Perpetual Transformation in Social Care

This transformation mindset will help Social Sector Leaders navigate immediate challenges, such as workforce shortages, and potential challenges ahead where the Federal election and subsequent budgets may lead to tighter funding and perhaps austerity measures in the medium to longer term.

In this blog, we reflect on ‘Transforming Social Care’, a report prepared by our Deloitte global colleagues, and explore three approaches that Social Sector Leaders can adopt as they drive social sector transformation for the benefit of communities across Australia.

These three approaches include:

1. Invest early and holistically, in what works for clients.

2. Invest in data assets, data driven decision-making and outcomes measurement.

3. Invest in client centricity and strengthening family and community-based support networks

1. Invest early and holistically, in what works for clients

There is an imperative for Social Sector Leaders to “invest early and holistically” across all social services;  particularly for children, young people, and families, where a recent report from The Front Project reveals that the annual avoidable cost of late intervention in Australia across multiple domains is A$15.2 billion.

Figure 2: How Australia can invest in children and return more, A new look at the $15bn cost of late action (2019), The Front Project

Accordingly, it is important that Social Sector Leaders prioritise driving greater investment in prevention, early intervention and breaking the cycle through their own programs, advocating to government for system change, and collaborating to enable transformation.

In the US, the Nurse-Family Partnership is a holistic program that arranges home visits by registered nurses for low-income, first-time mothers. The program has significantly reduced child abuse, rates of parental incarceration, and increased workforce participation, whilst delivering $5 of future cost savings for every dollar spent.

In Australia there are a range of programs that invest early and holistically in a child’s first 2000 days, such as Western Sydney’s Kids Early Years Network (KEYS) operating out of WentWest in partnership with health and human services agencies providing a “revolutionary new approach to align health and social sector goals that are designed to deliver cohesive, coordinated client services”. Other programs focus on family preservation and reunification programs that break the cycle of inter-generational disadvantage.

The challenge is how to leverage these proven programmatic approaches into systemic transformation, shifting away from specific vulnerabilities and siloed services to building and participating in an ecosystem that is holistic, integrated, preventative, wellbeing focused, strength based, and sustainable.

The wider adoption of proven programmatic approaches and achievement of systemic transformation requires collaborative investment in enablers, such as the UK’s Early Intervention Foundation and the Parenting Research Centre.

There are comparable programmatic, systemic and enabler approaches in other service domains such as homelessness, where social sector organisations such as Mission Australia have invested in Housing First programs, systemic funds have evolved such as the NSW Social and Affordable Housing Fund and the research undertaken by AHURI has enabled best practice and the development of policy and funding mechanisms.

2. Invest in data assets, data driven decision-making and outcomes measurement

There is an imperative for Social Sector Leaders to increase investment in their data assets (people, processes, and technology) and build evidence of the effectiveness of their programs in delivering outcomes.

These investments have a goal of helping to achieve greater impact by guiding the design and operation of programs; enabling continuous improvement; delivering better client outcomes; and ensuring commercial sustainability.

However, this can be challenging due to a combination of factors: unavailable, siloed and fragmented data; variability in data quality; misalignment of data and technology strategies; immature approach to outcome measurement; lack of standardisation and benchmarking; and limited organisational capability.

Social Sector Leaders need to focus their transformation on data-driven decision-making to be a core organisational capability, owned by the executive, framed by strategy, and with the goal of delivering greater impact. They will also have to collaborate and invest in system level transformation relating to operational and financial benchmarking and outcomes measurement.

The importance of financial benchmarking has been recognised by the National Disability Insurance Agency and they have commissioned a survey of disability service providers to help each organisation benchmark their financial performance.

There have been some positive developments in relation to outcome measurement including Mission Measurement – a US based firm that has developed the Impact Genome Project® (IGP). IGP is a philanthropic funded platform that standardises impact data and creates online tools that enable actionable benchmarking, more accurate predictions and evidence analysis to design more effective social programs. It consists of universal outcomes taxonomy of over 150 standardized common outcomes across 6 domains and 12 impact areas. Harnessing the power of big data, this database technology ‘unpacks’ social and science evidence to determine what works and how to maximise programs effectiveness.

In relation to outcomes based payment mechanisms, in Australia the NSW Office of Social Impact Investing has piloted the use of an “outcomes rate card” for social benefit bonds that aim to reduce homelessness along with a guide for outcome measurement.

3. Invest in client centricity and strengthening family and community-based support networks

It is critical for Social Sector Leaders to not only focus on client centricity for their programs but also strengthen family and community-based support networks.

Social Sector Leaders are already investing in approaches that put their clients’ beliefs, values, feelings, and aspirations at the centre of the design and delivery of their programs but there has been less emphasis on the value of utilising family and community resources.

Consumer directed care mechanisms, like the NDIS, have enabled, indeed necessitated, client centricity but the NDIS still has some perverse incentives, and can be difficult for people with disability to navigate. However, the NDIS could be a launch pad for a more holistic future model of care, such as Hilary Cottam’s ‘Radical Help’, that puts the client in the context of their family and community, and focuses on relationships, growing capabilities and creating possibilities.

Figure 3: Six elements of Radical Help Model

The Radical Help model has six elements:

• Vision – holistic vision of “good lives lived well”
• Capability – shift from managing needs to growing capabilities
• Above all, relationships – a relational rather than transactional framework
• Connect multiple forms of resource - harness human capital
• Create possibility - use cultures of open trust instead of starting with a risk-based ‘command and control’ perspective
• Be open and take care of everyone – include those who seek help as well as those whose role it is to offer help

In essence, the Radical Help model keeps resources, power and decision-making close to the client, devolves power to local teams within communities, and designs around social networks rather than individuals.

Next steps on the transformation journey

With the risk of budget repair and austerity measures into the future, Social Sector Leaders will need to go beyond “doing more with less” and make strategic decisions to transform their organisation and the systems they operate in to deliver better client outcomes and greater impact for the communities they serve.

As Social Sector Leads embark on this challenge, we encourage leaders to consider how they can drive the transformation of social care through the three approaches explored in this blog, and build on the insights shared in the ‘Transforming Social Care' report prepared by our Deloitte global colleagues.

Need Help?

Deloitte Social Impact Consulting 

Deloitte Australia’s Social Impact Consulting Practice supports social sector organisations, government agencies and businesses to deliver greater social impact aligned to their vision and mission. Our team is passionate about bringing the latest trends in strategy, technology and innovation from adjacent industries and global players to support social sector organisations to be ‘future fit’ in an increasingly complex, disrupted and competitive market.

Should you require any support, please feel free to reach out to either Tharani Jegatheeswaran (Partner – Social Impact Consulting) or Les Hems (Principal – Social Impact Consulting) or Vivian Stephens (Director – Social Impact Consulting).