Co-producing better ways to manage and respond to waiting lists

We wanted to hear from a range of people across the East Midlands on the issue of waiting lists. So, in September 2023, we interviewed ten people who represent their Local Authority on the project’s monthly progress meetings. 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, and one further contribution via the workshops. We received 83 surveys from social care staff and 15 further contributions via the workshops.

We have used all 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 this summary report or this summary video.

IMPACT Project Officer, Obert Tawodzera is conducting a review of published evidence related to the management of waiting lists across health and social care. The review seeks 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 is being updated throughout the project to ensure new evidence is included. This will ensure the project is using current information to support decision-making and delivery.

We have 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 meets monthly and provides strategic coproduction oversight to support the effective and successful implementation of the intended project outcomes.

The steer provided by this group is shared with the Operations Group which also meets monthly to deliver the project outcomes. The Operations Group consists of a senior representative from each local authority in the East Midlands and colleagues from East Midlands ADASS and Partners in Care and Health.

The project also regularly provides updates to the East Midlands ADASS Executive Branch to ensure the outcomes continue to align with their strategic aims. The Executive Branch consists of the ten Directors of Adult Social Care across the East Midlands.

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.

Working together, we discussed the findings from the surveys, online meetings and literature review and asked participants to share whether anything was missing from the collected evidence. We also used the time together to hear what matters most for people in the region and gather ideas on what types of change would make things better.

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 ideas from the workshops with the project’s Operations Group and Steering Group and they identified the recommendations that are a priority for their local area. Those priorities were then shared with senior leaders at the East Midlands ADASS Summit on 8th March. 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 that is specific to their community’s needs