Newton Europe’s associate director on the end-to-end service delivery model
More from: Transforming adult social care
Councils are taking increasingly difficult measures to address shrinking budgets. The word efficiency has become a buzzword. As councils consider how to meet the financial challenges of 2015-16 and beyond, the more innovative among them will also be talking about effectiveness.
If efficient services deliver the same results with the minimum resources required, then effective services deliver the best outcomes possible with the resources available. To do this they need to be designed from first principles to meet the needs of stakeholders, to deliver a great customer experience for service users and best value for the taxpayer. Contrary to popular opinion, a well-designed customer journey or care pathway will invariably deliver both.
We were working with a council recently that had already taken great strides to improve service efficiency. It had successfully implemented a single point of access call centre for adult social care, cutting costs. It then used the information the call centre produced to reduce the volume of calls that needed to be referred to other council professionals. At this point attention turned to other areas of spend to identify further efficiencies, until we pointed out the service hadn’t been considered end-to-end from first principles. There were still more improvements to be realised.
We worked with the local team to identify what service users cared most about and sought to design and implement a pathway that maximised these areas while eliminating unnecessary cost and waste.
Implementing the new end-to-end model has cut assessment waiting times from 28 to six days; reduced demand for services by 40% through more effective provision of information, support, and guidance; reduced the number of hand-offs among council professionals significantly; and reduced costs in this already efficient service by over £7.3m annually.
The importance of analysing processes from end-to-end can’t be overstated. If councils have cut costs in isolation then ineffective decisions will result.
We worked with an occupational therapist recently who was proud of her local reablement service, describing how practitioners carefully selected the service users to work with so they could be sure each person would exit the service more independent. This also theoretically reduced the call on limited reablement staff.
This makes perfect sense until we consider the net effect of the costs and benefits to the council as a whole.
Once we had demonstrated the impact on service user outcomes for those individuals who did not receive reablement but could have benefited from the service and had modelled the lifetime costs of the care packages that resulted, an irrefutable case was made to enhance and redesign the service.
The result is over 250 additional service users receiving reablement every month and a £4.7m saving for the taxpayer.
Most councils have undertaken efficiency programmes since 2008 but hidden opportunities like the ones above exist, even where significant aspects of services have been outsourced. It’s exactly this end-to-end approach that the government hopes will realise service improvements and reduced cost through integration.
With the budget challenges of 2015‑16 and beyond still to be solved, there has never been a better time to think about how council objectives can be met in both efficient and effective ways.
Steven Phillips, associate director, Newton Europe
Are your efficiencies effective?