This blog post looks at a sensitive issue and describes the collaborative approach being facilitated by the New Zealand Government’s Service Innovation Lab at the Department of Internal Affairs. Before an issue enters the Service Innovation work programme, it’s important to get the right people in the room to explore whether there really is a problem – and if yes, its exact nature.
We left the hospital and waited a week for someone to call. Then we realised — there is no Plunket for dead babies...
— Words from the father of a stillborn child, whose comments were shared at a recent hui run by Service Innovation.
There is a degree of taboo attached to discussing baby deaths – as there was around mental health until recently. Courageous conversations take place in Service Innovation – but it’s a safe place where people know their words might lead to action.
The ‘Death of a Child’ hui was held to examine a gap in services to parents who had lost children either before (from 20 weeks), during, or soon after birth. It was a ‘pain point’ the SmartStart team had brought to the Service Innovation team, knowing that a robust, parent-focused solution was likely to require a multi-agency approach.
Like mental health, this is also a significant issue. Similarly, the ‘death toll’ for both is higher than the road toll.
Between 2007 and 2017, 8351 babies died between 20 weeks gestation and four years old. On average that’s about 830 such deaths each year, not including those miscarried before 20 weeks. Statistics are not kept for the latter, but rough estimates put that figure around 13,000 to 15,000. That’s an awful lot of grief for many parents and whānau.
While there are support services in some places there’s currently no joined-up approach. The starting point was a hui to hear and learn from those who do work with these families.
This hui was a good example of exactly how some of the Service Innovation team’s work starts: with conversations, complaints, networking – often with people identifying where they believe government can do better for its people.
Often exploration of a seemingly unrelated issue has started with another agency and then, drilling into their issue, the discovery of something bigger that several agencies touch on – but not one owns or can solve alone.
Those represented at this hui included representatives from the health sector, Inland Revenue, the Ministry of Justice, the Perinatal and Maternal Mortality Review Committee, Victim Support, District Health Boards and Non-Governmental Organisations (NGOs) such as Baby Loss NZ, Sands NZ, and the Funeral Directors Association. The College of Midwives and the Nursing Council were identified as needing to be involved in any future work.
What was the outcome?
The aim was to see if there’s a piece of work that could be explored in either a research or design discovery. These initial conversations are critical in helping peel back the layers and get to understand if there is a potential issue. The Service Innovation Lab’s scoping process is a critical part of clarifying this.
In this instance there was a strong feeling there could be more to discover. Any work will require collaboration and the team within SmartStart, Te Hokinga ā Wairua – End of Life, and Births, Deaths and Marriages in Department of Internal Affairs have been integral to the work in this wider area already.
One idea is to explore whānau pani as a core concept in bereavement design. There was also recognition this issue had already been identified.
In 2017 the Child and Youth Mortality Review Committee report, recommended that Ministry of Health, Ministry of Justice, Oranga Tamariki, the Chief Coroner and New Zealand Police work with whānau and families to develop a multi-agency protocol for the care of whānau and families after the sudden and unexpected death of a baby.
For now, participants are providing feedback on the hui report. Service Innovation will also need to ensure any proposed work falls within its scope.
Hui participants left with a commitment to continue the kōrero and a desire to share what they’d learnt so they can contribute to a more equitable level of service to grieving whānau.
If this story triggers something and you want to talk with someone about the death of a baby you will find local contacts here: Sands NZ.
Service Innovation – who are we?
Our team works with other agencies across a range of projects, usually focused on improving services around a life event. You’ll find us either at ‘the Lab’ on Thorndon Quay or Level 10, 45 Pipitea St in Wellington.
Our work is about creating opportunities to work in different ways; exploring the ‘unobvious’. Our team works collaboratively and openly. Often the outcome sought, or issue to be resolved, cannot be owned or addressed by individual ministries.
The Lab is located off-site to offer neutrality for people coming in to work from diverse agencies, as well as from the private sector and NGOs. We encourage people to think outside the business as usual mindset, so working in the Lab helps remove them from daily distractions.
We strategically co-locate and invite agencies into the Lab because we know innovation is often sparked, like kindling for a fire, by rubbing ideas together.
Among the Service Innovation team we have software developers, service designers, researchers, those knowledgeable in the ways of government and support staff who work alongside agencies, providing skills and guidance to progress ideas as they grow through relationship-building, scoping, discovery, design, alpha and beta phases to full roll-out – or are justifiably dropped along the way.
We explore tikanga and te ao Māori in much of our work to support outcomes that are fit for all New Zealanders. Funding comes via Department of Internal Affairs from several areas including the Digital Government Partnership Innovation Fund and our work programme is determined by a Working Group comprising DCE-level staff representing several core government agencies.
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7 Mar 2019