The response by councils to COVID-19, person centred design.
An example of the importance of understanding the nature of demand into a service, and ensuring that the variety expressed in the demand is reflected in the design — using Councils response to COVID-19.
There seem to be two general types of response to COVID-19 disruption to the publics lives, and both are reflections of different fundamental ways of thinking about the design of services:
1 We specify the design
The response where we create online tools to identify, learn about, and specify the required outcomes. These outcomes are often food parcels, shopping, prescriptions, befriending, etc. We pre-define the service that they need, and we design a flow of work that takes the person quickly and effectively through the process.
It works for some, and does not work for others. It works where the person needing help has access to the technology, and that their need is directly reflected in the mechanism itself.
A Real Example:
Doris filled out a pre-designed form.
“I need someone to deliver food to me, and here is the type of food I want. I need very soft food, and I am fed up of soup.”
So, we should do some filtering perhaps? This elderly lady, Doris, has got a able daughter who lives nearby. And Doris is not short of money.
- A digital system will have to be well designed to pick up on the food needs. But would it reject her because her daughter lives nearby.
- A call taker will often use triage questions to filter out those less in need. Would Doris be filtered out?
We then called her back, to get more details…
In this case the call taker got off the phone after about 15 minutes complaining bitterly about Doris…
However, just by luck there was someone else in the Hub who happened to be the case worker for Doris, and this is what we learned. Doris is estranged from her family, and there are big rifts that cannot be bridged because Doris does not meet the mental health threshold for help, so we have learned to deal with her as she is. She will disengage from you if you mention her daughter.
Doris has had throat surgery a few months ago, and she has recently been diagnosed with more throat cancer, she has a short time to live. Doris is living and coping on her own but is stubbornly clear as to what she wants. It is this stubborness that is helping her through her life on her own.
The call taker, instantly felt very remorseful and realised that he has pre-judged her. He then went out of his way to personally select the right food from the supermarket, and allow Doris to pay for the items.
We have discovered that a designed form on its own is often inappropriate to use as a method of demand capture, because in at least 50% of cases that we documented, what was written changed significantly when we called them up and had a further conversation.
We also had a significant group who were not techologically enabled, due to no funds for internet access, theft of phone, or simply inability to use the technology.
2 Person centred Design
We are dealing with people, many of then will not be thinking logically, and will be in need of help to understand their options, and need help to deliver the actual help they need. We need to design the right flow, and use of understanding that demand, that matches their requirement, and not ours.
The flow will take its own path, depending on the need. Our response has to be able to deal with this variety, and that is almost always best performed by people rather than technology led. Perhaps the best way that I know to design this is for hte designer to sit in the Hub full time, and design the response as the demands and people are learning is the best way. The service designer becomes the facilitator for the workflow, a nd helps the team to devleop a robust design over time that uses the learning from the previous few days.
This is an example of person centred design, and its principles are opposite of of service led design.