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Prototyping a new health and work service

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The 300-mile journey from London to Penzance takes between 5 and 5 ½ hours. As you ride out from the capital you pass acres of scenic countryside. Passing along the sea at Dawlish, crossing the river Tamar, and seeing St Michael’s Mount you certainly feel away from the metropolis, and, with Cornish and Devonish ancestors it was great to be back in the south west.

However I was not visiting for sightseeing. I travelled west to witness ‘experience prototyping’ in action with a team I’ve been mentoring drawn from the local Jobcentre Plus and a local social enterprise, Rebuild Southwest.

I work in the recently-established Work and Health Unit, a cross-government team which is looking at building the evidence base of what works in supporting disabled people and people with long term health conditions to get in and stay in work. Evidence suggests that work is good for your health, and the Government is committed to supporting full employment across the UK. Helping people to manage their conditions and stay in work could have huge benefits to the economy, the health service and reduce the numbers of people on benefits.

To tackle this challenge, last year the Department for Work and Pensions and the Department of Health, working with the Policy Lab, conducted ethnographic (or observational) research with service users and stakeholders as well as data science (using powerful computers to make sense of large and complex data). This evidence was used by users and stakeholders at an ideation workshops where they came up with the idea for a new ‘well in work’ service. Policy is not developed in a greenfield site, and we needed to explore how this service might work and align with existing services. So the next stage was to prototype elements of it – or mock them up and try them out at a very small scale. Prototyping identify and resolves flaws early, reducing the risk and creating buy-in.

Our prototypes include a health and work passport, which helps the user to reduce the amount of times they must tell their story to each service provider, employer signposting of the service which will help support their employees, and co-location of the service in a GP surgery to make it easier to get the right help when you see your GP.

Enthusiastic volunteer teams in four geographic areas – Penzance, Bournemouth, Southend and Bow/Poplar in East London took on these ideas, made them their own and then tested and iterated them with potential users, businesses and healthcare providers. The Penzance team focused on the passport and the employer signposting.

My visit to the team allowed me to sit in on a conversation with one of these employers. It was clear the cost of in-work absence for them was high, and providing the appropriate support difficult – previous employer-funded support had been cut back in recent years, and making sure people got the right attention early on was the key takeaway. Once people fall out of work, they and their employers face uphill struggles as time progresses.

Whilst not directly related to the prototyping I was also able to visit some of the early-intervention activity the Penzance Jobcentre undertakes with ESA claimants who overlap in cohort. I saw how working to restore a community centre helped increase the participants’ sense of self-worth, as their contribution had real, tangible results. Participants talked about how participating in this ‘DIY SOS’-like activity reinvigorated them – helping them get up in the morning and even travelling substantial distances each day. For one taking part meant they could come off daily morphine and sleep because they were tired, not just because it was night. This was truly inspirational.

As my train wound its way back eastwards, I had plenty of time to reflect on things traditional policymaking in Whitehall can miss –

  1. Look beyond the system to consider the user – how do they feel as they interact with government services? What motivates them to contact and use government services and how can they be optimised for their use?
  2. Generating ideas openly and in collaboration with the people most affected by them- Innovative ideas come not just from civil servants sitting in a room at a workshop. However, bringing together jobcentre staff, clinical commissioning groups, service users and business people can facilitate the co-design of new approaches which people actually want to use.
  3. Local approaches matter: Though national policy is valuable when problems have national reach, local know-how can really improve service delivery.

This month we will bring together all of these groups and others to work up these prototypes into scalable trials. Sharing each team’s experiences and the feedback they have generated will help us build a trial service which can then be iterated and improved to support more people.

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1 comment

  1. Comment by David Durant posted on

    Interesting comment about the diary usage for data collection. Are you speaking to the DWP Personal Independence Payments team about their criteria for evidence and whether this would help?


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