The Behavioural Insights Team worked with Knowsley Metropolitan Borough Council (KMBC) to increase the number of people that take up council-provided Assistive Technology (AT) locally.
We developed behaviourally-informed materials and conducted a mail out targeted at key groups of residents who could benefit (those with blue badges, those who received assisted bin collections and all non-residential adult social care users). We also developed materials to support staff to offer AT more effectively. We observed a 39 per cent increase in referrals and a 27 per cent increase in installations following implementation of our intervention.
Local authorities and the NHS see AT as an important way to help people live independently in their own homes for longer. This is a better outcome for people themselves, and reduces demand on health and social care (HSC) services. However, increasing the uptake of AT is challenging. One important barrier is that both service users and staff struggle to engage with the very wide range of devices available and to understand how different devices can support people with different social care needs.
We developed an approach with two main elements:
1. A mail-out targeted at key cohorts: We sent a behaviourally informed leaflet out to key cohorts who were previously not routinely offered AT (blue badge holders and recipients of assisted bin collections) and to all individuals known to adult social care. The leaflet used a range of behavioural insights, but particularly focused on simplifying the offer and dealing with the risk of choice overload. The leaflet introduced AT by explaining four of the most commonly used AT devices available and setting out how they can help people with different types of needs. The leaflet also clearly explained the benefits of AT and had a clear call to action explaining how to access support.
2. Support to help staff HSC staff to offer AT more effectively: A range of HSC practitioners across the borough received a small leaflet which they could use when talking to residents about AT. The leaflet included four simple tips for offering AT and also an overview of key devices. They were also given copies of the clientfocused leaflet to give out and received a one hour briefing about the materials from the Knowsley AT team.
In the three months after we implemented our intervention, we observed on average 22 more referrals (a 39 per cent increase) and 16 more installations (a 27 per cent increase) a month (compared to the three months before we implemented). The size of the effect we observe, and the relatively stable trend in uptake before we introduced our change, suggest that our intervention was effective.However we were limited to a relatively straightforward before/after research design. Although we think it is likely that the intervention was effective we cannot entirely rule out the possibility that the increases were caused by chance, or by other factors. How is the new approach being sustained?: The AT team at KMBC will be doing several things to sustain the new approach:
1. They will periodically visit key HSC teams to resupply them with leaflets
2. They will periodically redeliver the staff briefing to key health and care teams to refresh existing staff and to cover new staff.
3. They will regularly conduct mail-outs and attempt to identify further groups of people known to public services that could potentially benefit from AT. More generally, the AT team will try to spread the use of behavioural insights through the Early Intervention & Prevention Programme which involves other Council teams as well as external partners.
Monthly records of assistive technology take-up are maintained. In 2019, the average number of monthly referrals was 92 which was a further increase of 13 referrals per month compared to the results achieved during the trial period.
Consider alternative ways of reaching people who could benefit: All councils with social care responsibilities are responsible for issuing blue badges, and if they are unitary councils they are also responsible for assisted bin collections. We believe touch-points like these are under-utilised, and provide a new way of reaching people who could benefit from AT but aren’t yet in contact with health or social care services.
Don’t offer too much choice. Many public services lean toward offering lots of choice, with the goal of personalising services. While admirable, this can often make services difficult to engage with and lead people to procrastinate or fail to act. While there are hundreds of AT devices available, in many areas there are a small number of ‘core’ devices which most people use. Focussing on these can help people understand and engage with the AT offer.
Support practitioners. Health and social care practitioners are busy and have lots of demands on their time and attention. Expecting them to complete, remember and act on detailed training about the devices available may be unrealistic. Councils should consider how to simplify the AT referral process for staff.