How people power can drive more effective social care outcomes

Think Local Act Personal have a great guide for councils (PDF) on developing care and support planning. Photograph: Think Local Act Personal on Facebook

Ahead of the Nuffield Trust’s Health Policy Summit, Julie Wrigley says new models of care should be driven by a new style of research

qa-logo-square-cutout-60This is one of a monthly series of blogs exploring what we have learned from our research into helping improve services for people with mental health problems, children, young people and families, and those in later life

People power is everywhere in the digital age. Travellers rate their hotel or restaurant on TripAdvisor. Musicians bypass record labels to share their music on SoundCloud or YouTube. Entrepreneurs crowdfund inventions.

The sharing economy has flourished via sites like Compare And Share, Streetbank and Borrow My Doggy.

And in the real world, everything from time banking to babysitting circles enable volunteering and mutual support to spread through communities.

The question is, can we apply these same people-power principles to research – in order to drive better outcomes in health and social care?

Care sector takes a lead

Some in the health and social care sectors have already realised the potential value of applying this approach.

Financial constraints, an ageing population, continuing integration between health and social care, increasing multiple co-morbidities among older patients and rising rates of dementia are all challenging.

Increasingly, and particularly since the Care Act 2014, social care seeks to provide more personalised and appropriate care. There is increased focus on wellbeing, prevention, choice and co-production.

As a result of these developments, health commissioners are interested in moving away from ‘one size fits all’ models and exploring the role that patient management can play in delivering better health with restricted budgets.

This ties in with approaches to people-powered public service reform such as asset based community development (ABCD) and Participle’s vision, based on enhancing ‘capabilities’, entitled Beveridge 4.0.

Putting the user first

Research has always played a key role in understanding people’s experiences of their health or social care.

Moreover, under a people-powered approach, research can also become the forum where users can help design new models or contribute creative new ideas to improve their care.

Some social care organisations are now inviting their clients to come up with their own user-defined outcomes when commissioning research – outcomes that are meaningful to them.

Think Local Act Personal have a great guide for councils (PDF) on developing care and support planning which is focused on meaningful, person-centred outcomes.

Encourage participation

One way to encourage genuine participation to improve services is by organising an event.

Information is provided by experts, but followed by opportunities for everyone to share and discuss ideas in small groups. These are called deliberative events, design workshops or prototyping workshops.

Another method is to train peer researchers to take over parts or all of the researcher role.

With support, they can talk to their peers about which questions are important, carry out interviews, perform analysis, write reports and present findings.

Or we can draw upon a variety of qualitative research methods to explore complex or sensitive topics, such as:

  • in-depth interviews – semi-structured, so that participants can influence the course of the conversation
  • discussion groups
  • observation
  • journaling – using images, photos, words, texts or Tweets.

Flexibility and fun

L-R: Evaluation, mapping and spider diagram. [raw][/raw] Click to see a bigger image

Sometimes a hybrid of the above methods can be most suitable. We recently researched the topic of wellbeing among people with a range of disabilities for a charitable trust.

Our researchers had planned to visit an activity club for adults with learning difficulties to host a discussion group. Unfortunately, they weren’t quite ready for us and some people had to leave early.

So we joined in a game of Kin Ball and had quick-fire individual interviews instead of the group discussion. The researcher observations were useful for extra context – as was a campaigning website we were directed to by one participant.

Whichever qualitative method is chosen, we like to aim for adventurous conversations by including fun techniques that can help people overcome their shyness and liberate their creativity.

Mapping is one technique for carrying out an audit of problems or assets. An evaluation wheel can start the process of identifying areas of good and poor performance.

Spider diagrams can switch attention away from obstacles to solutions.

New approaches

The challenges to our health and social care sectors are wide-ranging and complex. Decision makers will need quality, in-depth research to help them develop models which meet these changing needs.

Proven, time-honoured research methodologies will play a large part in this process. But we should also remain alert to new ideas and approaches.

People power is already a success in many areas of modern life. If care organisations and researchers can work together to harness their own source of people power, it may well generate extra light to guide our way forward.