Access to healthcare for older residents in Buckinghamshire

What was the problem?
In recent years local authorities have been encouraged to embed a culture of engagement and community empowerment when developing services, with the view to achieve real service improvement and more economical delivery. This process of involving the community in decision-making at all levels is set to bring about a transformation in the relationship between community, elected members and authorities.

Design group Engine was asked by Buckinghamshire County Council to facilitate the development of a best practice methodology for the engagement of local authorities, elected council members and service providers and users. The methodology, which came to be known as SHAPE: Services Having All People Engaged, was realised through a practical project that concentrated on residents of the county in the 50+ age range. Buckinghamshire County Council could by doing so learn new skills and approaches to community engagement while improving the access to health and social care services for both urban and rural senior residents.

One of the key characteristics of co-design projects is their complexity when it comes to managing expectations and establishing objectives that will be focused enough to yield tangible results, and flexible enough to keep people with different interests engaged.

What did they do?
To help Buckinghamshire County Council engage their residents and community in the development of services, Engine demonstrated a co-design process to show how tacit insights could be drawn from residents’ needs and experiences and translated into efficient and effective services. Engine developed this into a best practice methodology, using service design research, tools and methods to explore the problems and opportunities in the day to day lives of older residents.

The project began with the broad intention of improving access to transport and health for elderly residents of Buckinghamshire. The project involved a concentrated program of work over a period of 4 months. The main activities took place during and in-between a set of workshops that involved a wide group of participants. The whole process involved nearly 40 people from county and district councilors and officers, health professionals, voluntary groups and community representatives.

To begin with, participants were set the challenge of going on a bus journey to one of the local hospitals and to document their experiences in words and pictures. This was the starting point for a workshop dedicated to exploring the problems and opportunities from the users perspective. From the start, elected members, residents, officers and service providers had to work together, having equal status within the group, to generate ideas and arrive at consensus. Once agreement was reached within the group, the task of designing a service that would meet everyone’s needs and desires could begin.

What was the result?
The outcomes were twofold. Engine delivered a capacity-building programme SHAPE which engaged residents and council staff to create HealthConnect, a service development proposal designed to improve access to health and social care services in Buckinghamshire. It is a response to the way in which people with limited accessibility, especially in rural areas, find journeys to and from the doctors particularly stressful, time-consuming and expensive. It includes a range of channels and ways of accessing more useful information and how healthcare and transport providers can work more efficiently together to support the access of residents to their services.

The second outcome is the SHAPE methodology for user-centered service innovation, which can be downloaded from the Engine website. It contains the benefits and results of the process and details team roles, tools, methods and examples to achieve the best results. The methodology also addresses the organizational challenges around how a local authority and its delivery partners plan the process of engagement and organize themselves to benefit from that process to see real and sustainable change. The methodology was demonstrated through the program which would improve how 50+ residents access health and social care services from all over the county, taking into account times, availability and public and private transport.

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