The Three Conversations® in Harrow – Story of Change
The Three Conversations was introduced as an approach to adult social care in June
2019 as part of a major Transformation programme, working in the Early Intervention
Team with about half of all new people making requests for support. It then expanded
to cover most of the remaining new requests and was subsequently introduced for
people with existing care and support in August 2020, during the Covid-19 pandemic.
Working collaboratively with a project team including Partners 4 Change, the Mosaic
(database) team and Business Intelligence, the innovation site staff co-designed the
three innovations running for 12-16 weeks each.
Results from the first year of working in this way indicated a significant reduction in new
requests for support associated with fewer ‘repeat’ requests (falling from a third to a
quarter). Although more staffing resources were needed to achieve these results, the
reduction in new people requiring long-term care and support was significant, falling
from 7.2 to 5.5 people per week, worth approximately £700k in 2019-20 in cost-
avoidance. Feedback from citizens and families was generally positive and staff in the
innovation sites wanted to continue working in this way.
For those people with existing care and support, the new approach led to fewer
increases in the costs of that support with a full year equivalent saving of more than
£450k in just four months. Feedback from citizens was also positive.
In combination with other Transformation projects it was also possible to more fully
embed recommendations from NICE on user experience, redesign the Adult Social Care
pages on the website and build a database of community support resources for staff.
Covid-19 had a significant impact on adult social care and forced new ways of working,
but the approach has continued to be rolled out. Suggestions for those thinking of
adopting 3Cs would be to co-produce new database forms and technical solutions with
staff, simplify forms, report data from your innovation sites quickly and ensure there’s
commitment to act on what you find. Seeking feedback from some of the citizens
you’ve worked with and setting up weekly reflections on practice among the whole
team also helped.We found it invaluable to promote a 3Cs Change Champion to help
build the approach and give practitioners a peer to help guide and support their work.