Stakeholders & Beneficiaries

This case study looks at a for-profit housing and care provider for older people and people with disabilities in Scotland. The organisation provides care at home, housing support, care homes and responder-type services in ten local authorities in Scotland. This organisation is skilled in providing services through the support of digital systems, such as the emergency alarm system that aims to customise services for individuals and to give users more control over the service.

Co-creation process

Three key points of value co-creation have been identified in this case study. First, at the stage of service design, the service users co-create value through joining the Tenants’ Group, using the complaints procedure, attending the organization’s AGM and filling in survey questionnaires. The service users are also involved in the development of the digital system to offer opinions on the look, feel and functionality of the system. Service users are also involved in the staff recruitment. Second, at the operational planning, value co-creation process is recognized during the collection of information about service users, where the role of service managers is highlighted. The care package is developed with individual service users, who thus participate in operational planning and co-create value for the service. Third, at the stage of service delivery, the service users play a pivotal role in creating value through their day-to-day involvement in service interactions. The service users and frontline staff build a service relationship through service interactions, which facilitates the service users to create value. Moreover, supporting processes and technology are recognized as an important interface to facilitate value creation, by enriching the experience of service users, increasing their social contact with family and friends, and helping staff to better understand user needs and to handle emergencies more effectively.

Digital Transformation Process

We have not looked at the digital transformation. However, technology and digital systems were mentioned as facilitating the effective provision of services in this case study.

Results, Outcomes & Impacts

The outcomes and impacts are identified in two aspects. First, the service users’ involvement in service interactions and operational planning has contributed to the service improvement at the micro level and thus has impacted the value that individual service users receive from the housing and care services. Second, the frontline service staff have learned through service interactions with service users, which enables the service staff to perform their job more effectively and thus impacting their capacity to facilitate value creation and co-creation.

Challenges & Bottlenecks

There are some challenges related to the stages of service design and service delivery. At the service design stage, the service users are less likely to be involved in the design of service while various respondents have attributed the low involvement to the service users’ apathy to involvement outside service interactions. Three main challenges are identified at the service delivery stages. First, ‘too much care’ and a disparity in care offered by different frontline staff could result in service users’ unrealistic expectations of service and therefore, value destruction. Second, a lack of continuity in care to foster relationship building; personality clashes; a lack of resources; and a lack of knowledgeable or appropriately trained staff are seen as four ways to hurdle fostering service relationships and thus, pose challenges for value creation.

Transferability & Replicability

The case study organisation is a Scotland based organization, but its idea may be applicable to other contexts. However, this case study has not explored this aspect.

Success Factors

One central success factor identified in this case study is that knowledgeable, skilled staff who take a caring approach are important to value co-creation. For human-centred services in particular, this supported the development of the service relationship and trust.

Lessons learned

Four practical lessons have been learnt from this case study. First, frontline service staff play an indispensable role in co-creating value during service interactions. It was necessary, therefore, that staff were appropriately trained and knowledgeable. They needed the appropriate soft skills to manage the service relationship and engage with and understand service users’ narratives to co-create value. Second, services need to be accessible to service users and support the co-creation of value. Third, the organizational culture enabled or constrained value co-creation for service users. Culture had implications for the extent to which service users view themselves and public service staff view service users as capable of contributing to value creation processes. Finally, qualitative performance management tools should be developed to capture the multi-dimensional, subjective nature of value.

Stakeholders & Beneficiaries

The key stakeholder organizations in this case study are the Consultancy Agency and the Council while in detail, the stakeholders include the Council staff, consultancy staff and service users involved in the user research and the testing of website. The main beneficiaries of service design are citizens who use Council services and the Council itself since clear information and improved communication would make the service experience easier for both sides, by managing the expectations of customers and easing staff workload.

Co-creation process

The Consultancy agency has facilitated the Council to employ three main service design methods. The first one is journey mapping, in which a professional service designer from the Consultancy has supported the Council staff to establish the ‘as is’ and ‘to be’ of services from a customer and staff perspective. The second is personas method to inform the discovery phases. The Consultancy agency has purchased Experian data to develop various personas of fictional residents of the Borough. Some of personas have also been selected to guide the journey mapping sessions with Council staff, which is the third service design method. These service design sessions have encouraged the Council staff to understand user needs. Nevertheless, no real service users have been involved in these sessions and all the pain points for users have been articulated by the Council staff.

Digital Transformation Process

Digital transformation in this case study is mainly reflected on the service re-design task of developing the Council’s website. The Consultancy agency updated and aligned the website with Government Digital Standard guidelines. Through service design, the Council’s website has been modernized to ensure the effective provision of information and digital forms to support users to self-serve themselves.

Results, Outcomes & Impacts

In this case study, the service design process has generated positive and concrete results in three aspects. First, a triage system has been created with the re-design of reception area. The improved reception area is seen as more aesthetical and enhancing the internal efficiency since it changes the interconnection in the services, which allows staff to better manage their time. Second, the digital improvement has been viewed positively. The new website makes services more accessible for customers while the improved technology supports backend business processes, leading to greater efficiency from an operation perspective. Third, the service design methods, with the journey mapping sessions in particular, have been seen as helpful for rethinking about user needs and gaining perspective on the aims of the service and the implications for staff and customer experience.

Challenges & Bottlenecks

Several challenges have been identified within this case study. A central one is that service re-design in one area potentially impacts another dimension of the service journey, particularly where services are interconnected. In this case, for example, the redesign processes have led to new tasks for and new kinds of pressure on the frontline staff in the reception area, and they have not received sufficient training in how to handle the new tasks. Another key challenge identified is related to resources and time constraints. The Council staff in this case study have limited time and resources to spend on service design, which has affected who could attend the service design sessions. As a result, the council staff could not be sufficiently involved in the service design process. Also, user involvement is absent in the service design, which has been highlighted as a weakness of the service design approach. Lastly, a challenge in relation to continuous improvement has been identified as concerns have been raised around whether there has been sufficient testing or there will be resources and momentum for continuous service improvement.

Transferability & Replicability

The experience and the lesson learnt in this re-design of council services may be transferrable to service design practices in other public service settings.  

Success Factors

The service design approach is considered as the key success factor, which has enabled the Council staff to shift their focus towards a user perspective of services rather than on the internal efficiencies of business processes.  

Lessons learned

Four practical lessons have been learnt. First, clear communication between the Consultancy agency and the Council staff is essential for the collaborative approach. Second, a strategic and holistic approach to service design would support the change process. Third, the inclusive involvement of the Council staff in the service design process is necessary. Fourth, an emphasis on a user perspective and a focus of internal business processes need to be both taken into account.

Stakeholders & Beneficiaries

Various actors in the local community become relevant stakeholders in this case, since one of the aims is to create more active links between the community and the elderly care services. Private businesses, civil society (NGOs and volunteers) and other public sector actors are invited in to provide inputs in the ‘co-creation’ of the village at the ideation and planning stages of the process. Moreover, local stakeholders are invited to ‘co-create’ the services when the new care facilities open. This can be volunteers taking part in arranging activities, schools or nurseries setting up performances, or private businesses providing services such as hairdressing, cafés etc. The main beneficiaries of the case are senior citizens suffering from dementia and their next of kin.

Co-creation process

The municipality has placed emphasis on co-creating the new services with potential residents, their next of kin, and other local stakeholders. To co-create the new services, the municipality is drawing on inspiration from service design and co-design. The design processes are mainly being carried out ‘in-house’ and facilitated by a development team with experience and training in facilitating innovation processes.

Digital Transformation Process

We have not focused on the technological aspects of the dementia village in the case study. However, introduction of new technology will be important for the development and operation of the new services.

Results, Outcomes & Impacts

There are two ways of understanding ‘results’ in the context of this case. First, the main results of the dementia village project are linked to the construction of the new care facilities. Second, we may also highlight the results of the co-creation processes undertaken to create new solutions in this new service setting. These processes have generated a range of ideas for new solutions that will shape the new services. In this case, it is too early to assess outcomes and impact of the dementia village and the various new solutions within the new care facilities because it has not yet opened. We understand outcome and impact as the effects of new solutions which may be measured in various ways.

Challenges & Bottlenecks

There are some obvious challenges involved in co-creating dementia care. When the end users have cognitive impairment, and may even lack the ability to communicate verbally, co-creation and co-design is difficult. Finally, the challenges and constraints of service design in this context largely concern the complexity of the project and in providing high-quality services in dementia care. Dealing with dementia is inherently challenging.

Transferability & Replicability

The dementia village concept is already spreading across countries and communities (I.e. from the Netherlands to Norway) and across municipalities in Norway. However, the concept may be implemented with more or less focus on involvement and co-creation. We find that there are potential for inspiration, learning and transferability in the way Bærum has aimed to co-create the new dementia services with users and other stakeholders.

Success Factors

Not relevant.

Lessons learned

One of the central lessons learned from this case is that co-creation of innovations with services users is possible also when service users suffer from cognitive impairments.