Presentation at the Improving Information Sharing & Management dissemination event at the LGA in London on May 24th. Presented by Mary Weastall of Bradford Council.
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Bradford's Learning on Multi Agency Working - Mary Weastall, Bradford Council
1. Unravelling the complexity of
multi agency working
Bradford’s Learning and the IISaM
project
Mary Weastell
Strategic Director
Bradford MDC
2. Unravelling the
complexity of multi
agency working
Bradford’s Learning and
the IISaM project
Mary Weastell
Strategic Director
Bradford MDC
22 May 2013
3. Presentation introduction
• Bradford as a Place
• Bradford’s Total Place pilot
• Families First, our Community
Budget
• Principles for success
• Information Sharing as an Enabler
• Lessons from Bradford for
Partnership working
• The IISaM legacy
4. Bradford as a Place
• Over half a million people live in Bradford District
• Large economy worth £7.5 billion
• Population concentrated in five urban centres
• Much of the district is undisturbed countryside
• Gap between the most wealthy & the least is
large
• 26th most deprived district on IMD 2010.
• A lot of vulnerable people & families with
complex needs
5. Bradford as a Partnership
• Strong history of good partnership working
• Partners committed to continual improved – 2013 we are refocused our Local
Strategic Partnership
• Deep partner collaboration in development & delivery of Community Strategy
priorities
• Good relationships across sectors – integration with health & joint strategic
commissioning
• Total Place experience demonstrated established appetite to tackle
entrenched problems together
6. Bradford’s Total Place
• Gateway to Integrated Services: supporting vulnerable groups
at point of re-entry into community
• Enhancing social capital, community self-reliance, and taking
cost out of the system
• Three client groups:
– Young people leaving care
– Offenders over 18 leaving prison
– Older people with mental health
problems leaving hospital
7. Discovery and Development:
• service providers defining current situation
• understanding dependencies & problems
Customer Insight:
• real life experiences of services users
• understanding of impact of services on wider family
Forging the Future:
• service users & providers work on new pathways
• freedom to think creatively, & design transformational changes
Total Place Methodology
8. ntensive family
ntervention worker/
parenting
practitioner
DfE DH
LA YJB PCTPolice
Surestart
Parent support
advisers/School
s
Police officer
YOS worker
CAMHS/
Mental Health
Worker
Drug and
alcohol team
DWP
JCP
Employment
Personal advisers
VCS
Young carer
support worker
Prisons
Probation
Family Support
Workers
Probation Officers
CLG
Housing
authorities
Housing link
worker
MoJHO
…“turn around the lives
of 120,000 families with
multiple problems,
improving outcomes &
reducing costs to
welfare & public services
…”
10. Families First: principles
• Shift emphasis from “doing to” to “doing with” co-production
• Building resilience within families and communities
• Reduce the degree of dependency & repeat demands
• Timely intervention & prevention of further breakdown and
cost
• Any “front door” – think family,
think community
• Cost avoidance, efficiencies &
savings
12. Families First: benefits mapping
Outputs/Enables Strategic GoalsBusiness Change Interim Benefits End Benefits
Support from being
a CB prototype
Previous experience of
Total Place and of key
relevant programmes,
e.g. family intervention
programme,
Start2Finish,
Worklessness Co-
Design
Engagement from
LSP, BDP and all its
separate agencies, a
multi-agency
reference group, VCS,
families,
Support from Whitehall for local
democracy and a degree of local self
determination, including the ability to
prioritise assets appropriate to local need,
and to sometimes prioritise local
outcomes over national ones where there
are conflicts
Cost Benefit Analysis
Support from the
Audit Commission
Planning for Delivery
of New CB Services
Intensive process
based on the Total
Place methodology to
jointly redesign the
new service delivery
Planning the
support processes to
enable the
implementation of
the new service
delivery –
improving
management
information
systems,
information sharing
and storage
solutions, putting in
place the
monitoring,
performance
management and
evaluation
frameworks,
building capacity
where required
Implementing
Delivery of CB
New Services
Improved data and
information
sharing
Common
assessments where
appropriate
Improved
integrated case
work management
and more agencies
providing key
worker “grip”
Better referrals
across agencies
picking up
referrals
Joint
commissioning of
new services
Reduced demand
for repeat services
Sustaining children in
education and parents in
employment
Reducing risk of eviction
and homelessness and
supporting people to
retain tenancies
Reducing anti-social
behaviour
Improved parenting
Better financial
management of debts and
access to benefits
Reducing number of
families in poverty
Addressing alcohol, drug
and mental health
problems
Reducing Crime and
reoffending
Reducing repeat
victimisation
People take pride
in Bradford
district, act with
dignity and
respect and live in
resilient and self-
reliant
communities
Bradford is an
inclusive district
where all people
are able to
participate in the
social and
economic life of
their communities
Appropriate monitoring, performance management and
evaluation
Local intelligence and
data analysis
Continuing improvement
13. Information & Data Sharing so
that…
• family tell their story once – share need assessment
• good case management of interventions wrapped around
family
• reduce duplication & services stop working to opposing aims
• grip families who actively avoid contact
• timely intervention & prevention of further breakdown,
reduce the degree of dependency & repeat demands
• “Whole system change” for better outcomes for families,
their communities and the district as a whole
14. IISaM in Bradford
Families First
Data Quality
Identifying
Families
Data
Security
Governance
Processes/procedures
for sharing information Training needs
Identify data
sets held
across
partner
Risk
Consent
Form for
frontline
staff
Data
audit
Governance
Review
Draft
Protocol
Guidance on secure
transfer of data
Protocol
guidance
Developed & delivered
information sharing
training sessions with
partners
Referral form
for new
service
clients
“Understanding
partner
decision
making”
workshops
Understanding
legal gateways
Stakeholder
Analysis &
Engagement
15. Building Trust & Confidence
• Information Governance partnership
• Understanding about legal gateways and
organisational cultures
• Barriers and boundaries are necessary for safe
information handling - but they need to be
visible
• Handbook to signpost people around the
information arena and storing our
organisational learning
• Practitioner development through the EASI
16. In summary: lessons for Partnerships
• Organisational boundaries less important than ever
• Clear shared strategic agendas
• Solutions can only be determined jointly
• A culture for change – accept challenge & criticism
• Understand the problem – don’t rush the solution
• Engage people – client-focused, family empowerment,
community capacity building
• Prevention and early intervention
• Unlock assets & opportunities
17. Lessons for information sharing
• Don’t underestimate the importance of
“enablers” for any change programme
• Capture and develop organisational learning
• Understand your information governance and
framework arrangement and keep that
knowledge up to date
• Give time, space and energy to keeping
practitioner networks alive
19. Unravelling the complexity of
multi agency working
Bradford’s Learning and the IISaM
project
Mary Weastell
Strategic Director
Bradford MDC
Hinweis der Redaktion
NEEDS UPDATING…… As the agenda for today suggests, and as John Curtis has outlined in his introduction, each of the three localities that have been involved in the Improving Information Sharing and Management project have been asked to illustrate a different stage in the improvement journey that we have been on together. I want to illustrate how we came to Information Sharing as a real enabler to Families First, Bradford’s Community Budget programme. I will spend a little time outlining the Families First problem definition and design. Families First is a really radical service redesign, which strongly emphasises the importance of good and safe information sharing in modern public services. So I will outline how we got started on the IISaM improvement journey in Bradford. And I will be honest – in that we thought the Information Sharing part of that programme was going to be fairly straight forward, and that only required some tightening up some practices. That’s not quite how the work has panned out – and so I will end my presentation with a brief reflection on some of the lessons we have learned, and are still learning, as a benefit of being involved in IISaM.
Bradford is a large district with a big economy. We have a real rural/urban split; a growing older population & a higher than average birth rate. We do have some very wealthy areas. But also some very deprived areas.
We have been a very active partnership and networking kind of place for a good number of years now. We have really seen our partnership working grow and mature, from a good way to get our heads together to think about the district and its needs, to really strategically prioritising our efforts to get the biggest change needed. We have recently changed the Bradford District Partnership, our LSP, and associated strategic partnerships so that it is less about servicing an entity and is even more about being solution focused. Our Total Place experience really helped with that level of maturity. We had some hard discussions across different agencies about improving client pathways across with whole system, and the good will and the good relations survived those difficult discussions! Our Total Place experience was what prompted our involvement as a Community budget first wave prototype, to think about working with families with complex needs in a different way.
A wide range of partners got involved in scoping sessions which identified the overall theme The BDP Board then agreed to focus on the idea that, if we get the client or service user involved in finding service improvements and becoming a “co producer”, we can both build up the capacity of our communities to become active agents in their own and their families lives, & it will almost always lead to better and more efficient services. We then focused further on three client groups – in effect, giving rise to three TP pilots.
Each theme was subject to three phases. I don’t intend to talk you through all of these, but just wanted to emphasise that this was about bringing strategic leaders, service providers and service users together to work on improved service design. This put us as a set of partners in really good stead for the Community Budget first wave prototypes.
For those of you who were involved in Community Budgets, you may recognise this illustration from the Dept for Education back in 2010. It’s their take on the Prime Minister’s commitment to turn about the lives of families with multiple problems, recognising that such families cost a great deal of money to services, but also that these resources are not necessarily helping to change families long term. Bradford agreed to be a Community Budget first wave pilot, as we recognised the need to take an approach across the whole collection of services that interact with families with multiple problems. We have previously been a Total Place pilot and have an excellent history of partnership working. Community Budget’s seemed a very natural progress for Bradford Council and our partners.
We did a lot of work with senior politicians and strategic leaders, with service managers and frontline staff, and with families themselves, to understand what was getting in the way of working effectively with our families and why it wasn’t as cost effective as it could be. We were able to describe the things that we though needed to be fixed. And ultimately identified that we were perpetuating a real dependency that had developed, where services “do to” rather than “work with” families
A very deliberate and thought-through direction to the programme leads to make sure definitions, principles, ethos and service design were right for Bradford PROBLEMS Duplication of services - no one agency has an overview Services dip in & out of people’s lives - duplicate assessments Focus on a primary client & not the whole family situation Families have to tell their stories many times & support can arrive too late High demand for services – repeat demand Dependency - services “do to” rather than “work with” families
We were able to, collectively, articulate a model for radical redesign for services within the council and across other agencies that work with families. The vision was that we shift emphasis from “doing to” to “doing with” co-production so that we can build resilience within families and communities, and reduce the degree of dependency & repeat demands. And that we have timely intervention to step families down towards greater stability, prevent further breakdown and avoid costs
And we were able to work back from that vision to think about the benefits we wanted the programme to deliver, the business change that we needed to secure to deliver those benefits, and what would enable us to make those changes.
The reason that I am sharing the stages in the process is because taking such a systematic and participative approach really did help us to get started - in the right place. In our original thinking, Families First was about whole system change, but we quickly realised that we had to start with some fundamental improvements in some of our information management and sharing approaches across agencies.
You’ll hear more through the rest of the sessions about IISaM, and the way that we’ve developed the resources and toolkits together, but you can see from this schematic that the project team – and our IISaM project officer, Jill Duffy – has been very busy in Bradford! We have particularly benefited from learning from other localities too, and have joined the IISaM work with other “information” projects within the council. I’d like to reflect on one area in particular – building trust and relationships
Where IISaM has been an absolute success for us is the momentum that has been gained across partners to understand how decisions to share information, in what format and under what conditions, are taken by different agencies. Those of you who work within Information Policy will know that it is often assumed that people don’t share because they are risk adverse, or they think that they can’t when the legislation does allow it. IISaM has really helped us as partners to understand that some boundaries are important. And that we need to have clarity about why we think we need to share information – and question whether we actually do need it to achieve our aims – so that we seek to share only what is truly critical. The momentum I mentioned has lead to an awareness that we need to keep the Information Governance learning in the partnership arena alive going forward. We want to continue to develop a repository or directory that signposts a way around the Information Governance landscape in Bradford, so that people can easily find key policies, protocols, who to connect with, and where accountability lies for maintaining good information sharing governance. And we were very please to support the EASI project that grows our local practitioner development – but you will hear Sue Richardson’s presentation later about EASI.
Total Place is not just a public sector issue – the VCS & private sectors are integral to the solutions; and so organisational boundaries are less important than ever. We are one place. And Bradford’s experience demonstrates that we can work across organisations & develop joint strategies in localities We think this is even more important in this times of reduced resources. You have to make sure that your LSP is fit for purpose – and recognise that partnership working is about relationship development and managing, and does require organisational - & individual – egos be set aside. But it is an opportunity to demonstrate to any partners with lingering doubts that LSPs mean business. Be prepared to listen and hear criticism of your services This will help you really understand the problem before trying to find the solution And make sure you do that by including the client, their family and networks In doing so you will find that you shift the emphasis from “doing to” to “doing with” And this gives us more space to prevent problems deepening and to intervene early Finally, don’t just think along “deficit” model lines about needs – recognise & exploit the assets the area has in its communities & people
Just in concluding, a couple of points that I hope are the legacy we will keep in Bradford after IISaM. We didn’t think we were on an information sharing journey. We were. It emphasised for us the importance of the enablers – such as data management and the data itself – to our Families First programme. Some of the “old hands” in Bradford who have worked in and around the topic of information sharing did say that some of our ambitions about early trigger points for more timely intervention were going to be difficult to crack. And they are still not cracked. A recent workshop of service practitioners re-confirmed that they really want to be able to generate a whole family story across the agencies – so we still have some way to go yet. But hopefully we will not have to reinvent the wheel. We have recognised the importance of understanding what information sharing frameworks and policies and protocols we have in place – and maintaining that knowledge, so that we don’t automatically reach for the drafting pen as each new information request comes up. And we do want to help practitioners and front line managers to keep their newly developed networks vitalised and productive. If IISaM’s legacy is to leave us with those relationships healthy and sustainable, it will have done its job.