Improving access to accountability of public services - engagement: final report

Journey Maps

Key Journey Stages

From an analysis of people's experiences of public service use, two key common journeys were identified in relation to accountability:

1. When a person uses a public service and experiences a failure of service delivery or is dissatisfied and does not attempt to access accountability.

2. When a person uses a public service and experiences a failure of service delivery or is dissatisfied, and accesses accountability processes.

Within both of these typical journeys, there were barriers to access at all stages. The illustration on the follow page outlines a high-level roadmap of these accountability journeys, including common drop off points.

Accountability Process

Image text:

• Context : They use a public service – frequently or one off – or engage with public spaces  
• Expectation : The user has an expectation of the service or quality of the space that they’re using.
• Incident : Something happens that is outwith the user’s expectation or previous experience of the service or space.                      
• Discover : They decide to do something about the experience, find out who to speak to and what to do next.
• Contact : They make an inquiry and follow the service’s accountability process.
• Action : Next steps are taken by the service provider or external body, and correspondence is continued.
• Result : The story ends, with an agreed outcome or because contact ends.
• Barriers : Somethings prevents them from progressing to the next step. They fall out the process and are unable to seek  accountability.
• Intended action and desired result: The actions that they would have liked to take or the solution they want to see.

User Journeys

Experiences of public service accountability in Scotland, collected throughout the public engagement activities, were anonymised and synthesised into three user journeys.

This process of amalgamating real-life stories ensures that, while individual experiences are included, details cannot be attributed to any one account and anonymity is maintained.

Between them, the user journeys represent all of the key themes associated with this study.

User Journey 1: Seeking accountability for decisions taken around cessation of services

1. Context

The local Integration Joint Board (IJB) proposed they would close a specialist dementia ward; the only such ward in a rural area. This proposal was put forward in a report that outlined three options for alternative provision, but the closure of the ward itself was a part of each of the proposals. The report also recommended the selection of one option in particular.

The community did not feel that they understood why the decision had been taken, nor that the proposed alternatives were adequate. They also felt that, although recommendations had been put forward, the final option had already been selected. Staff felt intimidated and punished for speaking out.

2. Incident

Staff and patient families did not feel that they had been involved in creating the options put forward, and that the decision had come as a shock.

They researched and created their own alternative proposal, and put that forward to the IJB. They didn't feel that their proposal was adequately acknowledged, but were determined that it be considered as part of the final decision.

News of the proposals spread informally through the community, and a group was formed to try and save the service.

3. Discover and contact

Through personal contacts, Helen, a member of the community group, was able to speak to a senior figure in the IJB. They spoke for over an hour on the phone.

The representative from the IJB appeared to agree with Helen's suggestions, but Helen felt it was clear they were not going to happen since they weren't part of the options put forward. Helen felt humoured and that she was being controlled.

During this call, Helen and other members of the group were invited to attend an IJB meeting where the matter was to be discussed. It was implied that they would be there to represent the views of the community and to join in the discussion.

The community group created a Facebook group to raise awareness in the wider community and worked with UNISON.

4. Action

Poor communication from the IJB ahead of the meeting led to a demonstration held by the community group on the day of the session. They wanted to make sure that the IJB could see that the community was concerned about the proposals.

As the meeting began, the group tried to join, but an attempt was made to turn them away on the basis that there weren't enough seats available. After some discussion, extra seats were found.

During the meeting it was agreed that the IJB would proceed with the recommendation put forward in the report, and that they would undertake public consultation before the next IJB meeting, when the decision would be finalised.

The community group began to feel that it was a hopeless situation, as none of their efforts seemed to make an impact. They were perplexed that public consultation was to take place so late in the process.

5. Result

After the IJB meeting there was no further engagement with the community group. The group wrote to their MP, MSPs and the Health Minister to seek their intervention. They told elected representatives that without their support their next step would be to heighten their concerns through the press.

They did not receive a reply and soon after were featured in national news. They felt that the press was the only option for accountability open to them, as elected and unelected officials had disengaged from the process.

The consultation began only two weeks before the next IJB meeting. The wider community felt that the consultation was not handled well and that there was no real discussion. They didn't see how their views would be incorporated into the decision making process.

While the local community rejected the proposals, the proposals were approved following a wider regional consultation of the proposals. There was also disagreement as to whether staff were adequately consulted, or consulted at all.

The community had really come together over this issue. The group and others gave a lot of time, energy and resources to collaborate on researching, on seeking the views of the wider community and building a solutions-based case. However, no response was given and the situation did not change.

At the next IJB meeting the final decision was taken; to follow the original recommendation despite the efforts of the community. The community were left feeling disempowered and that the process was intimidating. They questioned whether they would spend their time, energy and emotion on seeking accountability again.

User Journey 2: Carer Seeking Support

1. Context

Sally is a carer for her son, Adam, 21, who suffers from autism. She receives support from a social worker, but predominantly cares for him alone at home.

Adam can be difficult to manage because of his medical condition, and a number of past care workers have refused to continue their visits. Sally has made a number of complaints about carers not showing up, or not being equipped to deal with Adam's condition.

They live in a small village with a limited number of carers and social workers, which has left them feeling isolated and unable to ask for help.

Sally believes the support systems in her area treat her differently because of this: "They just think I'm difficult to deal with and can't be bothered with us anymore."

2. Incident

Sally was in an accident and could no longer physically support Adam around the house. She spoke to a care worker, expressing her need for more support. The carer agreed that Adam needed more care, but her department was short on staff and she didn't know of any specialist care homes. She told Sally that nothing could be done and she'd have to make do.

Sally was frustrated because she didn't believe the carer had the authority to make this decision.

3. Discover

Sally phoned the social care support number on her council's website, as she had done before, to explain the change in circumstances.

The lady on the phone told her to write to the local health and social care complaints service and gave her the address.

4. Contact

Sally wrote and posted the letter.

After one week she still hadn't heard back, so she called the council again and reiterated the urgency of the situation.

The council agreed to send an occupational therapist to the house to evaluate Adam, something that needed to be done before he could be assigned more care support.

5. Action

Sally was annoyed that the care worker she spoke to initially was not clear about her need for an occupational therapist evaluation before more care support could be offered to Adam.

Instead, they encouraged her to write a complaints letter, which turned out to be the wrong process and wasted time. She was left feeling confused by a lack of clear guidance, and worried that the council weren't guiding her through the right processes to enable her to receive immediate care support.

The occupational therapist didn't come out to visit for another three weeks, and told Sally that it would take a further 4-8 weeks to log the assessment and process the request.

Sally felt extremely frustrated and hopeless. She was unsure whether the council would assign any more support to Adam, and couldn't wait another month or two to find out. She started searching for alternative options online, and came across the Autism Network Scotland.

She attended one of their support groups for carers in her area and learned a lot about the various types of support available.

The group helped Sally with a self-referral process, and provided her with advocacy to support correspondence with her council and social workers.

6. Result

Through the support of Autism Network Scotland and their advocacy via self-referral, Sally managed to find Adam a place in a specialist care home for adults with learning disabilities not too far away.

Sally learned a lot more about the support available for adults with learning disabilities, having read up on policy guidance and strategies for autism, which she found through the Network.

She was frustrated that she had to become an expert in navigating the system herself, and, wanting to help others who might be in Adam's position, she wrote to her council and suggested that social care in the area should be aware of the Scottish Strategy for Autism. She was hoping to see them implement a better referral system, but didn't receive a reply.

Eventually she became a volunteer for Autism Network Scotland and now runs her local community support group.

User Journey 3: Neighbourhood Planning Appeal

1. Context

Jason received a planning notice from the council through his letterbox, letting him know that his next door neighbour was going to build a large extension that would obstruct his family's views, and that the building work would go on for at least 13 months.

2. Incident

Jason was surprised by the planning notice as there was no notification for consultation before planning permission had been granted, leaving him and his family feeling cheated by the notification. After asking around, he found that many of his neighbours had received the same letter and were equally frustrated, but didn't want to make any objection to the extension as they thought it would be making an unnecessary fuss.

On top of this, they were worried about ruining relationships with the neighbour, they couldn't be bothered spending time on the process or arguing about it, and because they didn't know they had a right to complain.

3. Discover

Jason didn't know what to do, and felt helpless because his neighbours weren't being active.

He tried contacting the number on the planning notice, but was told this was the wrong contact for an objection. He searched on the council website but couldn't figure out who to contact or what the process might be. Then he phoned his friend who worked as a council employee. They told him to speak to a planning officer and to get support from neighbours to write an official objection letter.

4. Contact

Since Jason was so unclear about the process and felt pressured to work with his neighbours to put together an objection, he wanted some advice from the planning department.

However, when he phoned the council and asked to be put through, they told him to write an official appeal letter. He didn't know how to present his case, or what information to include. He had to google information on this, and looked at examples so he could work out what an appeal letter should look like.

5. Action

He then tried to get his neighbours together to write a joint appeal, as advised by his friend. However, he had no clarity on what needed to be done, what the process would look like, or what an outcome might look like. This made it difficult to get his neighbours on board, and further complicated the start of the process.

The appeal then went to a planning committee, but neither Jason nor any of the neighbours were invited. They didn't know what would happen at the committee, or how they would be informed of any decisions. This left Jason and his neighbours confused, as they had followed the process to no avail and had not been brought along or considered during the decision making process.

6. Result

Jason and his neighbours were left with no knowledge of the decision and felt forgotten about. The work being done on their neighbour's home stalled, but Jason was too concerned to talk to them about it in case it damaged their relationship as neighbours.

He didn't want to keep pushing the council, and felt that he was becoming an annoyance, even though he had valid reasons to object to the planning notice. He is now afraid of the repercussions in the neighbourhood should he and the neighbours continue to push the case.