Developing and evaluating an online needs assessment process: using a participatory action research approach to develop a theory of change to improve digital offerings within adult social care.

Background Increasing numbers of people, approximately two million, have requested adult social care support through local authorities in England.

In particular, more requests from working-age adults are notable, as well as those from older people.15 The provision of healthcare is free at the point of use for everyone.

Conversely, state funded social care provision is not and people are assessed on their need for care and ability to pay for it.16 The Care Act 2014 sets out local authorities' duties.

All must undertake an assessment of any person who appears to have needs for care and support, regardless of whether those needs are likely to be paid for by the state.17 Nearly a quarter of a million people are waiting for an assessment of their needs in England.18 The impact of this delay can lead to unmet needs, causing increasing stress and burden, both on informal carers and statutory services.

Attempts to address this include digital solutions.

Currently, the digital transformation of health and social care is a priority for the Department of Health and Social Care (DHSC) and NHS England (NHSE), especially following the Covid-19 pandemic.19 Aims I intend to address this gap by designing and evaluating how an online needs assessment process is being implemented in one regional local authority trailblazer in England.

Plan of investigation The study design will draw on a Participatory Action Research (PAR) approach, to better understand and enhance organisational or community functions through shared participatory research.20,21 Stage 1: Building relationships and priority setting: Undertake a scoping review of needs assessment processes in adult social care.22 Develop working relationships with practice staff to ensure collaboration and shared agreement.

Establish working practices and define research questions.

Stage 2: Evaluation of online needs assessment implementation: Access data collected online to identify trends and any emergent issues Interview both local authority staff, to understand their experience of the implementation stage (n=15-20) and people using it to apply for support (n=10-15). Stage 3: Collaborative data analyses: This stage runs concurrently with Stage 2.

Each step of analysis will be agreed collaboratively, and time is planned for reflection. Interviews will be analysed thematically.23 Stage 4: Planning and taking action: Provide recommendations for practice.

Scope the feasibility for future research, to conduct a larger implementation study to test online needs assessments in more local authorities.

Potential benefits A public engagement group with lived experience of adult social care have and will be consulted throughout this study.

This will ensure the study is understandable and addresses public perspectives, and the key findings make sense in relation to their real-world experience. The proposed findings have the potential to improve the digital offer in adult social care practice.

Future research includes using a theory of change approach to explore mechanisms and conduct a larger implementation study testing online needs assessments in more local authorities.