Supporting System Recovery: Sustaining Positive Changes

Stephen Boxford is Head of Research at Cordis Bright, which provides consultancy, advice and research aimed at improving public services. He has extensive experience working in multi-agency partnerships, involving Local Authorities, NHS and Voluntary & Community Sector organisations and is currently working on evaluation of the local care approach in Greater Manchester.

At time of writing we have been in lockdown for more than 100 days. The health and social care system has experienced significant financial pressures for more than 10 years.

In this context, we have witnessed professionals across the health and social care system continue to work hard and with dignity to look after and support the population through the COVID-19 pandemic.

Cordis Bright have been working with clients across health and social care to support them through the pandemic. This has meant using research and evaluation to support robust and improved decision-making, ensuring the right responses and that innovation, and approaches that have been shown to work, are continued as we move into recovery.

In particular, we have been thinking about how systems work across health and social care and what the likely system responses will be as a result of the COVID-19 pandemic.

We have identified five responses:

• Revert.

• Status quo.

• System improvements.

• Rapid adoption.

• Innovation and transformation.

Linked to this, we have been using rapid evaluation to help clients understand how their local systems have responded and, most importantly, what the impact of these responses have been for local people.

This has been used to help shape their immediate responses to the pandemic, as well as inform their thinking for the future. Our approach to real-time evaluation is multi-method and multi-stakeholder, creating a robust evidence base. It is quick to deploy, provides rapid learning, and focuses on outcomes for citizens. It is based on our track record of undertaking evaluations on complex, whole systems change involving multiple partners.

The Making Every Adult Matter coalition (MEAM) recently commissioned us to conduct a rapid evaluation to explore the flexibilities adopted by services supporting people experiencing multiple disadvantage (predominantly homelessness, substance misuse, mental ill health and contact with the criminal justice system) during the COVID-19 pandemic.

Positive developments had included more rapid responses to individual needs, new and / or more intensive types of support, greater strategic buy-in, better recognition of gaps in service provision, and improved partnership working and sense of shared purpose.

The research concluded that, as we transition into the recovery phase, local areas and national government action is needed to sustain positive change. This includes:

• Reflecting closely on learning from the crisis period: organisations, services and individuals have been adapting rapidly and the focus has been on delivery. Time, tools and processes will be needed so that local areas and national government can take stock of which new ways of working have had an impact and assess how to apply the learning for services supporting people facing multiple disadvantage.

• Cross-sector leadership and planning to ensure positive changes can be maintained: local areas and national government will need to identify the flexibilities that they wish to maintain and develop plans to ensure these can be funded and commissioned. The provision of suitable, permanent accommodation for all who need it will be a key part of this, but wider cross-sector flexibilities will also be important.

• Ensuring the involvement of people with lived experience of multiple disadvantage: responses to the pandemic have highlighted the importance – and power – of keeping people facing multiple disadvantage at the centre of decision-making and service design. Local areas and national government should seek to maintain this culture and manner of working when planning for the next stage of the response.

More about this research can be found here.