Case study · Health and social care

Designing England's first system-wide integrated digital health and care technology service

DHACT puts needs-matched care technology inside everyday care assessments in Greenwich, jointly run by the council, the NHS and the local Integrated Care Board.

2,800+
residents referred
6,800+
devices provided
400+
staff trained
£4m+
released back into care for others
My role
Service design lead
Partners
Royal Borough of Greenwich, Oxleas NHS Foundation Trust, South East London ICB
Duration
2023 – 2025
Delivered with
DHACT programme team across 5 organisations

The question

How might we make technology a natural part of how health and social care empower people, when the trust, confidence and shared accountability to support it did not yet exist?

Context

Two systems, one life

In England, the NHS and council-run social care are funded and run separately. Residents move between them constantly as their needs change, but nobody designed the handover. In Greenwich, demand was outpacing a stretched system, and a national strategy shift made redesign urgent.

Why this was more than a technology rollout

Integrated partnerships are rare. Greenwich had the conditions: aligned leaders secured shared funding across three organisations. But the gaps between them were real.

  • Separate referral routes
  • Incompatible data
  • Different accountability
  • Uneven confidence in technology
“The technology was never the hard part.”

My role and scope

  • Led the service design workstream across three organisations, from first research to live service.
  • Built the operating model with senior leaders, then retold it in frontline language so all three organisations could decide on it together.
  • Ran monthly co-design sessions with residents, who set the six outcomes the service is judged against.
  • Supported benefit modelling, including the data flows mapping.

Scope

Working alongside commissioned partners Alcove and Rethink Partners, from 2023 to 2025, covering research, service and operating model design, go-live and continuous improvement.

DHACT delivery structure: service users and co-production group, the programme delivery team across five organisations, and governance and funding. The service design role is highlighted.
How DHACT is delivered across five organisations. My role is highlighted in red.

What we built

A jointly commissioned service with integrated budgets and governance. Health and social care teams consider needs-matched devices inside daily care assessments, helping people manage risk and live independently.

Devices connect to a 24/7 monitoring and response team, which gives urgent help when needed alongside proactive, data-led outreach.

Six outcomes, set by residents

  • Emotional wellbeingStaying connected in the community
  • SafetyFalls and mobility
  • Physical wellbeingHealth status and medicines
  • Choice and controlMy home, managing my day
  • Daily livingEating, drinking, getting out
  • Living independentlySafe at home

How we got there

  1. From shared understanding to shared direction

    An operating model built with leaders and retold in frontline language gave three organisations something concrete to decide on together.

  2. Residents co-creating throughout

    Monthly design sessions ran from first research to live service. Residents set the six outcomes the service is judged against, and they still review them.

  3. Go-live became grow-live

    Daily check-ins and live dashboards with accurate data meant three service improvements shipped in the first month alone.

For the full project report, please contact me.

DHACT operating model: the end-to-end journey from opportunity identified, through assessment and referral, devices provided, monitoring and response, to review and service end, with data monitored throughout.
The operating model, built with senior leaders
Co-design sessions: service teams and partners in workshops, and residents trying the technology and sharing feedback with the team.
Monthly co-design with residents
DHACT operating model and journey map for frontline staff: the service user's journey in four stages, from referral to review, mapped against the high-level processes and teams behind each step.
The operating model and journey map, used in drop-in sessions with frontline staff

Outcomes

  • £4m+ released back into care, tracked through a programme-wide benefit model.
  • 2,800+ residents referred and 6,800+ devices provided through one joined-up route.
  • 400+ staff trained to use technology as part of everyday care assessments.
  • Winner of the Service Design Award 2026, shared at the Service Design Network global conference.

What I learned

Design the conditions, not just the service

Co-production is a governance decision before it's a design method. The bigger job was making collaboration possible across organisations that rarely meet.

Go-live is where design starts

We planned for grow-live: daily check-ins and live data helped us ship three improvements in month one.