Systemic change

Introduction

In this section we consider what a different system would look like, how to bring about systemic change and how to evaluate the impact. And we show how intersectionality enhances efforts to ensure that resources are used with optimum effect to make the most difference for the people who need them.

Systemic change

Systemic change targets the root causes of issues rather than addressing symptoms. It aims to reshape societal, organisational or institutional frameworks that keep alive inequity, injustice and inefficiency. This can cover a range of areas, from social justice and environmental sustainability to economic reform. 

Systemic change requires a series of steps: 

• Identify the problem: Begin by thoroughly researching the systemic issues within the social care system, such as disparities in access, quality, and support for marginalised populations. 

• Set clear goals: Define specific goals for improving social care, such as reducing wait times for assessment, increasing funding for mental health support, and enhancing caregiver training programmes. 

• Collaborate widely: Engage a wide range of invested parties, including social workers, social care professionals, advocacy groups, and policymakers, to build a coalition for comprehensive social care reform. 

• Advocate for policy reform: Lobby for policy changes that align with the goals of improving social care, such as advocating for increased government funding and regulatory reforms. 

• Cultivate inclusivity: Ensure that the voices of marginalised individuals and communities who draw on social care services are heard and included in the decision-making process. 

• Educate and raise awareness: Promote public understanding of the challenges within the social care system to garner support and momentum for reform efforts. 

• Implement innovative solutions: Pilot new approaches within social care, such as community-based care and support models or ‘technology-enabled lives’ solutions, to challenge the status quo and demonstrate more effective alternatives. 

• Measure and adapt: Continuously assess the progress of social care reform efforts using data and feedback both from providers (including practitioners) and people who draw on care and support (including paid and unpaid carers), and adapt strategies based on what works best. 

• Hold accountable: Hold social care organisations and institutions accountable for their roles in maintaining or keeping alive issues within the system, ensuring transparency and accountability. 

• Persist and persevere: Recognise that social care reform is a complex and long-term process, and stay committed to addressing setbacks and challenges along the way. 

• Celebrate achievements: Acknowledge and celebrate milestones in social care reform, such as improvements in outcomes for people who draw on care and support or reductions in disparities. 

• Document and share learning: Share the experiences, challenges and successes of social care reform efforts to inspire others and facilitate collective learning within the field. 

By applying these steps, systemic change can lead to transformative outcomes that enhance the wellbeing and support of individuals and communities in need.

Use this tool below to develop a vision, values and a strategy to embed intersectionality for equity.

Intersectionality is outcomes

Using the lens of intersectionality will help deliver better adult social care.  

• Intersectionality promotes wellbeing by showing where inequity is and improving the response to this.   

• Intersectionality helps the workforce to think about their own needs and to support each other.  

• Intersectionality puts people in touch with their motivation for being in adult social care, and inspires them to make a difference to individuals and promote social justice.  

Intersectionality enables everyone: 

• to be treated equitably 

• to feel a sense of belonging and value 

• to have the resources and support they need to achieve their full potential. 

These are the outcomes that we are aiming for. The test is whether people experience a difference. Change feeds change.  

Each person and group has a responsibility to monitor itself. The equity impact must always be sought. For example, if a change is made to improve access to assessment, does this enable people who were shut out before to make contact? 

As a sector rooted in human rights and social justice, social care can lead the way through co-production to influence other partners.

Use the tool below to identify outcomes to achieve by embedding intersectionality.

Example: Making intersectional change

In the Change Project, we discussed how intersectional conversations about overlapping and interconnected oppression give rise to actions that can be taken to increase equity. Participants gave examples of how intersectionality is changing adult social care:

• I am on a project group working with people with learning disabilities and autism. One of the things that they said to us is ‘Your assessment tool is designed to restrict the understanding and relationship with people.’ They saw it as a divisive and restrictive tool that can lead conversations in ways that limit understanding of who they are and splits their lives up into different elements. The group asked ‘Why can’t we use another tool?’ So we are redesigning this with them.
  
  
• In our service, we are looking at where our mechanisms have been set up to be equal but they aren’t equitable. For example, we assume everyone can make a complaint. However, when we look at who is using the complaints process, it is clear that this is not a representative group. It is related to different and overlapping barriers that people face, for example because of ethnicity, class and age. We are bringing the intersectional lens to find out who is disadvantaged and to make changes so that barriers are removed and we can find out how people really experience our services and put things right when we need to.