Conducting medical benefits follow-up entails every detail of the process, for both citizens and caseworkers, being subject to regulation. A design process was implemented in the sector with a view to inspiring the sector to try new paths, and these new paths were created by internal and external actors in cooperation – a cooperation characterised by a large degree of citizen involvement with a view to getting their ideas for the optimal medical benefit process.

The main goals were: better citizen experiences, better staff experiences and better results. The project completed Kolding Municipality’s design process model from discovery to implementation. Initially, a team of internal design and innovation consultants explored the medical benefit department. The consultants participated in various meetings, interviewed citizens etc. From the discovery phase, the participants gained a series of insights on which the further design process towards implementation could build.

My Plan has now reached the diffusing lessons stage. Since it was winner of “DeSigne” in Marts 2017, (Kolding Municipality´s internal design award) honoured for the following criteria; Design-driven renewal, Innovation Height, Inclusion of employees, users and citizens, Effect and results.

My plan was also finalist in Danish Design Award (DDA) in 2017 within two categories; Message received and Improved welfare. For being, a tool developed for the Danish medical benefit system that explains the very complex rules in a very simple way and allows the citizen to take care of their own case and get well faster.

The jury said: “Cognitive difficulties can both be a symptom of and a consequence of being in stressed life circumstances such as prolonged illness." There is therefore a great need for design solutions that help people with reduced cognitive function levels to navigate in the complicated rules and offers that make up the Danish medical benefit model. My Plan is a graphically simple and well-functioning solution that, according to the Job-centres, provides a better overview and provides the basis for more equal cooperation between citizen and system.

The most important aspect was to reveal the need and wishes of the sick citizens and how they experienced the meeting with the medical benefit department. Involving them directly in developing the system, the meeting and a tool – My plan changed the approach to the citizens, the framework and the attitude within the apartment. Involving the citizens … Involving the medical practitioners in insights from the users and in developing the cooperation with and around the sick users by revealing possibilities and challenges in the cooperation. New inspiration and forms were developed and medical practitioners appreciated and took ownership of new ways of cooperating. The employers had a need for early and continuous contact from the medical benefit apartment. With My Plan the responsibility became the users and My plan made it easy for the user to remember.

Users, employees, medical practitioners and employers were involved through observation of meetings, user travels, interviews – individually and in groups, workshops and follow up meetings. The systematic involvement of users and relevant stakeholders increased the implementation and so do the ongoing evaluation of the service. Finally knowing the results and impact of the process and the product, as well as wining the internal prize, being candidate for a national prize, increases the believe in the process and the product.

Following the implementation of Min Plan Kolding Municipality has seen a 24-per cent drop in medical benefit expenses – from 1,343 full-time recipients in January 2015 to 1,018 in October 2016 – and a direct monthly payoff of more than DKK 2 million. And not least, the number of citizen complaints has dropped by as much as 38 per cent. " We are very pleased with Min Plan. It offers a clear structure for citizen interviews, and it is a useful tool for matching expectations. Min Plan helps ‘play down’ the system, and we have somehow managed to turn negative expectations to the system into more positive expectations. It is an easy-to-use dialogue tool, which offers simple explanations, precisely when the citizens need it the most. The citizens now experience a different degree of involvement. A citizen told one of my members of staff that it has helped her regain her dignity. And of course that is vital to citizens’ lives and well-being. This tool really makes a difference." Inge Meta Holm Nielsen, manager, Department for medical Benefit, Kolding Municipality

From interviews and feedback from citizens it has become clear that My Plan makes a difference. The citizens have reported that they now feel like an active part of their own case process. My Plan gives them an overview of appointments and helps them make sense of the complex follow-up plan. The staff are also happy with My Plan. It clearly structures their interviews with citizens and is a useful tool for the matching of expectations. Several members of staff have said that My Plan helps play down the ‘system’ and thus change negative expectations about the system into more positive ones.

The medical benefit area faced a number of challenges e.g. negative publicity in the media, numerous citizen complaints and the prospect of a large reform as well as sick case managers. In addition, the staff was aware that being absent owing to illness and participating in a follow-up process could cause citizens to worry needlessly, meaning that they in fact had to be ‘strong’ to be a part of the system. Designing the process inspired the area to try new paths. We succeeded in creating new paths in collaboration with both in-house and outside players, and by involving citizens in giving their input concerning the design of the optimal medical benefit process. The design process improved citizen experiences, improved staff experiences and provided better results.

The overall support is the realization of Kolding Municipality´s vision – We design for life. The vision is currently ongoing and is grounded in 10 initiatives that work to support the vision of Kolding; as a hub of entrepreneurship, leader of social innovation, a strong education system and position Kolding as “an international lighthouse in the fields of design, entrepreneurship and social innovation”. All municipal managers (about 250) have been involved in a design process to develop a management foundation based on the vision. Four basic management principles were identified and described. Together with six management competences these principles make up Kolding’s present management foundation.

The four management principles are: 1) outlook, 2) productive diversity, 3) professionalism and 4) design-driven innovation.

The overall goal for this process was NOT to streamline, but to control damage. Obviously, the documented results and effects on users, employees and economics shows the value of a design-driven innovation-process in the public sector.

Involving the primary users and relevant stakeholders in a design-driven process was absolutely worth the effort. The change approach to medical benefit became very different because of the involvement. To carry out and complete a user-driven process at a time, where the medical benefit area in Kolding Municipality faced a number of challenges: negative publicity in the media, numerous citizen complaints and the prospect of a large reform, required quite a lot of patience and respect but also insistence.

We are eager to share knowledge and experience with design-thinking. Citizens that helped to co-create the new vision, now play a key role in co-producing outcomes and making the vision a reality. The citizens are involved in the municipality’s development on at least two levels:

1) All design-driven social innovation projects are based on the dogma that research into the context and involvement of the affected citizens is required in order to gain human-centred insight. In addition, the citizens function as vital partners at the various test stages.

2) Urban and city development projects are largely characterised by co-creation, where the affected and interested stakeholders take part in the creative idea generation process.

The design process has reduced the municipality’s costs by 6.6 million Euros per year from 2013-15.