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Bradford - Total Place summit masterclass presentation
- 1. Bradford’s Total Place Experience What we've learnt about the importance of interconnectedness of the public service around the customer Strategic Director – Mary Weastell
- 4. Gateway to Integrated Services – Methodology Determine Joint Leads Phase 3 – Forging the Future Identify Key Stakehol-ders Phase 2 – Customer Insights Phase 1 –Discovery and Develop-ment Offline Work to Consolidate Outputs Design New Pathways & Develop business cases Agree Scope Facilitated by Leads Facilitated by Providers , VS & Leads Facilitated by Leads Involving Service Providers & Voluntary Sectors stakeholders Involving Service Users Involving Service Providers Voluntary Sector Service Users
- 8. Insights from Older People and their Carers
Editor's Notes
- Challenge 1: The current approach to providing the basic needs for the care leaver (e.g. housing, financial support, staying safe, education/employment/training and health care) is not always achieving the desired outcomes. The challenge is to bring together the various public, voluntary and private sector providers to ensure basic needs are met. The impact of not meeting these needs triggers a domino effect (e.g. the lack of suitable accommodation for young people leaving care will frequently exacerbate other problems e.g. lack of an address means no access to a GP resulting in serious risk of unrecognised mental health problems; delay in releasing offenders as no bail address is available). Challenge 2: In addition to the basic material needs of young people, there is also the issue of emotional/psychological support. Unlike young people leaving stable family environments, care leavers often lack the source for ongoing support that is needed for day to day living (i.e. mum/dad). The challenge is to provide a consistent level of service whereby young people have access to services that understand their needs and dilemmas and are willing to mentor and coach the young people through their difficulties. For some young people this may be beyond the age of 21. Challenge 3: Current legislation means that Bradford remains responsible for any young person who is originally from Bradford, even if they are living outside of the area. Although some services may be provided in the other locality, these may not include care leaving services for the young person – a young person from Bradford resident in that other area. The young person often has to rely on Bradford staff travelling to the area to provide this service. The challenge is to establish a more efficient and cost effective way of providing a consistent level of appropriate support nationally and across authority boundaries.
- Challenge 1: Older people are entering acute hospitals with physical problems (e.g. fractures etc.) but also may have secondary mental health related issues such as dementia or depression, or they may acquire mental health problems during their stay (e.g. delirium). Challenge 2: There is national evidence that, for a number of reasons (e.g. staff training) older patients’ mental health needs may not be addressed as well as they could be in hospital where the focus is on their physical condition and recovery. This can lead to the patient’s stay in hospital being prolonged. This problem is further exacerbated by the disjointed discharge process which often leads to additional delays. Challenge 3: Double Cost By applying the national ratios, extracted from the Alzheimer Society’s “Counting the Cost” report, to the Bradford situation, the additional financial cost of these extended stays in the acute hospital equates to £3.3 million per year. “ Counting the Cost” also demonstrates a link between the length of stay in hospital and the likely outcome for the individual. The longer the individual stays in hospital, the greater the likelihood they will be discharged to a care home.
- Challenge 1: By using the “resources follow risk” strategy to designing the offender management process, we are in danger of under resourcing the support for women prisoners. The majority of women prisoners are assessed in the lower risk categories, yet often have more complex and significant support needs. The challenge is to establish a method of assessment, which whilst accounting for risk also considers the “whole of life” cost of managing the offender in the community and which also ensures proportionality of sentencing is maintained Challenge 2: Offenders who serve shorter sentences (e.g. less than 12 months) are often in prison long enough to lose all their social support structures (e.g. jobs, housing etc.) but not long enough to benefit from the support services offered to long term prisoners. These prisoners are not supervised on release and because they do not benefit from the statutory framework of supervision, are often left to drift, increasing their potential to reoffend. The challenge is to provide an integrated approach to assessment and offender management for all prisoners upon release. Challenge 3: The collection of information has been designed to serve the needs of agencies and providers at specific stages in the process, from sentencing to release. This does not provide continuity in offender management. There is a lack of sharing of this information between the different agencies. This results in wasted time for all participants as well as duplication of information. More seriously, it can mean critical information that will impact upon the success of the rehabilitation e.g. mental health issues, may well be missed. The challenge is to establish an integrated process which enables the information to be captured once and shared between all the relevant parties.