Part two: mobilisation guide

To support adult social care teams effectively in the current situation, this page provides practical suggestions on how to extend existing or implement new technology solutions.


We know that identifying the right technology is only part of what is needed to make changes to services; creating the conditions in which the technology is taken up effectively and used at scale is as important as choosing the right technology solution. The barriers and issues which exist in normal times still need to be navigated and addressed; and given the urgent need for pace there are implementation and mobilisation challenges that are unique to the current situation. These are outlined below with suggestions on how they may be addressed.

Key messages
  • Pace is key. Keep people focused and things moving. Remember we are all using systems and processes that were not designed for this pace or this type of response. You’ll need to ensure in your resourcing plan that you have capacity to drive the pace
  • Focus on key aims. Make sure these are clear at the outset and act as a touchstone throughout
  • Appropriate leadership. Clear direction from decision makers is key. Visible, tight delivery teams and effective project management are crucial, particularly in the early stages
  • Common challenges. The themes and challenges will be familiar but the approach may well need to be different based on your local circumstances
  • Keep things moving and adjust as you go. Balancing pace and risk is a dynamic process. Make sure you have others / leaders on board. Keep the likelihood of future scrutiny lightly in mind, but also consider the risks of not moving forward
  • Think people. Keep the safety and protection of service users at the heart of everything. This will mean you make good decisions and provide motivation when it’s needed to rapidly deliver interventions for local people
  • Mobilise well. Choose who you want as part of a project or mobilisation team carefully. Getting the right people as well as the right skills will speed up how you work effectively together
Governance
  1. Quick and effective decision making:
    • ensure that the essential criteria for tackling your challenges, impact and solutions are clear and are addressed as you develop any business cases or proposals
    • be clear how your plans relate to COVID-19 response and impact and articulate this clearly to make it easy for others to understand and support
    • for certain audiences (eg finance) and decisions makers, understanding the contribution of COVID-19 responses to the longer term may be needed. Be ready to articulate this if you need to
    • be mindful of possible post-COVID-19 review, audit and/or scrutiny. Test your proposals with others to make sure they are robust.
  2. Councillors and senior leaders:
    • ensure that key councillors and senior leaders are sighted on and supportive of your plans; develop briefing content outside of formal papers if necessary and take the time to engage them
    • consider your local political landscape and ensure that those which need to be sighted on proposals are.
  3. Leadership / key sponsors:
    • identify the right leader or sponsor(s) for your work – both at a strategic level and operational level.
  4. Your project may require additional funding. This could be substantial depending on your level of ambition. Consider whether there are new sources of funding available specifically for COVID-19 response. This could be internal, external, national or local funding available to support systems respond to COVID.
  5. Be clear from the outset whether any funding secured is dependent on delivering savings or demonstrating a return on investment. Clarify financial reporting and performance reporting requirements with internal stakeholders early on.
Supplier management
  1. Consider the best routes to decreasing procurement risk whilst working at pace. Speak to procurement about internal processes which might assist and consider existing local and national procurement frameworks. (We are aware some councils have used frameworks such as G-Cloud, YPO and Consortium Procurement for care technology but there will be others. If you have used other frameworks that we can signpost other councils to please let us know).
  2. Extend existing contracts for incumbents if this is appropriate.
  3. Identify and respond to key tests outside a full formal process such as:
    • financial status of potential supplier
    • rapid market analysis to identify potential alternative suppliers
    • price comparison.
  4. Use external sources of market intelligence – both formal (eg national bodies, frameworks) and informal (eg personal networks, other councils, market experts).
  5. Managing risk: seek advice early from internal commercial / procurement colleagues and contracting experts to minimise risk within a contract framework.
  6. Consider the level of resource and support required by different suppliers: do they have capacity and the ability to scale? How will you work with them? Do you need additional business support to support both the council and your supplier?
  7. Supplier selection and competition: you may wish to adjust your approach to keep pace but remember that this is a key decision point.
  8. Take time to develop a clear specification so that you are clear what your needs are and what you want to procure (technology and services).
  9. In the current climate consider additional assurances and checks on new risks. For example, how robust is their supply chain? Do they have product in stock or can source it quickly? Is their workforce available and working? Do they have capacity? Is certification to industry standards important?
  10. Contract management: consider an approach which enables the supplier to concentrate on providing the service and technology – at least at the outset.
  11. Collaboration: consider taking a more collaborative approach with care technology suppliers. Play to each other’s strengths and work together to get things moving quickly. Understand what is mission-critical for them and vice versa.
  12. Data and performance information: be clear what is essential in terms of data and performance information in order to hold people to account but take a practical approach to avoid slowing progress.
Information governance
  1. GDPR may not necessarily be relevant to all technology and all deployments. As a first step, consider whether there are any information governance requirements relating to your project.
  2. Start IG work early including developing a Data Privacy Impact Assessment (DPIA). This is a key governance requirement that can slow progress if not in place. Ensure you have support for your work and take the time to brief IG leads.
  3. Alongside the governance to permit data sharing, consider early on the mechanism for sharing data. Seek advice from IT leads and / or analysts where needed.
  4. Support all those involved to strike the right balance between managing risk and keeping things moving. Have you worked with this supplier before? Is there an existing DPIA as a template – perhaps from a similar project?
Identifying service users

Deploying a preferred care technology solution to the right end users is key but can be challenging. Consider volumes, timescales and resources. It may be helpful to consider:

  1. Who are your priority cohorts? Remember to demonstrate the strong and clear link to the drivers and aims of the project
  2. How can you quickly identify potential recipients? Do you need to initiate a data request and if so what are the parameters? Are there existing corporate data sets or lists that might help?
  3. Clarify your process for service user / resident selection: Does this need professional oversight? Who is going to do the work? What level of recording or assessment might be needed? Or can you communicate the offer and allow people to identify themselves? Are there other external organisations / partners who might help with this? Eg care providers, NHS partners, housing providers, voluntary sector and community organisations. What governance sign-off or quality assurance process is required?
  4. Clarifying responsibility and clinical governance. Consider what your protocol is around escalation of need. What role is technology playing in your current MDT processes? Are there any operational considerations that will need ironing out to stop people falling through gaps and getting the support they need.
  5. User on-boarding / consent: consider if you need to consent people to use the solution as part of the roll out and how to approach this. Who is best placed to speak to service users to get them on board? What level of resources is this likely to take over what time period?
  6. Training: Consider the training that will be needed to help people to use the technology effectively. How will this be delivered or supported under COVID-19 conditions?
  7. Installation and set-up: can this be achieved remotely or in a low or no-contact way? Could someone already going in to the home take this on? Challenge your suppliers to think differently.
  8. Feedback: seek feedback early on and then regularly from those using the technology. How are service users finding the technology? Are there any issues with the technology, the service or any other aspect of the project? This will be invaluable in troubleshooting issues from the outset.
  9. Engage relevant social care practice leads / safeguarding leads early on to make sure any questions or concerns are resolved.
  10. If there are issues that need to be addressed or monitored consider light touch ways that this can be achieved such as: sample audits / reviews, development of clear protocols that are signed off, taking a risk-based approach and only focusing on more complex / higher risk cases.
Care providers and partners
  1. It is possible that your care technology approach may need the support or buy in of care providers, either because it is supporting care delivery or because it is in the home of service users and providers may need to interact with it or support its use.
  2. Consider any implications for their businesses – operational, financial, commercial or regulatory implications.
  3. Communicate effectively and succinctly and reassure, support and tailor communications materials for them.
  4. Use their knowledge and expertise, particularly of service users.
  5. Offer support and troubleshooting.
  6. Signpost to Digital Social Care – a dedicated online resource available to support care providers with use of technology including dedicated support to help during COVID-19
  7. Consider the role and relationship of key partners to your project and involve them / communicate with them accordingly. Key partners are likely to include the NHS, districts and other local councils, care providers, voluntary sector, housing providers and others.
Communications and culture
  • Develop a clear communications strategy and plan; this is always an essential tool to support culture change but is even more important when moving at pace. This could include:
  • clearly defined audiences and channels
  • key messages
  • clear plan – but dynamic / iterative approach
  • social media
  • reaching residents
  • protocols for communications content approval and sign-off
  • identified capacity and resources for delivery

In the current conditions there is little time for a long-term culture change programme. However, awareness of the risks and opportunities of culture and attitudes to care technology is important. Consider who in your organisation to communicate with and who can help champion the approach (such as teams or leaders with an interest in this area). You may also want to consider any specific training needs associated and the best approach to delivering this eg virtual / video-based.

Mobilisation
  1. Secure resources: the right people as well as the right capacity.
  2. Consider a project management approach which is agile, light, rapid and organised. If you can secure project management resource with relevant previous experience and knowledge, then do so.
  3. Risk management:
    • keep a tight risk log from the outset; use others to review and contribute to this
    • identify and manage key strategic risks early on: procurement / commercial, legal, operational, safety / safeguarding
    • remember to highlight the risks of not acting / proceeding to engage and encourage others
    • in the COVID-19 situation health risk, safety and infection prevention are relevant and powerful considerations. Be clear how these are impacted and managed by your plans.
  4. Consider whether you need external specialist help to support successful deployment and implementation. Does your organisation have a successful track record of deploying technology? Have you worked with your selected supplier before? Do you / your team have experience of the range of issues outlined in this guide? Consider whether you need specialist external mobilisation support.
  5. Provision of hardware: ensure that your supply chain is secure and reliable.
  6. Consider how the care technology can be installed in a way that does not increase disease risk. For example, you may keep larger stocks of kit on hospital sites and issue it as part of a discharge package or use people already going into homes such as care workers to deliver and support basic setup.
  7. Consider connectivity and any dependencies on broadband or mobile signal availability.
  8. Consider security issues of hardware as well as data, and any risks associated with cyber security and how these will be mitigated.
  9. Where necessary, consider providing training for key staff or users who will need it.
Benefits tracking
  1. Create a benefits framework that is light touch but effective, that has a clear link to your over-arching strategic aims, and that will provide the evidence you need that this was an effective intervention in relation to COVID-19. Specifically:
    • define COVID-19 benefits for service users, workers, and any other relevant groups
    • capture a baseline upfront where it is essential to do so and implement tracking mechanisms
    • consider when and how you will evaluate impact: mid-point and at the end? Or more frequently if appropriate
    • develop a clear approach to capturing qualitative impacts / outcomes
    • review your approach and framework once the project is underway; there may be emerging outcomes / benefits that you didn’t anticipate but now want to capture
  2. Communicate emerging benefits to key internal and external audiences in an appropriate format; use case studies and good news stories to promote take-up and to influence longer term attitudes towards care technology.
  3. Consider your longer-term data needs and ensure that if there will be a need to match care technology data with case management systems data or other corporate datasets that there is a unique identifier that can facilitate integration of data. Consider whether this needs to be anonymised or pseudonymised in the context of your DPIA.
  4. Safeguarding: When setting up new care technology solutions, check that your processes allow you capture increased opportunities to safeguard. Technology is enabling more interactions, more connectivity and greater independence for service users. It also presents more opportunities for professionals to recognise safeguarding needs.
This guide has been developed by the Care and Health Improvement Programme in partnership with RETHINK Partners to support adult social care teams who are seeking to use and deploy care technology – fast – as part of their COVID-19 response.

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