Analysis: A few pioneers, but councils and NHS still show limited uptake of digital outcomes

After four years, usage of the government’s flagship vehicle for agile service design support is still predominantly used by Whitehall. PublicTechnology research assesses uptake so far among local government and NHS trusts – and which local public sector entities are leading the way

Credit: Sunil Prasannan/CC BY-SA 3.0

The Digital Outcomes and Specialists framework is designed to give public sector organisations an accesible means of embarking on agile delivery projects, and obtaining the support needed to do so.

Through the government’s Digital Marketplace platform, the procurement vehicle allows buyers to describe the overall problem they need to solve, details of what outcomes are required by various users, and the context in which all these challenges need to be met – including boundaries of budgets and timescales. Suppliers can then ask questions, which are answered publicly, before putting forward solutions.

The focus is on short sprints in support of staged goals, demarcated by the four defined stages of an agile project: discovery; alpha; beta; and live.

A data set maintained by the marketplace – covering opportunities posted from the first weeks of the initial DOES framework launched in February 2016, right up to those posted earlier this month – contains details of the procurement process for 1,812 outcomes that have been sought by the public sector.

At one end are large, multi-service transformation projects; the largest deals awarded through DOS were a £36m contract related to the Department for Work and Pensions’ children’s platform, and another worth the same amount to “transform service delivery” across the Department for the Environment, Food and Rural Affairs.

At the other end of the scale is an engagement worth exactly one ten-thousandth of that amount: a £3,600 contract to perform an accessibility audit on the website of the Dartmoor National Park Authority.

Of the 1,812 outcomes opportunities posted, a total of 109 are listed as listed as having been cancelled, and a further 19 as unsuccessful; cumulatively these equate to 7% of the total.

Of the 951 notices for which data is available, about one in three – 312 contracts – were awarded to large companies. Some 273 deals were won by medium-sized firms, equating to 28.7% of the total, while 264 engagements (27.8%) were sealed by small firms and 104 (10.9%) by micro-companies.

Well over half of the outcomes were sought by central government entities, although PublicTechnology research found that the volume and nature of how the framework is used varies greatly across departments.

Take up is even patchier across councils and NHS trusts; local government and local or regional NHS entities have respectively posted 140 and 75 opportunities in the past four years. These have been split across 57 authorities and 42 NHS organisations.

Reading through the contract notices, it is evident that many of them – although using the language of agile – are simply calls for product supply.

But, while most public sector entities are not still using the DOS framework as was intended – in fact, not using it at all – others have begun to seek outcomes, rather than products from their suppliers. Others still have wholeheartedly embraced this model.

Here, we profile three of the most active adopters of digital outcomes across local government and the NHS, and some of the agile projects they have undertaken.


Hackney Council – 35 outcomes sought
The east London borough is by far and away the most enthusiastic user of the digital outcomes vehicle across local public sector organisations.

Indeed, the nine further opportunities that are still awaiting conclusion and are not included in the figure above is almost as many as any other authority has posted across the last four years.

Improving digital services for social housing tenants has been a major focus. Among the projects launched by the borough include the development of tools to request repairs and report anti-social behaviour. The authority has also worked to make improvements to the rent-paying service, as well as building a tool for residents to better manage arrears.

Outside of housing, Hackney has also constructed a service for citizens to file planning applications, or view and comment on other applications. The council has also built and launched Hackney Works – a free online platform providing employment help to residents of the borough. 

It has also sought support with a variety of discovery projects for new or proposed services, including a ‘Hackney Welcome’ platform that “joins up council services for people moving in to the borough”, as well as examining how it could “redesign the front door for adult social care”.

The authority’s development of a digital tool to recruit and retain foster carers exemplifies its commitment to agile principles; having worked through understanding the potential of the service through research, it has built it to ‘live’ status – but is still working to iterate and improve to ensure it benefits users and the authority itself.

Hackney said: “We completed a discovery phase to understand the potential for digital to support the recruitment and retention of foster carers and developed an MVP to support applications, through a diagnosis tool and online application process. We would now like to build on those tools to improve the user experience and data quality. If we can identify why a single candidate dropped out of the application process and convert them into a foster carer, the council would save the equivalent of £8,000 per annum.”


South London and Maudsley NHS Foundation Trust – 6 outcomes sought
This mental health trust provides in-patient care for more than 5,000 south London residents each year across four hospital sites. Its 4,600 staff provide community services for a further 45,000 patients.

The trust has shown an appetite for seeking digital solutions to meet its desired outcomes, with projects including a redesign of its internal intranet, and the development of a tool allowing medical staff to search for and access “complex clinical data for research, including large amounts of unstructured free text”.

South London and Maudsley has also undertaken projects including the construction of a room-booking platform for use by staff, and its most recent outcomes notice was for the “redevelopment and merging of the trust’s two main websites… providing scope for future microsite development”.

This opportunity covered everything from user-research, through designing building and implementation.

“Our website needs to reflect our reputation and established brand. Patient focus is essential, with the opportunity to empower people with the tools they need to access our services,” the trust said. “A site with an emphasis on outcomes and quality for patients is important; it will be led by clearly defined user journeys for our audiences, helping people find relevant content quickly and easily.”


Devon County Council – 10 outcomes sought
While Hackney is seeking outcomes for an inner-city urban area and population, the other council to post a significant number of opportunities serves a county largely taken up with coastal and rural communities.

Devon has used the DOS framework to seek support or exploration with a number of projects related to internal operations and citizens.

It began in July 2016 with a discovery exercise to explore the potential of a project portfolio management platform to replace a system in which the progress of ongoing projects was recorded manually in a spreadsheet.

Its next opportunity, which came in early 2018, sought the implementation of a “digital platform to enable service transformation” on a wider scale.

In the last two years it has posted a number of other agile transformation opportunities, including a discovery exercise dedicated to “analysing performance data for customer touchpoints”, and a project focused on the “creation and maintenance of local service directories”.

Its most recent opportunities indicate that transformation will gather pace further in the coming months and years; in October, Devon sought a partner that could assist with a redesign of its whole ICT and digital service.

“DCC is prioritising digital within business change. This will increase the demand for digital solutions within the organisation,” the authority said. “DCC has also signed the Local Government Digital Declaration and is determined to adopt a user-centred approach to digital service redesign.”


Other councils to have posted outcomes opportunities include: Buckinghamshire (6); Bristol (5); Belfast, Essex, Kent, Nottinghamshire, West Berkshire, and Westminster (4); Aberdeen and Lewisham (3); Allerdale, Brent, Chelmsford, Gloucestershire, Newham, North East Lincolnshire, Powys, Southwark, and Surrey (2); and Adur and Worthing, Ards and North Down Basingstoke and Deane, Bassetlaw, Bath and North East Somerset, Birmingham City Council, Castle Point, Cornwall, Dudley, Gateshead, Greater London, Harlow, Harrogate, Isle of Wight, Leeds, Leicester, Leicestershire, Lisburn & Castlereagh, Liverpool, Luton, Mid Sussex, North Lanarkshire, North Lincolnshire, Oxford, Reading, Sefton, Solihull, South Somerset, Southend-on-Sea, Stockport, Tameside, Taunton Deane, Trafford, Warwickshire, Welwyn Hatfield, and West Dorset (1).


Other NHS bodies to have posted opportunities include: Lancashire Care NHS Foundation Trust (9); Guy’s and St Thomas’ NHS Foundation Trust, and NHS NEL Commissioning Support Unit (5); Leicestershire Partnership NHS Trust, NHS Wandsworth CCG, and Moorfields Eye Hospital NHS Foundation Trust, and Salford Royal NHS Foundation Trust (3); Gloucestershire Hospitals NHS Foundation Trust, Humber NHS Foundation Trust, Kingston Hospital NHS Foundation Trust, and Oxleas NHS Foundation Trust (2); and Cambridge University Hospitals NHS Foundation Trust, Camden and Islington NHS Foundation Trust, Dorset HealthCare, East Sussex Healthcare NHS Trust, Frimley Health NHS Foundation Trust, Greater Manchester Mental Health NHS Foundation Trust, NHS Redbridge CCG Hertfordshire Partnership University NHS Foundation Trust, Kettering General Hospital NHS Foundation Trust, Lincolnshire Partnership NHS Foundation Trust, Manchester University NHS Foundation Trust, Mersey Care NHS Foundation Trust, NHS Bromley CCG, NHS Education for Scotland, NHS Medway CCG, NHS Western Isles, Norfolk and Norwich University Hospitals NHS Foundation Trust, Nottinghamshire Healthcare NHS Foundation Trust, Royal Brompton and Harefield NHS Foundation Trust; South East Coast Ambulance Service NHS Foundation Trust; South West Yorkshire Partnership NHS Foundation Trust; Taunton and Somerset NHS Foundation Trust, Somerset Partnership NHS Foundation Trust, South Western Ambulance NHS Foundation Trust, Newcastle upon Tyne Hospitals NHS Foundation Trust, Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust, Shrewsbury and Telford Hospital NHS Trust, Welsh Ambulance Service NHS Trust, West London Mental Health NHS Trust, Wye Valley NHS Trust, Mid Essex Hospital Services NHS Trust (1).


This article is part of PublicTechnology’s How to Design a Government Service project, in association with BJSS. This specially created content week will feature a range of exclusive interview, feature, and analysis content dedicated to the art of delivering digital services for citizens and public sector professionals – from the earliest stages of discovery, right through to maintaining live services in use by millions of people. Click here to access all the content.


Sam Trendall

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