edwards, who contributed a foreword to the blueprint. Debra was open and honest in saying we have done a good job but it could be – and must be – better. My tendency is to agree with her. Within the blueprint we have tried to reflect common practice from local authorities, rather than making it simply about theoretical best practice and what people should do. That means we focussed more heavily at this time on the role of co-production in service design. The use of co-production throughout every stage will be a goal of the continued development of the blueprint and of these kinds of services.
CMM: What barriers prevent councils from scaling innovative, preventative approaches using TEC?
PB: The starting point for creating the blueprint was ADASS members at their 2024 conference saying we want to do more in technology, but we need help and, at the same time, TSA members asking how they could help local authorities get beyond simply investing in pilots. The lack of a blueprint for this was one of the biggest barriers.
There is also a perception that these services lack a strong evidence base and a strong business case – alongside a general lack of understanding of what these services are and how they work. So, alongside the blueprint itself, we also created sample benefits cases people could use, along with a description and overview of the most common services being run by local authorities.
From the local authority and commissioner of digital lead perspective, the services are described in terms of what the problem is you are trying to solve. Who is it for, who uses the data and what information comes from the systems? For these services to become common place everywhere, we will have to develop a common understanding of the answers to those questions, evidence that they work and an approach to launching them.
CMM: How can local authorities ensure proactive and preventative care services are designed to address real challenges?
PB: You need a clear vision of what you are trying to achieve and for whom you are trying to achieve it from the start. I think the most vital element that has been under addressed by many local authorities who have only done pilots is service design. The blueprint offers insight into how you go through service design and how you involve people who draw on care and support. It answers questions about how you involve care providers, or social workers. The temptation for local authorities when they receive funding is to jump straight into buying kit without taking the steps before that to look at what the service they are trying to deliver will look like. We are trying to remind local authorities through the blueprint that technology is subservient to enabling a service that delivers something to people.
CMM: How can local authorities ensure proactive and preventative care services are designed to be practical, sustainable and scalable?
PB: One of the things that came through clearly from the people who have been successful is to carry out trials and pilots that test the service, not just the tech. The tech already works. If you want to have a successful proof of concept you need to test the wraparound service, not the tech. Start by having a business case, not just for the pilot or the trial, but a business case that shows what the service is going to look like when it is up and running.
The blueprint encourages local authorities to do all that thinking up front and then takes them through how to best run a proof of concept and what the wraparound service is. That is critical because, if you do not focus on developing the service, you will perhaps end up with a successful pilot, but not necessarily a working system for day-to-day business as usual.
CMM: How can local authorities ensure proactive and preventative care services create lasting impact and are continuously refined?
PB: We must move away from getting investment to buy kit to getting investment to design, build and launch services. That is why we are clear that the blueprint is not about technology. It is not even about data or insight. It is very much about how you design and deliver services that are enabled by proactive preventative care technology.
Almost always funding has been available for the local authority to buy the kit, but no support for them to do the preparation that should come well before they have decided what technology they want to buy. The blueprint outlines the eight stages to go through before you even get to the point of technology selection.
For example, if you have a goal to use technology to help better inform your assessment and reassessment services, that is a different mindset. It is a completely different starting point because then you are saying, ‘What goes into an assessment? What other data and insight does a social worker need? What else would help them make a better informed care decisions and, ultimately, make better decisions about how to right-size someone’s care package?’ It is using the outcome to determine the technology, rather than using technology to determine the outcome.
CMM: Can you provide examples of local authorities that have successfully created proactive and preventative care services?
PB: There are several that stand out. Hertfordshire and London Borough of Sutton both approach this from the mindset of how to deliver better services for people. They are trying to use these services partly to deliver better care outcomes for the people who draw on care and support, which is right, but also demand management for the local authority at a time when budgets are static, if not falling, but you have got more and more people drawing on care and support. How do you best use the budget you have got?
Essex has heavily looked at supporting people to reduce falls in care homes. In reducing falls, you reduce the number of ambulance call outs, the number of hospital bed days, the stress suffered by the person who goes to hospital and the degradation in their condition when they spend an extended time in hospital. All that has a knock-on effect in terms of care outcomes and care experience, but also a financial effect.
It is about getting the balance right between what we are doing for care outcomes and care experiences and how we use this to help with demand management.
To read Unlocking the Power of Proactive and Preventative Care Services, visit the TSA website. Then, leave a comment on this feature or join the conversation to share your thoughts.
Paul Berney is an Associate for the TEC Services Association and author of Unlocking the Power of Proactive and Preventative Care Services. Email: [email protected] X: @TSAVoice