LOTI’s pilot Local Authority Sandbox launched on October 3rd, with an immersive event that aspired to break silos that have existed in health and care for decades, and bring people back into the heart of conversations about care. In this blog, I take you behind the scenes of designing London local government’s first immersive event of its kind.

The Bigger Picture

The process in the months leading up to this was iterative, requiring us to zoom in and out to different levels of the system at various points. The weeks of interviews gave us a foundation of knowledge ranging from institutional priorities to the types of forms a social worker might fill out. 

We turned this into a system map – our way of making sense of the fragmented parts of health, social care, and community services, piecing them together into a single, coherent view.

The map shows how residents, caregivers, care providers, and local authorities interact, where bottlenecks might occur, and how missed opportunities can snowball into greater challenges passed from one part of the system to another. It also visualises systemic pressures at key inflection points that influence the experiences of staff, residents, and frontline workers alike.

Choosing our stories

While tools like the map helps bring the big picture together, we wanted the focus to be on the people these systems were built to support. That’s where the stories came in, turning abstract points on the map into the real, human experiences.

We grounded the event in two stories: “Mrs. S”, a 70-year-old woman who ends up in hospital after a neglected illness, and “Aleesha”, the partner and carer for Ibrahim who was living with early onset Alzheimer’s.

Mrs. S’s journey highlighted two key challenges faced by older adults in London:

• Shrinking community, primary and social support
• Difficult transitions from hospital to care

Aleesha’s story highlighted two big challenges:

• Missed opportunities to support carers
• Hard-to-navigate social care support

Each story was based on real experiences we heard from practitioners and individuals with lived experience in our research. To visually bring these stories to life, we created comics for each persona, one for Mrs. S and one for Aleesha. 

Immersive theatre as an empathy building tool 

We chose immersive theatre so our event attendees weren’t just hearing about the stories but were also interacting with them, influencing the narrative, and most importantly experiencing the emotions of someone going through it. 

We designed this with the support of professionals working in immersive theatre. Using our two stories as the basis, we identified key experiences and moments we wanted to highlight, and designed interactive ‘mechanics’ around them. 

I illustrate this with two examples of mechanics used in our immersive play on the day:

• Interactive Hospital Discharge Scene

At one point In Mrs. S’s story, she was ready to be discharged from hospital. Here, participants took on the role of a care home assessor during a hospital discharge. They listened to a conversation between care home staff and Mrs. S and had to fill out a discharge form, noting details like medication and mobility needs. Their goal was to make a decision about whether they could admit her into their care home. The catch? The conversation wasn’t always clear, and important information was buried or left out—just as it often is in real life. 

• The Social Care Inbox Exercise

In a scene during Aleesha’s story, participants took on the task of sorting through a mock social care worker’s inbox, filled with hundreds of emails from various people and organisations. Some emails were urgent, others routine updates, and yet others had missing information. They had to sort through a stack of emails in real time to find one particular email and move Aleesha’s story along. It revealed how overwhelming the administrative side of care can be and how hard it is to provide timely, clear guidance when the system is disjointed.

By actively engaging in these scenarios, our participants got to experience the real, human consequences of system failures.

Key takeaways

1. A real story grounds the abstract conversation

Conversations at workshops, especially in health and care, can sometimes feel process driven, distant and abstract.  But on October 3rd, through immersive theatre the stories of Mrs. S and Aleesha grounded every discussion that was had in the breakout sessions. Participants used examples from the stories like  ‘Mrs. S shouldn’t have had to do this,’ or ‘When Aleesha struggled with that’, instead of drifting into abstract talk about systems and policies, the immersive experiences helped us stay grounded in real-life experiences, rich with nuance and detail.

2. Reframing is a powerful tool 

Typically, discussions about social care and health are dominated by the topic of funding. This time, however, the topic didn’t surface in any of our discussions which was both surprising and refreshing. I believe that by  reframing the conversation from ‘fixing social care’ to ‘supporting residents’ through storytelling, we shifted our focus from financial constraints to genuine human problems and creative solutions. This opened the door to a far more innovative and liberating discussion.

3. Constraints can be your friend

One of the biggest challenges with designing this event was that the system is so vast, the stories are so varied, and this format was so new that there were really no rulebooks on where to start. The constraints that we had, our event space, the number of participants we could accommodate, the budget, our sphere of influence,  actually proved to be great protective boundaries providing structure within which we could work and be really creative.

If you have used or are thinking about similar approaches as the ones in this blog, please get in touch.