Business Opinion

100 Day Challenge to unlock frontline expertise

Robert Jamieson, Assistant Programme Manager, Nesta

Over the next five years, Essex County Council will spend approximately £1bn on providing support for people with learning disabilities and autism amounting to roughly a quarter of their annual social care budget. Essex isn’t alone in this – it is the reality for local authorities up and down the UK.

What if local authorities challenged themselves to spend this money differently and rethink the support that they are currently providing for people? What if they decided that the services that they currently commissioned were outdated and didn’t fully meet people’s aspirations?

These are the kind of questions Essex County Council were asking themselves earlier this year when they teamed up with us at Nesta to deliver a 100 Day Challenge.

The 100 Day Challenge is a structured innovation process that unlocks the knowledge and expertise of frontline health and care practitioners, and the people who they help and support, to come up with solutions to the challenges they face in their services and care.

These are intensive periods of action, experimentation and collaboration that bring together frontline teams across whole local systems. They usually include people from health, social care and the voluntary and community sector. There is no single approach and each local area throws up its own unique set of demands, challenges and personalities.

The focus of this Challenge was to help Essex County Council and communities learn how to support people with learning disabilities and autism to live a meaningful life. Three teams based in Canvey Island, Colchester, and Saffron Walden tested sixteen ideas ranging from new ways of supporting young people into employment, to bringing health services into the community and setting up an inclusive cricket team.

The Challenge gave team members the space to collaborate and build on each other’s expertise – it involved more than 36 organisations and 23 people with learning disabilities and autism, working together to improve outcomes for more than 300 people.

The teams were ambitious in their attempts to meaningfully involve people with learning disabilities and autism the whole way through the Challenge – from coming up with and testing ideas, leading teams as Team Captain, and taking part in leadership activities.

Take Nick Bunyon, who was taking part in a supported internship programme for young people with learning disabilities and autism during the Challenge. He joined the leadership team (who provide oversight and support throughout the 100 days) and was the driving force behind ‘Nick’s Rule’. His suggestion that everyone should have a voice and a chance to have their ideas heard has now been turned into a tool that is being used across the Adult Social Care department at the council. Social workers now use it in their reviews and team meetings, as well as at the Forums that they hold to discuss individual cases.

Or Louise Sayer, a ‘disruptor’ according to a recent Guardian article, who led the Saffron Walden team and was instrumental in designing and producing an “easy read” magazine featuring local information and events, designed and produced by people with learning disabilities and autism.

Essex has used the 100 Day Challenge to kickstart a wider drive to improve learning disability and autism support. The lasting impact of the Challenge remains to be seen, but it is clear that Nick and Louise (and others) seized the opportunity to have their voices heard, an opportunity that perhaps isn’t often afforded their peers.

Nesta would like those who hold the purse strings to see that by providing front-line staff, and people who use services, with the opportunity to work differently and test new ideas, system change is achievable.

Not only does this save money for the NHS and the care system in the long run, it improves the lives of people and communities.

We want to see more councils handing the reins over to those at the front – they will be surprised with just how much impact they can have.

To find out more about the 100 Day Challenge method, and the team behind it, visit

Edel Harris





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