Getting smarter on shielding
This article first appeared in The MJ
As the nation continues to respond to COVID-19, local government has become more important than ever in supporting the most vulnerable. Now technology is playing a vital role in facilitating social care under these increased pressures.
On the 11 May 2020, Whitehall published OUR PLAN TO REBUILD: The UK Government’s COVID-19 recovery strategy. This document contains some challenging messages for those at risk of severe illness if they succumb to COVID-19 and places additional operational demands on our public services. Firstly, this group of individuals (collectively placed on the ‘Shielding list’) has broadened in scope and grown in number from 1.5m people in April to an estimated 2.5m today. Secondly, the ‘shielding period’, initially 12 weeks from the start of April, is now likely to extend beyond the end of June. Government expects every person shielding to be contacted, with regular follow-up calls to confirm well-being and identify new needs.
As both the number of clinically vulnerable people shielding and their recommended time in isolation increases, Whitehall’s strategy rightly recognises we need to support them in the smartest way possible.
It falls to local authorities to deliver the national Shielded programme locally, and the scale is monumental. For example, in Hampshire (excluding Southampton and Portsmouth) over 50,000 individuals are shielding. The county council was quick to recognise that it could not manage this work within ‘business as usual’ capacity. It invested in temporary additional contact centre ‘seats’ to receive calls from shielding individuals who were sent an initial automated message alerting them to the availability of support.
In other areas where authorities have smaller numbers to contact, officers have been seconded into the council customer contact centre or given lists of phone calls to make in between their day job.
Whilst the immediate response of local councils is truly commendable, the human effort and financial cost is substantial, and few would suggest that these approaches are sustainable.
When the scale of the challenge became apparent, Hampshire CC worked with PA Consulting and its alliance partner, Amazon Web Services (AWS), to explore what role technology could play. The three organisations had previously delivered the world-first scale deployment of Amazon Alexa in social care together. We needed to devise a way of ensuring that every shielding individual was contacted in a systematic and cost-effective way, being highly cognisant of the absolute priority of securing all personal data.
The approach we implemented is the Wellbeing Automated Call Service or WACS. It is a bot-driven outbound call system that asks people how they are and if they need help. It makes follow-up calls to check if things have changed, and it records all activity to ensure no one is missed. For less than 10 per cent of the cost of a human call centre, we have automated the identification of support needs for people shielding in Hampshire.
Just three weeks in, WACS has already contacted 6,200 people and more are being added and called each day. We have identified three key lessons:
Start quickly, scale fast, adapt often: WACS telephoned its first shielding individuals less than two weeks after HCC’s lead officer for Shielding set out their operational requirement. Within days, WACS was making 100 calls per hour and we now have over 10,000 contacts in the system. WACS now makes over 1,650 calls per shift, comparable with several days’ worth of work in a multi-seat human call centre; saving valuable time and resources.
Promote the approach continually: it is a sad fact that phone-scammers and cyber-criminal are taking advantage of the current crisis. People are understandably cautious about picking up calls from unknown phone numbers. Simple steps to build confidence include using a familiar dialling code (in Hampshire, the call identifies as a Winchester number), weaving notification about the programme into press articles and social media, and leveraging council staff networks to spread the word. If some people do reject the calls, WACS logs this for alternative forms of follow-up; no-one can be omitted just because they did not answer an unexpected call.
Integrate seamlessly with the local support infrastructure: WACS and similar automated call systems are not a silver bullet. Use them to consistently assess, prioritise and re-direct people to the help they need in a rapid timeframe. HCC’s shielding residents have diverse support needs, from prescription delivery, to food shopping, to ‘a friendly voice to talk to’; we’re seeing that people are grateful to get the WACS call, even if they have no current needs. When a resident identifies to WACS that they have a need, the call is transferred to the call centre to resolve. Trained call handlers then play the part that only a human can; empathising, discussing options and providing onward connection to support, including a volunteer workforce.
Despite being in the early phases of rollout, this technology has already shown huge potential to make a significant difference to people’s lives and alleviate staff pressures. 20,000+ new names were recently added to HCC’s Shielding list. Up to 20 per cent will need on-going help to see them safely through isolation. Without a smart method of managing the process, the pressure on council resources could be overwhelming. WACS is making a worthwhile contribution to delivering the Government’s ambitions on ‘Smarter Shielding’.
Last word to Graham Allen, director of adults’ health and care at Hampshire CC: ‘WACS is a really great service and without it we would have been really struggling with the volume of shielded list updates.’
Steve Carefull is a social care technology expert at PA Consulting.