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User Research
Questionnaire
A questionnaire designed by Digital Gaps to capture the importance & value of ODI user research into identifying the barriers for social prescribing physical activity.
Participation
Importance of identified barriers
Importance of Emerging Barriers
Barrier Title
Barriers
Stakeholders impacted
High
Medium
Low
Button
1
Finding activities
Difficult to know what activity sessions are available
Service users
Frontline workers
Managers
Comment
2
Few OA Activities
Not enough local activity sessions can be found
Frontline workers
Service users
Managers
Comment
3
Little promotion of OA
Not even heard of OpenActive, nevermind find a way onto OpenActive feed
Activity providers
Managers
Comment
4
Exercise not a priority
Don’t see referral into exercise as their role
Frontline workers
Managers
Comment
5
No trust in info
Don’t trust information that exists
Frontline workers
Service users
Managers
Comment
6
Cope with cohort needs
Need to know if the providers can cope with needs of the cohorts
Frontline workers
Activity providers
Comment
7
Activity appropriate for client
Need to know if activity appropriate to client needs
Managers
Frontline workers
Activity providers
Service users
Comment
8
Exact activity offering
Need to understand exactly what the activity/service is offering to ensure client can cope
Service users
Frontline workers
Activity providers
Comment
9
Support to attend
Client lacks confidence, has anxiety, embarrassed so needs hand-holding to attend
Service users
Frontline workers
Comment
10
Difficult to motivate clients
Frontline workers lack confidence and skill set to motivate client to be active
Frontline workers
Comment
11
Client not interested
Client isn’t interested in doing physical activity, too many other problems
Service users
Frontline workers
Comment
12
Demand needed to invest in sessions
Need to know that demand exists before new businesses or sessions will be set up
Activity providers
Comment
13
Demand needed to invest in S/W
Application providers are driven by commercial demand
Activity providers
Managers
Social prescribing application provider
OpenActive application providers
Comment
14
H/W & S/W needed
Don’t have the best hardware device or software
Activity providers
Frontline workers
Service users
Comment
There are no rows in this table
Indication of value added & estimated effort
Value of Emerging Strategies
Title
Strategy description
Lots of Value
Some Value
No Value
Easy to do
OK to do
Hard to do
Comment
1
Area-wide Physical activity session data collector
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”
Comment
2
Managers understanding of open data benefits
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 strategy will be a key weapon for managers but having them on board to drive the take up of OpenActive will be key.
@Procurement
Comment
3
Pathways
Activity finders that simply search for named activities () 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 , , as filters. This strategy introduces the concept that 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 and .
@Activity-type groups
@Organization/Organizer
@Social physical activity / Activity by stealth
@Accessibility
@SPLW
@Activity-type groups
@Intensity levels
Comment
4
Activity buddy
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 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.
@SPLW
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 to consider linking in some way to a volunteer management system
@SPAcP
Comment
5
OA Governance
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.
Comment
6
Social physical activity / Activity by stealth
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 to show the group work but then use the and to promote the social side of their activity.
@Attending-type
@Client activity confident
@Activity further info
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 strategy.
@Training frontline workers
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 strategy is one way to achieve this. Encouraging leisure centres and local activity providers to consider would be another idea.
@Pathways
@Social physical activity / Activity by stealth
Comment
7
Procurement
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 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.
@OA Governance
Comment
8
Investment into the right tools for SPLW
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,
Comment
9
Place Implementation guidance
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.
Comment
10
Digital maturity of the ecosystem
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
Comment
11
Training frontline workers
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.
Comment
12
Holistic approach
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 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.
@Pathways
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 but the point here is to include physical activity as part of a holistic quality of life discussion.
@Social physical activity / Activity by stealth
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.
Comment
13
Accessibility
The accessibility aids available to an activity can be described in two parts, The first are those that are part of the venue where the activity is taking place and the second are those associated with the activity itself.
It is generally agreed that a taxonomy would best describe the accessibility of a venue and activity. As venues are common to all sectors then it is recommended that OA (ODI) should work with a cross sector governance group and a leading disability group to agree an accessibility taxonomy. This research has engaged but this is currently a private sector business model. If an accessibility taxonomy can be agreed then OA should adopt an appropriate subset to establish their Activity accessibility taxonomy.
Comment
14
Date last updated
OA has the ability to recognise when the data was last updated through the last modified data in the feed. This will be made more prominent as a last-updated field to give confidence to the social-prescriber. It is also recommended to include an assurance-date which is looking to future proof OA as whilst assurance is not currently perceived an issue, it could become one.
Comment
15
Target audience
Any frontline organisation, e.g. council, charity, Police, NHS, Housing etc, may make referrals to sessions delivered by local activity providers’. Each sector will have their own definitions of audiences categories and related taxonomies. It would be unfair to expect the Activity Providers to align their activities against every sectors different set of audience categories.
As with the strategy, it is recommended that the OA (ODI) work with a cross-sector governance body to agree a This should be relatively short and focus on key need groups e.g. partially sighted. This will allow each of the sectors to map their own taxonomy e.g. Snomed () to the cross-sector target audience which will then allow applications to filter out appropriate activities based on e.g. a Snomed term.
@Accessibility
Part of the
@Social-Prescribing-Ready Profile
Comment
16
Client readiness
There is concern from Social Prescribers that their client may not be ready for an activity. Generally the OA data set is being reviewed to give a richer set of data to provide enough information for the SPLW to make the best decision concerning their client needs.
The strategy is probably a good one to consider. Also the will help.
@Intensity levels
@Activity further info
This strategy is for the activity provider to develop a readiness check that the can carry out with their client and decide whether the client would be ‘ready’ for the activity. This would probably be carried out normally when the client first joined the session but to avoid making it more difficult for the client this allows the check to be performed by the .
@SPLW
@SPLW
The readiness check could be based on a national standard check e.g. Par-q or their own but it should advise whether the activity is appropriate to the client. The readiness check should be on the activity providers website such that a link can be added to the OA data for the to access. This will mean that both the activity provider and the can focus on providing the best match to client needs.
@SPLW
@SPLW
@SPLW
Part of the
@Social-Prescribing-Ready Profile
Comment
17
Client activity confident
Clients often need motivating and will lack confidence to attend a session that they have not been to before. The can consider the strategy or even the strategy but a really popular suggested strategy is to provide information about the activity through photos. This is not dissimilar to how people might choose to buy their house, a holiday, a car etc. A gallery link could show photos of inside the venue and include describing accessibility as per AirBnB case study. It could include photos of the activity in session, meet the team, what the entrance and reception looks like and whatever else the activity provider wishes to show.
@SPLW
@Activity buddy
@Holistic approach
Comment
18
Activity-type groups
OA has a comprehensive list of activity types but this is only really useful to the SPLW when they know specifically what the client is looking for. The SPLW needs to have a way to find the best activity. The strategy offers one route. The activity-type list is difficult to navigate / search as it is not very broad at the top and so more broader layers could be added e.g. indoor physical sports, indoor physical team sports, indoor non-contact sports, indoor team non-contact sports etc. This would allow the SPLW to consider a smaller number of potential activity groupings to identify potentially well-matched actual activities. are also familiar with the Open Referral UK standards which includes a Service-type. This is a broader set of services which includes some physical activity types. See
@Pathways
@SPLW
@OR and OA roadmaps
Comment
19
Activity facilitation
It is important to s that the activity ‘looks after’ their client. Understanding what facilitation is available is a key requirement. It is a helpful to a client to know if there is a reception, someone who will welcome or meet & greet, whether there is an activity lead to seek help from and what additional support is available e.g. activity helper, befriender, carer. This information can be included in the OA data set. An activity provider looking to accept SPLW clients should be encouraged to complete this information. See
@SPLW
@Completeness checker
Part of the
@Social-Prescribing-Ready Profile
Comment
20
Attending-type
have indicated that they would like to know if the session is for self, 1to1 or in a group as usually they favour the 1to1 and groups.
@SPLW
Open referral has a field called attending-type which gives an indication of the type of attendance - is it a home visit, an online session, an app, a telephone call or a physical venue?
It is suggested to include this field in OA with the extended definitions for physical venue i.e. venue self, venue 1to1, venue group. This might also help with the current Covid restrictions and potential new normal to offer online services e.g. Zoom trainer.
Part of the
@Social-Prescribing-Ready Profile
Comment
21
Provider quality assurance
There are issues of trust with activity quality especially with smaller community groups. The risks should be a case by case risk management decision and the richer data will provide evidence to help that decision. The quality of the activity could be trusted through the quality of the provider.
Sport England have an existing quality standard called Quest.
@Quest Quality standard
MCRActive are doing their own quality check e.g. whether a safeguarding policy is in place. It would make sense if this was a cross-sector initiative but should at least be a cross geographical boundary standard. There are two considerations. Firstly that a common standard is adopted - such as Quest. The second is considering how compliance to that standard is assessed.
This strategy suggests that consideration is given to the ‘Active’ areas trusting each other’s quality kitemark. This may use the same standard as other areas, but in terms of trusting the assessment undertaken this should start across the 33 Active Partnerships borders. The issue with having a wider shared inspection / assessment Geography is not about the trust in the assessment process, but that actually most of the risks / issues tend to relate to provider management. Hence if Provider A is OK in location A, this is no guarantee that the same provider will be OK, 100 miles away, as the management control will be very different.
Technically this would mean an assurance system outside of OA data but adding a reference and a link to verify the accreditation.
Care should be taken as to not burden the small activity providers too much and also not to under promote those without this quality standard as the client may trust their local church even without a quality kitemark.
Note Open Referral allows many quality reviews which could be a local CVS (Council for Voluntary Sector) kitemark, NHS social prescribing kitemark, Active kitemark, CQC or Ofsted etc.
Comment
22
Booking
OA has an open booking standard which if implemented would allow the , having found an activity in the opportunity data, to then immediately make a booking without having to go through a separate booking process to find that there are no spaces available.
@SPLW
At this moment in time, having the ability to easily make a booking for a specific session is not deemed a priority for a . This is because the SPLW is quite prepared to do whatever it takes to get their client to an activity. They are happy to make a phone-call, send an email or even visit a venue to make the booking.
@SPLW
They do accept that having a field that tells them how to make the booking would be useful i.e. which phone number, email or even a weblink.
However, it has to be recognised that Social Prescribing is an emerging practice and there are some concerns about SPLWs spending too much time with clients. As Social Prescribing picks up pace then it does seem likely that being able to quickly book a session will become important.
It is expected that Open Referral will also start to want to be able to book services as the momentum builds for using that open data set.
This strategy recommends using the existing field in OA to indicate the means to make a booking but that the open booking demand is likely to come as Social prescribing progresses. However it is not yet known whether Social Prescribing will become business as usual and so investment to promote open booking might be a bit early.
Comment
23
Activity further info
The need to understand as much as possible about the activity before a client is signed up is clear. The rich data set should prove adequate but changing OA data set and the knock on effect it has to application providers is significant.
This strategy suggests including activity further information links that can be added for the activity provider to add what they think might be useful e.g. FAQ, FB page link, taster sessions adverts, SP only sessions adverts. There should be a text description field for every link and it would make sense to categorise these (FAQ, Social media link, promotions, directions, special notices etc) as this will also give some help as to the sort of thing that an activity provider could provide.
Part of the
@Social-Prescribing-Ready Profile
Comment
24
Intensity levels
It is generally accepted that there are three levels of intensity for physical activity - Low, Moderate and Vigorous. If this was a well defined standard then it would make it easier for to know for sure that the activity providers were aligning to the same understanding of intensity levels.
@SPLW
This strategy suggests that the OA data set includes a controlled list with descriptions for activity providers to describe their intensity level and for the to understand what might be appropriate for their client.
@SPLW
The key is agreeing the definitions which won’t be easy but should be worthwhile and could be added to the cross-sector taxonomy strategies. The science around MET may be able to provide a relatively easy calculation for an individual but needs expert input .
Part of the
@Social-Prescribing-Ready Profile
Comment
25
OR and OA roadmaps
Some were aware of the Open Referral data standard and many Application providers have all been made aware of it as the NHS HSSF are currently considering it as one of their standards required for Social Prescribing software. . They don’t publish their requirements until the end of 2021. They are looking at recommending that Open Referral UK is adopted as a means to access data from service directories. They are also now considering OpenActive.
@SPLW
@#r32
There are different strengths and weaknesses in both standards. Frontline workers across the public and third sector are likely to want to understand what services and activities are ‘out there’ in the local community.
This strategy is suggesting that these two open data standards would benefit from identifying a roadmap which would see them merging over a period of time. It is recognised that existing investment has been made on both sides and hence the ‘over time’ suggestion would give fair warning but going forward would appear to be complementary, favourable to the investors and make better use of public sector investment.
The risk to both standards of not merging is that it will create unnecessary competition and costs between them to become The defacto standard, extra cost for the application providers, confusion for the service/activity providers and ultimately the frontline missing out on knowing what is available without needing two different tools. An alternative strategy would be .
@Converting data to and from OA and OR
Comment
26
Frontline worker review / rating approach
Almost all SPLW interviewed expressed nervousness about recommending anything that they have not visited. There is a recognition that additional information that can be included within OA may partially address this. There is a potential solution where feedback from visits from “peer frontline professionals” will normally provide adequate confidence for a referral to be made.
Currently this often happens informally within individual teams but the strategy here is to widen this peer network of trust such that if a fellow frontline worker (perhaps at ICP level) has given the ok, then they won’t need to check it out themselves. The recommendation is to explore this a bit further to identify a professional rating system that could use to provide confidence to . A small set of national pilots could define and trial the model to capture the impact in terms of improved productivity and increased numbers of referrals.
@AcP
@SPLW
Comment
27
Sufficiency & demand
As take up becomes fairly mature, then the resulting open datasets will provide evidence of sufficiency and demand which would support managers and commissioners in spending budgets to provide local support. This in turn is useful information for the to meet the demand and of course the ApP to provide the software tools.
@AcP
This strategy suggests that some form of management information dashboard might allow a local understanding of what the current situation is and provide evidence to move things forward be you a manager or Activity provider or Application provider.
Comment
28
Richness checker
It is recognised that the quality of the data will be mixed. Various amounts of effort will be put into data entry according to the business case for that organisation. If the strategy of is accepted then the ability to check that an Activity has completed all that data would be useful.
@Social-Prescribing-Ready Profile
This strategy suggests that a richness checker tool be made available so that ApP can surface the that have made the effort to meet the SP ready profile. This tool could be commissioned / commissioned by ODI and made available to ApP at a subsidised rate to incentivise adoption.
@AcP
Comment
29
Completeness checker
If are recommending that they would like certain fields completed before a referral will be made then as in strategy then the would benefit from being informed of where their current entries fall short.
@SPLW
@Social-Prescribing-Ready Profile
@AcP
This strategy suggests that an automated completeness tool would encourage and support an AcP entering the data to give them every chance of receiving a referral. This should also increase the quality of the data. This tool could be commissioned / developed by ODI and made available to ApP at a subsidised rate to incentivise adoption.
Comment
30
Language translator
It has been pointed out that whilst SPLW tend to deal with language barriers in their own ways, it would be useful if the text available from OpenActive could be available in different languages. Effectively this should be left to innovators and wouldn’t be expected to be part of the OpenActive data set. Lancashire and South Cumbria are progressing with a pilot based on Open Referral Service unique IDs but this could be reused for OpenActive.
Comment
31
Curation
It is generally accepted that the OA data set is not adequate for a number of data consumer’s usage. This creates a demand for a commercial curation service. Currently there is only one commercial service. This commercial service is generally well received and provides value for money. However, due to the need for this service it does create a dependency risk which may put off some organisations and will put all at risk of price increases they might have to accept.
This strategy suggests some consideration of encouraging other commercial offerings to create some competition in the market and provide some fall back if any one organisation should close for whatever reason. Another alternative might be to work with the single commercial offering to provide some form of franchise across the areas of the country. Perhaps in similar way to the telecommunication and utility supply companies. This will help with the risk of scale if OA takes off and requires curation then this single supplier may struggle to scale.
Comment
32
OA feed and API
The technical review has found that it is quite difficult for a developer to consume data from the RDPE feed. More than one ApP commented that their only real option was to use the ‘Imin’ API.
It is recommended to improve the guidance material and provide more support to enable consumption of the Feed but also to develop a standard REST API definition that could consume the feed(s) and present another consuming means for developers to make use of.
Comment
33
Converting data to and from OA and OR
Alongside the range of projects that are looking to position OA as a potentially valuable asset in the SPLW world, there is a similar parallel set of initiatives that are recommending adoption of the Open Referral UK data standard . This work is led by .
A comparison of the data fields of the two standards has been carried out . An attempt has also been made to convert OA data to OR format and technical considerations have been carried out to allow the conversation from OR to OA.
This strategy suggests that an alternative to bringing the standards together through , might be to provide the ability for converting data to and from each standard. This will give an amount of flexibility to the market to make sense of the open data collected and provide aggregated views as appropriate to the frontline.
@OR and OA roadmaps
Comment
34
Social-Prescribing-Ready Profile
There are a number of additional fields of information that it is recommended will increase the likelihood that patients take-up a referral to take up an identified physical activity. These in essence provide additional information to address potential concerns that may be relevant to SPLW patients. It is recognised that this will create a data burden for some activity providers and hence populating this set of information should be clearly signposted (within the chosen OA compliant software packages) as only relevant only for activity providers willing to welcome SPLW patients into their sessions.
There are also existing OA data fields that will be important but are at risk of low data quality and these should also make up the SP ready profile.
This would then be used by the to only view activities that have completed those fields and to inform the data provider that they need to complete further fields if they want to receive a referral from a social prescribing system.
@Richness checker
@Completeness checker
Comment
There are no rows in this table
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