Co-producing better ways to manage and respond to waiting lists
Project Background
In recent years, longer wait times have become more common within adult social care. In many cases, delayed care can remove opportunities for preventative interventions, resulting in greater stress on people who draw on care and support, unpaid carers and care services.
This project worked alongside the East Midlands Association of Directors of Adult Social Services (EMADASS) and people with lived experience to co-produce better ways of managing waiting lists for Care Act Assessments.
The project explored how the evidence from this Demonstrator can be made useful in other nations across the UK.
What work did the Waiting Lists project do?
We collated evidence from a range of sources to understand:
- Factors contributing to longer wait times
- Impact on people and carers
- Impact on staff
- Positive actions and potential improvements
The work we did includes:
Listening to local insights
We wanted to hear from a range of people across the East Midlands on the issue of waiting lists. In September 2023, we interviewed ten people who represented their Local Authority on the project’s monthly progress meetings (the Project Management Group). They provided information on how Care Act assessments are managed in their area, the factors contributing to waiting lists, and the strengths and opportunities within their areas to make improvements.
We then created a survey and held an online workshop where we invited people who draw on care and support and informal carers across the East Midlands to share their experiences of waiting lists and their ideas for improvement. We did the same for frontline adult social care staff in the region. We received 84 surveys from people who draw on care and support and carers, with one further contribution via the workshops. We received 83 surveys from social care staff and 15 further contributions via the workshops.
We used this information to get a better understanding of the issues people are experiencing while on waiting lists and what they would like to see improved. You can read more about what people told us in the following summary report or this summary video.
Reviewing published evidence
IMPACT Project Officer, Obert Tawodzera conducted a review of published evidence and grey literature related to the management of waiting lists across health and social care. The review sought to answer three key questions by looking at information published across health and social care:
- What factors contribute to prolonged waiting times?
- What are the impacts on patients and families navigating delays in assessment, diagnosis, and support or treatment?
- What processes and interventions are being used to understand and alleviate waiting lists?
The literature review was initially produced in October 2023. It was further updated in January 2024 to ensure current information was used to support decision-making and delivery.
Establishing a project governance that includes co-production
We established a Co-production Steering Group with representation from:
- People who draw on care and/or support
- Unpaid carers
- EMADASS Project Sponsor
- Frontline Local Authority staff
- Healthwatch UK
- East Midlands Care Alliance
- Voluntary services organisation
- IMPACT Leadership Team
The Steering Group met monthly and provided strategic coproduction oversight, support and challenge to the project. In addition, monthly meetings of the Project Management Group, consisting of a senior representative from each local authority in the East Midlands, colleagues from East Midlands ADASS and Partners in Care and Health, supported the effective and successful delivery of project outcomes.
The project provided regular updates to the East Midlands ADASS Executive Branch to ensure the outcomes aligned with their strategic aims.
Facilitating local co-production workshops
In January and February 2024, we designed and led five workshops across the Integrated Care Systems footprints within the East Midlands region as follows:
- Lincolnshire
- Nottingham and Nottinghamshire
- Leicester, Leicestershire and Rutland
- West and North Northamptonshire
- Derby and Derbyshire
The workshops were open to people who draw on care and support, carers, frontline staff and project representatives from each Local Authority in the East Midlands. They were held as face-to-face meetings to increase inclusivity. The exception was the Derby/Derbyshire meeting which was held online to enable people from all parts of the county to attend.
Working together, we discussed the findings from the surveys, online meetings and evidence review and asked participants to share anything they felt was missing from the collected evidence. We heard what matters most for people in the region and gathered ideas on what types of changes would make things better.
Using the Co-production Workshop outputs to support decision-making
Participants in the co-production workshops came up with lots of fantastic improvement ideas which focused on the following themes:
- Clearer lines of responsibility and communication within adult social care and with other organisations
- More effective system-wide approach to Personalised Care, All-age and Strength-based approach to meeting people’s needs
- Improved public awareness and understanding of adult social care and where to access key information
- Improving the accessibility of adult social care communications with the public
- Using a proportionate, data-informed approach to more effectively manage local assets across the system and empower staff to communicate effectively
- Workforce planning, training and development
We shared all the recommendations from the workshops with the Management Group and Steering Group and they identified the priorities for their local area. Those priorities were shared with senior leaders at the East Midlands ADASS Summit on 8th March 2024. They decided which ideas they would aim to deliver by the end of this project, and which they could focus on over the next 18 months.
The Steering Group met to consider the final recommendations, and agreed the project should focus on coproducing guidance, frameworks and/or toolkits on the following areas:
- Effective asset mapping
- Developing waiting well packs for citizens
- Developing waiting well guidance for staff
This regional work will support local authorities across East Midlands in developing content specific to their community’s needs.
Setting up and facilitating Co-production Task and Finish Groups
The Steering Group emphasised the importance of ensuring the voices of people who draw on care and support, carers and frontline staff continued to contribute to the next phase of the project. We worked with the Project Management Group to develop a delivery approach that embedded coproduction and continued to promote cross-regional working. This took the form of three task and finish groups – one focused on each of the Steering Group recommendations.
To aid effective project management and ensure we were clear in what we were asking of task and finish group members we mapped out:
- the main activities for each task and finish group
- a timeline for each group
- the key perspectives / skills required to support each task and finish group
Throughout April 2024, we used this information and worked with the Project Management Group to recruit task and finish group participants. The Project Management Group contacted their professional and community networks to encourage participation. The Strategic Improvement Coaches contacted everyone who had contributed to the project previously and promoted the opportunity on the project website for expressions of interest.
We received between 20-25 expressions of interest for each of the three task and finish groups with representation from across each of the five Integrated Care Systems footprints within the East Midlands region. People who draw on care and support, carers and frontline staff were all well represented in the groups.
Between May to July 2024, members of the Steering Group co-chaired the three Task and Finish Groups with the Strategic Improvement Coaches. The Waiting Well Pack for Citizens and Waiting Well Guidance for Staff groups met six times during this period. The Asset Mapping Task and Finish Group met three times as additional work was needed between meetings to identify where the group could add value. The Steering Group suggested that the task and finish group should focus on creating a resource to signpost the public to people within and beyond adult social care who are able to connect them with the information, advice and support they require. The draft templates received mixed feedback from the task and finish group. Due to the limited time remaining in the project, a decision was made by the Steering and Management groups to pause this activity. The work completed to date has been handed over to East Midlands ADASS.
What did the waiting lists project create?
The project has created three documents for use across the East Midlands to communicate the region’s commitments to improving how they manage and respond to waiting lists for Care Act 2014 assessments.
The documents aim to:
- reduce stress for people who draw on care and support and unpaid carers through improved information and advice on adult social care, needs and Carers’ assessments and local support (see Waiting Well Pack for Citizens),
- empower adult social care staff in further improving their communication with people who draw on care and support and unpaid carers waiting for needs and/or Carers assessments to enhance their sense of job satisfaction and reduce work related stress (see Waiting Well Guidance for Staff),
- support adult social care managers to foster working environments that prioritise both staff wellbeing and providing a service that adheres to the regional Social Work Practice Framework (see Top Tips for Managers).
The Waiting Well Pack for Citizens and Waiting Well Guidance for Staff are regional templates with sections within them [highlighted in red] which will be edited with local information. However, the consistency of the core information in the documents aims to set regional standards on what communities across East Midlands can expect to receive when contacting their local adult social care teams.
News and Updates
Waiting Lists Demonstrator Launch and Celebration Event
Yesterday, colleagues involved in our Demonstrator project on co-producing better ways to manage and respond to waiting lists in the East Midlands gathered for a celebration and launch event in Leicester. Raj Gill-Harrison, who chaired the project steering group, opened the event before handing over to Jon Glasby, IMPACT’s Director. Jon talked about how we…
Project Team
Naomi Russell
Naomi has worked in social care since 1994, and qualified as a social worker in 2003. Naomi has mostly worked with young people and working age adults, and has worked in various teams in local authority adult social care departments.
In 2023, Naomi completed an MA in Research Methods, with a focus on strengths-based approaches. Naomi draws on her practice experience and her research skills in her role as a Senior Strategic Coach for IMPACT.
Lorraine Mighty
Fuelled by her lived experience, Lorraine has a strong commitment to leading and contributing to social justice change initiatives. Across her 20+ year career in the private and education sectors she has specialised in strategic programme and change management, learning facilitation and leadership and organisational development in multinational organisations.
Lorraine particularly enjoys creative problem solving in complex systems. She uses her natural curiosity, strategic thinking and relationship building skills to support the people she works with in developing values-led, evidence-informed and pragmatic solutions to the issues they seek to address.