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.
Bradford's Learning on Multi Agency Working - Mary Weastall, Bradford Council
Unravelling the complexity ofmulti agency workingBradford’s Learning and the IISaMprojectMary WeastellStrategic DirectorBradford MDC
Unravelling thecomplexity of multiagency workingBradford’s Learning andthe IISaM projectMary WeastellStrategic DirectorBradford MDC22 May 2013
Presentation introduction• Bradford as a Place• Bradford’s Total Place pilot• Families First, our CommunityBudget• Principles for success• Information Sharing as an Enabler• Lessons from Bradford forPartnership working• The IISaM legacy
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 islarge• 26th most deprived district on IMD 2010.• A lot of vulnerable people & families withcomplex needs
Bradford as a Partnership• Strong history of good partnership working• Partners committed to continual improved – 2013 we are refocused our LocalStrategic Partnership• Deep partner collaboration in development & delivery of Community Strategypriorities• Good relationships across sectors – integration with health & joint strategiccommissioning• Total Place experience demonstrated established appetite to tackleentrenched problems together
Bradford’s Total Place• Gateway to Integrated Services: supporting vulnerable groupsat point of re-entry into community• Enhancing social capital, community self-reliance, and takingcost out of the system• Three client groups:– Young people leaving care– Offenders over 18 leaving prison– Older people with mental healthproblems leaving hospital
Discovery and Development:• service providers defining current situation• understanding dependencies & problemsCustomer Insight:• real life experiences of services users• understanding of impact of services on wider familyForging the Future:• service users & providers work on new pathways• freedom to think creatively, & design transformational changesTotal Place Methodology
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 andcost• Any “front door” – think family,think community• Cost avoidance, efficiencies &savings
Families First: benefits mappingOutputs/Enables Strategic GoalsBusiness Change Interim Benefits End BenefitsSupport from beinga CB prototypePrevious experience ofTotal Place and of keyrelevant programmes,e.g. family interventionprogramme,Start2Finish,Worklessness Co-DesignEngagement fromLSP, BDP and all itsseparate agencies, amulti-agencyreference group, VCS,families,Support from Whitehall for localdemocracy and a degree of local selfdetermination, including the ability toprioritise assets appropriate to local need,and to sometimes prioritise localoutcomes over national ones where thereare conflictsCost Benefit AnalysisSupport from theAudit CommissionPlanning for Deliveryof New CB ServicesIntensive processbased on the TotalPlace methodology tojointly redesign thenew service deliveryPlanning thesupport processes toenable theimplementation ofthe new servicedelivery –improvingmanagementinformationsystems,information sharingand storagesolutions, putting inplace themonitoring,performancemanagement andevaluationframeworks,building capacitywhere requiredImplementingDelivery of CBNew ServicesImproved data andinformationsharingCommonassessments whereappropriateImprovedintegrated casework managementand more agenciesproviding keyworker “grip”Better referralsacross agenciespicking upreferralsJointcommissioning ofnew servicesReduced demandfor repeat servicesSustaining children ineducation and parents inemploymentReducing risk of evictionand homelessness andsupporting people toretain tenanciesReducing anti-socialbehaviourImproved parentingBetter financialmanagement of debts andaccess to benefitsReducing number offamilies in povertyAddressing alcohol, drugand mental healthproblemsReducing Crime andreoffendingReducing repeatvictimisationPeople take pridein Bradforddistrict, act withdignity andrespect and live inresilient and self-reliantcommunitiesBradford is aninclusive districtwhere all peopleare able toparticipate in thesocial andeconomic life oftheir communitiesAppropriate monitoring, performance management andevaluationLocal intelligence anddata analysisContinuing improvement
Information & Data Sharing sothat…• family tell their story once – share need assessment• good case management of interventions wrapped aroundfamily• 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
IISaM in BradfordFamilies FirstData QualityIdentifyingFamiliesDataSecurityGovernanceProcesses/proceduresfor sharing information Training needsIdentify datasets heldacrosspartnerRiskConsentForm forfrontlinestaffDataauditGovernanceReviewDraftProtocolGuidance on securetransfer of dataProtocolguidanceDeveloped & deliveredinformation sharingtraining sessions withpartnersReferral formfor newserviceclients“Understandingpartnerdecisionmaking”workshopsUnderstandinglegal gatewaysStakeholderAnalysis &Engagement
Building Trust & Confidence• Information Governance partnership• Understanding about legal gateways andorganisational cultures• Barriers and boundaries are necessary for safeinformation handling - but they need to bevisible• Handbook to signpost people around theinformation arena and storing ourorganisational learning• Practitioner development through the EASI
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
Lessons for information sharing• Don’t underestimate the importance of“enablers” for any change programme• Capture and develop organisational learning• Understand your information governance andframework arrangement and keep thatknowledge up to date• Give time, space and energy to keepingpractitioner networks alive
Mary WeastellStrategic Director, Bradford Councilmary.email@example.comThank You
Unravelling the complexity ofmulti agency workingBradford’s Learning and the IISaMprojectMary WeastellStrategic DirectorBradford MDC