Welcome and Introduction

Nuala Doherty, Centre for Effective Services

1

Objectives of Meeting

• Share knowledge and experience of implementation based on

case studies

• Exchange information on upcoming implementation events

or relevant initiative

• 9th Meeting of the Implementation Network since its

establishment in 2011

2

Chatham House Rules

Chatham House Rules apply

i.e. participants are free to use information received

at these meetings, but neither the identity nor the

affiliation of the speaker(s) may be revealed

➢ Encourage openness, sharing of information

➢ Create ‘a safe space’ for honest dialogue and learning

3

Agenda

Arrival and Tea/Coffee 10.00 – 10.30

1. Welcome and Introduction (Katie Burke, CES) 10.30 – 10.40

2. Case Study Presentations 10.40 – 11.40

– Implementation of the Northern Ireland Social Work Strategy

Christine Smyth and Sean Holland, Department of Health, Social Services and Public Safety

Northern Ireland

– Learning from the implementation of disability and dementia projects around Ireland Fiona Keogh, Genio

3. Group Work / Table Discussion 11.40 – 12.30

Lunch 12.30 - 13.10

3. Questions and Answers with Case Study Presenters 13.10 – 13.45

4. Update on Implementation Events and Initiatives 13.45 – 14.25

5. Close and Next Steps 14.25 – 14.40

Case Study Presentations

Improving and Safeguarding

Social Wellbeing

The

Implementation

Journey

Underpinning belief

Social work works

Hopes

• A framework for action

Relevant to social work across all sectors

Drive improvement and transformation

Make best use of resources

Confident and dynamic workforce

• Improve service user outcomes

• Improve social work systems/services

Enablers

• Clear leadership;

• Dedicated resources;

• Agreed priorities;

• Top down/bottom up;

• Strong service user engagement

• Engagement/commitment;

• Whole system approach;

• Strategic coherence.

Progress to date

• Good engagement;

• Hearts and minds;

• Early wins;

• Innovation Scheme;

• Lots of ‘fires’.

Challenges

• Strategic transformational initiatives versus local

improvement projects.

• Things always take longer than anticipated;

• Context changed - are we still going in the right direction;

• Change is difficult – systems set up to deliver the results they

deliver;

• Engagement of practising social workers ;

• What does success look like? How do we measure it?

• Ownership and accountability for delivery and results;

• Maintaining focus on outcomes;

• Managing expectations.

Learning from implementation

Clear direction

Motivation

Demonstrable results

Delivery capability

Organisation and Structure

Where to next?

How to:

- manage the midlife crisis?

- motivate the grassroots?

- Know if it’s worth the effort?

- Scale up and sustain what works?

In the Business of

Smart Social Investment

Dr Fiona Keogh

Director of Research and Evidence

Supporting policy

implementation: learning in

disability and mental health

services

Content

1. Context and Genio’s strategy

2. Learning in the context of the

implementation framework

3. Learning on scaling up

14

GENIOSupports cost-effective, social innovation

focused on providing opportunities for

people who are marginalised to be self-

determined and to live full lives in their own

communities

Supports policy implementation across:

• Disability

• Mental health

• Dementia

15

Policy coherence

• Disability, mental health and dementia

• Full expression of Citizenship - full lives

• Live in your own home

• Participating fully – being included

• Meaningful activity

• Self-determined

• Valued person

• Effective and efficient use of resources

16

Personalised supports and services• consider the wider needs and potential contributions of the

person, moving away from a focus on deficits;

• a response to one person rather than group-based;

• chosen by the person/family (with support as appropriate)

• delivered in the community fostering inclusion and

participation;

• inclusive of family and community supports and mainstream

services;

• reliant on paid professionals only when appropriate;

• cost-effective and represent good value for money.

17

Current model of provision• Cost of delivering services is high and even with

efficiencies will remain high

• Increasing demographic pressures cannot be met

within current model

• Resources not allocated according to need or

linked to outcomes

• Achievement of personal outcomes not compatible

with service delivered in group setting

Source: Dept. of Health (2012) Value for Money and Policy

Review of Disability Services in Ireland pg. 160

18

Policy implementation STANDARDISED SERVICES TO PERSONALISED SERVICES

TOP DOWN BOTTOM UP

GROUP FOCUSED INDIVIDUALISED

FITS PEOPLE TO AVAILABLE

SERVICES

DESIGN AROUND THE CITIZEN

OUTPUT FOCUSED OUTCOME FOCUSED

SEGRATING INTEGRATING

STIGMATISING VALUING

RESOURCE INTENSIVE COST EFFECTIVE

UNSUSTAINABLE SUSTAINABLE

19

People living as included

and valued citizens

People with support needs

Communities

Politicians

FamiliesPolicy makers

Commissioners

Service providers

20

> Costed demonstrations

> Increased capability

> Evidence

Innovation funding

Building Skills and

Leadership

Measuring Impact

Costed

demonstrations

Increased

capability

Evidence

21

Macro Level

Informing policy development

Building relationships

Sharing learning

Resources and decision making for scaling up

Micro level227 projects

Where scaling up happens

22

Learning on scaling up?

Scaling = implementation + change

management

Work across many stakeholders

simultaneously

Work on ‘several fronts’ simultaneously

Work at macro and micro level simultaneously

Who can do this?

23

Learning from one project

cluster

24

DATA SOURCES

• 38 disability

• 16 mental health

• 627 beneficiaries

54 community living projects

• Quantitative

• QualitativeMonitoring data

• McConkey et al (2013)

• 23 Genio supported projects

Commissioned independent

research

25

PROFILE OF BENEFICIARIES

Disability

N=277

Mental health

N=222

Total

N=499

Mild 31% 40% 35%

Moderate 41% 39% 40%

Severe 26% 21% 24%

Missing 2% 0 1%

McConkey study: 21% of sample had epilepsy and 10% autism/ASD

26

Supporting people to live self-directed lives in the community: learning from 54 Irish projects

http://www.genio.ie/files/Summary_Learning_Paper_2014.pdf

27

Features of successful implementation

Multi-level leadership More than housing

The person leads the

process

Community links

Involving families and allies Start small and ‘model’

change

Engaging and consulting

with stakeholders

Challenge of

reconfiguration

Staff skills and training This takes time

Readiness Focus on outcomes –

monitor progress

28

STAGES OF IMPLEMENTATION

1. Exploring & preparing

2. Planning & resourcing

3. Implementing & operationalising

4. Business as usual

29

1. Exploring and preparation

• Multi-level leadership

• The person leads the process

• Involving families and allies

• Engaging and consulting with others

• Readiness

• Supportive tools

• Strategic partnerships

30

LEADERSHIP – MULTI-LEVEL AND SHARED

CEO, Board, Senior HSE etc.

Senior managers

Front-line staff

People using services and families

31

Person leads the process

Usual service delivery Supported Self-Directed

living

Person as passive recipient Person as self-determined

(with support if needed)

No control over service delivery Involved in design of supports

and services

Wraparound services

promoting dependency

Tailored and targeted supports

promoting Self-Directed Living

Person viewed as dependent

with ‘list of deficits’ to be

addressed

Person as citizen with abilities,

interests and contributions

32

Consultation and engagement

• Involve families and allies individually, in a

timely and respectful way

• Engage with stakeholders on the basis that

‘no-one has a veto’

• Needs to be thoughtful and tailored to the

desired outcome

33

Readiness

Organisation:

• Assess organisational readiness

• Tools such as logic modelling to get clarity on

outcomes and actions that lead to them

Individual:

• Need to challenge the concept of ‘readiness’

• Methods for assessing readiness based on person

in an artificial setting

34

2. Planning and resourcing

Start small and model change

• Peer-to-peer

• Staff

• Management – learning at manageable

scale

Staff skills and training

• New way of working – new skill set and

new recruitment

35

3. Implementing and operationalising

• Need for simultaneous activities

• Intentional and incremental linking with the

community

• Challenge of reconfiguration

• This takes time! – but needs to be

observable progress

36

SIMULTANEOUS ACTIVITIES

Identifying accommodation

Supporting person to move and link with community and build relationships

Reconfigure the organisation to provide ongoing individualised supports

37

4. Business as usual

• Keep your eye on the prize!

• Focus on outcomes and monitor progress

• Incrementally move funds over to the new

model

38

The Challenge of Scaling

39

Rogers ‘Diffusion of Innovation’ curve

40

What do we mean by scaling?

Scale the reach of the model – numbers,

geography, % coverage etc.

• Expansion: same organisation gets bigger

• Replication: same model spread to different

organisations

• Collaboration: partnership between one or more

organisations

• Mandate: legislative support, national commitment

and funding

41

Issues to consider

• Scaling up is a task unto itself (complex

and multi-dimensional)

• Who is responsible for scaling up?

• Specific support needed for optimal scaling

• What are the incentives and levers for

change?

• How can we use them?

42

In the Business of

Smart Social Investment

www.genio.ie

Thank You

Group Work

Questions and Answers

Case Study Presenters Dr Fiona Keogh, GenioChristine Smith, Department of Health, Social Services and Public SafetySean Holland, Department of Health, Social Services and Public Safety

1.

Implementation Events and Initiatives

GICEICImplementation Network Learning CommunitiesTCD Certificate in Implementation Science

47

Global Implementation Conference 2015 – Dublin May 15

Implementation Academy – Tuesday, 26 May

• Unique opportunity for participants to take part in master classes taught by

experts in implementation science and practice on a range of key topics

• Speakers from: Parenting Research Centre, Australia; Linkoping University,

Sweden; National Implementation Research Network, United States; and Sick

Kids, Canada.

• Will cover the challenges of measuring implementation, developing

organisational leadership and making an impact on community change

• Introductory or advanced level sessions

48

Global Implementation Conference 2015 – Dublin May 15

Conference – Wednesday 27 and Thursday 28 May

• Third GIC and first time that the event will be held outside of the USA.

• Conference will have combination of keynote addresses and breakout sessions to allow participants to explore implementation from a theoretical perspective but also to consider implications for both policy and practice.

• Theme is Implementation for Impact and content will focus on

– Capacity Development for Social Impact

– Shared Measurement Systems and Rapid Results

– Working together to develop the Implementation Infrastructure

– Communication and Knowledge Capture

– Regional, National, and Global Implementation Collaboration

49

Global Implementation Conference 2015 – Dublin May 15

Conference – Wednesday 27 and Thursday 28 May

• Keynote Speakers include: ― Stephen Brien, Social Finance, United Kingdom

― Lisa Saldana, Oregon Social Learning Center, United States

― Bryan Weiner, Unversity of North Carolina at Chapel Hill, United States

― Abraham Wandersman, University of South Carolina, United States

• Breakout Sessions 32 breakout sessions – each with a paper presented by an international speaker.

Session structured by a session chair, who is an expert in the field of implementation and makes a contribution to the session in the form of reflections, questions and discussion points.

• Flash presentations

Meet 45 presenters in 7 meetings rooms for brief presentations on implementation practice & science.

50

Global Implementation Conference 2015 – Dublin May 15

Registration

Every effort has been made to keep registration fees as low as possible for all participants, while still covering the costs associated with hosting an international conference.

51

Global Implementation Initiative (GII)

• To coincide with the GIC, the Global Implementation Initiative have developed a new website: www.globalimplementation.org

• History and activities of the GII

• Global Activities

• Including Implementation Network of Ireland and Northern Ireland (Signed Memorandum of Understanding)

• Other Implementation Networks across the globe.

• Resources – which may support professionals in their work within the field of implementation practice and science

Like on Facebook: https://www.facebook.com/globalimplementation

Follow on Twitter: https://twitter.com/GlobalImplement

52

Global Implementation Initiative (GII)

53

Global Implementation Initiative (GII)

54

European Implementation Collaborative (EIC):

• EIC website – www.implementation.eu live in April 2015

Make links and exchange learning on implementation science and practice - working with individual

country and regional implementation initiatives.

‒ ‘Go to’ portal for individuals/organisations interested in EIC‒ Repository of information –articles, toolkits, reports, case studies, briefing papers,

videos and events ‒ Host webinars ‒ Country/Regional Implementation Network Pages

• Official launch – Tuesday, 26 May, 4.30 – 5.30pm in Trinity College Dublin

– Programme and line up to be confirmed closer to the date

– Will have introduction to EIC and European Networks

– Followed by drinks reception

Keep in touch• Become part of EIC LinkedIn Group – go to page and send request to join• Email Breda bryan@effectiveservices.org to be added to mailing list.

55

• Schools Based Implementation Learning Community

Chairs: Julie Healy (Barnardos) and Eleanor McClorey (youngballymun)

• Area Based Interagency Implementation Learning Community

Chairs: Maurice Leeson (Health and Social Care Board) and Aisling Gillen (Tusla).

Implementation Learning Communities

56

• Trinity College Dublin – Certificate in Implementation Science

Close and next steps

58

Meeting Close

• Next Meeting – November 2015

• Thank You!