Presentation on theme: "An effective workforce for Early Help Delivery"— Presentation transcript:
1An effective workforce for Early Help Delivery Nuala O’RourkeWigan Council
2The drive to integration Total PlaceCommunity budgetsPublic service reformDH drive for Health and Care IntegrationMovement of Public Health into Local AuthoritiesCommissioning of Health Visitors moving to Local AuthoritiesAdds to national drivers
3The drive to integration Total Place lessonsPeople at the heart of service designReducing dependency / enabling self reliancePooling budgetsReducing bureaucracyPut the customer at the heart of service redesign.Enabling communities to support themselves – reducing the demand on the public sector by finding better ways to help households and communities become more self reliant.Pooling budgets – looking at all the money coming into the locality as one pot and focusing on delivering outcomes rather than services.Reduce bureaucracy through a change in the way Whitehall interacts with localities – inspection, ring fencing etc – but also through a change in the way we interact with each other and ‘lean’ thinking in how we structure ourselves across the region.
4The Public Service Reform Challenge GM Priority: Growth and reformTotal tax intake in GM £17bnTotal public spending in GM £22bn£5bn gapThe revised Greater Manchester Strategy has two priorities, sustainable economic growth, and ensuring all residents contribute to and benefit from that growth. While good progress has been made on supporting growth, there will need to be a significant increase in ambition and impact on public service reform. The aim is for GM to be a net contributor to the national public finances by Currently there is a £5bn per year gap between total tax take in GM (estimated £17bn) and total public spending (£22bn).
5Intensive family intervention worker/ parenting practitioner Multiple funding and accountability structures make coordinating support for families very difficultDfEHOMoJDHCLGDWPLAPoliceYJBCCGHousingauthoritiesJCPVCSPrisonsYOS workerYoung carersupport workerPolice officerCAMHS/ Mental Health WorkerDrug and alcohol teamHousing link workerEmployment Personal advisersFamily supportworkersParent support advisers/SchoolsSurestartIntensive family intervention worker/ parenting practitioner
7What does integration mean Many different modelsCo-locatedAlignedFully integrated under single line management
8Integration in WiganIntegrated Safeguarding and Public Protection teamIntegrated Health teamLIFE team
9Integrated Safeguarding and Public Protection team A partnership response to domestic abuseA coordinated community response modelA co-located team includingPolice, Children’s social care, Probation, Housing, Independent Domestic Violence Advocates, Drug and Alcohol outreach, Young person’s violence advocateWith daily input fromHealth EconomyAdult Social CareProcess overseen by and approved by CAADAAligned – multiple line managementCo-ordinated Action Against Domestic Abuse (CAADA) is a national charity supporting a strong multi-agency response to domestic abuse.
10Delivery ModelDaily meetings which respond to domestic abuse incidentsAll agencies share their knowledge of the whole familyA joint action plan is jointly agreed and implemented immediatelyIndividual agencies take ownership of on going activity with the familyTaking MARAC principles to a daily meetingLaunched in March 2013
11Integrated Health Support Team An integrated targeted intervention and support service to vulnerable pregnant women and their families.Works with top 2% most vulnerable pregnant women in the Borough (circa 75) and their families to reduce the risk of children becoming looked after and / or suffering significant harm.Team consists of Public Health midwives, Midwifery Support, specialist Speech and Language therapist and a targeted Speech and Language therapist, Family Support WorkerWon 2 national awards from RCM & BJM. 3 x Public Health Midwives (WWL NHS Trust)1.2 WTE Midwifery Support Worker (WWL NHS Trust)1 x Specialist SALT (Bridgewater NHS Trust)0.8 x Targeted SALT1 x Family Support Worker (Bridgewater NHS Trust)Won 2 national awards from RCM & BJM
12Delivery Model Joint assessments Joint team meetings Shared case notes Joint visitsShared family plan
13The Life ProgrammeA long term attachment rooted service where families are invited to take part and work intensively with a range of workersA team of workers with a range of skills including police, social care, early intervention, health and housing.Located in a local building which operates as a drop in centre for family members
14Delivery ModelAll workers support families and share their expertise with the teamStaff have specialist areas – but all members of the team carry a case load and act as a keyworker for the family – or members of the familySmall case load – 12 families on each site – but as this includes the extended family it adds up to nearly 100 individuals.Staff work with families for a period of up to two years with a defined exit plan seeing a step down in the level of support over an extended period of time
15Learning – Aligned Integration Working in a co-located team can blur the lines between professions and need all involved to have a flexible approachThe benefits are not shared equally across all agencies and without shared budgets the cost can outweigh the benefit to some partnersRelationships and engagement are critical to success and the timeliness of appropriate interventions is key to delivering and sustaining change.
16Learning – Single teamAll staff need adopt a person centred approach to family work with a single family assessment built into the centre of the approach so that we ensure that the child’s needs are paramount and services wrapped around the familyHaving all professionals managed within one team enables the change process to be managed, removes competing agendas and prevents the family from playing off professionalsThis means that team members are team members first and carry their professional skills on their shoulder to be used as and when needed by family members or other team members.Multi disciplinary teams are not new – but have mostly been aligned
17What helps develop the single team Having a job role outline that defined the role of the team member.Some common competencies that tied the team together,Common statements that outlined the primary task that we were all working together to achieveA set of fundamental principles that set out the way that we worked with families.An acknowledgement that as a team we had different sets of value bases and motivation for the work that we do. Embedding the fundamentals within the IPA process so that we could measure our journey.Providing daily debriefing sessions in the early days of integration supported by a manager. Understanding that t he team moved from roles where they had been seen as the expert in their specialism working with a particular cohort to working outside their comfort zone. Staff need support to understand that they don’t need to know all the answers, its ok to say I'm not sure but we can find out.Recognising each individual team member as a consultant from their specialist area. Being open to share working practices. Involving the team in the development of the service.Providing high quality supervision and support to enable team members to manage the change in the way of working.
18LearningWe are asking our new integrated teams to support families into behaviour change which the public sector has been struggling to achieve for many yearsNeed a workforce than understandsWe need to take an asset based approach with familiesFamilies and individuals need to be encouraged to take responsibility for their behaviour and understand the impact in order to be willing to change.Behaviour change takes time and families often relapse and need further motivation and support
20Aim in WiganTo develop and begin to implement by 2015/2016 an approach to full integration of early help including Health Visitors and our Early Help team.Locality based modelSingle line management of staff
21What are the challenges we have identified Communication:Need for an agreed shared vision and understanding with clear communications strategy:Strategic partners / managementWorkforcePublicAccountability / governance / clear leadership.
22What are the challenges we have identified AccountabilityGovernanceNeed for clear leadershipAbility of organisations to let go
23What are the practical challenges we have identified Systems:Fragmented commissioningRange of assessment processes and paperwork to be agreedData: systems / sets / sharingWorking models e.g. key working / corporate caseloadAccommodation
24What are the challenges we have identified Workforce:Workforce sign-up.Workforce competencyWorkforce cultureChange managementHR / Pensions / TUPE
25Discussion topicsWhat type of integration are delegates developing in their locality?Do we all share the same challenges?What do we see as the benefits of integration?How will we measure our success?