The Ripple Framework: A co-design platform (a thousand tiny methodologies)

The Covid-19 pandemic highlighted long-standing issues in the healthcare sector in the UK, including difficulties in retaining and recruiting staff. These are complex and interconnected problems, making them difficult to solve. We identify this as a methodological challenge that needs to be addressed. We illustrate a potential way of achieving this through the Healthier Working Lives (HWL) research initiative funded by the Healthy Ageing Challenge, Social, Behavioural and Design Research Programme (SBDRP). The SBDRP is an interdisciplinary, intersectorial programme, aiming to find ways of improving working conditions for care workers. The HWL study took place in 6 care homes in Scotland, with 31 participants, of which 25 were frontline staff, and 6 were in administrative and managerial roles. We acknowledged the complexity of these issues and sought to support care workers by developing a flexible response able to adapt to their precarious circumstances. By reflectively engaging with a set of care homes across Scotland, and learning about their circumstances, the project has the potential to bring about a fundamental rethink regarding optimal strategies for supporting the care sector in overcoming its difficulties. Our own attempt at this resulted in the Ripple Framework (RF), a methodological platform to assist both the research team and care workers in working together meaningfully. The RF allows researchers and care workers to become actively immersed in the context and restore their agency to speak out and act within their social setting. The RF emphasises dialogue, capacity-building, and empowerment, suggesting its potential to go be applied beyond the healthcare sector.