Human Services Blueprint Technical Specifications


Right service | Right time | Right duration
© Australian Capital Territory, Canberra, May 2014Icon of technical
Human Services Blueprint Technical Specifications
ISBN: 978-0-9752447-2-2

The Human Services Blueprint is an across Government and community sector project, endorsed by the ACT Government and informed by broader community engagement.

The Technical Specifications is one of three documents in the Blueprint suite of documents.

The Human Services Blueprint Technical Specifications should be read in conjunction with the Human Services Blueprint and the Human Services Blueprint Consultation Report.

Executive Summary
A cohesive Human Services System for the ACT
Blueprint Design
Blueprint Architecture
Realisation Pathway
Key terms used in the Blueprint
Overview of the Design Process
A different approach to developing the Blueprint
Design process
Design assumptions
The Blueprint Architecture
Key Graphics
Context
The Population of the ACT
Drivers for the Blueprint
Human Services System Interactions through the Life-Course
Scope
System Design
Vision
Purpose
Values
ACT Human Services System root definition
Functions
Capacity development functions
Integrated delivery functions
Structure
Leadership and Governance
Learning and Development
Control and Coordination
Operations
Processes
Outcomes
Triple Aim
Key performance behaviours
Sustainability
Overcoming constraints
Realisation Pathway
Maturity Model
Continued engagement
Next stepsAcknowledgements

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Executive Summary

A cohesive human services system for the ACT

The Human Services Blueprint (Blueprint) represents a redesign of the responses available to people and families, in situations where their resilience, and capacity to participate in social and economic life, is challenged by vulnerability or adversity.

The ACT Human Services System (human services system) aims to develop the capacity of people and communities to enable their full participation in a strong and healthy community. The human services system also intends to support people in appropriate ways - from providing a universal access model, to more targeted early intervention and prevention services, to provide an intensive service offer where required - and to do so in an integrated and cohesive way so that it is simple to understand, access and navigate.

The role of the human services system is to listen, learn and adapt to the changing needs of our community, making progressive change towards a person-centred, cohesive and sustainable system.

Under the human services system, each stakeholder has a responsibility to align decision making with the vision and purpose of the human services system, and to respond as part of the human services system to build the capacity of people and communities. This includes having the capability to identify and connect people with the supports they need, when they need them.

Diagram - Human Services System

The Blueprint, therefore, provides a framework for all systems (health, education, justice and community) to work in alliance as the human services system to deliver person-centred, high-quality outcomes-focused responses.

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Blueprint Design

The Blueprint is an outcome of Phase 1 of the Blueprint project. The Blueprint was developed using a collaborative, community engagement, design process.

The purpose of Phase 1 was to describe a cohesive, person-centred and sustainable human services system for the Australian Capital Territory (ACT), and a map of how to get there.

The process to develop the Blueprint involved high-level ministerial endorsement and joint community-government leadership. Advice was developed by a group of community and government stakeholders whose shared ideas were tested and refined with broader community engagement outcomes.

Consultation and engagement undertaken to develop the Blueprint identified that people wanted better, equitable, services that built on the strengths of existing programs, with less wait times and a more personal touch. These themes are captured in the values and principles which will be used to guide decision making related to the human services system.

The result of this design process was the development of a Blueprint which sets out the vision and purpose of a human services system, with values and principles to guide decision making. It includes system design elements and a realisation pathway to implement and operationalise a cohesive human services system that is person-centred and sustainable.

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Blueprint Architecture

The Blueprint architecture has three parts: Context; System Design and Outcomes.

Diagram - context system design outcomes

The Context describes the environmental and community circumstances and stakeholder needs and expectations within which the system operates.

The System Design is made up of vision and purpose, functions, structure and processes. Together these provide a description of the Blueprint - all the elements that need to be in place if the needs and expectations of key stakeholders are to be met.

The Outcomes are the results that emerge from the system. If effective, the outcomes will positively change both the context within which the system operates and the needs and expectations of those who have a stake in and/or interact with the system.

Context

The ACT enjoys a great degree of relative advantage, with disadvantage located amongst relatively affluent communities. Many Canberra suburbs have high numbers of both the most, and the least, disadvantaged individuals.

The development of the Blueprint responds to the desire to have improved, more efficient and effective services in order to respond to changing contexts such as an ageing population, national reforms including the National Disability Insurance Scheme, and financial constraints.

By having an integrated system that captures and shares information, and listens and learns from the experience of people and the community, it may better understand and adapt to the dynamic needs of our evolving community. Further, governments and other organisations will be in a better position to appropriately design and target services, policies and programs to meet individual and community needs.

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System Design

Vision and Purpose (page 22)

The Blueprint articulates the following shared vision for the human services system, which is supported by and encapsulates the values and principles.

All Canberrans have the capability to fully participate in strong, healthy and inclusive communities and are enabled by a cohesive human services system that is:

The Vision is supported by a purpose that articulates what needs to happen for the human services system to achieve its goals. The purpose sets out the human services system's primary objectives against which performance to achieve the vision are measured.

By working cohesively, the purpose of the human services system is to develop the capability of people and communities to enable their full participation in a strong, healthy and inclusive community by:

Functions (pages 27-30)

The human services system has two main aims to deliver in order to meet the needs and expectations of the community. Its main functions are to develop capacity and integrate the delivery of responses.

Capacity development includes building the capacity of:

Integrated delivery of responses includes:

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Structure (pages 31-34)

The human services system needs to have core elements in place to have the capacity to meet and deliver the above functions and be viable over the longer term.

The graphic below depicts the Structure the human services system must have in place for it to be cohesive, person-centred and sustainable.

Diagram - Person Centred

Structure

Description

Leadership and Governance

Create a clear sense of authorisation and direction and effective policy in place to support that direction

Learning and Development

Construct an adaptable and innovative system that has an ongoing understanding of changing needs and circumstances and capacity to respond to change

Control and Coordination

Managing and coordinating the core services delivered to individuals, along with monitoring and evaluating their performance (including top down and bottom up controls)

Operations

System activities that enable the system purpose to be achieved

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Processes (pages 35-38)

The processes describe how the functions will be delivered and set out the capabilities needed to deliver them. Processes either support capacity development for people, communities and the system as a whole, or support integrated service delivery.

For example, to deliver the structures:

Individual elements are further outlined in the table on pages 37-38.

Outcomes

To evaluate the human services system performance to achieve its vision, a Triple Aim has been developed. The Triple Aim intends to measure the progressive development and realisation of the Blueprint, and simultaneously measure:

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Realisation Pathway

Change will not happen overnight.

The Blueprint puts in place a framework to progressively realise change by identifying and understanding what needs to happen to improve service experiences and population outcomes and effectively use available resources.

The Blueprint recognises that we are not starting from scratch and that there are important initiatives already running in our community that align with the direction we would like to head. It also recognises that improvements are required to achieve its goals.

As such, the Realisation Pathway provides a methodology to identify, understand, align, redesign and develop what needs to be in place to achieve a cohesive human services system that is person-centred and sustainable. The pathway to align practices and cultures is iterative, and involves localised prototyping to inform scalable and sustainable system reform.

Continued engagement

Continued collaboration and co-design is vital to realising the vision as the next phases of the Blueprint project are rolled out.

The values of the human services system that underpin any future work include respectful and responsive. These mean that our approach to future engagement will value the unique contributions that diverse perspectives bring to a vibrant community, and also listen, learn and adapt to the changing needs of people and communities.

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Key terms used in the Blueprint

This section provides descriptions for key terms used throughout the Blueprint suite of documents.

Person-centred

For the purpose of the Blueprint, person-centred refers to the need to ensure that the design and delivery of the human services system response, focuses on what matters to the person. In addition, it also means ensuring that the person is able to be involved, as a co-designer, of the services they need.

Integrated

For the purpose of the Blueprint, the focus of integration is on organisational and process boundaries and how to ensure smooth handover across them. While there are many ways this can be achieved, the ultimate measure is that, for the service user, the boundaries are invisible and their experience is of 'one service'.

Control

A key structural element discussed in this document is described as 'control and coordination'. The word control is often used in the pejorative sense of one person, or organisation, exercising control over another. In this document 'control' does not simply mean top-down control. The structure described in this document is specifically designed to balance top-down authority, ensuring that what is intended to occur does in fact do so, with the autonomy of front-line staff and communities, who have a much richer understanding of what is required within their specific context. When control is effective, it balances the need for consistent, policy-driven practice with the innovation and flexibility needed to deliver effective person-centred services. Effective control is a balance of authority and autonomy.

Community

For the purpose of the Blueprint, community is defined broadly as comprising locally based and interest based population groups, community based services, infrastructure and social capital, in recognition of the important role communities play in supporting individuals and families in the ACT.

Early Intervention and Prevention

Universal services, such as those available in health and education sectors, are building blocks for individuals to reach their potential. Prevention and early intervention approaches at key transition times throughout the life-course particularly in early childhood and early in the life of a problem - can increase the chances of positive outcomes.

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Overview of the Design Process

The Human Services Blueprint (Blueprint) describes the development of a human services system, defined as a cohesive, person-centred and sustainable system, which aims to develop the capacity of people and families to enable their full participation in a strong and healthy community.

The Blueprint was developed using a collaborative design approach involving experts and stakeholders - in a broad-reaching conversation between service users, communities and government.

The design of the Blueprint articulates the Vision and Purpose, Guiding Principles, Functions, Structures and Processes to achieve a cohesive, person-centred and sustainable human services system. The Blueprint is only the beginning and is the end product of Phase 1.

Phase 1 ran from September to December 2013. It involved stakeholders from across government, the community sector and community. It had endorsement by the ACT Government and was informed by broader community engagement.

Phase 2 will involve policy work to sequence key activities required to deliver this system, and will continue throughout 2014.

Phase 3 will align and test key elements and activities required to deliver the system, and will occur in 2014 and 2015.

Phase 4 will involve evaluation.

The following graphic outlines annual priorities and deliverables that have been identified with a view to arriving at the desired future state. Note that the Blueprint Work Phases may change slightly over time to reflect the iterative nature of design work, which aims to respond to issues and challenges as they arise.

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Summary of the interrelated work phases of the Human Service Blueprint.

A different approach to developing the Blueprint

The Blueprint was developed using a different approach to the regular approach used by government. The approach applied principles of participatory co-development, design thinking and systems sciences. Rather than a more usual policy development cycle that develops a nearly polished product and asks for comment, the approach to develop the Blueprint was iterative, testing and refining ideas throughout the process.

As a result, the Blueprint pays particular attention to designing the linkages between the situations of people in the ACT, the results and outcomes needed from a cohesive human services system and how a full spectrum of responses could be connected into a sustainable mix and balance within the resources available across the system as a whole - including those of people themselves.

The structure of the text and visual maps used draw on the methods and research of systems theory to make these connections explicit and conceptually rigorous.

Design process

The Blueprint was developed using a design process. This allowed for iterative development of the Blueprint and maximised opportunities to incorporate co-design and action learning principles into the design process.

Design processes supporting the development of the Blueprint included:

Design processes support innovation in service design, policy programming and governance practices by:

  1. Establishing a shared understanding of the issues and drawing together diverse perspectives
  2. Providing an opportunity for diverse participants to imagine a preferred future, rather than being limited by current realities
  3. Allowing for rapid feedback on potential solutions to increase the potential for shared commitment to the final outcome.

Depiction of the centrality of engagement to the development of the Human Service Blueprint.

For further details on the consultation process and findings, please refer to the Human Services Blueprint Consultation Report.

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Design assumptions

The Blueprint represents a redesign of the responses available to people and families, in situations where their resilience, and capacity to participate in social and economic life, is challenged by vulnerability or adversity.

An assumption in developing this Blueprint was that no single perspective will be able to capture the complexity of multiple organisations, delivering a range of services and development initiatives to many different communities, population groups, families and individuals. These different perspectives inform the Blueprint.

The following assumptions emerged as central pillars used to inform the design process:

  1. Person-centred

    This includes valuing self-determination and self-capacity by focusing on what matters to people and what would enable their participation, rather than what matters to agencies or services. As a result, people have the capacity to act and make decisions in partnership with the system to work towards achieving positive outcomes.

    Strong evidence indicates that current service responses are not always person-centred and generate fractures and discontinuities that get in the way of effectiveness. Improving experiences of support is seen as a critical driver for redesign.

  2. Supporting participation

    The assumption of participation is a core value in the redesign. This includes the full range of reciprocal relationships that sustain a person within family, peer, workplace and social settings.

    It is acknowledged that some people may make choices not to participate. In some cases there are non-voluntary statutory responses which are in place to ensure the safety and wellbeing of vulnerable people in our community.

  3. Building resilience

    The concept of resilience is assumed to cover positive strengths and protective factors, as well as situations where the limits or constraints on resilience are reached. As a consequence, participation is affected, which in turn may result in compounding risk.

  4. Inclusive Services System

    While the label “Services” is used in the title, it is seen as being one form of response. A full range of responses including promotion, education, community development, building self-capacity and self-determination, are all considered in scope, alongside more formalised services provided by organisations supported by a range of funding sources.

  5. Community focused

    This includes notions of place but also recognises that people may see themselves as belonging to non placed-based communities.

    Implicit within this is a value of building community capacity to support individual and family resilience. This places a special value on responses and organisations that are aligned with communities, contribute to collective impact, and in some sense 'belong' within communities, rather than responses that are one-dimensional and only address individual symptoms.

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The Blueprint Architecture

Diagram - the Blueprint Architecture

When thinking about blueprints for a building, for example, it requires different perspectives, such as: floor plans, elevations, and site plans, to provide enough information to enable the plans to be picked up by anyone and built to specification. So too, the Blueprint will need to be clearly articulated from different perspectives, if it is to be understood well enough to be implementable.

This Blueprint aims to describe the systems architecture for a cohesive human services system in the ACT.

There are three main parts to this architecture:

  1. The first is the environmental and community CONTEXT within which the system sits. This provides the rationale for the system and the opportunities and constraints within which it must operate. It also contains the stakeholder needs and expectations, which provide the focus for the system design and the evaluation of whether or not the design is effective.
  2. The second is the SYSTEM DESIGN, made up of vision and purpose, functions, structure and processes. Together these provide a description of the Blueprint - all the elements that need to be in place if the needs and expectations of key stakeholders are to be met.
  3. The third is the OUTCOMES. These are the results that emerge from the system, that if effective, will positively change both the context within which the system sits and the needs and expectations of those who have a stake in and/or interact with the system.

These parts are described in more detail in the following table.

Context

From Page 10

Context, Needs
and Expectations

This focuses on understanding the 'place' within which the system sits. A human services system may only work when the context is taken into account. This includes having a good understanding of the needs and expectations of key stakeholders.

System Design

From Page 22

Vision and Purpose

Vision and Purpose are central to an effective system design and should articulate the 'place' within which the vision and purpose are to be fulfilled. The interplay of vision, purpose and place, informed by the values and principles that guide the system, is what creates a system that is forward looking and meets the needs of the people within our community. This is why it is important to gain a good understanding of the context prior to determining the purpose.

Functions

Functions describe what the system delivers to whom and the results of that delivery. If the purpose is to be met then the functions have to meet the needs and expectations of the community being served.

Structure

Structure refers to the parts of the system that need to be in place - and the interactions between them - to deliver the functions, and be viable over the longer term. It describes what is needed to convert inputs into outputs for a specific community and how planning and learning will take place.

System Design

From Page 35

Processes

Processes describe how the functions of the human services system will be delivered and the capabilities needed to deliver them. Processes relate to either the front facing service delivery processes, or the back facing system capacity processes.

Outcomes

From Page 39

Outcomes and performance measures

The outcomes of a human services system need to demonstrate how the system is fulfilling its purpose to achieve its vision.

Performance is measured to indicate whether or not a difference is being made.

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Key Graphics

This Blueprint contains a number of important system maps that provide a visual representation of the design of the Human Services System Blueprint.

Page

System Graphics

6

Overview of the Blueprint Architecture

This diagram provides an overview of the architecture of the human services system. It highlights the three core components of context, system design and outcomes.

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Human services system interactions Through the Life-Course

This visual highlights the importance of viewing the human services system throughout the life journey, providing, for nearly all of us, different services at different times. Above all, we are people moving though our own individual journey, our needs changing throughout our life, and the graphic focuses on the horizontal nature of this journey to contrast it with the vertical manner in which services are currently organised.

20

Service Functions Wheel

The 'service function wheel' highlights the person-centric focus of the overall system architecture and the fact that some people will need to go around the wheel a number of times before developing the capacity to self-manage.

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Scope

This visual depicts the human services system as a distinct system which is overlain on health, education, justice and community systems, demonstrating the joined-up nature of the human services system.

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Capacity Development Functions

This graphic demonstrates the links between the three levels of capacity development: individual and family, community, and human services system.

30

Integrated Delivery Functions

This graphic outlines the functions for the integrated delivery of responses in relation to access, early intervention and prevention and intensive responses.

31

Human Services System Structure

This diagram describes the key components that will need to be designed into the structure of the human services system if it is to meet the needs of the people of the ACT and be sustainable over time.

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Detailed Structure

This diagram describes this structure in more detail, showing the key components that will need to be designed into the structure of the human services system if it is to meet the needs of the people of the ACT and to be sustainable over time.

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Context

The Population of the ACT

The ACT is a city-state with the smallest land area of all Australian states and territories. It is home to 365,421 people (as at June 2011).

The ACT Government is continuing to successfully promote Canberra as a regional centre for health, education, employment and business.

As the national capital and home to the Federal Government, a large proportion of Canberra's population is employed in the public sector, which contributes to its unique socio-economic profile.

This profile includes, relative to the rest of Australia:

Among the states and territories, the ACT has the lowest proportion of individuals experiencing high levels of relative socio-economic disadvantage and also the highest proportion of individuals experiencing little or no relative disadvantage.

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Disadvantage in the ACT

Although the ACT enjoys a great degree of relative advantage, it also has second highest proportion of socio-economically diverse areas (above average percentage of both most and least disadvantaged). This means that the ACT's disadvantage may be located amongst its relatively affluent communities.

Public housing in Canberra is generally “salt and peppered” across suburbs and has historically been located in the older suburbs where land is now more expensive. Many Canberra suburbs - for example, Red Hill and Reid - have high numbers of both the most, and the least, disadvantaged individuals.

Disadvantage is under-reported when the standard Census-based measure of socio-economic disadvantage (the Socio-Economic Indexes for Areas - SEIFA) is used because it is based on areas. This under-reporting has been known to government and community service providers for many years. However, to increase our understanding of this issue, the ACT Government undertook further analysis of the Socio-Economic Indexes for Individuals (SEIFI) developed by the Australian Bureau of Statistics to better understand disadvantage in the ACT at the individual level.

SEIFI is a new, multi-dimensional measure of individuals' relative access to material and social resources based on personal attributes such as income, education or housing status. Using this measure, it is estimated that more than 40,000 ACT residents experience high levels of disadvantage - not the 712 identified using SEIFA at the suburb level.

Identifying where people experiencing vulnerability and disadvantage live can help governments and other organisations to better target services, policies and programs to meet their needs.

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Drivers for the Blueprint

There are a number of external factors impacting on the human services system — such as increasing levels of demand, an ageing population, revenue pressures, increasing wages, national reforms, and advances in technology — that create an environment for change.

As Canberra continues to be promoted as a regional centre, a wider regional demand for services is emerging. Services across Canberra and Australia are experiencing increasing levels of demand. In part, this is an expected outcome of our growing and ageing population. There is an increased emphasis on supporting people to age in place, promoting independence and reducing demand for high cost residential services.

Service systems are further impacted by paradigm shifts which are moving towards giving individuals purchasing power for their own services. Consumer-controlled funding models may represent a profound transformation and fundamentally change — or remove — the funding base of many organisations.

There are increasingly diverse and innovative models of operation and funding in the human services sector, such as social enterprises and social impact bonds. For example, philanthropic partnerships are growing in Canberra with the help of Hands Across Canberra — a group of community, business and government leaders seeking to facilitate philanthropy to support community sector services and charities. Social Ventures Australia have also established a Social Enterprise Hub in Canberra which provides business development support to community organisations or social entrepreneurs that want to develop a social enterprise to create employment for people excluded from the labour market.

Technological developments are driving demand for services and information that is easily accessible at any time, and delivered according to the needs of individuals and families. Currently there are many different access points and channels such as phone, internet, face-to-face and Canberra Connect.

It is important to note these drivers are relevant now and may change over time. It will be the role of the human services system to listen, learn and adapt to the changing needs of our community.

The following table outlines a range of drivers for the Blueprint.

Drivers for Change

From

 

To

Increasing vulnerability
and demand for services

Icon - Arrow

Increasing resiliency

Increasing early intervention and prevention to reduce demand for intensive service offers

Tailored service offers

Crisis focused responses

Icon - Arrow

Responding early

Preventing crisis

Fragmented and inefficient service delivery

Icon - Arrow

One system approach

Shared infrastructure

Focused on outcomes not inputs

Multiple reform efforts

Icon - Arrow

Alignment of reform efforts

Constrained resources

Icon - Arrow

Restructure service outputs and models to work within available resourcing arrangements

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Human services system interactions through the
Life-Course

The human services system takes a whole-of-system approach that is person-centred and able to respond at any age or stage of life.

Each person has a unique journey, in which the interactions with human services are just one part. People are sons and daughters, mothers, fathers, sisters, brothers, and members of a family and social group. Sometimes people are in need of care or are caregivers, and sometimes they are both.

Furthermore, people actively seek wellbeing and are not just passive recipients of what the system has to offer. They seek wellbeing for themselves and their family and will have different goals depending on their personal circumstances.

It is also important to note that the significant interactions with the human services system will often happen over a relatively short period, but can have significant impact on future wellbeing and life outcomes.

People seek wellbeing throughout their life—before during and after any type of interaction with the formal service system. However, service providers are often unaware of this longer and broader journey, seeing the person simply as a client or customer who has some specific needs that require a response. A person is a client/customer for only a limited time. Seeking wellbeing is, however, a lifelong journey. This perspective highlights that the person plays an active, not a passive role in service interactions. People are not simply consumers of what is presented by someone else. They are not passive recipients, following a path determined by the provider, but active partners in a journey towards wellbeing.

This 'life-journey' perspective highlights that the services provided by the human services system must be based on supporting people in the context of their own lives, and not just vulnerable people but all Canberrans. Interacting with human services is just one aspect of a person's search for wellbeing, a continuous process of taking steps towards a better life, which is different for each person.

The following visual highlights the importance of viewing the human services system interactions throughout the life journey, providing, for nearly all of us, different services at different times. Above all, we are people moving though our own individual journey, our needs changing throughout our life, and the graphic focuses on the horizontal nature of this journey to contrast it with the vertical manner in which services are currently organised.

By understanding this flow, it is possible to design a human services system that better meets the needs of people and communities, and reduces the costs of service delivery over time.

Summary of the drivers for change to be addressed by The Human Services Blueprint.

While each journey is unique, we have used a small number of 'archetypes' to help think through the service implications for a wide range of people who would interact with the human services system. These archetypes typify major groups of service users who, together, constitute a large percentage of total service demand.

The archetypal journeys used to guide the design work are:

  1. Families requiring support during family formation, pregnancy and early childhood development
  2. Families, including children, exposed to family violence, or other risky/
    adverse environments
  3. Young people with vulnerability to successful transitions to adulthood and independence
  4. People/families at risk of, or experiencing, offending and incarceration
  5. People and families who experience a sudden crisis (e.g. losing your job, sudden illness, divorce)
  6. People requiring assistance as they age
  7. People/families experiencing disability or illness.

    While interactions with the human services system will vary for each of these archetypes, the system challenge is the same; that is, to ensure that people are:

  8. Aware of their own needs and the services that can help
  9. Able to access and engage with the services needed
  10. Able to effectively use the services
  11. Able to develop their use to meet changing needs
  12. Able to 'move on', not becoming trapped in a cycle of service dependency.

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Archetypal Life Journeys

The archetypal journeys used to guide the design of the Blueprint were:

  1. Families requiring support during family formation, pregnancy and early childhood development.

    In 2011, there were 56,792 families with children living in the ACT with just under a quarter of those families being single parent households. Of all families with children, 65 per cent had at least one child under the age of 15 years (2011 Census Fact Sheet, Chief Minister and Treasury Directorate (CMTD): 2012).

    In the ACT 22 per cent of children were developmentally vulnerable on one or more domains in 2012 (Australian Early Development Index (AEDI): 2012). In 2009, 230 women aged 19 or under gave birth in the ACT (Chief Health Officer (CHO) Report: 2012).

    System Objectives: Promote effective parenting skills, encourage social participation and minimise the impacts of disadvantage during the early years of life.

  2. Families (including children) exposed to family violence, or other risky/
    adverse environments

    In 2011–12, 548 people were homeless in the ACT as a result of Domestic Violence. Specialist Homelessness Services Collection Report 2011–12.

    In 2012–13, 1,234 children and young people received a Care and Protection service, and 30 per cent of all children exiting care had experienced more than two placements.

    System Objectives: Promote safe and healthy living environments for families and children, and respond quickly and appropriately when safety is at risk.

  3. Young people with vulnerability to successful transitions to adulthood and independence

    In 2011–12, half of the people accessing homelessness services in the ACT were under 25 years of age with 30.6 per cent of service users aged from 15 to 24 years of age (Specialist Homelessness Services Collection Report 2011–12).

    In September 2013, the number of young persons in Bimberi Youth Justice in the ACT was 54 (remands and committals) ACT Criminal Justice Statistical Profile—September 2013.

    System Objectives: Promote positive life choices and skill development for young people with a dual focus on immediate safety concerns and working towards future aspirations.

  4. People/families at risk of, or experiencing, offending and incarceration

    During 2012, the average occupancy for men at the Alexander Maconochie Centre was 261.3 daily, and for women it was 13.5 daily. In 2009–10 the recidivism rate for prisoners returning to detention in the ACT was 41 per cent, which increased to 47 per cent in 2010–11. ACT Government, ACT Criminal Justice Statistical Profile, December 2009–December 2012.

    System Objectives: Promote positive life choices and skill development to support people to participate meaningfully in their community and to promote public safety.

  5. People requiring assistance as they age

    In 2011, 10.6 per cent of the population in the ACT was 65 years or over, with 44 per cent of individuals within that age bracket also having a disability. Census 2011.

    The rate of people aged over 70 years who are living in residential aged care in the ACT is 80.8 per 1,000. Chief Health Officers Report 2012.

    System Objectives: Support choice and control in the determination of options that will best suit the needs of individuals, carers and support networks.

  6. People and families who experience a sudden crisis

    When crisis occurs, social connections can play an important role in helping people get through difficult times. In 2011, the proportion of people in the ACT who report having no involvement in social and community groups in the last 12 months increased from 23.8 per cent in 2006 to 27.8 per cent. Measure of Australian Progress 2013.

    System Objectives: Provide timely and appropriate support to help get people back on their feet in times of crisis and to build capacity and community connections to prevent crisis from occurring in the future.

  7. People/families experiencing disability or illness

    In 2013, there were 8,481 people in the ACT in receipt of the Disability Support Pension.

    In 2012, 11.2 per cent of the population in the ACT provided care to people with a disability (nationally 11.9 per cent), of which, 2.8 per cent of the population in the ACT were primary carers and 8.2 per cent are carers but not the primary. Survey of Disability and Ageing 2012.

    System Objectives: Support choice and control in the determination of options that will best suit the needs of individuals, carers and support networks.

The system objectives outlined under each life journey have been used to inform key performance behaviours in the Outcomes section.

The following graphic depicts a range of statistics relevant to the life journeys outlined above.

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Summary of relevant statistics to the listed life journeys.

System Interactions

A person-centred human services system would help to develop a population who are able to identify and assess their own needs, able to access the needed services and manage their own needs and interactions with helping agencies.

In terms of identification, the human services system would help to develop individual, family and community capabilities, so that they are able to self-identify and remove any stigma attached to seeking help. For the delivery of formal services, the human services system would support the early identification of those who are not able to self-identify. Thus the focus of the formal service agencies would be to develop individual, family and community resilience, only 'stepping in' when resilience is challenged, and being a true 'safety net' for those most in need, rather than a 'first-port-of-call'.

The following 'service function wheel' provides an operational definition of what it means to be person-centred, describing the functions that need to be delivered at different stages of service interaction.

The service functions include:

This diagram describes the system interactions with individuals, families and communities, and the outcomes desired from each stage. It is depicted as a wheel to highlight the person-centric focus of the overall system architecture and the fact that some people will need to go around the wheel a number of times before developing the capacity to self-manage.

The following statements provide a description of what 'results' the service functions aim to support stakeholders to achieve:

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Depiction of the differing functions and outcomes of the Human Services System at various stages of service interaction.

Scope

The human services system in the ACT has as its prime function the responsibility to develop the capacity of people and communities through the delivery of integrated responses. This enables full participation in a strong and healthy community.

Within this context it is proposed we define the 'human services system' broadly, as it represents a better way of organising responses for people in the ACT. This is envisaged to include the full spectrum of services supported by community, health, education and justice systems, noting that each system is a dynamic and interrelated component of a broader human services system.

This Blueprint recognises that each 'system' delivers a range of responses provided by government, community sector, and for-profit partners. The Blueprint provides a framework for these systems to work in alliance as the human services system to deliver person-centred responses.

Under the human services system, each partner has a responsibility to align decision making with the vision and purpose of the human services system, and to respond as part of the human services system to build the capacity of people and communities. This includes having the capability to identify and connect people with the supports they need, when they need them. The functions to enable these systems to work in alliance as a cohesive human services system are further articulated under the Functions section.

The following visual depicts the human services system as a distinct system which is overlain by and draws on existing systems, emphasising the joined-up nature of the human services system to deliver cohesive and sustainable, person-centred responses.

Diagram - Human Services System

Note: Community responses may, for example, include housing, disability, children, youth and family support
as well as community infrastructure, such as transportation.

System Design

System design is made up of vision and purpose, functions, structure and processes. Together, these provide a description of the human services system, and represent the elements that need to be in place if the needs and expectations of key stakeholders are to be met.

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Vision

The Blueprint provides a shared vision of the desired future state of a cohesive human services system. The Vision encapsulates the purpose and values of the system.

All Canberrans have the capability to fully participate in strong, healthy and inclusive communities and are enabled by a cohesive human services system that is:

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Purpose

The purpose sets out the human services system's primary objectives against which performance to achieve the vision are measured.

In order to achieve the vision, the human services system in the ACT has as its prime purpose the responsibility to develop the capacity of people and communities to enable their full participation in a strong, healthy and inclusive Canberra community.

The Triple Aim of the human services system, further explained under the Outcomes section of this Blueprint, is to work cohesively to develop the capability of people and communities to enable their full participation in a strong and healthy community by:

This purpose statement is expanded in Human Services System Root Definition to describe: i) what the system does, ii) how it does it, and iii) the outcomes it aims to achieve.

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Values

Values are shared beliefs that guide priorities and provide a framework for decision making that defines how we will work to achieve our goals.

Respectful

The System will respect people and communities in the way it works by valuing the unique contributions that diverse perspectives bring to a vibrant community and to work in genuine partnership with all stakeholders (individuals, communities, human service providers and leaders).

Responsive

The System will listen, learn and adapt to the changing needs of people and communities.

Cohesive

The System will have a coherent and shared responsibility and work in partnership to achieve positive outcomes for people and communities.

Excellence

The System will be accountable, transparent, innovative, forward looking and reflective.

Effective

The System will balance achieving positive outcomes for people and communities while making good use of available resources.

Note: The Social Compact: A relationship framework between the ACT Government and Community Sector outline the shared vision, role and contribution of the community sector and ACT Government and principles for working together and guiding standards or undertakings for both the community sector and ACT Government for working together, planning and policy development and governance, management and accountability, and delivery of quality services and programs.

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Principles

Principles are a shared set of criteria that guide daily decisions.

Person-centred

People and communities are at the centre of decision making, and services are delivered holistically.

Community-focused

Service design responds to the context in which it is delivered by understanding the needs and expectations of people and communities.

Strengths-based

Relationships and service responses empower individual and familial resilience, self-determination and independence.

Outcomes-focused

Service design, funding, accountability and performance measurement focus on individual, community and system outcomes.

Simple

Information and access to services is easy to understand, navigate and access.

Collaborative

People and communities, community services and government agencies are aligned and united in their efforts to build collective impact.

Sustainable

The current needs of people and communities are balanced with considerations for future needs.

High quality

People and communities are supported by evidence-informed, innovative, continuously improving responses that appropriately meet their needs and enable them to achieve their desired outcomes.

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ACT Human Services System Root Definition

A root definition is a high-level description of the system and captures the vision, values, principles and aims of the human services system. The root definition is described in more detail under the 'Function', 'Structure' and 'Processes' sections of this Blueprint.

The ACT human services system is a system that…

By maintaining a viable, adaptive and sustainable system of…

  1. Capacity development, promotion, prevention and risk reduction including:
    • Promotion of individual/family strengths by providing information, resources and opportunities for individuals and families to develop their own understanding, knowledge and skills to maintain or enhance their social participation and to develop capacity for self-determination to resolve issues when they arise
    • Promotion of community strengths that support communities to build social participation for individuals and families, and support community-based resolution of issues if they arise
    • Human services system capacity development where government agencies and community organisations work alongside and with each other to build the capability of the system to understand and respond to straightforward social needs, recognise when emerging patterns of vulnerability or complexity require a step up in social response, and facilitate connection to the supports needed.
  2. Integrated service delivery is one where clients benefit from joined-up social services, where integration models on the funding, administrative and organisational levels create increased connectivity, alignment and collaboration within and between them. Services become increasingly convenient and accessible to the needs of key populations and capable of providing individualised and targeted responses for people across key stages of their life-course, through:
    • Simple access and navigation to ensure an 'open door' and 'any door right door' approach
    • Coordinated and progressive responses that address emerging or complex issues limiting social participation, using 'least intrusive, most effective, closest to home' approaches
    • Crisis and/or complexity and statutory responses that provide tailored and timely support with a focus on capacity building to prevent cycles of crisis from occurring
    • Improving the experience of using the service with a focus on high quality, enabling access and reliable engagement.
  3. Enabling and sustainable 'single system' infrastructure:
    • Leadership and Governance: through an authorising environment, and processes of inclusive 'purpose and culture' development, that enable a network of agency and community based services to function as a single system that is sustained and maintained as required
    • Learning and Improvement: through data informed intelligence, understanding of community demographics and needs, reflective action learning and structured performance improvement
    • System-wide network control and coordination capability: that can build and manage the effective and efficient use of the combined capacity and resources across multiple organisations and services, to ensure that the purpose and intent is translated into practice
    • Coordination: through building alignment of roles, processes and information that enable a responsive, person-centred approach to be woven seamlessly together
    • Effective Operations: through balancing the needs and expectations within individuals and families with the resources available.

In order to…

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Functions

If the Vision, Purpose and more detailed Human services system root definition describe what it is we are aspiring to achieve with the human services system, the 'system functions' refer to those things that the human services system will need to deliver, and what will be the result of that delivery. It is important to get a good understanding of the core functions any system has to fulfil before developing the structures and processes needed to deliver them.

Functions refer to the activities and the 'outcomes' or results that arise out of system interactions. That is, what will be the effect of all the activity?

In this Blueprint, the archetypal life-course journeys (referred to on pages 15-17) are used to identify service experiences for large segments of the population who would interact with the human services system - acknowledging that the common functions described here will have unique attributes for each population.

The human services system has two main functions:

  1. Develop capacity
  2. Integrated delivery of responses.

Capacity development functions

The critical human services system functions are those that inform, enable and empower others to act. By developing the capacity of people, communities and agencies/organisations to build strengths and resilience and to respond early to emerging issues that affect participation, the system as a whole, may achieve better outcomes while leveraging its specialist skills and resources.

Capacity development is targeted at three levels:

  1. Individual and family capacity
  2. Community capacity
  3. Human Services System capacity.

    The links between these are shown in the following graphic and more detail is provided below.

Depiction of the interrelationships of the three levels of capacity development functions of the Human Services System.

Individual and family capacity

Community capacity

Community is defined more broadly than place and geographical boundaries and may be considered on the basis of culture, heritage, language, interest, peers, occupation, as well as virtual communities. From a human services system perspective, each represents networks with a social capital of connections skills and resources that are available to support individuals and families to participate and develop reciprocal strengths. For each journey the mix and nature of the communities available may change.

Human services system capacity

While each of these three areas is important, more detailed work was done on the functions needed to build the capacity of individuals and families across the different life journeys (described on pages 15-17). The additional detail is discussed in the section titled Integrated delivery functions.

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Integrated delivery functions

While capacity development functions enable individuals and families to participate fully in their communities, integrated delivery functions allow for the differentiation of service responses at times when the capacity to self-manage is affected.

There are three integrated delivery responses that collectively ensure people receive the right supports, in the right place, for the right duration, and at the right time. These responses include:

  1. Access Model: Providing simple to access and navigate responses that ensure agencies work together to link individuals and families to the supports they need. This includes self-help through to supported access models that provide common assessment tools and processes that are strengths-based and help people to identify outcomes that matter to them.
  2. Early Intervention and Prevention: Responding early in life or in situations to prevent escalation of issues. This includes light touch and preventative models of support, identification of risk indicators and leveraging informal supports to enable early resolution of issues in the future.
  3. Intensive Service Offer: Tailoring supports to respond to crisis situations and/or complexity in a timely and effective manner. This includes statutory and non-statutory responses that support self-determination where possible, wrapping supports around individuals and families, case coordination processes with lead workers, and supporting the stabilisation of situations in order to enable people to work towards positive outcomes.

    While these functions represent a graduation of responses from least to most intensive, all delivery functions focus on building resilience and capacity for self-management in order to re-enable independence where possible.

Depiction of the integrated delivery functions of the Human Services System.

The above graphic outlines the integrated delivery functions of the human services system, demonstrated by the dynamic nature of individuals accessing appropriate responses that change as their needs change.

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Structure

The structure of the human services system is important to ensure both its short-term success and its longer-term sustainability.

Four structural elements have been identified as key to achieving a cohesive human services system:

  • Leadership and Governance: Create a clear sense of authorisation and direction and effective policy in place to support that direction
  • Learning and Development: Construct an adaptable and innovative system that has an ongoing understanding of changing needs and circumstances and capacity to respond to change
  • Control and Coordination: Managing and coordinating the core services delivered to individuals, along with monitoring and evaluating their performance (including top-down and bottom-up controls)
  • Operations: System activities that enable the system purpose to be achieved.

While the above elements relate to an overall human services system, they are also relevant to individual organisations and services. For example, they have been written to be applicable to the ACT human services system, to individual Government or community based organisations, or to specific services and programs.

The structural elements of the human services system, including their broad application, are described in the following diagram.

Diagram - Person Centred

The diagram describes structure in more detail, showing the key component that will need to be designed.

The diagram below describes this structure in more detail, showing the key components that will need to be designed into the structure of the human services system if it is to have capacity to meet the needs of the people of the ACT, create an effective relationship between people and communities and the system, and to be sustainable over time.

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Leadership and Governance

The purpose of leadership and governance is to:

Leadership and governance should balance the “demands of today” with the “needs of tomorrow”.

To achieve this, it is important that leadership and governance structures have high-level and across-agency authorisation that is consistent and coherent, with a clear purpose and direction. It should support local delivery (including building community capacity, outcomes-based funding, alignment of procedures and shared information access points) and provide clarity to local management, which may include joint Government, community and service user authorities.

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Learning and Development

The purpose of learning and development is to help service units to:

Learning and development should focus on “outside and tomorrow” as well as the immediate day-to-day demands placed on the human services system.

To achieve this, it is important that learning and development structures incorporate a focus on data collection and usage so that future needs are managed and risks are mitigated, developing the workforce including staff and volunteers, and supporting innovation.

It should support ongoing research to understand changing needs and circumstances through an “intelligence framework” to capture significant patterns and trends and understand future needs. It should also feature quality improvement programs.

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Control and Coordination

The purpose of control and coordination is managing and coordinating the core services delivered to individuals, along with monitoring and evaluating their performance.

Control and coordination's focus should be the “inside and now”: legal, regulatory and operational requirements along with funding and resourcing considerations.

To achieve this, it is important that core services are defined and delivered in a collaborative and sustainable way with service providers. Agreements about performance targets and measures should be matched by an appropriate allocation of resources.

Services should be organised around the needs of people in their communities. Attention should be given to coordination across services, especially when they cross directorate boundaries, to support a person-centred approach to human services delivery (for example, an “any door is the right door” approach).

Some common tools to support a coordinated approach include shared timetables or schedules, agreed protocols for managing boundaries between services, agreed standards for measuring practices and performance, and an aligned set of objectives.

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Operations

Operations are the primary activities, or business, of the human services system. They deliver value to individuals, families and communities and enable the purpose of the human services system to be achieved.

Operations should assess need and manage demand, utilising triage, common assessment tools and, where appropriate, service co-location, for example. Location of services should be acutely informed in a part of any community response.

While the detailed work of describing the operations will be part of Phase 2 of the Blueprint design, the guiding principle for these activities should be to “develop the capability of people and families to enable their full participation in a strong and healthy community”.

Organising these operations will be driven by a concept of “value creation”—how the structures are best organised to maximise value.

However, they are finally defined and organised, a major challenge will be to ensure that services are open and accessible to those in need, while managing demand within available resources.

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Processes

Processes describe how the functions of the human services system will be delivered and the capabilities needed to deliver them. Processes relate to either the front-facing service delivery processes, or the back-facing system capacity processes. To be effective, the human services system processes must:

Processes provide alignment between the functions and the structures, completing the service system architecture, as depicted on the following page which is the key to reading the system processes table on pages 37-38.

Depiction of the processes which align the functions and structures of the Human Service Blueprint.

While further work will be required to design the individual processes during Phase 2, the following table outlines anticipated processes required to deliver the preferred human services system:

Structures

Processes to Support Capacity Development

Processes to Support Integrated Delivery

Leadership and Governance

Shared accountability framework to support improved outcomes and ongoing improvement.

Joint community, corporate and Government commitment to collaboration, identification of service needs, and responsibility for community outcomes.

Learning and Development

Online evaluation bank enabling open sharing of cross systems evaluations to inform policy and practice development

Demographic information is captured and used to inform policy and practice

An across system workforce development strategy is established to build capacity for person-centred and integrated service delivery.

Reflective practice models allow front line workers to contribute to the ongoing design and development of the system

Tiered outcomes frameworks allow for population based and personal outcomes measurement

Multi disciplinary workforce development modules are delivered online and available across government and non-government sectors.

Control and Coordination

Multi-agency service delivery partnerships allow for collaboration and coordinated service delivery

Pooled funding models support multi-agency collaboration

System-wide information sharing protocols support holistic and multi disciplinary responses

Social Impact Investment supports innovative and sustainable responses

Risk based reporting model to reduce red tape.

Community-based assessments are recognised by the formal service system

Leveraging community based infrastructure to provide points of access and information (e.g. community centres, libraries, medical centres, schools etc.)

Community-based and Territory-wide networks enable holistic understanding of people's needs and aspirations

Investment in early identification and intervention models to reduce demand over time.

Control and Coordination (continued)

Aligning and embedding work that has proven effective (e.g. Strengthening Families, Throughcare).

Service hubs provide open access to spaces that enable multi disciplinary/multi-agency collaboration

Supporting and strengthening peoples roles and responsibilities.

Operations

System workers proactively identify individuals and groups that may need assistance to participate

Shared IT systems enable
choice-based information sharing where possible, and linking of
cross system support networks

Client data is available on mobile devices to support outreach service delivery.

People have access to tools and resources to support self-management in a variety of formats including, online, phone, and face-to-face

Multi disciplinary/multi-agency support networks are wrapped around people when needed, rather than requiring multiple referrals

Multi disciplinary panels assess complex needs in order to allocate resources appropriately.

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Outcomes

The overall goals for the human services system described in the Human Services System Root Definition on pages 24–26 are based on concepts of the 'Triple Aim' framework developed by the Institute of Healthcare Improvement, as a way to achieve simultaneous improvements across the three core performance domains: individual; population; and system.

While originally developed within a health context, it has achieved solid international acceptance as a means of focusing performance and developing sustainable services across a range of sectors.

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Diagram - Individual Population System

Triple Aim

In the context of the Blueprint, the performance of the human services system will be considered against the following domains:

  1. Individual: Improved experiences for those interacting with the human services system, including access, quality, reliability, and continuity
  2. Population: Improved capability of individuals and families to participate fully in strong and healthy communities
  3. System: Effective use of available human and financial resources.

    Pursuing these three overall aims as simultaneously balanced objectives for the human services system, will provide a discipline for progressive development and realisation of the Blueprint, acting as a lens through which each step of development is viewed, and with objective data used to guide improvement.

    The 'Individual' lens focuses attention on designing approaches and processes that work for people. However, this lens can also be used to identify waste, where blocks, discontinuities, or poor quality are costly and/or add little value. Similarly, taking an individual lens facilitates tuning of systems and processes to the real needs of individuals and families, combined with evidence of what works at a population level.

    The 'Population' lens focuses attention on the life-course 'journeys', where there are distinct patterns in the drivers of need and demand, requiring different responses and performance from the human services system. A population lens helps focus attention and resources on activities that will have the greatest impact, balancing promotion, prevention and primary, secondary and tertiary risk reduction, within each journey to most effectively use resources across the continuum.

    The 'System' lens focuses attention on sustainability and maximising the value of limited and constrained resources and the need to reduce the per capita cost of service delivery. However, at a people level this lens helps focus on collaborative partnerships with individuals, families, and with the ecology of organisations within the system, in order to make the best use of collective resources.

    Without this balance the Blueprint for the human services system could improve quality at the expense of cost, or reduce costs in ways that both leave people dissatisfied and reduce performance in ways that ultimately are more costly as the consequence of poor population level outcomes drive up service demand.

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Key performance behaviours

The Triple Aim approach provides a framework to articulate the key performance behaviours that the human services system will be required to deliver. The key performance behaviours form a basis for monitoring performance overtime, in recognition that moving towards the preferred human services system will be an iterative and multi-year process.

Key performance behaviours to be delivered by the human services system overtime are outlined below:

  1. Individual

    Improved experiences for those interacting with the human services system, including access, quality, reliability, and continuity

    • Person-centred and strengths-based; builds resilience and capacity for choice, participation and independence
    • Community focused; facilitates connections and social bonds
    • Approachable, respectful and inclusive
    • Simple, seamless and accessible across multiple entry points
    • Responsive, timely, flexible and effective
    • Transparent, honest and trustworthy
    • Accountable.
  2. Population

    Improved capability of individuals and families to participate fully in strong and healthy communities

    • Promotes effective parenting skills, encourages social participation and minimises the impacts of disadvantage during early years of life
    • Promotes safe and healthy living environments for families and children, responding quickly and appropriately when safety is at risk
    • Promotes positive life choices and skill development for young people with a dual focus on immediate safety concerns and working towards future aspirations
    • Promotes positive life choices and meaningful participation of offenders in the community while improving public safety
    • Supports choice and control in the determination of options for people as they age, with consideration to the needs of the individual, their family and carers
    • Provides timely and appropriate support to get people back on their feet in times of crisis while building capacity and community connections to prevent crisis from occurring in the future
    • Supports choice and control in the determination of options for people with a disability, with consideration of the needs of individuals, their family and carers.
  3. System

    Effective use of available human and financial resources

    • Streamlines and reduces inefficiencies in order to reduce the cost per service episode
    • Shifts 'upstream' demand in order to reduce dependency on crisis responses
    • Builds independent resilience to minimise duration and intensity of support
    • Creates effective tiers of response to match intensity of need (Progressive Universalism)
    • Builds partnerships with capacity to drive collective impact from combined resources.

The key performance behaviours will be developed into a comprehensive performance measurement framework in Phase 2.

Sustainability

A fundamental challenge to be addressed in the realisation of a cohesive human services system is to achieve sustainability within the opportunities and constraints of the resources available within the system; including those of individuals, communities, non-government organisations, private businesses and funding from the wider ACT and Federal funded systems.

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More efficient for the future

Delivery of human services is a long-term investment in the people and the community of Canberra.

Being more efficient means making the best use of the resources you have—producing as many services as possible from a given set of resources, but also providing services in a way that best meets people's needs and wants.

The need for future services depends on being able to fund the services and infrastructure the Canberra community deserves and expects. A sustainable system allows the Government to support those in need, to function effectively, and to make investments for the benefit of current and future populations.

Sustainable service systems include collaboration between agencies, better methods for targeting those in need, integrated policy focused on key systems that can maintain the gains of investment in prevention or intervention and ongoing quality assurance.

It is important then that systems should be sufficiently resourced to be flexible and capable of change and capable of delivering services across the breadth of community needs. Service integration can engage all agencies and individuals with the responsibility to deliver services to individuals, families or communities.

The dimensions of process and structural quality are very important determinants of good outcomes. An important aspect of sustainability is administrative simplicity and efficiency, where this is balanced against a system that targets priority assistance to those who need it the most.

There are a number of key metrics that capture the key challenges facing the human services system in the ACT. These are measures that reflect the key drivers related to rising service demand and constrained resources.

The number of people engaged in most statutory and crisis services is rising due to the fragmented and crisis-driven nature of the service system.

Limited investment in community and early intervention will lead to continued increases in statutory and crisis service demand. An increased focus on community and early intervention approach can reduce demand over time.

The following time series graphics provide visual examples of system performance, providing qualitative depictions of a rising demand for statutory and crisis services.

Graphic 1 indicates a continuation of the demand trend where current human service delivery practices remain unchanged.

Graphic 1

Representation of the expected reduction in numbers of people engaged in statutory and crisis services under the Human Services Blueprint .

Graphic 2 depicts a 'preferred future' that shows a decline in the demand for these services.

Graphic 2

Graphic 2 Representation of investement in early intervention and prevention services will initially cost more, but will lead to reduced expenditure in the longer term.

Investment in early intervention and prevention services will initially cost more, but will lead to reduced expenditure in the longer term.

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Return on Investment Modelling

A common challenge in addressing demand for government services is that narrow funding cycles focus on services that meet today's needs, compromising the capacity to invest in initiatives that could reduce future demand.

Budgets are often constrained at a threshold where there is no free resources to do anything other than respond to presenting need, even when it is clear that the pattern of need will persist and generate large future costs, which could be mitigated by incremental investment to change the underlying pattern.

By contrast where there is a clear focus on predictable trajectories of need and service demand these predictable future costs can be anticipated enabling the impacts of today's action or inaction to be compared with future service costs. If a different mix of responses, made today, can reduce the future liability by more than the cost required, then debate on funding constraints can be shifted to a different level.

In the ACT most households receiving government assistance require some short-term, low cost assistance and are able to avoid long-term dependency on human services. However, a proportion of households move along pathways of repeated service use and higher and higher cost service provision. If the proportion of individuals requiring repeat services or higher cost interventions can be reduced through preventive interventions, then this investment may reduce the overall long-term cost of human services.

The focus is changing predictable trajectories of high-cost service demand over time, using a return on investment approach drawing on longitudinal data to target investment in preventative interventions.

Examples where this has been applied include the future impacts of unsupported teen pregnancies and parenthood and the impact of long term unemployment and patients with predictable risk of readmission or high hospital service usage. A successful Victorian pilot project—'Doorway'—supports people with mental illness from homelessness into stable housing resulting in fewer hospital admissions and an overall reduction in social housing and health costs.

Taking a return on investment approach represents an opportunity for the human services system since relatively predictable trajectories are known to be common in our client populations. In a tight fiscal environment it can provide the platform for the human services system to deliver better outcomes for people, for populations and ongoing sustainability.

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Overcoming constraints

The process of idealised design used in the development of the Blueprint focuses on conceptualising the best implementable system possible with the challenge—what stops us from doing this tomorrow? The process focuses on three types of constraints:

Type 1 External

Type 2 Resource and organisation, those that will require investment and/or preparation

Type 3 Behavioural—current behaviour patterns and mental models

The below table outlines a range of constraints to achieving the Blueprint, along with mitigation strategies to overcome them:

Constraint Type

Constraint

Making it Happen

External

Restrictive legislation

Uncertain Federal funding

Risk adverse

Divided governance arrangements

Monitor and influence change

Taking mitigated risk to enable innovation

Shared accountability and governance frameworks

Resource and Organisation

Programmatic funding

Workforce retention and development issues

Fragmented policies and processes

Incompatible data bases and IT systems

Inconsistent assessment processes

Pooled funding models and social impact bonds

Whole of system workforce development strategy

Shared evaluation and learning processes to inform consistent approaches

Data linkage and systems interface development

Common Assessment Framework

Behavioural

Professional demarcation

Inconsistent values and understanding of the vision

Resistance to change

Siloed practices

Practice frameworks that recognise specialist and generalist expertise

Workforce development and cross system collaboration strategy

Create a change and risk reward environment to support innovation

Treasury reforms to support joint budget initiatives, relationship management and succession planning

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Realisation Pathway

The Realisation Pathway provides a framework for progressive implementation of the Blueprint. The Realisation Pathway articulates processes to identify, understand, align, redesign and develop elements of the Blueprint. It takes an iterative, prototyping approach to inform scalable and sustainable system reform.

  1. Identification of System Outcomes and Drivers

    The Blueprint outlines a Triple Aim for the human services system: to improve experiences, population outcomes, and resource utilisation. Realising the Triple Aim requires progressive identification and prioritisation of system outcomes to inform short-term, medium-term, and longer-term investment priorities. System outcomes have been articulated in the key performance behaviours on page 40.

    Prioritisation will involve analysis of the drivers impacting on the current capacity of the system to achieve the identified outcomes, in order to target investment to those outcomes that will achieve the greatest return on investment. The prioritisation process will consider the following:

    • Short-term priorities—must be delivered to support future change processes and priorities that can be achieved quickly to deliver early results. These priorities will be sequenced to ensure a balanced investment between short and medium term priorities
    • Medium-term priorities—require a long lead in time to deliver longer term change and therefore require early investment
    • Long-term priorities—depend on completion of other change processes and will likely require future investment.
  2. Identification of Locality Needs and Expectations

    The community focus and capacity development functions of the Blueprint support the prototyping of the Blueprint within a local context. While not all communities are geographically based, local prototyping will provide a feasible scale to test the Blueprint elements in order to inform scalable change. Prototyping within a locality will require analysis and consultation on local needs and expectations, linking to the broader system outcomes and drivers relevant to the particular locality.

  3. Alignment and Redesign of Existing Building Blocks

    The strengths based focus of the Blueprint is supported by recognising that there are existing building blocks that support the Blueprint objectives, such as; community based resources and infrastructure, service delivery models and networks, and social capital. Alignment of building blocks that are congruent with the Blueprint will allow for early achievement of outcomes while recognising that some building blocks will require redesign in order to align. Redesign may include investment in capacity building, technologies and infrastructure to enable a cohesive human services system within the local context.

  4. Development of Supporting System Policy and Processes

    In addition to aligning and redesigning existing building blocks, prototyping will also highlight supporting system policy and processes that need to be developed, such as governance models, funding models, and common assessment tools. This will require increasing the flexibility of existing governance and funding models to achieve the identified outcomes.

The below diagram provides an example of the realisation pathway in action, noting that Phase 2 will articulate the prioritisation of outcomes to be achieved:

Depiction of the realisation pathway for the Human Service Blueprint.

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Maturity Model

The Maturity Model recognises that for the human services system, as a framework, to become an integrated system which delivers person-centred and sustainable responses, progressive improvements will need to be made over time. Progressive improvements will be identified using the Realisation Pathway methodology and the degree to which things align under the human services system will be evaluated and measured against the Triple Aim.

The intent of the Maturity Model approach is to embed system improvements, leading to increasing realisation of a cohesive human services system which is person-centred and sustainable. The Maturity Model will test system elements to identify those that already align, along with areas requiring redesign or development. The alignment of system elements will be assessed on the basis of the following maturity levels:

Level 1: Inconsistent—System elements do not align and require complete overhaul to form part of the human services system, or cessation.

Level 2: Partially Consistent—System elements align with, but require some degree of redesign to achieve consistency to form part of the human services system.

Level 3: Consistent—System elements align with, but require embedding to form part of the human services system.

Level 4: Optimal—System elements align with and are embedded as part of the Human Services System.

The maturity of the human services system will be measured by the (increasing) proportion of system elements that have optimal alignment. The Maturity Model also provides an investment strategy for assessing new budget proposals in future years. As part of establishing the Learning and Development Structure, processes will be established for assessing maturity across the system.

Prototying to Inform Progressive Implementation

Continued engagement

Achieving a cohesive human services system that is person-centred and sustainable will take time. Continued collaboration and co-design throughout each phase is vital to realising the vision of the human services system as the Blueprint project rolls out and the system is progressively realised.

The values of the human services system that underpin any future work include being respectful and responsive. These mean that our approach to future engagement will: 1) value the unique contributions that diverse perspective bring to a vibrant community, and 2) listen, learn and adapt to the needs of people and communities.

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Next steps

The second phase of the Blueprint project will involve policy work to sequence key activities required to deliver this system, and will continue throughout 2014. The third phase will align and test key elements and activities required to deliver the system, and will occur in 2014 and 2015. The fourth and final phase will involve evaluation and embedding of the Human Services System Blueprint across the ACT.

Future phases will continue to be developed in collaboration with the community, community sector and government agencies.

If you would like any further information on the Human Services System Blueprint project or to be involved in future phases, please contact the Community Services Directorate at:

Strategic Policy
Community Services Directorate
GPO Box 158
Canberra ACT 2601
or: HumanServicesBlueprint@act.gov.au
www.communityservices.act.gov.au

Acknowledgements

The ACT Government acknowledges the significant contribution of the individuals and organisations that contributed their time and expertise to design the Blueprint between September 2013 and February 2014.

Phase 1 was supported by Synergia Consulting PTY LTD. The ACT Government acknowledges the expertise that Synergia partners, Philip Gandar and David Rees, have contributed to the Blueprint's design.

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Human Services Taskforce membership

Core Design Team membership

Blueprint Project Team

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