Our health and care system faces increasing pressure from an ageing population, a backlog of people waiting for support, staff shortages, and evolving healthcare needs. Health charities provide essential support where the NHS can’t or has insufficient funding and are under pressure to increase reach and impact.

To meet rising demand, services need to be scaled but they are often supported by systems, technology and processes that have been in place for some time and are no longer fit for purpose. 

What’s more, in the rush to digitise services during the pandemic, technology and system choices were often based on immediate need rather than a holistic view of an organisation’s long term need.

These factors hinder growth and can result in fragmented service delivery and a disjointed user experience for staff and end clients. People are forced to navigate a spaghetti of systems, websites and contact points which is confusing and frustrating.

Overlapping systems also mean duplicated data and inefficient processes. Again causing more administrative overhead for staff and hindering an organisation’s ability to operate efficiently.

This all impacts effectiveness: people fail to sign up or drop out of services. For staff, at best it reduces job satisfaction, at worst it means they look for new jobs. 

Fragmentation of services and disconnected data also makes it difficult to track and measure impact, and therefore hard to demonstrate value to stakeholders. Meanwhile, duplication of systems and processes makes it hard to adapt to the changing needs of users, increases operational costs and limits scalability.

So change is needed. But how do you scope change when the subject is multifaceted and complex?

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‍Understanding the landscape: mapping the as-is service ecosystem

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First, we need to build a shared understanding of the problem. The most effective way to do this is by collaboratively mapping services, processes and systems.

Start by understanding experiences: 

• Who are the staff involved in delivering services and what do you already know about their experiences, needs and pain points? 
• What data exists around the way services are being delivered?
• How are end users interacting with services and what do you already know about their experiences, needs and pain points?
• What are the touchpoints and commonalities between services?
• What are the processes that support these interactions, what data is generated, where is it stored and which systems currently power delivery?

The best way to gather this insight is through a combination of depth interviews with subject experts across your organisation, combined with workshops where teams can collaboratively prioritise and organise thinking.

The insight can be represented in an as-is service ecosystem map, highlighting users, processes and systems. Then you can overlay known pain points, and gaps from the perspective of both internal and external users.

It can be helpful to think about service delivery as a theatrical performance: service users are the audience, frontstage represents the service elements they interact with and backstage is where processes, systems and staff facilitate delivery.

You will inevitably uncover areas where you don’t have much data or where the data shows a particular behaviour that you don’t understand. In which case you can conduct more research into that particular area.

At the end of this stage you will have co-created a detailed map of your current services. If you do this on a wall where everyone can see it, you will generate further insight and discussion. Once it’s transferred to a whiteboard or document, treat it as a living document and encourage further contribution.

So now you understand the as-is systems and experiences, how do you move forward?

It’s time to collaboratively identify change candidates. Where are the biggest opportunities to improve experiences, streamline systems and optimise processes?

Towards a unified service delivery model

Instead of the current fragmented approach, where services and systems have evolved organically over time, a future model can bring everything together into a cohesive ecosystem - a unified service delivery model. 

This means streamlining processes, creating service patterns, eliminating duplicate data, to create better experiences for staff and service users.

The foundation of this model is a deep focus on staff and service user needs. Because you have mapped out needs across the full scope of someone’s end to end interaction with your organisation, you can now design the model around those needs.

This service delivery model can be represented as a to-be service blueprint. This uses the customer journey as a timeline and details the staff actions, processes, tools and systems needed to support that journey.

This will serve as a foundation for experiments that enable you to test and learn. The to-be blueprint will evolve and improve.

Benefits of creating a unified service delivery model include:

• The ability to scale service delivery for more reach and impact
• Improved experiences through better integration and coordination of services
• Increased operational efficiency and cost savings
• The ability to define strategic priorities underpinned by clear evidence
• More accurate measurement of impact, as data is centralised and easily trackable
• Better collaboration and knowledge sharing amongst staff
• And, at the heart of it, happier staff and users

Once you know how you want to deliver services, you can then evaluate your current systems against the model and identified needs. Can you deliver the model based on adapting existing systems or do you need to make fundamental changes?

This work will put you in a place to make evidence-based decisions about what is fit for purpose and what needs to be replaced. Meanwhile, there are quick-wins that you can implement to improve experiences while bigger changes are scoped and funding agreed.

Creating the foundations for growth

Investing time and effort in mapping out your current service ecosystem will build the deep understanding and shared vision that is needed for meaningful change to happen. 

Subsequently collaborating with your team to create a unified to-be service delivery model will result in improved service experiences for staff and service users, improved efficiency, evidence-based decision making and, ultimately, the ability to support more people in need.

This joined-up, user centred approach to service delivery will position your organisation to adapt to evolving healthcare needs, scale its reach, and demonstrate tangible impact to stakeholders.

How we can help

We work across health and care to help organisations improve the way they deliver services.

Our clients include NHS England, NHS Mid and South Essex, Macmillan and Scope. We uncover user, patient, carer, clinician, and staff needs, co-design change, prototype opportunities for innovation and build watertight cases for investment.

By working with us organisations achieve clarity and vision for needs-based transformation, confidence around where to invest, improved service design capabilities and ultimately better experiences for patients, carers and staff.

Drop us a line to see if we'd be a good fit for your situation. Contact sam@macementer.com, 0117 251 0177.