Too many voices, one programme: designing decision-making in health and social care

Themes: Public services under pressure (budget, scale, complexity) |  Collaboration across organisations | Working in complex systems | Co-design and participation

What does it take to deliver a complex health and social care programme when no single organisation is in charge?

This session shares the honest story behind the Digital Health and Care Technology (DHACT) programme, a partnership between the NHS and local government. DHACT is helping residents with long-term health conditions live safely and independently at home through assistive technologies, proactive care and better coordination between services.

You’ll hear 2 perspectives, from a service designer and a service head, on rebuilding trust after a false start, shaping more democratic ways of making decisions across organisations, and introducing new collaborative ways of working across health and social care teams.

Leave with practical insights on leading collaboration, building shared ownership and applying service design beyond the design team.

This session is particularly relevant for service designers working in local government or cross-sector public service programmes who are navigating complexity, governance constraints and organisational change.

Participant takeaways:

• a clearer understanding of how decision-making actually happens in large cross-sector programmes - and why designing these processes can be as important as designing the service itself
• practical examples of how programme teams can structure collaboration across organisations, including leadership roles, working forums and shared artefacts that support collective decision-making
• insights into how residents can participate as co-producers in service development, and how this participation can influence real delivery decisions
• examples of how design practices can support non-design teams by introducing iterative working and small-scale testing without disrupting operational delivery
• reflections on rebuilding trust after programme failure, including what helped the DHACT team move forward and what they would approach differently in hindsight