Whole systems review
What we did
Camden Council undertook a whole systems review, using "systems thinking" principles to reorganise services to put the customer centre-stage and to reduce "waste" (e.g. duplication, unnecessary form filling, passing the customer over to other services and dealing with process failures). Staff from across the service were involved, together with key input from senior management who communicated the vision. Leads volunteered to be involved from each area of the service. A small team was set up to experiment with different ways of being more responsive to customer's needs, dealing with calls immediately and trying to involve other services (e.g. health and housing). As many staff as possible were given the opportunity to work in this team to roll out principles of systems thinking. Throughout the review much time, energy and effort was devoted to getting the principles of systems thinking implemented across the service. Three temporary Implementation Support Officer posts were set up to help work across the service to achieve the aims of the restructure. As a result of the review a number of significant changes were introduced.
Restructured organisation: reduced number of teams to improve continuity of support, simplified and reduced forms (particularly the assessment and reassessment forms), created a single point of access for customers, implemented new Lead Practitioner roles to up-skill staff who were no longer in specialist teams.
Changed resource allocation: changed the RAS from a complicated process based on a 21 page form to a "ready-reckoner" calculator focussing more strongly on the professional/customer relationship and the professional judgement of the assessing practitioner when allocating resources. To ensure consistency there is input from an allocations panel for larger budgets and operational management sign off.
More Direct Payments: A renewed focus across the whole service on increasing customer take up of Direct Payments, developing more personalised support options for customers and moving to outcomes based support planning and reviewing of progress.
Why we did it
Less money available within the organisation and an increasing population of customers needing support combined with a desire to become more customer focused. The work flow and customer journey had become fragmented as a result of the introduction of personal budgets, with different teams dealing with different aspects of the process, a confusing offer to customers and taking longer to assess and provide support. A specific objective was to reduce the length of time from when the customer contacted the service, to when their needs were met.
Reducing the number of teams has created less "hand offs" from one practitioner to another, so that customers do not have to repeat themselves, or wait for a new worker to be allocated to them. Removing the points based RAS & simplifying forms has led to a more streamlined process. However, there are some challenges. In shortening the process from assessment to support planning and delivery, the usefulness of the indicative budget in communicating the opportunities for choice and control has been reduced. Additionally the "ready-reckoner" approach uses the existing costs for services and can lead people towards traditional service options. More work is needed to encourage staff and customers to think beyond the services they receive now and there will be a further focus on staff training and use of supervision to improve the confidence of the workforce in promoting choice and control. Simplifying SDS process has been completed, but cultural change within the organisation is continuing.
Implementation Manager (Personalisation, Adult Social Care)
Paul.Kelly@camden.gov.uk Tel: 020 7974 2880