Partners in East Renfrewshire, at the instigation of Anne Kidd, chief executive of VAER, are working together to develop a new ‘Home from Hospital’ service as part of a Big Lottery Funded programme called ‘Better by Design’. Better by Design is a new approach from Big Lottery, aiming to apply the methods and mindsets of design to improve the social impact and sustainability of Scotland’s third sector. Taylor Haig is delivering this programme for Big Lottery in partnership with the Young Foundation.
Lynne Wardle, Director of Taylor Haig, is working with Anne and partners on Home from Hospital. Here she describes the initiative and what she thinks is particularly exciting about the approach in East Renfrewshire.
When I first spoke with Anne about the Home from Hospital project she was apologetic. “I’m sorry” she said, “but it’s complicated”. She went on to describe the many organizations – public sector, third sector and private sector – the local policies, national policies, new initiatives and existing services that connected and related to older people’s journey home from hospital. “But the good news,” she added, “is that we’re have a mature local partnership and I believe we can make a difference”. I believe she’s right.
The official narrative of the issues associated with hospital discharge is well rehearsed. But how do older people experience this situation? What are their expectations, their hopes and fears relating to hospital admission and the transition home, or to a new or newly adapted home? What about health professionals, social workers, carers, family members, neighbours and friends? Actually, what problem is “Home from Hospital” trying to solve and whose problem is it anyway? In a complex system there will be many different perspectives on both the problem and the solution.
As with any design-led approach we began with an exploratory phase. A workshop with stakeholders [practitioners] informed the initial ‘design brief’ and from there we’ve drawn on ethnographies, case studies, desk research and interviews with stakeholders to shape the approach.
Interestingly, when talking with stakeholders it was noticeable that most said very little about “Home from Hospital”. Instead, they spoke about their realisation that things had to change. The current systems and services to support older people don’t make sense in the changing world we live in. Stakeholders experienced a tension between ‘keeping the lights on’ – maintaining performance within the current paradigm – and working in new ways and with new models that haven’t yet got a clear form. The people in the partnership were restless and thoughtful but also open minded and optimistic – a great basis for a design-led approach!
It is apparent that partners in East Renfrewshire have positive regard for one another and empathy for the day-to-day pressures that can get in the way of innovation and change. They are also prepared to challenge assumptions and really seek to understand what people want and need and what assets, capabilities and capacity exits in communities that could be reconfigured in service of older people. They also want to get on and try things, to co-design with older people and prototype services quickly. Through learning by doing they hope to show not only that it is possible to design improved services for older people, but also it is possible to change the relationship between commissioners and community providers, between professionals and volunteers and between services and people who need support.
In East Renfrewshire, we’re not only developing a service; we’re prototyping a process, a way of working together that can be applied to other challenges and one that we hope will have the potential to sustain system-wide change in the way communities and public services collaborate to make life better for people.
To quote the well-known anthropologist, Margaret Mead, “Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.”
See http://blogs.iriss.org.uk/from-hospital-to-home/ for the original blog