Tight budgets and increasing demand mean children's services are under pressure to deliver more for less.
One approach gaining traction in the quest to find new ways of working more efficiently and effectively is the use of design processes and methods.
For the past few years, the Design in the Public Sector Programme, a partnership between the Design Council and Local Government Association (LGA), has been helping councils and their partners take a fresh look at some of their most complex challenges.
Unsurprisingly a significant number have centred on services for children and young people with councils keen to revamp their approach to tackling everything from childhood obesity to teenage pregnancy and services for disabled children and those in care.
Since being taken on by the LGA in 2015 the programme has supported more than 60 projects. In the last couple of years it has honed in on public health and prevention with a total of 14 projects involving 18 councils chosen to take part in 2018/19.
These include schemes to improve support for young parents in Surrey, enhance mental health provision for schoolchildren in Maldon, reduce smoking during pregnancy in Derbyshire and boost physical activity among teenagers in Birmingham and Solihull.
Design thinking
So what is "design thinking" all about? And how does it compare with the way councils more usually approach a problem?
One of the key principles is collaboration and the importance of bringing together people with different perspectives to explore a shared issue. "The more diversity you have, the more likely you are to come up with something original," says Ellie Runcie, director for growth and innovation at the Design Council.
Teams taking part in the Design in the Public Sector Programme must be multi-disciplinary or multi-agency.
"In children's services there are ever more complex issues such as knife crime," says Runcie. "It isn't just down to one agency or the local authority to try to tackle the problem, you need to work with multiple partners."
The process also promotes a "people-centred" approach where listening to service users or "customers" is key. After all - why would you design a product no one wants to use?
As part of this, councils and partners are introduced to various design research methods such as journey mapping, semi-structured interviews and diaries.
"It shows public sector managers they can engage in a much more meaningful way with their residents rather than simply understanding how a community feels about something through a town hall conversation, focus group, survey or letter," says Runcie.
These more traditional methods still have a place, she says. "But we feel the people-centred design methods the teams use give them hundreds of insights they wouldn't have otherwise had."
Another key principle is to test early to find out if an idea has potential. The public sector is familiar with piloting, but often pilots involve hundreds, if not thousands, of participants.
The design programme encourages councils to start small before leaping into larger-scale trials, thus reducing the risk of wasting time and money on something that is a non-starter.
The fact councils complete the programme alongside other authorities is important as they share learning and provide constructive feedback on each other's ideas. Teams are encouraged to communicate visually - a great way of getting ideas across quickly.
There is growing interest in the approach, with applications from about 40 local authorities in 2018/19, up 25 per cent on the previous year.
Shortlisted teams are invited to pitch to a selection panel. Crucially, participation in the scheme must be supported at the highest level. "We require chief executive sign-off and senior leaders to be involved as project sponsors," says programme manager Jessie Johnson.
The programme typically spans four months and consists of a series of workshops and coaching sessions with design experts.
Going somewhere new and working with people you don't normally work with in itself "shakes things up" with workshops designed to be hands on and "pull people out of their comfort zones", says Johnson.
These include five full-day workshops based on the Design Council's "double diamond" framework for innovation which is in turn based on research that set out to explore why some projects and solutions are better than others.
Instead of moving in a straight line from problem to solution, this encourages authorities to take a step back and ask: "Is this the right problem to be solving in the first place?"
Teams are expected to carry out research with local families and users of services to really get to the bottom of key challenges. Often the insights generated can lead them in a new direction.
A survey of participants in the 2017/18 scheme found 88 per cent said it had helped them "transform the focus of their challenge and move forward".
Johnson cites the example of Portsmouth where partners where keen to tackle high levels of air pollution in one part of the city.
One obvious solution would be to encourage people to use cars less. However, research with local families revealed a key reason children were ferried to school by car - despite the fact most schools were in walking distance - was down to lack of time.
"So the whole project focused on supporting young families with children to get ready for school in the morning in good time and how you might involve children in that process and make it fun and engaging for them," says Johnson.
At the end of the programme teams will be at different stages. Some may be ready to think about piloting but for others the process may have raised further questions that need to be explored before they can move on.
"At the point at which they leave us they will have a number of really well-explored opportunity areas which they can then take forward as a team," says Johnson.
One aim of the programme is to give managers the skills and confidence to apply the design process to other challenges and share the learning with colleagues.
Design expertise
Another hoped-for outcome on the part of the Design Council is that councils may be more likely to draw on the expertise of design professionals. Runcie is keen to stress that design can work hand-in-hand with other approaches to informing service development including systems leadership, data science and understanding behavioural change.
Design thinking can be useful in all areas of the public sector maintains Johnson but if you're talking issues like public health, prevention and early intervention then where better place to start than children's services.
"One would hope that if more people look at and tackle children's services and early years services in this way then later down the line we're going to have a much healthier population," she says.
The latest collection of projects includes one in Liverpool looking at the first 1,001 days of life.
"The point services currently engage is when someone realises they are pregnant and presents themself to the service," says Johnson.
But research revealed the first port of call for information was often family and friends so "already habits have been shaped and formed".
One of the key questions for this team has been how to reach expectant mums and their partners before their first scan.
According to the Local Government Association, cuts in government funding to councils - equivalent to the loss of 60p from every £1 since 2010 - mean all local authorities have had to find new ways to deliver services. By focusing on residents young or old, councils are more likely to develop systems and services that work, suggests a spokesman.
For Justine May, head of transformation and innovation for bi-borough children's services, this makes sense.
"I don't really think we can afford not to be thinking like this," she says. "To achieve any significant change we need to find ways to think differently about more than just how we reconfigure our services but essentially what we are here to do and the value we exist to provide.
"That's one of the things design thinking helps you to do. It's not just about how I might reconfigure my children's centre, it's about ‘How do people use it? What do they want?' and it is those fundamental questions that are really going to guide us."
- Applications for Design in the Public Sector 2019/20 open this summer. www.designcouncil.org.uk/DiPS
Westminster: Design process helps reshape services for children with SEND
Managers wanted to re-design services for children with special educational needs and disabilities (SEND) in Westminster and brought this complex challenge to the Design in the Public Sector process in 2016/17.
In trying to deliver a more effective service and make cost savings, the authority faced a number of challenges, explains Steve Comber, head of SEND local offer and SEN outreach for bi-borough children's services, spanning Westminster and Kensington and Chelsea.
While there were pockets of good practice across the borough, the service was fragmented with a range of providers delivering services "in quite traditional ways" in set locations. There was "often duplication of effort or inconsistent advice and support" and the authority was aware it was not consistently picking up children with additional needs early enough.
It was conscious there would be a huge amount of interest from parents about potential changes to services so it was important the multi-disciplinary team taking part in the design programme included a parent representative.
For Comber the process had a profound effect. "It has informed the way I think about the public sector full stop," he says. "We design services for people and it's those people who should be telling you how well those services work and what their needs are because ultimately they're the people who'll be using the product."
Research with families provided illuminating insights. While much of the local offer centred on providing activities for children, parents were actually using services to seek out professional advice and help.
Tracy Beard, bi-borough head of service for short breaks and resources, was tasked with implementing what became the Perfect Pathways project starting with setting up a new keyworker service to support families from the point of diagnosis - something parents wanted.
The authority also introduced a system, which launched in September, which means it is notified of an SEND diagnosis by health partners. "We actively go out and seek the parent rather than waiting for them to come and find us," says Beard.
One of the biggest asks from parents was a new one-stop centre for SEND children. By looking at things differently the team was able to make this happen using the savings from bringing a previously commissioned after-school, weekend and holiday play service in-house.
"For the same money we have brought that service in-house but it will be opening seven days a week now and offering more activities including training for parents," says Beard.
The centre, which is being refurbished, should be fully up and running by July.
Savings have also been made by providing holiday activities for families in the south of the borough closer to home - helping reduce what was a £70,000 a year transport bill with money ploughed back into services.
All agree the authority now has a more positive relationship with parents and families. Meanwhile, the hope is identifying and supporting children much earlier on will lead to better outcomes down the line.
"We're confident this is the right approach to enable us to achieve positive outcomes for those young people," says Justine May, head of transformation and innovation at bi-borough children's services.
According to her, design thinking has had an impact across the two boroughs where "increasingly we see the language of co-production built into everything".
Further work with the Design Council will include a training programme for bi-borough frontline managers, commissioners and transformation leads. Starting this summer the bi-borough team will also be working with the body on a large-scale review of 0 to 5 public health services.
Huntingdonshire: Tackling child obesity
For Huntingdonshire District Council the Design in the Public Sector programme's recent focus on public health offered the chance to explore ways to tackle the complex issue of childhood obesity.
"On the surface it looks as if our childhood obesity is okay," says head of leisure and health Jayne Wisely. "But there is disparity right the way across the district and some areas with significantly worse levels of obesity than others."
There were particularly high levels of childhood obesity in the town of Ramsey so the Huntingdonshire team - which included a colleague from Cambridgeshire County Council's public health team and input from the local clinical commissioning group - attempted to dig deeper using the programme's design research methods.
This included getting Ramsey families to log what they got up to in a day, which provided valuable insight into the pressures they face when it came to providing healthy meals and getting out to do activities.
After completing the programme in May 2018, the authority set up a local project team, which included community groups and people working in family settings.
They explored a number of avenues including sessions on food and healthy cooking and an outdoor activity session. Neither were a particular success in terms of numbers and attracting "the right type of people", explains business analyst Lauren Wilby.
A breakthrough came when Wisely attended a conference where one of the speakers was Elaine Wyllie, founder of the Daily Mile initiative to get primary pupils jogging a mile every day.
A local junior and primary school agreed to trial the scheme, which got under way in April. The hope is this will be a success.
Huntingdonshire is still finding its way, but one of the biggest lessons from the design process has been about not rushing into solutions and having the confidence to say "we're just not there yet", says Wisely.
The authority is using many of the design tools and techniques it picked up as part of a major transformation programme that got under way about 18 months ago, helping ensure "we really capture the voice of the customer and understand what they need", says Wilby.
It is also planning to use design principles in a new project to look at ways of improving life chances in an area with high levels of deprivation.
Staffordshire: Community and council secure future for family centre
Staffordshire County Council had taken the difficult decision to close a number of children's centres across the county, including two in the town of Burntwood where local mums set up a campaign group and went on to form a community interest company (CIC) to run the settings.
It was this passion that Wayne Mortiboys, now strategic delivery manager for Lichfield and East Staffordshire, was keen to harness when the authority embarked on the Design in the Public Sector programme in 2016 in an effort to find a sustainable future for the Spark Burntwood project.
Director of Spark Burntwood CIC Esther Allen, who was part of the team, admits she did not know what to expect but "was interested in any sort of partnership working".
At first the authority and community group appeared to be coming from slightly different angles but the collaborative design approach helped them identify common goals, explains Mortiboys.
"The thing we definitely agreed on was we wanted to improve outcomes for vulnerable children in Burntwood," he says. "In addition to that, Spark had a desire to make themselves more commercially viable and the county council was keen to support that."
In particular the council wanted to adopt a more proactive approach to identifying and supporting young children at risk of social services intervention. When the authority applied to the programme in February 2016 under-fives made up around a fifth of the 0 to 19 population across Staffordshire but the number on child protection plans was disproportionately higher at between 40 to 45 per cent.
"We were conscious that as a local authority we did not have much contact with this age group," explains Mortiboys. "People register births and then - until they need a primary school place - don't really come back to us unless it's in a time of crisis or we are directed to them."
The team went on to develop an incentive scheme where Spark Burntwood was paid extra for each child who attended sessions and was deemed likely to be vulnerable.
"They were generally charging £2 a session. We paid them £3 a session for every child that met the criteria we agreed so there was an incentive for them to find those families," explains Mortiboys.
This move away from grant-giving to a more transactional way of working offered a win-win situation. "It helped them commercially but also helped us make sure we were getting the most bang for our buck by targeting those children," says Mortiboys. "Families that may not have come to a children's centre because it was run by the county council were now coming to a community-managed facility which maybe had less stigma attached."
The programme helped the team look at how to get the most out of their facilities and maximise income by being open all week, available for hire and offering a wider range of activities for all ages.
"They do a lot more customer engagement now and learn from what is working well rather than just putting things on," says Mortiboys.
Above all he believes the collaborative design-led approach enabled the council to respond in a different way to the opportunity presented by Spark.
"The difference here was that we really took the time to understand what the community was trying to achieve rather than automatically going into ‘Why you can't do that'," he says. "We were able to take that passion and channel it in a positive way rather than it becoming a battle of them and us."
One of the decisions taken after completing the programme was to concentrate efforts on a single site. Spark Burntwood is now on a sustainable footing and going from strength to strength with funding to employ Allen as a part-time volunteer co-ordinator.
"It is a really strong force in the local community, has a huge Facebook following and almost everybody in the town knows about Spark and what it does," says Mortiboys.
Meanwhile the authority has seen an increase in the percentage of children from wards in the Burntwood area starting school with a good level of development.
Allen, who welcomed the creative approach to problem-solving and time for reflection, agrees the design process helped put Spark "on a firmer foundation" and boosted understanding between Spark and the authority.
"I started Spark as a mum and a teacher and had little knowledge of how local authorities and early years children's services operated," she says. "We were very inexperienced and it opened our eyes to new possibilities, especially through hearing about innovation by other organisations across the country."
Mortiboys has gone on to deploy design methods elsewhere including a new scheme in the town of Burton to boost take-up of free childcare places for two-year-olds.
Again this has involved working closely with the local voluntary sector to create an incentive scheme to encourage childcare providers to actively identify families that would benefit.
For him taking part in the programme was a real "lightbulb moment" and he'd recommend the design approach to other councils "without hesitation".
"If you do what you have always done you will get what you have always got," he says. "On the first day every question was: Why? If you keep asking yourself why, you can get back to what you're trying to fix and start looking at the problem in a different light."
