Ninety seven per cent of local authorities are planning to introduce some form of online self-service for adult social care this parliament (Local Government Association, Care Act Stocktake).
When done well, online self-service can deliver a range of positive benefits including improved outcomes for service users and carers, better management of demand, better-quality interactions with council services and potential cost efficiencies in meeting the capacity challenge.
Commissioned by the Department of Health, the Local Government Association (LGA) in partnership with the Association of Directors of Adult Social Services (ADASS) and the Society of IT Management (Socitm), have produced a series of short, easy-to-read briefing notes, providing both thematic guidance and evidence from case studies to support digital adoption.
They are designed for senior managers with responsibility for digital or public engagement as well as social care informatics leads and web managers. The aim of these briefing notes is to both encourage increased engagement with digital and to support the sometimes challenging conversations with senior officers and local politicians about adoption of online solutions including assurance, investment, design and co-production.
Self-service relies on trust between the customer and the provider. Confidence about the identity of the person at the other end of an electronic transaction is critical to developing trust in the system. Ever since the days of local e-government in the early 2000s, having a secure process for identity and authentication has been the Holy Grail for establishing long-term trust. As providers of social care information, advice and services, local authorities are planning for an upsurge in online demand, stimulated by the 2014 Care Act.
What steps should your local authority take for handling user identities for online social care?
Self-service only works if it really is easy to use. If online facilities are hard to use, or do not give the whole answer, then people will give up. Even worse, they will then try much more expensive offline channels such as the phone to find the information. They may also be disinclined to try online again.
Getting it right covers many different things, such as the careful choice of words, intuitive navigation, an information architecture that reflects user needs, a search engine that works really well, and, if you have one, an A to Z index that also works well. Alongside this is a commitment to ongoing user testing and analytics of use, all backed up by a management team that really understands why all these factors are critical. In short, writing for the web is a specialist skill and the organisation should be passionate about ensuring the best possible user experience.
Online social care suffers greatly from poor usability, with a few exceptions. How can this trend be turned around?
Service redesign made possible by investment in digital solutions promises an efficient and effective response which both meets the duties of the Care Act 2014 and helps address the issues from rising demand and expectations. However, there are many possible pitfalls for the unwary. A robust and well-argued business case should help steer councils away from those pitfalls and towards solutions that are appropriate to their local environment.
Those responsible for public engagement by councils have difficult decisions to make as to where to focus their time and resources. Yes, we know that digital public engagement is part of the solution, but what exactly brings greatest benefit in the short, medium and long term?
In Briefing 4 we talked about how online needs assessment covers four different aspects; online referral, needs checklist, online review and carer's self-assessment.
From a software point of view, each aspect can be supported with very similar question and answer formats and so the software implementation is likely to be of comparable complexity. However, they have different impacts for the public and for professionals.
Each option raises policy and process issues – and even legal ones. This briefing looks at each in more detail with examples from councils that are implementing various approaches.
What can we learn from councils that are implementing the different forms of online needs assessment?
Briefing 4, Planning online transactional facilities, set out the pros and cons of financial self-assessment noting that 'some good examples are emerging'.
Progress since then has been slower than hoped for, though many councils have moved forward, using a variety of approaches to make clearer to their residents when they will have to pay for care.
Most websites surveyed for this briefing now have a clear description of the maximum capital threshold. Several offer some sort of interactive self-assessment ranging from use of SurveyMonkey to one that populates the back-office data directly. In this briefing, we set these out as case studies and start with an overview of the various issues to be considered when embarking on such a project.
One of the web's inherent strengths is the ability to link from one site to another at the click of a button. Health and social care services have taken some time to develop on the web, but now there are many national and regional information sources that can be linked for the benefit of adult social care users and their carers. Developed through the likes of NHS Choices, GOV.UK, charitable and commercial offerings, there is now a range of good online content available including widgets, data downloads, APIs and apps that can be used locally.
Many councils have implemented e-marketplaces over the last five years. Interactive directories of local care services have been a way to meet the Care Act requirement to ensure the availability of information and advice. Some councils have set up websites that enable users to purchase their own care, these have had mixed results. This briefing revisits the service reasons for investing in these tools, outlines some of the challenges and opportunities of each type of solution & sets out a wide variety of case studies from councils around the country, including some good examples of regional collaboration.
We have seen in Briefing 2 that it is not a straightforward task to get the user experience right. There are many pitfalls that can quickly lead to problems and a poor online experience.
As it requires much effort to get the user experience just right, it becomes very easy to neglect the need to promote self-service. However, you cannot assume that, just because the online facility is there and works, people will use it. Experience over the past ten years shows that it is important to invest time, resources and a little money to promote online information and services to potential audiences who are not yet used to going online for social care. What approach for promoting online social care should you take for ensuring the greatest take-up?
Digital and information has a critical role to play in widening access to services and improving outcomes. In this area councils have sought to develop more meaningful and, in some cases, formal relationships with the voluntary, community and social care enterprise (VCSE) sectors. Councils have been working with partners on projects a such as digital inclusion, improved information and advice and online engagement. How might councils benefit from working with third sector and care provider organisations to better meet the needs of residents using digital methods?