Living Well Collaborative Breakfast, Thursday 14 November 2019

The Collaborative meeting in November focussed on developing our approach to measuring impact and outcomes. It was also a chance for photographer Beth Crockatt to capture members at work for an Impact Story to illustrate the Collaborative’s early work with Nesta. See link below.

Making outcomes a reality

The outcomes paper that was presented at the Living Well Network Alliance Leadership Team meeting was circulated at the breakfast. This agreed to take forward the following recommendations:
• Agreeing to reduce the number of recommendations from 21 to 12.
• Agreed to change the term ‘pain and gain share’ to ‘high priority outcomes’
• Agreed to develop a range of I-Statement feedback mechanisms
• Agreed to develop an outcomes insight lab
It was recognised that we need to make the outcomes-based contract a reality and have key areas to focus on, including:
• Early Access (Single Point of Access)
• Living Well Centres
• Short-term support
• Medium and long-term support
• Vocational Support
• Crisis Services
• Acute In-patient
• Placements
These areas have been developed with people in the room, service users and carers, all who have fed back on their importance.
The Single Point of Access (SPA), Living Well Centres short, medium and long-term focussed support have all gone live during September and October.
We spend over £1m on vocational support services and we think we can make a bigger impact by working together. Black Thrive was hoping to be successful in a bid focusing on employment within the black community.
The Crisis Outreach service has gone live and we need to think about the impact this is having early on.
Within the acute in-patient area there has been negative feedback for a variety of reasons… this also links to discussions around Lambeth Hospital redevelopment of acute in-patient wards and the move onto the Maudsley site.
Placements: include supported housing, supported living, rehabilitation and complex placements
Work has taken place with Alice Glover (SLaM) and Certitude to seek feedback from those living in Certitude housing. This work has shone a light on issues people are experiencing.
Energising Collaborative outcomes work

Looking at these feedback mechanisms provides an opportunity to re-energise collaborative working around outcomes. It is an opportunity to create a space and forum to drill down and develop an understanding of the services, service users, carers and communities, particularly in relation to black communities.
We want to have much more targeted and focussed conversations that are driven from the bottom up, as opposed to our usual conversations, which tend to be led by the statutory sector.
It was suggested to set up an insight lab/jam … However, after a discussion it was agreed that the name is changed as it wasn’t really hitting the spot. We want to cultivate a conversation with front line staff and with people who use services and their carers, in a safe way. The idea is to have a rolling programme of initiatives that support and enable us to gain a deeper insight.
One of the areas we particularly want to focus on is around crisis, and it will be crucial to involve front line staff, people with lived experience, especially people from the black community.
We want to ensure that this insight is fed into the service redesign process;
Examples of how we might capture feedback were explored:
Vocational Services:

Mark Bertram, Manager of SLaM’s Vocational Services gave overview with the services’ vision in mind, that ‘Everyone has the opportunity to thrive and not just survive’… it’s about getting a job, having a purpose, being in this world. The insight has come from people that have been asked in great depth about their own way forward; recognising that they can do something with ‘my’ lived experience. This evidence has been collected over 10 years and has been published.

The outcomes that have been suggested are grounded in what people say they want; employment. There was also recognition that there was the opportunity for people to keep in contact with the service over a long period of time, possibly years, so people can phone in if they are having a rocky period.
The vocational support providers in the borough include: SLaM Vocational Services, Southside Rehabilitation Association (SRA), First Step Trust (FST), Status Employment and Mosaic Clubhouse who, under the banner of vocational support are working together to develop the insight.
See below new leaflet that captures what people say they want.

Disability confident employer
There was a challenge around if the borough of Lambeth could become an NHS disability confident employer, or the very least all Alliance providers. It was agreed to come back and discuss this further.

Here is the government link to being a disability confident employer

Black Thrive noted that they will be doing some work with people who have multiple long-term conditions and will be in contact with employers who are part of the Black Thrive partnership.
Early Support:
Single Point of Access (SPA) is where all new referrals go, and has taken over the task of the Hub. It is currently only over the phone and not face to face, although this does not mean that it might not be face to face in the future. The SPA is made up of health, social care and voluntary and community sector to screen and triage the referrals. The idea is that you get the right place the first time.
Short-Term Support:
This is a combination of LWN Hub and what was previously known as Assessment and Liaison within SLaM. Support is provided up to 12 weeks.  
The questions that have been proposed are based on Age UK/ Lambeth SAIL (Safe and Independent Living) feedback forms and have had initial conversations with the Service User and Carer Advisory Group. These questions would also be discussed with service users to be able to put in place to test with people who will access SPA and Short-term support.  We need to ensure that consent is sort at first contact.
For the SPA it was suggested that maybe questions on how long did you have to wait to get through on the phone, and how you feel about the interaction.
It was noted that we need to think about the outcome measure that SLaM will need to use DIALOG and how this fits in with the feedback mechanisms.
We are exploring the idea of having an Innovation Fund to support the insight lab and a more bottom up approach.
We also need to look at what resources are already in place including technology; SLaM Quality Improvement – Icare and any other opportunities.
There was a brief discussion about where the accountability of the insight lab would be, and this will need to be discussed further.

Natalie Sutherland

Click here for Vocational Services new leaflet
Click here for link to Nesta impact story

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