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Designing an integrated carer support service

Department of Social Services

In 2015, Apis was engaged to work with the Department of Social Services to redesign the Government’s system of support and services for Australia’s 2.7m carers. Our services focused on service and business design, user research, sector engagement and strategic advisory.

Challenge

In the 2015-16 Budget, the Government committed to redesign how it supports Australia’s 2.7 million carers, this included $33.7 million over four years for the establishment of Stage 1, a national carer gateway (Carer Gateway). Supported by Apis, DSS successfully launched the Carer Gateway in December 2015, delivering information and support to carers through a website and national contact centre.

The focus of Stage 2 involved working with the sector to design an Integrated Carer Support Service (ICSS). The Service Delivery Model developed through an 18-month co-design process (including two rounds of national public consultation) has formed the basis of a proposal to Government to secure funding and support for the implementation of the new service system.

The current system of support and services available to carers has evolved in a piecemeal fashion over the course of 20+ years. As a result, the Government’s investment had tended towards high-cost, reactive services such as emergency respite. Our challenge was to design a better investment approach; an approach that would improve carer outcomes and reduce future costs. It is well documented that the caring role has a negative impact on the lives of many carers.

The business problem facing our design team was to:

  • Identify what services and supports were proven to be effective in lessening this impact and improving a carer’s overall quality of life
  • In turn preserving the important relationship between carer and care recipient, and
  • Avoiding the significant replacement care costs that are incurred if the informal care (provided by carers) can no longer be provided.

Weight the Government’s investment towards low-cost, yet effective, preventative services;

  • Support carers in the important early stages of their caring role; and
  • In turn preserving the important relationship between carer and care recipient, and
  • Target carers most in need of support (i.e. those carers for whom the caring role is having the most detrimental effect).

 

Solution

At the core of our approach was the establishment of productive working relationships with carers, subject matter experts, services providers and peak bodies through frequent co-design workshops.

This included:

  • Establishing close working relationships with influential sector stakeholders early in the process, and building their confidence and trust. This was essential to ensuring their continued engagement and support of the process and resultant design;
  • Discovery activities with existing providers early in the engagement to document the current state, understand the strengths and weaknesses of the existing system, and identify the carer cohorts to be engaged;
  • Filling gaps in the current state of knowledge through extensive secondary research activities, such as a global literature review and national carer surveys; and
  • Allowing for public consultation and feedback on the Service Concept and Delivery Model.

Our co-design reference group (up to 150 individuals) saw the design of the future system evolve over multiple iterations – in response to their feedback. This created a sense of joint ownership for the final design. The quality of the resulting design was demonstrated through the overwhelming positive response we received through two rounds of national, public, consultation.

 

Outcome

Apis successfully delivered a Service Delivery Model for the Integrated Carer Support Service and working with the Department, secured funding and support from the Government for the implementation of the ICSS.

Our work reflects and incorporates the views of key carer support sector, whom we engaged through a National public consultation and throughout the co-design process.

Discovery activities informed our design concepts of the future system (referred to as the Integrated Carer Support Service or ICSS), including a literature review (one of the largest and most comprehensive reviews of its kind – spanning international research across the health, education and aged care domains) and a national survey of more than 1,300 carers.

We undertook an 18-month co-design process with a Ministerially appointed expert reference group and more than 150 carers, subject matter experts, services providers and peak bodies, that resulted in the development of the Service Concept and Service Delivery Model for the future Integrated Carer Support Service.

Our proposed service delivery model provides carers with:

  • A ‘single door’ through which to access a range of carer support services, including respite, peer support, counselling and coaching
  • Avenues for earlier uptake of preventative services, more accessible and flexible mechanisms for accessing support in their own time and creating better linkages between different services received by the carer, and
  • Delivers improved carer outcomes and reduced future costs.

 

Key Success Criteria

  • Close and targeted engagement with key sector stakeholders as early as possible helped build trust and confidence in the design process, and mitigate the risk of resistance to change;
  • Early commencement of discovery and co-design was essential for capturing the broad and diverse range of stakeholder viewpoints, and allowing sufficient capacity for incorporating them into design;
  • Engaging extensively with a wide range of stakeholders and using a variety of communication and engagement techniques helped validate and provide a strong evidence base for the Service Concept and Delivery Model;
  • Providing stakeholders with frequent exposure to prototypes and concepts, with opportunities for review and feedback through governance forums kept them engaged in the design process, and helped expedite the approval process; and
  • The use of easy to understand, visual prototypes helped to enhance stakeholder understanding of complex design concepts.