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Mitigating the Barriers

Cultural

Recommended approaches for cultural/process
4
Title
Mitigation type
Implementation
Strategy description
Tim's comments
Technical effort
Pointer to Tech Doc
Stakeholder Effort
Existing case study
Benefits
Measure of progress
1
Area-wide Physical activity session data collector
Cultural/Process
ODI supporting local
To increase the take up of OA and the range of information available, Local Areas (probably better at the Integrated Care System level), should provide an application that will allow every Activity Provider (and community group) in their area to load their session data on to an OA feed collector. This then needs to be widely promoted to large, but arguably more importantly to smaller, hyper-local providers that normally deliver a more appropriate “offer”
None
NA
M - Identify and procure an application to be used as a default in the area. Promote this and better alternatives in case someone prefers one of those. Simple aim is to get everyone on OA data feed.
Greater Manchester and LB Westminster councils have taken this approach
Builds critical mass
How many providers are on an areas OA opportunity feed? How many providers are there in the aea?
2
Managers understanding of open data benefits
Cultural/Process
ODI supporting local
Open data seems to be something that people are doing because someone has told them to or because someone has paid them to do it. Success will depend on a need to use open data.

The managers are at the heart of this process and so this strategy recommends that they are helped to understand the benefits that open data can bring in joining up the many systems across the different sectors in their Integrated Care Partnership and ideally the Integrated Care System. The
@Procurement
strategy will be a key weapon for managers but having them on board to drive the take up of OpenActive will be key.

NA
NA
M - Create an ICS/ICP benefit awareness raising campaign with links to open data training courses
Creates a case for demand
3
Activity buddy
Cultural/Process
ODI supporting local
It was very clear that the majority of the current SPLW clients would require some form of ‘hand holding’ initially. This was mostly undertaken by the SPLW themselves. However it was noted that this may not be the best use of their time. One
@SPLW
teams interviewed had their own list of volunteers/befrienders that they used to help their clients (most of whom were also former clients themselves). Indeed taking on these volunteering roles is known to be beneficial and short form part of SPLWS strategies locally. There are a number of volunteer management systems out there and it is thought that these could be beneficially aligned as Social Prescribing progresses.

There are a number of initiatives looking at making better use of volunteers e.g
@#r27

There isn’t an easy way to couple a volunteer management system and so this strategy is simply to highlight that it may be useful for
@SPAcP
to consider linking in some way to a volunteer management system
NA
M - Line up SPLW with local volunteer management systems
@#r27
Aligns OA with other data/systems
4
Social physical activity / Activity by stealth
Cultural/Process
ODI supporting local
Many SPLW have said that physical activity is not top of the agenda for their clients. Often this is because they see exercise as a burden and something they won’t enjoy. However Service Users have explained that they do enjoy socialising. This is a simple strategy for activity providers who wish to be attractive to Social Prescribers to consider offering social elements into their activities. Activity providers should complete the
@Attending-type
to show the group work but then use the
@Client activity confident
and
@Activity further info
to promote the social side of their activity.

Social prescribing link workers tend to be currently supporting clients who have complex needs. It is not surprising that physical activity is not top of their ‘to-do’ list. They prefer more social and interesting activities than doing physical exercise.

The link workers generally work on a shared decision making process and so physical activity has a referral rate of around 10%. (Note this is a lot higher if the client is referred into frontline workers working in the ‘active’ sector). This may be a result of the motivation generated by the frontline worker. See
@Training frontline workers
strategy.

UKActive have said that getting people moving is a step in the right direction and there are a lot of more interesting and social activities that involve physical activity. This strategy is about promoting activity through a more interesting and social angle. Use of the
@Pathways
strategy is one way to achieve this. Encouraging leisure centres and local activity providers to consider
@Social physical activity / Activity by stealth
would be another idea.
NA
AcP - Try to describe the social elements in the physical activity and perhaps include photos of people enjoying the physical activity together
Improves means to identify appropriate activity
5
Investment into the right tools for SPLW
Cultural/Process
ODI supporting local
Many frontline workers interviewed were frustrated that they don’t always have adequate resources, technology and tools. Encouraging people to take up exercise / attend any local group when they face many other challenges will rely on exploring the options together to build consensus. SPLW need access to the right mobile tools and devices to be successful in this respect.

This is not really a strategy but a statement to understand that implementing a digitally enabled data-ecosystem will need all stakeholders to have access to the right hardware,
NA
M - consider the hardware as part of the costs of a worker
Improves chances of ecosystem implementation
6
Place Implementation guidance
Cultural/Process
ODI supporting local
Deriving real value from OA is dependent on an end to end process across 4 stakeholders (see
). The ODI provides existing guidance on implementing elements of OpenActive as discreet projects.

This strategy recommends a “blue-print” programme plan that will set out a headline plan and supporting tools and guidance on how to implement OA and realise benefits across an ICS. Ideally this would be a programme at an Integrated Care System (ICS:
) level so that it had the cross-sector governance required to make it successful. The guidance should explain things from a cultural, process and technical point of view and be aimed at project managers who have the skillsets to make this happen. It is this place-based adoption that drives the greatest benefits to all partners.


NA
ODI to work with a place-based implementation to document an approach
Improves chances of ecosystem implementation
7
Digital maturity of the ecosystem
Cultural/Process
ODI supporting local
The research found that most frontline workers and activity providers have sufficient skills to be able to use the necessary tools / software packages. What is missing is the recognition that data / information about what activities are available should be captured and maintained through a federated model, such as adoption of OpenActive. People are too willing to capture and hold their own information and accept the overhead to maintain this (or more frequently, they don’t maintain it and are happy to then use inaccurate information).

At a local, probably at an ICS level, there must be stronger policies for adoption of open data and better adherence to this policy. This will free up frontline worker time, improve experiences for patients and deliver a step-change in the ability to help people engage in valuable and appropriate exercise and engaging in their communities. Citizens, frontline workers and society don’t want to use websites - and local leaders must push hard for a more data-integrated way of working.

During 2019, Active Lancashire, on behalf of the Lancashire and South Cumbria ICS undertook research into the digital maturity of social prescribing across the VCFSE. This shows, for example, a continued focus on websites by the sector, rather than recognising the opportunity to shift to a more data-enabled model
@Digital Maturity

Managers involved in SP will be key influencers to get on board here - see
@Managers understanding of open data benefits
NA
M - Attend and provide open data appreciation training. Policies on adoption of open data
Improves chances of ecosystem implementation
8
Holistic approach
Cultural/Process
ODI supporting local
Most SPLW commented that physical activity is not top of their clients’ lists - who tend to be pre-occupied by issues that might relate to debt, losing their tenancy, their job or suffering significant Mental health stress. The
@Pathways
strategy, could be enriched to and so it will be discussed perhaps later when they are through the crises. However, research is suggesting that physical exercise will help with well-being, mental health and creativity so it might be wise to consider a more holistic approach.

This strategy is suggesting that rather than a SPLW queueing up the physical exercise chat for down the line, that they chat about the issues that are bothering the client but they also talk about getting them to be more active as it will make the client will feel better. The SPLW can use strategies like
@Social physical activity / Activity by stealth
but the point here is to include physical activity as part of a holistic quality of life discussion.

have a course for SP to be more confident at referring into physical activity but care is needed to stick with the holistic and personal approach and not be tempted to push people into activities.
NA
M - consider a process to manage a holisitc approach which considers a balance of social, guidance and activities.
Improves means to identify appropriate activity
9
Pathways
Cultural/Process
ODI supporting market
Activity finders that simply search for named activities (
@Activity-type groups
) are great if you know what you are looking for. Frontline workers and patients, however, will benefit from wider search criteria to be able to find activities that are appropriate for the individual’s needs and interests. Activity finders could be encouraged to use
@Organization/Organizer
,
@Social physical activity / Activity by stealth
,
@Accessibility
as filters. This strategy introduces the concept that
@SPLW
will be familiar with in the NHS - pathway. A pathway might be the identification of a particular need or health condition that has a set of appropriate activity types connected to it. Pathways could have several steps each with appropriate
@Activity-type groups
and
@Intensity levels
.
DISCUSS WITH MIKE
NA
M - Managers will have to facilitate defining pathways in terms of
@Activity-type groups
with
@Intensity levels
. This could also include
@Accessibility
and
@Activity facilitation
.
Improves means to identify appropriate activity
10
OA Governance
Cultural/Process
ODI working collaboratively at national level
ODI have been very successful at “governing” OpenActive, with growing adoption of the standard within the physical exercise / sport arena. Broadening this success so that OA underpins exercise-referrals by SPLW, will benefit from cross-sector governance; without this, the alignment of OA with other emerging and developing open standards and related taxonomies will not happen and will cause confusion and duplication. Open Referral UK is currently going through an exercise to define its future governance, sponsored by DCMS and MHCLG. At the same time, a project led by the South West Academic Health Network is looking to define what standards the NHS will be recommending must be adopted by Social Prescribing systems. It is easy for this strategy to just say, “create a cross-sector governance with teeth and budget” but without this then the obvious benefits of open data will always be a struggle.
NA
ODI to consider recommendations
Joining sectors up
11
Procurement
Cultural/Process
ODI working collaboratively at national level
Procurement is a very powerful tool to drive adherence to open data standards. If the public and third sector insisted (desirable or essential) on compliance to the standard as part of a procurement exercise then progress will be made. For example, the project that is led by SWAHN -
expect compliance with OR APIs to be included in their procurement framework
@HSSF Essential & Desirable proposed final criteria
.

This strategy recommends the
@OA Governance
strategy should work with all sectors to encourage them to specify that OA and OR (and other) data standards are written into their relevant procurement strategies. Any procurement not asking for open data standards should be justifying why not.
NA
M - Include in procurement documentation
Drives compliance to OA
12
Training frontline workers
Cultural/Process
identified a need for Social Prescribers to be trained to be more confident in advocating sport and physical activity to their clients. This need was also apparent from this user research.

London Sport have created a training course
which can be reused and so this strategy is simply raising awareness and recommending to provide this training to SPLWs.
NA
FW - Attend trainnig course
Increases likelihood of referring a physical activity
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