First contact – designing a new referral form for adult social care

Navigating the maze of care and support services is not easy.

Although there are many great services in Brighton & Hove, services’ eligibility criteria and how or where to access services are not clear to our residents, or sometimes even professionals.

We already provide an online directory of services, MyLife Brighton & Hove and we’re recruiting volunteer Community Navigators with our partners Impetus.

I became involved through the council’s digital first programme, called Customer First in a Digital Age (CFDA). As members of the CFDA development team met with adult social care, we discovered that there was an online form for referrals. Yet it was underused, and didn’t capture all of the information needed by the team. Many referrals are being sent by email, missing vital information that the team need to respond.

Shadowing

I spent two days shadowing the adult social care contact centre (Access Point) team, listening to customers and speaking to social workers and care managers.

It didn’t feel like enough time but I learned a lot.

Identifying opportunities

As I listened to calls and discussed the current processes in place, some common themes emerged.

  • Many people calling or emailing the adult social care team needed to access a service provided by the NHS or another team in the council.
  • Referrals and information came through more slowly from professionals than direct contact with the person themselves.
  • And, as we’d initially been told, often emails that the team received contained a lot of information, but missed out important details that were needed to take action.

This all added up to it taking longer for people to get the help that they needed.

It was clear that as well as gathering the information that the team needed, a new online process could also help provide information and signposting to users.

Designing a new way forward

I started by writing out the information we needed to collect with some sticky notes.

As I created an initial order (flow) for the process, I highlighted opportunities to signpost people to services that were not provided by adult social care as early as possible in the process. Using sticky notes enabled me to move stuff around more fluidly than spending time designing a flow chart.asc-referral-postit-flow-before-build-web

However, if you haven’t gathered already, it was really complex. Following the advice of a colleague in our development team, working with an information analyst I started to focus on just one customer journey, for a referrer. This journey was subsequently split into two as we found two distinct groups with different user needs, ‘friends and family’ and ‘professionals’, before we moved on to self referrals. There are currently nine distinct user journeys in the new online tool.

Once an initial process was developed, I worked on the language and the questions being asked, using what I had learned listening to the contact centre as the foundation for the content and working alongside an adult social care manager. We also required legal sign off for the content to ensure the process complied with the Care Act, a new piece of legislation about how people can access services.

As well as the new content for the form, we’ve created notification emails that highlight the information that the access point team needs, and carefully reworded the acknowledgement given to people who email the access point team or submit a form to ensure there’s clear information about what happens next.

Challenges

Take up for this new referral form is still very low, though we’ve not promoted it, taking a soft launch approach. I feel that channel shift from email is a particularly difficult challenge.

It’s hard to know how users are interacting with the form, and there seems to be quite a high number of people who start using the form but don’t reach the end of the form and submit. This could be because of issues with the usability of the form, or because it’s simply doing its job and diverting people away to other services. We also have lots of interested colleagues trying it out.

One piece of data that I’m monitoring is which links to further information people on the form are clicking through to. However, aside from this link tracking, it’s difficult to monitor the performance of the form. We don’t have analytics tools that can help us here. The best insight will be from usability testing.

Moving forward

We will need to perform usability testing on the form to best understand how well this new content is meeting customer needs. This is scheduled to happen when a new self assessment tool goes live, as the user journey for self assessment will be funneled through the referral form. It’s really important that we get it right.

It may be that some of the information is removed from the form, and we use other patterns on our beta site, such as a “guide” to provide the information or we change the styling or the layout. There’s a difficult balance between providing useful additional information and getting in the way of our users.

I am looking at how we include information for carers on the form. There is an opportunity to sign post friends and family who are making a referral to get support for themselves as carers, as well as allow professionals to make combined referrals for someone with care and support needs and their existing carer.

Another opportunity is to work more closely with our partners and services that currently require separate referrals. For example we’re currently signposting professionals to the NHS falls service, where they need to fill out another referral form. Could we incorporate these questions into the council’s referral and provide more of a “one stop shop”?

Tell us what you think

I’m really interested in gaining more feedback about the referral tool. If you are a health or social care professional, or you’ve used our new Adult Social Care referral form for yourself or a friend or relative, I’m keen to have your thoughts. Have you tried out the form or would you use it in the future? Please leave your feedback and comments below.