Voice the Unvoiced

A strategy of shifting organisation culture to help decision maker share power with unvoiced and marginalised groups

In cooperation with

Keywords: Public Service, Social Marginalisation, Organisation Culture, Deisgn Justice, Co-design

Time frame: 3 months, from January to April, 2021

Tutor: Dr. Iain Reid, Dr. Jonathan Baldwin, Dr. Mafalda Moreira

Team menber: Lauren Liu, Sharon Marcelis, Jiaxin Dai, Hannah Heaton, Wu Yue

My role in this project: research and analyse, build personas and journeys, set ideal situation, conceptualise strategy, evaluate impact

Challenge

Challenge 1: the system of NHS neurological rehab service is marginalising vulnerable patient and reproducing social inequity.

Story shared from the gatekeepers of these vulnerable patients “There's a young guy who is originally from the north of India came here (UK) when he was maybe 16, and has been here for the last 20 years. But he has no entitlement to anything…fell from a ladder, has a complete high cervical spine injury, completely paralyzed, it's going to need care for the rest of his life. And essentially, he's not entitled to go to the spinal rehab unit. But for someone like him, we would trying, essentially he'll go into a nursing home, which for a young person of 34 is obviously not an ideal scenario.”

An expert from a drug and alcohol awareness organisation mentioned “If you miss so many appointments, that’s it, you can never come back. In general, alcohol and drug services it's like so you have to turn up your name in appointments and if you misse too that’s it, you are out. “

An Occupational Therapist (OT) working within Homeless Health discusses: “As soon as anyone is deemed NRPS (No Recourse to Public Funds), wards get very funny about that. They know that patients are going to get stuck, because we're relying on social care to do assessments and find them appropriate, you know, accommodation and that takes time. So they become hot potatoes if you like. I think sometime, well I know that patients feel that, you know feel a burden, feel that, you know that people really kind of want them to move on and out of that hospital bed. And I think because the other thing is, all these people who have no recourse public funds and, you know, immigration status isn't settled, there's a rolling tab on the care. And people have been given bills for thousands and thousands of Pounds.”

A nurse working in the NHS neurological rehab center indicated “For the people you know, that are having to actually manage these systems, there has to be a way for them to understand the difference between patients and the difference between rehab units and the difference in cost.”

Challenge 2: the organization culture of NHS is no flexible enough to engage vulnerable patient, which lead to lots of social problems and more costs in the long run.

NHS Personal Project Journal - Frame 34.

Strategy

The up-to-date policy and system today can be structural violence tomorrow because we are living in an ever-changing world. Therefore what we really need is a more flexible organisation culture. It should actively respond to changes, actively challenge current assumptions, actively re-examine and tranform deisgn values, practice, narratives to stop reinforce interlocking systems of structual inequility. To achieve these goals, it should share decision-making power with various stakeholders with lived experience.

Please watch the video below to see more about persona, journey and strategy.

Already got people's consent to show their faces in this video. Thanks a lot to these lovely people ♥

Impact

1. Reduce system waste and save public fundings in the long run

2. Diminish institutional discrimination and enhance social justice

3. Help marginalised people with brain or spinal cord injury get proper rehab service

4. Reduce destablizing factor like personality disorder, suicide attempt, challenging behavior so as to reduce repetitive offenders

5. Diminish institutional discrimination and enhance social justice

Reference

Clarke, A.J. and Clarke, A.J., 2011. Design anthropology: Object culture in the 21st century. Vienna: Springer.

Bourgois, P., 2003. In search of respect: Selling crack in El Barrio (No. 10). Cambridge University Press.

Costanza-Chock, S., 2020. Design justice: Community-led practices to build the worlds we need. The MIT Press.

McKercher, K. A., 2020. Beyond Sticky Notes. Doing Co-design for real: mindsets, methods and movements.

Hutchins, E., 1995. Cognition in the Wild (No. 1995). MIT press.

Co-design tools by Auckland Co-design Lab

A social designer's field guide to power literacy by Maya Goodwill in collaboration with Kennisland

Xiang, B., 2004. Transcending boundaries: Zhejiangcun: the story of a migrant village in Beijing. Brill.

Gray, D.E., 2013. Doing research in the real world. Sage.