Thread by @rufflemuffin

Taking 6 weeks out to write up case studies for Snook's 10 year back catalogue.

It's a privilege to have a vantage point across so many industries, sectors, systems, communities.

These are my open short hand notes of patterns I'm seeing

Everyone wants a system that will share data across sectors (housing, social care, health, education, criminal justice system) but is impossible due to data restrictions+poor technology

This comes up as an idea/need in nearly every piece of work I've ever done, still unsolved.

If only people had access to their healthcare data and health care providers had access to good digital services and technology, we would be able to enable many of the conceptual preventative measures that reduce pressure on the system (e.g unscheduled care)

The concept of preventative models like social prescription are great but access to real time data on activities, social events, services in local communities to prescribe is not accurate/available

(Lucky we started a community standard for that -> opencommunity.org.uk )

You can't take an asset based approach to build people's confidence or social mobility if people live in poverty, period. Fix the basics - food, shelter, love. Then build support around them.

People are desperate to talk and for someone to listen. Our services for a very long time have been designed like factories leaving people with only 10 minutes to talk (GP, Career Advice etc)

Nail artists and hairdressers provide an informal but vital 'impartial' space to talk

Information custodianship is poor and it's important because it provides pathways by signposting people to the relevant help in health and other areas of life. Content should be seen as a service, owned, managed and up to date, in a language we all understand.

Website projects have become a boring ask and cookie cutter project for many.

They are actually an opportunity for thinking about how an organisation can support people around stages in their lives or context and what a 'front door' is to any service.

All web design projects are McGuffins (Hitchcock term for the mysterious object in a spy thriller that sets the whole chain of events into motion)

They are the tangible manifestation of your transformation. It's actually about what services you provide and how, not a homepage.

Accessibility consideration has really grown as a requirement and I'm super psyched to see this with more mentions of WCAG 2.1 AA in briefs.

However, this doesn't mean that things are inclusive and there is a long way to go.

Personalised care keeps coming up in really simple ideas.

Name badges for staff with more about who they are
A person's favourite thing as part of the personal plan

These are nice - but we really ought to pay frontline staff more and invest in staff so people aren't exhausted

My favourite concept ever was death doulas. Not new but applied to a health board we worked with.

That said, we haven't got end of life care right working well as a pathway - lots of people end up back in hospital which is, as one nurse told me, 'the last place you want to be'

Asset based approach to seeing the strength in your community and positively what is around you will continue to be something we build into our system designs

We started some thinking with IRISS in 2010 on this

iriss.org.uk/resources/repo…

Many healthcare services I've seen are staffed by sessional or temporary experts.

They 100% fix the injury/issue but don't know the local providers to signpost to for longer term, self managed, community based care. Result often = returning to hospital and pressuring on A&E

Temporary nature of care staff has resulted in loss of consistent people-centered care where we sweat details on supporting people to live full lives

A fond memory is @CG_CarrGomm prototyping a visual care sheet for handover staff to help staff learn about people as humans

The referral process has become the king of dead end services.

Referrals made to support pathways to prevent relapse but not followed up by providers due to loss of contact (both ways) results in defaulting back on hospital/care/other services

The waiting list is the most under utilised service moment.

Exists because there isn't enough capacity to meet needs (e.g mental health)

We've created a population of people 'waiting' for help. I've seen so much deterioration in health due to not hearing anything in this space