Old and New Partnerships

Ann SkinnerCEO Resolving Chaos

Resolving Chaos – who we are

Resolving Chaos is a small not for profit, Community Interest Company.• We are a ‘spin out’ from the Department of Health. Transition to independence

took 2 years, we have been independent since Oct 2012• Our focus is to improve outcomes for people with multiple needs• We work with and support commissioners and providers to create a business

case for investing or re-investing in services to help people with chaotic lives and multiple problems improve their lives

• Our focus is that the cost of chaos results in high costs public services (A & E, prison, arrests, mental health care) and that an economic case can be made for systems change by commissioning the right support services

Our projects

Examples of our work are:• We have led 14 NHS funded Social Inclusion pilots. Two thirds secured sustained

investment as a result of the investment case we made• We have undertaken an investment review in LB Brent of Supporting People to

test the extent to which the SP Programme contributed to the Councils priorites – to review and identify outcomes and effectiveness to maximise impact and financial benefits to local communities

• Olympic boroughs project – to train individuals to use diagnostic tools – the chaos index and Service outcome tools – to calculate cost of services use over 12 months

• Lead Partner for the Lambeth, Southwark and Lewisham BIG Lottery Fulfilling Lives- Multiple and Complex needs programme

Partnership Working –moving with the timesPartnership and collaborative working is nothing new… but a necessity more than ever before in a climate where there is less funding and higher expectations.

Staying ahead of the game – a lot to get your head around and new commissioning arrangements and new people to get to know! • Localism – moving away from Regional infra-structures• Clinical Commissioning Groups & GP Commissioning• Health & Wellbeing Boards – include Public Health Managers• Health and Social Care Integration – radical service transformation over next few years• Micro-commissioning - Personal budgets for a range of vulnerable groups• Macro Commissioning - Prime providers and sub-contracting - MOJ• Payment by Results – demonstating economic impact against outcomes

Opportunity or threat (or both) ? Where do you fit and who you can work with in the market place to strengthen your service offer ?

Our Lambeth Southwark and Lewisham Partnership -BIG Lottery Programme for people with multiple needs

KEY REQUIREMENTS

• Cross sector partnership - led by the VCS but involving key statutory agencies, commissioners and other providers

• Bring experience of working with people with multiple and complex needs across homelessness, mental health, substance misuse, offending – mostly not accessing sustainable services as not eligible or barred from the system

• Enable potential ‘beneficiaries/users’ to shape and design the project

• Include a small core partnership group of organisations which can add significant value and which can make decisions quickly

• The core group and partnership may change and evolve as the project develops

Key Outcomes for the BIG Fulfilling Lives Programme are:

• People able to manage their lives better through access to more person centred and coordinated services

• Services users empowered to fully take part in design and delivery

• Shared learning , outcome measurement and cost benefit analysis will demonstrate the impact of service offer to key stakeholders and commissioners

Making the Case /Demonstrating Outcomes

Lead Agency

Wider LSL Partnership, moving from consultation to delivery

Core Group

VCS

Statutory agencies LA’s NHS, Slam

Users and

Carers

 

 

 

LSL PartnershipIncludes Core Group and the development of a wider partnership

CORE GROUP MEMBERS

The Core Group s key role is governance and programme management It has a committed, close working membership who have a strong track record and knowledge of working across the boroughs. It is made up of representatives from the 4 client groups, LSL commissioners and Slam. Working with the Lead Agency Resolving Chaos on the group are; • St Giles Trust – Evan Jones (Vol sector reference group lead)• Thames Reach – Bill Tidnum (User involvement reference group)• Certitude – Nicholas Campbell –Watts• SLAM Addictions – Mick Collins• LSL Commissioners – James Lee (Lambeth), Mike Hammond (Lewisham), Mark

Taylor ( Southwark), Tanya Barrow (Southwark)

The LSL Delivery Model

Aim: Focus on Systems change and influencing future investment.

Model includes;

• Target group – 270 people with entrenched and complex needs (approx 30+ per borough)• A multi-skilled team to ‘fast track’ individuals into new and existing services using a

consistent trusted adult , including peer support• Individual budgets to give choice to a wide range of services• Outcomes and economic analysis through the journey of the individuals• Building of a business case for future investment• Economic evaluation with other areas – Brighton, Newcastle, and Camden & Islington

LSL Feasibility Study – cost of use of services over 2 years

• Identifying the 5 archetypes within borough• High costs, poor outcomes, known by lots of services• ‘Super Tuesday’ Process identified 70 people (via health, housing , adult services, criminal justice)

across the three boroughs – Lewisham, Southwark, Lambeth• Comparative costs with the input of our intervention

Assumptions

• Marginal costs where possible• Locally agreed prices• Rent, medication and benefits not included• Estimate we have 60% of the service data• Outstanding crime and hospital information

Latrice 1 year – 2012/13 : £50,989

Housing Support; £18,000

Housing Moves; £1,950Ambulance; £230

A+E; £173Outpatients; £1,200

GP; £792Assessments; £1,313Psychiatrist; £6,408

START team; £2,523

Social Worker; £2,523

Detox; £2,523

ASBO; £5,350

Police call-outs; £920

Arrest; £5,384

Probation referral; £800 Case conferences; £900

Net savings from a 10% in costs over 2 years

PersonCost beforeintervention

Costafter

Saving p.a.per person

Proportion ofcaseload Numbers

Savingsmade

Charmaine £196,461 £176,815 £19,646 0.4 10 £196,461

Latrice £115,471 £103,924 £11,547 0.2 5 £57,736

Harry £128,306 £115,475 £12,831 0.2 5 £64,153

Tony £145,746 £131,171 £14,575 0.12 3 £43,724

Mandy £45,492 £40,943 £4,549 0.08 2 £9,098

TOTAL £371,171

CONFIDENTIAL DRAFT FOR OS

Our Role and LSL Business Plan

• Lead agency - Partnership Agreement for Core Group in place – roles and responsibilities

• Lead Evaluation mechanisms

• Lead Procurement mechanisms - for delivery

• Shared Learning with other Lead Areas

• Service user engagement mechanisms, including design of programme, eg: staff skills, evaluation, measurement of success

• 8 year Project and Resource Plan

Our Approach

• We are not a provider of commissioner – we have a neutral role to offer effective solutions and work with both

• Our expertise is commissioning, economics …..and multiple needs

• Our focus is not on research or policy or complex academic models but on supporting impactful delivery and better outcomes for our target group

• To develop a business case that demonstrates the impact of integrated service design, provider development and partnership

• ‘Speaking the language’ of commissioner and funders