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The road to sustainable wellfare

We are getting older and the number of chronically ill patients is increasing, which places growing pressure on the welfare sector to find new solutions for proactivity, business models and funding. Through the Social & Health Impact Center initiative, RISE is helping the welfare sector to meet its urgent need to achieve more socially and economically sustainable resource use. The idea is that the models currently being formulated for the welfare sector can also be used in other sectors of society, when it comes to, for example, achieving climate goals.

Demographic and societal changes put immense pressure on the publicly funded welfare sector in Sweden, as well as in comparable countries. Proactive and preventive solutions are required for more efficient use of resources.

When the Social & Health Impact Center (SHIC) initiative was started in 2018, the objective was to find a model for effective development in the welfare sector. What are the main factors for successful development? What skills are needed?

“SHIC is a knowledge centre helping the publicly funded welfare sector transition to more effective and more preventive solutions,” says Tomas Bokström, Project Manager at SHIC.

Structure through social health impact bonds

One model being tested involves so-called social health impact bonds.

“Major resources are invested into diverse projects within the public sector, but when the money runs out, things often go back to square one,” says Bokström.

“We believe in starting by defining the desired outcome of an initiative. Once all stakeholders agree on the desired outcome, an agreement is reached on what to do and how it should be funded, and then resources are also allocated to ensure implementation. Social outcome contracts are a way of structuring this kind of work.”

The SHIC team works operatively by assisting with needs analysis, literature review, implementation, and outcome evaluation. An important part of the work is to ensure learning during the project and that all knowledge is accessible to everyone.

The model can be used across the welfare sector, but even more broadly

Outcome evaluation crucial

Another crucial aspect of the work involves the application of evaluation techniques; in other words, how social and health outcomes can be defined, measured and valuated reliably and legitimately for all relevant stakeholders. 

One project is underway in Botkyrka Municipality, where the desired outcome is reduced sick leave among municipal employees. Based on a comprehensive analysis of the municipality’s data on sick leave, a review of existing research and discussions with managers and employees, a way of working is being developed to prevent sick leave and foster health-promoting workplaces. RISE is supporting the work in partnership with the Swedish Association of Local Authorities and Regions (SALAR).

“The model can be used across the welfare sector, but even more broadly, such as in efforts to achieve climate goals or at the junction between infrastructure and social initiatives,” says Bokström.

Funding for sustainable resource use

In parallel to its operative work, SHIC engages in dialogue with, for example, the Ministry of Enterprise and Innovation, SALAR, the Swedish Agency for Economic and Regional Growth, Vinnova and academia in order to devise proposals for funding the initiatives needed to achieve more socially and economically sustainable resource use.

“For these types of system-changing initiatives, the state needs to take responsibility and assist the municipalities financially, perhaps by means of national outcome funds. We are trying to learn from other countries in this work. The sharing of knowledge is by and large an important part of the development and refinement of social outcome contracts,” says Bokström.

Published: 2020-02-24
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