Enabling Social Prescribing

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Project Management

Project proposal

Simon Dickinson

Ian Singleton

Presentations

Identifying barriers & mitigating strategies to inform OpenActive

Background

Early intervention and prevention initiatives such as social prescribing seek to reduce the cost of the public sector in dealing with ‘preventable’ conditions whilst at the same time improving an individual’s quality of life. It is widely held that participating in physical activity will improve both physical and mental health.

Reliable and informative data detailing the type and availability of local physical activities is fundamental to the success of a social prescribing initiative. The frontline workers would like to focus their efforts on helping their clients but find themselves in the position of needing to carry out research to understand the suitability, accessibility, eligibility and availability of activities. Inevitably this results in missed opportunity both from the client missing physical activity and the provider missing out on potential customers. This leads to a decreasing community health ecosystem which will be detrimental to all. Providing the right data at the right time will create the opposite effect and grow the community health ecosystem which in turn will benefit the public-sector purse and improve the quality of life for individuals.

OpenActive is an open data standard that is rich in specific session detail and is machine readable such that it can be consumed by applications that frontline workers and their clients use to find and plan activities to meet their needs, geography and times available. OpenActive provides reliable up to date data as it uses the data from transactional payment systems which are well maintained due to the commercial opportunity provided to the data source. OpenActive has been used successfully with national campaigns such as ‘This Girl Can’ and ‘Fit for Life’ and offers a number of commercial products through working with partners.

The problem

The ODI is looking to undertake some research that will help foster rich local ecosystems of prescribing opportunities by:

Exploring requirements for, and barriers to, data access and data sharing for social prescription at the local (council) level, including physical activity data

Developing strategies for surmounting identified barriers, and measuring the success of these

Undertake a gap analysis of OpenActive data standards and tooling with regard to these strategies

Proposed Project

The following five pages set out our proposed approach to the work.

The limited timescales are tight, but we have invested significant effort considering the detailed plan and are confident that we can deliver on time. We have identified three main milestones, as follows:

KPIs and Barriers identified

Strategies formed

Recommendations made

Kick Off and ongoing Project Management

The key steps and activities will be to:

Hold the virtual briefing meeting with ODI

Develop the proposed stakeholder management board

Capture the Project Initiation Document (PID)

Provide the ongoing weekly progress reporting

The initial virtual briefing with ODI will be critical to provide an initial oversight of the broader research that exists, to address any areas for clarification and start to build a robust working relationship. This will inform the subsequent documentation of a PID for sign-off by a project board for the work. This will be signed off by the board at the first meeting and distributed to the stakeholders. A highlight report based on the high level plan will be produced each week to support the regular meeting with the ODI and communication across the board and stakeholders. The key milestones (KPIs and barriers identified, strategies formed and recommendations made) will provide opportunities for a wider engagement with interested parties through ‘show and tell’ exercises.

It will be critical to have strong agile project leadership and management to provide focus, coordination and keep deliverables on track due to the limited timescales and the breadth of stakeholders from a variety of organisations across the place.

The approach will be to create a project board of senior managers from across the five stakeholder groups identified (managers, frontline workers, activity providers, service users and application providers) with other influential and insightful stakeholders e.g. Sport England, Public Health, Third Sector Social Prescribing, NHS Social Prescribing and to meet with them three times across the project at the key milestones (KPIs and barriers identified, strategies formed and recommendations made). A project team will include the main consultancy workers and a representative from each of the stakeholder groups (see next section).

Desk-based research & analysis

The project team has a good understanding of OpenActive and the existing data standards and tooling. The purpose of the desk-based research is to consolidate and build on this existing knowledge through the following activities

Document stakeholder analysis and develop roles profiles - identifying organisations and roles across the local social prescribing ecosystem

Review and capture a more detailed understanding of the current OA standards, tooling and deployment

Complete a wider review of ongoing research into social prescribing initiatives nationally and locally to Pennine Lancashire.

Stakeholder analysis and develop role profiles

Digital Gaps have secured commitment from Healthier Pennine Lancashire to provide access to stakeholders as required. Pennine Lancashire is one of the five Integrated Care Partnerships (ICPs) across the Lancashire and South Cumbria Integrated Care System (ICS). There are 46 ICS partnerships across the country that represent the formal place-based collaborations between NHS, local councils, voluntary, community and faith sector organisations, public sector and local communities. Working alongside Pennine Lancashire will provide the right access to input from a broad range of roles and professionals such as link workers (employed by councils, health providers and by the third sector), council workers, social workers and district nurses working in integrated teams, GPs, end-users and providers of activity sessions. Working across the Pennine Lancashire footprint will provide a diversity of service user needs with rural and urban areas as well as deprived and relatively wealthy areas; it will also ensure we work across at least three council areas (Lancashire County, Blackburn-with-Darwen and at least one of the Pennine Lancashire District Councils. The wider Integrated Care System (ICS) will also provide a board member and are very interested in the synergy with current social prescribing initiatives.

The stakeholders will be divided into five groups broadly covering their roles in the ecosystem:

Managers: responsible for strategic decisions on public health, budget setting and commissioning

Frontline workers: responsible for ‘prescribing’ activities to meet personal need

Activity providers: responsible for providing activities to meet personal needs

Service users: responsible for deciding which activities to participate in

Application providers: responsible for developing ‘tooling’ to support the above ecosystem roles

Healthier Pennine Lancashire will provide people in various roles as per the table given in section 10 below. We would ask Active Lancashire to help with recruiting a number of activity providers.

An initial document review and a short interview with a single representative from the roles identified above will provide the basis for understanding the structure of the social prescribing ecosystem and for planning the user research. This will also inform development of the user and frontline worker role profiles which will be used to structure the research and be important to enable robust understanding of the barriers and issues for these different stakeholders. In particular this will inform any misalignment and need for development in terms of matching / mapping of current OpenActive standards against requirements identified through the research.

Personas for the typical users and the frontline worker roles will be drawn up to help empathise and structure user research and to provide a framework to identify relevant barriers . This work will also be used to position any need for controlled lists required by a role e.g. OA concepts, OA activity-types or others identified as needed; service/buildings accessibility, service-quality, outcomes etc.

Current OA standards and tooling

We will look to the ODI to provide an overview of current OpenActive standards, and the related ODI tooling for OpenActive including partner products. OpenActive provides the ability to join data and systems together and so effort will be made to create a comprehensive list of the applications in use across Pennine Lancashire. These will be grouped or tagged with reference to those used to collect information, assure information, consume information or suggest changes to information. This will be summarised and added to the Coda.io site to consolidate our understanding and ensure we have this to hand alongside the user research work at the end of milestone 1 (KPIs and barriers identified).

3.2.3 Review of wider research

The final set of activity in this stage is to identify and consider the wider set of research and initiatives related to social prescribing and access to accurate data about services and activities; this will include both local and national initiatives. One of the keys to success will be aligning and joining up these initiatives and ensuring that OpenActive is recognised as a valuable set of key information.

Digital Gaps and Porism are aware of and have worked on a broad range of related and relevant initiatives, some of which are outlined below. We will establish communication links with these programmes, understand their ambitions / purpose and make them aware of this OpenActive research and subsequently identify the potential overlaps and synergies - to ensure that the final recommendations can build upon and consider these opportunities.

The following lists our current relevant knowledge and experience at this stage:

Local Government Association (LGA) Loneliness projects where Digital Gaps and Porism were the main partners to LGA - considering adoption of Open Referral UK

Open Community discovery work where Porism with Digital Gaps and an application provider, Placecube, developed an alpha with Bucks CC. There is a beta in progress now.

NHS England and NHS Improvement Primary Care, Community Services and Strategy Directorate work on a “national minimum dataset for social prescribing”

What AccessAble does and their taxonomy

Digital Gaps are currently involved with a pilot study undertaken by the Lancashire and South Cumbria ICS to trial the implementation recommendations from the LGA report. An ‘end of pilot’ report is due in early February which also should provide some insight which will benefit this project

Digital Gaps and Porism are aware of and have previously worked with Blackburn on an LGA pilot to consider using open referral as part of a strategy to create reliable data about local support services for frontline workers. This delivered a report setting out considerations for implementing an aggregation of collecting information using the open referral data standard, assuring the data and publishing it into some form of data-lake for many applications to then consume from. There is also a user story report which focused on what the frontline workers and clients wanted. Both of these reports will be reconsidered in the light of the OpenActive project to identify any conclusions/recommendations that might be useful

Porism’s work advising the NHS Digital First Social Prescribing Pilot in Enfield and Barnet

NHS Connect development by the Healthy London Partnership

Work by London Sport

Blackburn’s

https://refreshbwd.com/⁠

Digital Gaps is currently working with Elemental, Orb enterprise, Vidavia and, hopefully soon Iplato, to implement the open referral data standard into products that seek to provide the right information at the right time to frontline workers and citizens

Consideration of wider taxonomy mapping between SNOMED and the LGA needs and circumstances - which may be important to help create a speeider mapping of the needs of people being supported by link workers and the breadth of types of activities available through OpenActive

We will establish communication links with any interested party so that they can benefit from the research carried out here. We will look to share progress information following each of the planned milestones. We will create an online space using Coda.io where all our information will be available for others to comment on. We will share social media links to point to information on Coda.io. This will allow a transparent engagement that will undoubtedly help identify barriers from a number of partners.

User research

The key to identifying strategies to overcome the identified barriers is robust user research. We believe that we have a fairly rounded understanding of OpenActive and we have an excellent set of relationships with stakeholders across Pennine Lancashire. We will therefore complete the desk-research comparatively quickly, creating more capacity to invest into the user research to highlight the real issues that are experienced by the stakeholders and provide sufficient insight for the project team to identify potential and practically deliverable solutions.

We are proposing three sets of activity, as follows

Initial one-to-one interviews with a small number of stakeholders

Workshop style user research with larger numbers of people - to consult upon and confirm the initial findings. This will ensure that the recommendations are supported by a richer set of supporting evidence

Consolidation and summary findings.

The user research will deliver the first milestone - ‘Barriers and KPIs Identified’.

The stakeholder analysis will form the basis of those involved in the research. Time is a constraint but the covid-19 situation has made it culturally more acceptable to perform online video interviews and workshops and so we believe that we can do more research than would normally be possible.

The initial user research will be individual interviews with set questions covering data, technical, cultural and management information / KPI considerations, alongside opportunities for personal suggestions and opinions. We will ensure that interviews also consider the different end-user client audiences - where access to OpenActive data (or sub-categories of OA) may be more or less relevant to different needs or groups. Our experience is that some of the real and perceived barriers will be cultural and may relate to wider organisational anxieties and experiences; hence we recommend a focus initially on one-to-one qualitative research, which is likely to deliver in-depth insight and more honest and pertinent dialogue.

Following these initial interviews we will consolidate the findings into a set of summary barriers / issues, with relevant, specific and identified examples. This information will then be used for the subsequent workshop events.

As a small consultancy, we believe that our independence and our skills at facilitating workshops are our greatest asset. This will be critical to build rapport quickly with stakeholders and allow insight into the real rather than superficial barriers; the solutions will rely on practicalities and specifics and we believe that a similar two-stage approach will be critical. We will run three subsequent workshops using Miro and will target an audience of 12 people from a cross-section of the stakeholder roles; this will ensure a rich discussion. We will also request each attendee to fill out a short questionnaire to provide some more quantitative evidence in terms of the key barriers.

The project team will subsequently meet together to create a list of conclusions that will then support the development of strategies and mitigations to address the identified barriers (see next section). .

Barrier strategies and measures

Having ascertained the barriers and issues (see section 4 for current experience of barriers) then time can be dedicated to considering how they can be resolved / addressed.

The strategies will form the second milestone - ‘Strategies formed’.

The personas will help as the project team will create user stories for all identified barriers. This is deemed a standard agile way to explain to all what the requirements might be. Each of these stories will then have a potential solution or strategy which we envisage will be described as a set of steps and/or features. It will make reference to existing tooling and data standards as appropriate. Any KPIs will be aligned to the stories including how they will be measured.

The project team will do the main brainstorming calling on their own experience, the interviews, the existing standards and tooling and the existing complementary research. We envisage initial discussion and consolidation with ODI through the weekly progress meetings, before finalising the findings, which will cover the barriers (to accessing and sharing data at the local level, with the evaluation of their severity), suggestions for mitigating / resolving these issues and recommendations for ongoing KPI / MI reporting (alongside recommendations for establishment of the baseline).

At this stage, we will run a set of workshops with key stakeholders to capture feedback and enable some subsequent action planning. Three workshops are proposed, to be attended by representatives from the identified stakeholders; attendance will be considered and agreed as appropriate in conjunction with input from the ODI and Pennine Lancashire. We would expect to make good use of the knowledge and relationships gained from user research and invite those involved in the research to participate in these feedback sessions.

The project team will devise a set of questions for each strategy to gain feedback from the appropriate stakeholders. They will cover ‘how they will be used’, ‘what benefit they will provide’, and ‘what issues they might create’. These will be used in an engaging way in the workshop but also added to an online questionnaire to gather more specific feedback. This will provide the necessary feedback / demonstration of the suitability of the strategies and the ability of any refinements to OpenActive standards and tooling to meet and mitigate the barriers and identified requirements from the user research.