An exciting new approach to more truly co-designed services is underway in Queensland. Recently piloted in a range of mental health and alcohol and other drug agencies, this new approach has implications for a wide range of organisations across the health, community services and education sectors.

The Stretch2Engage Framework aims to build organisational capacity to better engage with people who use services, and their families and supporters in service design activities.

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What is service engagement?

When we talk about service engagement, we are talking about processes that organisations implement to involve people using services, and their families and supporters in the design, evaluation and improvement of programs and services. This is different from individual engagement, which is focused on more person-centred support and treatment through relationship development and shared decision making about individual care.

Service engagement and co-design

Co-design typically refers to the inclusion of end users in decisions about how products, programs and services are designed and implemented. When done well, co-design is not a once-off consultation, but an ongoing relationship in which stakeholders work together to clarify problems, identify needs and develop solutions.

Co-design alters the balance of power in the relationship between service providers and consumers, and involves a cultural shift from "doing for" to "doing with". Although these changes can be challenging for organisations, co-design offers many benefits. It can be empowering and engaging for people using services to be genuine partners in service development, and to have their views fully heard and considered.

Co-design also provides organisations with much better information about what people need and value in relation to service. It can lead to more innovative and effective programs and service systems. Using the concept of service engagement, the Stretch2Engage Framework seeks to develop and embed practical forms of authentic co-design within service delivery contexts.

The Stretch2Engage Framework

In 2015 the Queensland Mental Health Commission (QMHC) funded the development of a draft set of principles on service engagement for mental health and alcohol and other drug (AOD) agencies. The work was undertaken by the Stretch2Engage Partnership: the Queensland Alliance for Mental Health (QAMH); Queensland Network of Alcohol and Other Drugs (QNADA) and Enlightened Consultants.

The principles were developed following extensive consultation with people who use services, their families and supporters, and with service providers. Helen Glover from Enlightened Consultants led the creation of the framework in partnership with people who use AOD and MH services.

The seven Cs

The Framework development process identified seven value domains (the seven C’s) which may enhance organisational capacity to effectively engage with people who use services, and their families and supporters (see box below). These domains are supported by a broader set of principles and are now known as the Stretch2Engage Framework.

Stretch2Engage value domains

  1. Stretch2Be Curious: Eager to know or learn
  2. Stretch2Be Clear: Initiatives are transparent in their reason and are easily understood
  3. Stretch2Be Champion: Vigorously lead, promote and support the organisation in their engagement initiatives
  4. Stretch2Be Creative: Use of imaginative methods to evoke new ideas
  5. Stretch2Be Collective: Intentionally seek out and engage people from diverse backgrounds and experiences
  6. Stretch2Be Comprehensive: Willing to explore all aspects and embrace divergent views
  7. Stretch2Be Committed: Pledge to ongoing service engagement initiatives

Engagement practice

The Stretch2Engage Framework uses these value domains to identify practice principles and how they can be applied in service engagement activities. The Framework outlines some examples of approaches and practices services might like to consider under each value domain. These examples are not intended to be prescriptive or exhaustive. The Stretch2Engage Framework challenges each organisation to integrate these values within their culture and everyday work, and to develop their own engagement practices from this base.

For example, the principle Stretch2Be Curious highlights the importance of authentic listening with the intent to hear what people who use services really want, and having the courage to admit when we don’t have answers to the questions being asked.

Stretch2Be Curious identifies the need to ask detailed, rather than broad 'satisfaction’ questions to get to the heart of what people would find most helpful, and be prepared to take on new and better ways of doing things, even when this might require fundamental changes in thinking and practice.

Stretch2Be Curious expects organisations to design new programs and test ideas continually with people who use their services.

If service engagement has been well implemented, then organisations will be asking people who user services and their supporters specific and detailed questions about their views about services, will ensure inclusion of views at all stages of program design, development, implementation and evaluation, and will be prepared to make significant changes to the way they provide services based on this feedback.

The Stretch2Engage Framework challenges each organisation to integrate these values within their culture and everyday work, and to develop their own engagement practices from this base.

Engagement capacity

The vision of Stretch2Engage is that organisations internalise the principles of good service engagement, and implement effective and sustainable engagement approaches based on these principles as part of business as usual.

Achieving this requires building engagement capacity, which is strongly connected with organisational culture.

Staff knowledge and skills are important, but so are underlying values and attitudes, leadership, resourcing, policies and tools, the discourses that surround different stakeholder groups, organisations’ orientations to learning and risk, and the way in power is structured and used within organisations.

How does Stretch2Engage differ from other approaches?

Stretch2Engage builds on thinking developed through other approaches including consumer participation and experience-based co-design. Stretch2Engage takes this thinking further by:

  • Placing the responsibility for engagement clearly with organisations, rather than with people who use their services
  • Moving away from representative approaches to engagement in favour of those in which organisations engage directly with a broad range of service users and carers
  • Emphasising the importance of organisations building their capacity to undertake effective engagement, which will often require a substantial change in organisational culture
  • Seeing service engagement as a core part of organisations’ business as usual, undertaken by all staff, rather than as a periodic event or specialist activity.

The Stretch2Engage Pilot

In 2019, QMHC funded a pilot of the Stretch2Engage Framework. The pilot involved seven mental health and AOD service providers in Queensland trialling creative new ways of engaging people who use services, and their families and supporters in service design activities using the Framework.

This pilot project was supported by QNADA, QAMH and Enlightened Consultants who make up the Stretch2Engage Partnership. The pilot involved a range of learning strategies including workshops, coaching, peer learning, and skilling up on specific techniques that support engagement such as journey mapping and empathy mapping. The pilot also resulted in the production of a range of resources to support service engagement.

Lirata was proud to be selected as the evaluation partner for the project. We worked closely with QMHC, the Stretch2Engage Partnership and the service providers to identify how the Framework was used, its impacts on organisational capacity to engage people in service design, and its level of sustainability and value for money.

The evaluation findings will be released soon, along with a toolkit of evaluation resources for organisations undertaking service engagement initiatives.

The values and approaches embedded in the Stretch2Engage Framework are widely applicable for organisations working in the health, human services and education sectors.

Next steps

There is strong interest among stakeholders in progressing service engagement initiatives and continuing to build engagement capacity across the mental health and AOD sectors.

The values and approaches embedded in the Stretch2Engage Framework are widely applicable for organisations working in the health, human services and education sectors. The Framework provide a welcome stimulus for moving forward with practical co-design approaches.

Sustainable service engagement requires significant change in organisational and sector culture. To achieve these benefits will therefore require leadership, a dedicated focus within organisations, and skilled training and support.

 

Assistance with co-design and stakeholder engagement

Lirata Consulting assists organisations to create meaningful strategies for involving stakeholders in service design, improvement and evaluation. For further information or assistance, please contact the Lirata team:

Phone: +61 (0)3 9457 2547
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
 

Download

The Stretch2Engage Framework: Pushing the boundaries of service engagement and design (PDF 298 KB)

External resources

Further information about Stretch2Engage is available from the Queensland Mental Health Commission, by phoning 1300 855 945 or visiting the Stretch2Engage page at the QMHC website: