As a part of Bristol City Council’s Better Lives programme we were tasked with designing and implementing a number of small but impactful interventions to better manage ‘front door’ demand (handled by Care Direct, the adult social care team within the Council’s contact centre).
The interventions focused on behavioural change within the front door team to:
Bristol City Council reframed the problem of unsustainable demand for adult social care services by looking at the sources of demand and at making changes to the way the front door team handles contacts.
After the first phase of implementation, we called for a ‘stocktake’ evaluation session to consider some new insights related to how demand was being managed at the front door in Bristol. Data analysis had demonstrated that 59% of contacts passed to safeguarding senior practitioners from the Care Direct team were quickly screened out rather than being investigated. A second additional finding was around the poor quality of online referrals the Care Direct received, and the large number of different online channels involved. This resulted in an unnecessarily time-consuming email triage process to determine the priority of (and actions needed for) each case. Following the stock take, two larger interventions based on the new findings were designed and implemented.
The front door interventions were co-designed through a series of workshops with operational stakeholders and frontline staff from across the service, based upon evidence we gathered through our avoidable demand analysis. We used feedback sessions and surveyed Care Direct team members to monitor the impact of the changes on the team, in order to make sure that they could respond to any concerns and to the training needs of advisors. Embedding a coach within the team enabled the team to improve the quality of strengths-based conversations at the frontline. The coach was a former advisor, so had a deep understanding of the type of demand the Care Direct team manage.
Using applied behavioural science we redesigned the web forms that members of the public and professionals use to submit online referrals to the service. We included strengths- based language and improved the quality of information capture, in order to enable more effective call backs and to reduce referrals. We also applied behavioural science techniques to the redesign of the adult social care website to make it easier to navigate, provide clearer information and referral pathways, and signpost Tier 1 services and resources (such as the council information directory Well Aware).
Working with the Front Door project group, we designed a set of Primed Metrics to measure the impact of the interventions, as well as their impact on the public and professionals contacting the service. These Primed Metrics feed into the Trajectory Management process designed by iMPOWER that is being used to direct operational decision making and measure the impact of the Better Lives programme on the service user’s outcomes, as well as the council’s financial benefits.
Early indications of the impact of the front door demand management interventions are very positive:
“Key to the success of the project was making small incremental changes. This approach meant that we could quickly evidence success to the teams, which encouraged them to work with us to make further changes.”
Nikki Davey (Front Door Project Manager, Bristol City Council)